Helping Clients Stop Self-Sabotaging

with Lisa Firestone, Ph.D.

 Lisa Firestone, Ph.D.
Director of Research and Education
The Glendon Association
Senior Editor
PsychAlive.org

(For Professionals) (For the Public)

www.glendon.org www.psychalive.org
 Poll #1:
In what areas does self-sabotage
affect your clients?
- Work
- School
- Relationships
- Personal Goals
- Family Life
 Self-Sabotage at Work
• A 2007 study showed that how people view their abilities in the
workplace impacts their success. People who thought of their
abilities as fixed were more likely to become anxious and
disoriented, causing their performance to suffer.
• A study from the Bureau of Labor Statistics showed that a
positive self-image was strongly correlated with overall career
satisfaction, higher pay and better health.
 Self-Sabotage in Relationships
• According to the American Psychological Association,
about half of U.S. marriages end in divorce.
• According to data collected by WotWentWrong, an app
that tracks why people break up, the most common
reason for splits in couples who’d dated longer than six
months was “too much fighting.”
 Self-Sabotage and Addiction
“Giving up smoking is the easiest thing in the world. I know
because I've done it thousands of times.”
- Mark Twain
• 90 percent of people who lose a lot of weight gain it back.
• 60 to 90 percent of smokers trying to quit relapse within the
first year.
 The Prevalence of Procrastination
• Procrastination has quadrupled in the past 30 years.
• 85-95 percent of students have problems associated with
procrastination.
• A 10-year study released in 2007 showed that procrastination
makes people “poorer, fatter and unhappier.”
• 1 out of 5 people procrastinate so badly, it could jeopardize
their jobs, relationships and health.
 The Unconscious Fear of Success
Ogilvie’s five observations of why athletes may have
“success phobia:”
1. Social and emotional isolation
2. Guilt over asserting themselves in competition
3. Fear of discovering their true potential
4. Anxiety about the possibility of surpassing a previous record
established by an admired performer
5. Pressure of constantly having to match or exceed one’s
previous best performance
 The Unconscious Fear of Success
Our observations of why people limit themselves:
1. Fear of challenging one’s critical inner voice
2. Fear of breaking a “fantasy bond”
3. Fear of existential issues
4. Fear of surpassing one’s parents/ breaking with family norms
 Definition of the Voice
The critical inner voice refers to a well-integrated pattern of destructive
thoughts toward our selves and others. The “voices” that make up this
internalized dialogue are at the root of much of our maladaptive behavior.
This internal enemy fosters inwardness, distrust, self-criticism, self-denial,
addictions and a retreat from goal-directed activities. The critical inner
voice effects every aspect of our lives: our self-esteem and confidence,
our personal and intimate relationships, and our performance and
accomplishments at school and work.
Common Critical Inner Voices
About Yourself:
You’re ugly.
You’re stupid.
You’re not like other people.
You’ll never succeed, so why even try?
About Your Career:
You’ll never be successful.
No one appreciates how hard you work.
You are under too much pressure; you can’t
handle this stress.
About Your Relationship:
He doesn’t really care about you.
You’re better off on your own.
Don’t be vulnerable, you’ll just get hurt.
 Poll #2:
Do your clients commonly express
having these critical inner voices?
- Often
- Sometimes
- Rarely
- Never
 Part One:
Where Do Critical Inner Voices Come From?
 How Voices Pass From
Generation to Generation
 Separation Theory
Robert W. Firestone, Ph.D.
 Integrates psychoanalytic and existential systems of
thought

 Two kinds of emotional pain:

 Interpersonal
 Existential

 The core conflict

 Defended versus undefended lifestyles

 Formation of defenses in childhood

 The concept of the Fantasy Bond

 The concept of the Critical Inner Voice

 Attachment Theory
Sir John Bowlby, Ph.D.

Harry Harlow, Ph.D. Rene Spitz, M.D

Mary Ainsworth, Ph.D.

Mary Main, Ph.D. Erik Hesse, Ph.D.

Adult Attachment Interview:
predicts the baby’s attachment to
the parent with 80% accuracy before
the baby is even born
 Where do voices come from?
Patterns of Attachment in Children
Category of Attachment Parental Interactive Pattern
 Secure  Emotionally available, perceptive, responsive

 Insecure – avoidant  Emotionally unavailable, imperceptive,

unresponsive and rejecting
 Insecure- anxious/ambivalent
 Inconsistently available, perceptive and responsive
and intrusive
 Insecure - disorganized

 Frightening, frightened, disorienting, alarming

 Attachment Figures

• Low Risk Non-Clinical Populations

 Secure 55-65%
 Ambivalent 5-15%
 Avoidant 20-30%
 Disorganized 20-40%
• (Given a Best Fit Alternative)

• High Risk, Parentally maltreated

 Disorganized 80%
The Brain in the Palm of Your Hand
Daniel Siegel, M.D. – Interpersonal Neurobiology
 9 Important Functions of the
Pre-Frontal Cortex
1. Body Regulation
2. Attunement
3. Emotional Balance
4. Response Flexibility
5. Empathy
6. Self-Knowing Awareness (Insight)
7. Fear Modulation
8. Intuition
9. Morality
 Division of the Mind
Parental Ambivalence
Parents both love and hate themselves and extend
both reactions to their productions, i.e., their
children.

Parental Nurturance Parental Rejection, Neglect Hostility

 Prenatal Influences
Disease Trauma Substance Abuse/ Domestic Violence

24
 Birth
Trauma

Baby
Genetic
Structure
Temperament
Physicality
Sex

25
Self-System
Parental Nurturance
Unique make-up of the individual (genetic
predisposition and temperament); harmonious
identification and incorporation of parent’s
positive attitudes and traits and parents
positive behaviors: attunement, affection,
control, nurturance; and the effect of other
nurturing experience and education on the
maturing self-system resulting in a sense of self
and a greater degree of differentiation from
parents and early caretakers.

26
Personal Attitudes/Goals/Conscience
Realistic, Positive Attitudes Behavior
Towards Self
Realistic evaluation of talents, Ethical behavior
abilities, etc…with generally towards self and others
positive/ compassionate attitude
towards self and others.
Goals Goal Directed
Needs, wants, search for Behavior
meaning in life
Moral Principles Acting with
Integrity
Anti-Self System
• Unique vulnerability: genetic predisposition and temperament

• Destructive parental behavior: misattunement, lack of affection, rejection,

neglect, hostility, over permissiveness

• Other Factors: accidents, illnesses, traumatic separation, death anxiety

The Fantasy Bond (core defense) is a

self-parenting process made up of two
elements: the helpless, needy child, and
the self-punishing, self-nurturing
parent. Either aspect may be extended
to relationships. The degree of defense
is proportional to the amount of
damage sustained while growing up.
28
 Anti-Self System
Self-Punishing Voice Process

Voice Process Behaviors

1. Critical thoughts toward self Verbal self-attacks – a generally
negative attitude toward self and
others predisposing alienation

2. Micro-suicidal injunctions Addictive patterns. Self-punitive

thoughts after indulging

3. Suicidal injunctions – suicidal Actions that jeopardize, such as

ideation carelessness with one’s body,
physical attacks on the self, and
actual suicide
 Anti–Self System
Self- Soothing Voice Process
Voice Process Behaviors
1. Self Soothing Attitudes Self-limiting or self-
protective lifestyles,
Inwardness
2. Aggrandizing
thoughts toward self Verbal build up toward
self

3. Suspicious paranoid
thoughts towards others Alienation from others,
destructive behavior
towards others
4. Micro-suicidal
Injunctions
Addictive patterns.
Thoughts luring the
5. Overtly Violent person into indulging
thoughts
Aggressive actions, actual
violence
 Part Two:
Challenging the Critical Inner Voice
 Helping Your Clients Identify Their
Critical Inner Voice
Help Clients:
1. Recognize the events that trigger their Critical Inner Voice
2. Recognize the specific outside criticisms that support their Critical Inner
Voice
3. Become aware of times they may be projecting their self-attacks onto
other people
4. Notice changes in their mood
 Identify Negative Thinking
Are you…?
 Filtering: You magnify the negative aspects of a situation
and filter out all of the positive ones.

 Personalizing: When something bad occurs, you

automatically blame yourself.

 Catastrophizing: You automatically assume and anticipate

the worst.

 Polarizing: You see things only as either good or bad.

There is no middle ground.

Source: Mayo Clinic

 Exercise 1.1:
Visualizing the Real You

All exercises from Conquer Your Critical Inner Voice

 My physical abilities:

 My positive qualities:

 My interests and activities:

 My long-term goals:

 My short-term goals:

 Where do I stand in relation to my goals?

 Exercise 1.2:
Your Critical Inner Voice Attacks

 Self-critical attacks as “I”  Self-critical attacks as “you”

statements statements

Example: “I don’t think I’m an Example: “You’re not

attractive person.” attractive.”

__________________________ __________________________
__________________________ _____________________________
__________________________ __________________________
__________________________ __________________________
 Exercise 1.3:
Keeping a Journal:
Your Critical Inner Voice/The Real You

 My critical inner voice  The real me

as “you” statements as “I” statements

Example: “You’re so stupid.” Example: “Sometimes I struggle

with work, but I catch on quickly
and then usually do a good job.”
___________________________ ___________________________
___________________________ ___________________________
___________________________ ___________________________
___________________________ ___________________________
 Exercise 1.4:
A Plan for Action

 Actions dictated by my critical inner voice  Actions to take that reflect the real me

Examples: Examples:
“Have another piece of cake.” “I want to eat healthy and take care of
“You should just be on your own.” myself.”
“You can’t trust anyone, so don’t get too “I don’t want to be isolated and will seek out
close.” friends”
“I want to stay vulnerable in my close
relationships.”

________________________________ ________________________________
________________________________ ________________________________
________________________________ ________________________________
 Exercise 2.1:
Seeing Your Parents Realistically
A. Describing Your Parents’ Traits and Behaviors

1. Did you experience any long-term separations from your parent or

parents during your childhood? Through death? Divorce? Illness? If
so, describe your reactions at the time.

2. What do you think your parents offered you that has been the
most valuable to you in your adult life? Describe these traits,
values, or ideals.

3. What faults or weaknesses did you dislike in your parent or

parents? Describe these traits.

4. Were your parents strict or overly permissive in their discipline of

you and your siblings? Describe an example of how they
disciplined you.
 Exercise 2.1:
Seeing Your Parents Realistically
B. Your Parents’ Behaviors That May Have
Caused You Shame or Guilt
Mother Father
As a child, were you beaten or scolded in the
Yes No Yes No presence of others?

Did your parents show with words and

Yes No Yes No gestures that they liked you?

Yes No Yes No Did you ever feel humiliated by things your

parents did or said in front of others?

Yes No Yes No Did your parents begrudge you things you

needed?
 Poll #3:
Do you use homework assignments
as an adjunct to therapy?
- Yes
- No
 Assessment Instruments

 Firestone Assessment of Self-Destructive Thoughts (FAST)

 Firestone Assessment of Suicidal Intent (FASI)
 Firestone Assessment of Violent Thoughts
 Firestone Assessment of Violent Thoughts - Adolescents
 Voice Therapy
Cognitive Affective Behavioral Approach
 The Therapeutic Process
in Voice Therapy
Step I
Identify the content of the person’s negative
thought process. The person is taught to articulate
his or her self-attacks in the second person. The
person is encouraged to say the attack as he or she
hears it or experiences it. If the person is holding
back feelings, he or she is encouraged to express
them.

Step II
The person discusses insights and reactions to
verbalizing the voice. The person attempts to
understand the relationship between voice attacks
and early life experience.
 The Therapeutic Process
in Voice Therapy
Step III
The person answers back to the voice attacks, which
is often a cathartic experience. Afterwards, it is
important for the person to make a rational
statement about how he or she really is, how other
people really are, what is true about his or her social
world.

Step IV
The person develops insight about how the voice
attacks are influencing his or her present-day
behaviors.

Step V
The person then collaborates with the therapist to
plan changes in these behaviors. The person is
encouraged to not engage in self-destructive behavior
dictated by his or her negative thoughts and to also
increase the positive behaviors these negative
thoughts discourage.

If you are interested in attending a voice therapy training or in getting training materials please contact
jina@glendon.org or visit www.glendon.org.
Self Anti-Self
 Reactions to Change
• Fear of the unknown or unfamilar
• Anxiety over living free from your inner critic
• Guilt over surpassing people from your past
• Sadness about the preciousness of life
Curious
Open
Accepting
Loving
 Self-Compassion Vs. Self-Esteem
Research from Dr. Kristin Neff:
Self-Esteem
• Self-esteem refers to our sense of self-worth, perceived
value or how much we like ourselves.
• Low self-esteem is problematic, however trying to have
higher self-esteem can also be problematic.
• The need for high self-esteem may encourage us to ignore,
distort or hide personal shortcomings so that we can’t see
ourselves accurately.
• Our self-esteem is often contingent on our latest success or
failure, meaning that our self-esteem fluctuates.

SOURCE: http://www.self-compassion.org/
 Self-Compassion Vs. Self-Esteem
Research from Dr. Kristin Neff:
Self-Compassion
• Self-compassion is not based on self-evaluations.
• People feel compassion for themselves, because all human
beings deserve compassion and understanding, not
because they possess some particular set of traits.
• Research indicates that in comparison to self-esteem, self-
compassion is associated with greater emotional resilience,
more accurate self-concepts, more caring relationship
behavior, as well as less narcissism and reactive anger.

SOURCE: http://www.self-compassion.org/
Studies show that self-compassion has a
significant positive association with:
• Happiness
• Optimism
• Positive affect
• Wisdom
• Personal initiative
• Curiosity and exploration
• Agreeableness
• Extroversion
• Conscientiousness
 Hardiness
In 30 years of research, Hardiness Institute founder Dr.
Salvatore Maddi found that what predicts how well we
will do in life, our relationships, careers, etc. isn't how
much money we have or even how many obstacles we
face; it's a matter of how hardy we are.
Three C’s of Hardiness

Commitment
Control
Challenge
 Differentiation

Child Self Real Self Parent Self

 Steps of Differentiation
Step 1: Break with internalized thought processes, i.e., critical, hostile
attitudes toward self and others
Step 2: Separate from negative personality traits assimilated from one’s
parents
Step 3: Relinquish patterns of defense formed as an adaptation to painful
events in one’s childhood
Step 4: Develop one’s own values, ideals, and beliefs rather than
automatically accepting those one has grown up with
 Guidelines for Continued
Personal Development
 Be Aware of the Fear That Accompanies Change
 Realize That Psychological Pain is Valid
 Develop a More Realistic View of Your Parents
 Differentiation – Unlearn Old Behaviors, Learn New Behaviors
 Become More Aware of Specific Defenses Against Feeling
 Recognize the Value of Friendship
 Seek Your Own Personal Meaning in Life
 Guidelines for Further Developing
a Meaningful Life

 Practice Being Generous in All Your Relationships

 Become Aware of Existential Realities
 Develop a Spiritual Perspective and Appreciate the Mystery of Existence
We create the world we live in.
A human being is a part of a whole, called by us 'universe',
a part limited in time and space. He experiences himself,
his thoughts and feelings as something separated from the
rest... a kind of optical delusion of his consciousness. This
delusion is a kind of prison for us, restricting us to our
personal desires and to affection for a few persons nearest
to us. Our task must be to free ourselves from this prison
by widening our circle of compassion to embrace all living
creatures and the whole of nature in its beauty. Nobody is
able to achieve this completely, but the striving for such
achievement is in itself a part of the liberation and a
foundation for inner security."

- Albert Einstein
 Resources: Books

Visit www.psychalive.org for resource links

 eCOURSE
Overcome Your Inner Critic:
How to Free Yourself from Imagined Limitations
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