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Inner Critic of the Spoonie: Fibromyalgia and Self-Talk, what we say to ourselves matters

We all have an inner critic—the voice of doubt. The voice persistently, loudly, and glaringly directs our attention and processing toward what we do wrong. To problems, faults, deficiencies, deficits, and inadequacies. Sticky, shameful areas. Those of us with chronic pain, fatigue, and other invisible idiopathic disorders, syndromes, and diseases, are in danger of developing a destructive inner critic.

Our body responds to our inner critic by withdrawing. Shoulders round in, gaze drops to the floor, our head rounds down towards our knees as if we are trying to crawl within ourselves to escape.

It feels like being beaten down from the outside in. Every interaction is lacking. It reminds you of your deepest insecurities about how you present to others and your value in this world. When self-criticism becomes too loud, we can spend too much time focusing on negative thoughts and encourage our brain to make us feel small.

The inner critic is the voice inside your head that analyzes your behaviors, actions, and feelings, tapping into your deepest anxieties. It can take on the qualities and characteristics of a powerful judge, parent, or mentor. Though harmful and limiting, the "voice" can seem protective, purposeful, and wise. We often let it play on repeat, turn up the volume, and tune out the present moment. It can become so familiar and constant that we barely hear anything else. It can say things like,

  • You'll never be good enough

  • You should just quit

  • No one could ever love you

  • You always say the wrong thing

  • You are so stupid

  • You are ugly

  • It's all your fault

  • Nobody likes you

  • You'll never be able to help yourself

  • You have so many problems

  • You are such a burden

  • Your _______________ is worse than anybody else's

  • You should be ashamed of yourself

  • Why do you waste your time trying

  • Everything is a mess because of you

I could go on and on. I am sure you have some you could add to this list. Our inner critic has been shown to impact cognitions (the way we think), affect (positive/negative mindset), interpersonal goals (our social relationships), and behavior.¹ Therefore, we need to pay attention to what we say to ourselves. Let's look at the components of the inner critic.

Inner Critic Operations- Covert and Destructive

Not rooted in Experience

The inner critic repeats the same old demands and degradations, ignoring the present situation in an authoritative, mean (picture any bully A-Hole) voice. In fact, it works against you in the present by preventing you from really being able to experience it. It's hard to process what's in front of you when you have a loud voice making you feel like a 2-foot-tall pile of poop in your ear. It's difficult to feel around the shame and guilt that are triggered. We are too worried about protecting ourselves.


Everything is generalized with the inner critic's voice. Words like "always" and "never" are used to overgeneralize in a predictable, simplistic tone with no room for exceptions. It will bring up guilt about something that happened in the past or create fear about something that is going to happen in the future that you cannot change.

Not situation-specific

It is liable to show up at any point in time. Failures or shortcomings usually trigger it, but it can show up in response to something good, like a compliment, or for no reason at all. It can make it difficult to feel at ease and can keep showing up time and time again.

No moral authority

This piece is really important to grasp. So write it down. Your inner critic does everything in its power to prevent you from constructive behavior. "It blocks processes that contribute to developing values, ideals, realistic self-assessments, and openness towards others."²


The inner critic always makes you feel worse. It will stunt your potential, create continuous stress and pressure, and, sadly, prevent you from living your best, full life. When your criticism runs through your mind, your body and face tense and your breathing becomes heavy; you will feel more anxious, depressed, dissatisfied, and dejected.

Inner Critic Awareness

The first step is always creating awareness. As I mentioned earlier, our inner critic often becomes so loud we just let it run on auto-pilot. So the first step is to listen and note when your inner critic is running things and what your inner critic, in particular, is saying. So grab a notepad for a day and start t pay attention to what you say to yourself throughout the day. You may wake up, and your inner critic is the first to greet you with something like,

"Way to hit the snooze button again instead of getting out of bed. You are so lazy! You'll never move up at work because you can't get out of bed on time." It feels like a punch in the gut, a slap in the face, and kills all motivation, confidence, and value.

Sometimes our inner critic only shows up in certain situations. When we have to cancel plans when we are about to sign up to learn something new, when we are out in social situations or others. Notice and write down when these situations occurred, what the inner critic said, and how it made you feel.

We can immediately become disgusted when we first see the inner critic for what it is. It's like seeing a monster living inside us all along. While it's good that we are gaining awareness, we don't want to shriek away from it in horror, suddenly ashamed of our own thoughts. Our inner critic takes the form of negativity and painful experiences, anyone who has abused us or made us feel small.

Their words are etched and echo in the critical voice, not the authentic voice. So distance yourself and know that this voice can be made tiny. Try not to judge your inner critic, as that only encourages more doubt, shame, and negative internal dialogue. Instead, be curious! Imagine you are a scientist recording data. Just observe and track your inner critic. Don't worry; we will work on shifting it later. But we need to understand when and why we become critical first.

Here's a great chart that describes the difference between the inner critic voice and true experiencing.²

Fibromyalgia's Role

Researchers still do not agree on what causes fibromyalgia. Still, studies can reveal associations and relationships between personality traits and emotional states that can impact how we feel about ourselves and our place in the world. Please know I am not saying that these characteristics cause fibromyalgia or are a symptom of it. One systematic review published in 2018, which examined all of the research on fibromyalgia and personalities, found that measurements and scales of personalities that were used and the qualifying criteria for fibromyalgia varied wildly.³ Additionally, when they only looked at individuals with fibromyalgia who didn't have anxiety or depression, the rates of personality traits were the same as those without fibro.³ But, many Spoonies have anxiety and/or depression and may not be treating it yet, so I think it's important to cover this.

So remember, they are still debating what causes fibro, how to classify and test for it, and deliberating on what are all the symptoms and how best to treat them; meaning, this may or may not apply to you.

Nevertheless, considering how devastating and overwhelming fibromyalgia can be, it's not surprising that we struggle psychologically. Evidence shows that Spoonies have higher rates of negative affect (emotional distress like anger, contempt, disgust, guilt, fear, nervousness, and poor self-concept),

neuroticism (tendency toward anxiety, depression, self-doubt, and other negative feelings), perfectionism, stress, anger, and alexithymia (problems with feeling and regulating emotions and impulsivity).⁴

All of these characteristics can contribute to a hostile, powerful inner critic.

Other personality traits like high harm avoidance (worrying, pessimism, shyness, and being fearful, doubtful, and easily fatigued) and low self-directedness (struggle with purpose, direction, and reliability), negative self-image and body perception, low self-esteem, and self-efficacy found in women with fibromyalgia also impact what we tell ourselves.⁴

Lastly, living with an invisible illness that has been stigmatized and invalidated until fairly recently shapes how we feel perceived by others, also influencing and supporting our critical inner voice.

Now it's important to keep in mind that just because studies find higher rates overall does not mean you personally fit this psychological mold. But, because data suggests many of us do, I think it deserves a discussion. If you resonate with these traits and states, please don't start beating yourself up! I share this with you so that you understand YOU ARE NOT ALONE. The great news is if you have a personality trait that is not serving you, you can change it! Research published in 2019 in the American Psychological Association states that personality traits are relatively stable but can be changed with consistent effort.⁵ So, with awareness, learning, redirection, and growth, we can work to change that voice! With a personality change will come a host of other benefits. So, stay with me, and I'll explain what to look for in more detail.

When Our Inner Critic Shows Up


Often, our inner critic is, as I described earlier, like a judge presiding over our every move, ready to administer punishment any time we fall short. The stronger the perfectionist you are, the worse this becomes. Whenever you fall short of your idea of "perfection," your inner critic gets a chance to take center stage. The "Not good enough" mistake-focused comparison critic never allows you to be satisfied. This can feel very comforting and even supportive, and often what we view as "pushing ourselves" and the reason for our success. While it may motivate us in the short term, eventually, never being satisfied leads to exhaustion and unhappiness. No one is perfect, and without mistakes, we'd never learn. I will go into more detail later about how to work with your inner critic.

Body Image & Self-Esteem

What do you tell yourself when you look in the mirror? What do you think when someone compliments you? How valuable do you feel? When a chronic illness like fibromyalgia or Chronic Fatigue Syndrome comes along, it can change many things. We may have less energy or the ability to exercise or cook healthy meals. We may seek comfort in food. We may put on a few pounds or have always struggled with our weight. But what do we tell ourselves those pounds represent? How do we feel when we think these thoughts? This may be a problem whenever we get dressed, see people, or become intimate with our partner. It may be a loud voice that talks quite often.