your inner monologue matters

kindness towards self/ what your mind makes you believe/ anecdotes from clinical postings

you spend all your life in your mind. your experience in this world is a direct by product of how your mind talks to you. when i wake up on monday mornings, i dread having to smile at my colleagues all day or be deemed unfriendly. on wednesday evenings i hate to make myself a cup of tea that i would have otherwise enjoyed. ‘why isn’t it the weekend yet?”

on the contrary i love Saturday afternoons. i allow myself to sleep in until 10 am and lay down in my post-ac cooled down room to stare at the ceiling. i don’t have to think about how i’ll be perceived in my own home; nor do i have to rack my brain to come up with something witty and conversational.

Hi! This work is a part of magazine article ‘dear almost everything’ (By Tahniat Nizami). Subscribe for free for notes from wards, study tips and essays on everything I can’t help but notice.

it has been proven through science that the diseases of the brain also alter your inner monologue. schizophrenia is one such psychotic disorder where the patient experiences their own voice being repeated in their head or out of their body. it could be a positive or a negative monologue. these are called as auditory hallucinations.

during our clinical postings in psychiatry last november, our professor made us watch a 7 minute youtube documentary on how a patient experienced life with schizophrenia, a debilitating mental disease.

they called this voice with a name. so kerry would tell her nice things about how capable she is and john would tell the other patient some seriously disturbing things. depending on the severity of the disease a schizophrenic patient could experience it multiple times a day or constantly. on repeat. like an inner monologue.

now imagine what effect that would have on the mind. being talked to on repeat. to simplify it for the purpose of discussion at hand and without meaning to be insensitive, let’s dive in further.

how we talk to ourselves determine the whole outcome of the day. when something bad happens or a situation makes you uncomfortable, how do you deal with it?

i, for one, would milk it till one small bad thing would ruin my whole day. this is especially very prominent in educational environments in india. there’s a educational hierarchy in most or all medical schools that expects the junior, the bottom of the food chain, to be subservient to your seniors even on the rare occasions that you are right.

it is very common to be made to feel small and insignificant in a busy opd in the middle of a weekday when all you’re trying to do is learn something valuable.

i’m not here to condone age old traditions, maybe i am, but the point is, bad days in medicine are inevitable. it’s a high stakes environment and everyone has one common goal through out the work day— to do it right. you’re going to make mistakes and you’re going to be yelled at. terribly. in front of your juniors, patients and worse, your friends.

so what do i do on these days?

cry mostly. this one time an attending yelled at all of us for not bringing our scrubs on a NON-OT day and threatened to cancel our attendance. I cried during lunch, alone in the prayer room.

and i would’ve gotten away with it but then i had to meet my friend in our small make shift canteen for terrible coffee as a daily ritual and my eyes were all swollen. trust me when i was telling her what happened i felt like an idiot for letting it get to me.

but these days are inevitable. it means you can’t avoid them, dear reader.

you can’t avoid them at your office job even if you have the best cubicle on the floor, you can’t avoid them in your own college, you can’t avoid them in life in general.

so what now? did i just expose you to the never ending reality of life on an otherwise normal day for no reason?

hold on.

"You yourself, as much as anybody in the entire universe, deserve your love and affection." — Sharon Salzberg

The Voice You Don’t Notice

Did you know that 5 to 10% of the world does not have a thinking voice? Instead they think in images and abstract concepts. One of my own friends admitted to not hearing any voice, instead she thinks in images, a bunch of them. Must be nice.

Most of us are never taught how to deal with our feelings. We go most days being easily irritable, and angry without knowing what is truly bothering us.

This is a common theme in brown households where things are swept under the rug frequently. No discomfort is ever dealt with and no one wants to upset the ‘easily upset’ family member.

You start to lose sensitivity to your own emotions. You never know when the dreadful lump in your throat will come back, or when your eyes will become blood shot or what will throw your mind into a spiral of over thinking.

The very first step to regulate your inner monologue is:

The minute you sense something is wrong, pause. Before you even ask yourself anything, notice where you’re feeling this new emotion.

An easy guide for me is that I feel anger in my throat. Anxiety makes my stomach upset. And fear constricts my chest. When I feel jealous, I can feel my breath trapped at the back of my throat.

Find it. See where your feelings are harbored. You won’t get it in the first try. If you’re anything like me, the impatience of having to endure it with scrutiny will make you want to give up. But don’t cave in to that feeling.

When you have found where you’re feeling it, sit with it. Give it all your attention.

And then ask yourself, what am I feeling?

Guilt.

Anger.

Sadness.

Fear.

Nervousness.

Now try to find the cause of this feeling. I usually replay the recent events to see what imagery triggers that emotion again.

This seems like a checklist if this is anything new to you. But once you have trained your mind to sit with your feelings it feels almost like a kindness from a stranger.

Talk to yourself:

Brene Brown in her book dare to lead talks about vulnerability, shame and guilt. She quotes neuroscientist Antonio Damasio “We are not necessarily thinking machines. We are feeling machines that think.”

How crazy is that? Our feelings should first priority in our self-care. Because when your constantly validating your feelings for yourself you don’t look for it on the wrong places.

I use this method of talking to myself as gently as I can. On days when I’m not feeling well, I ask if I want a cup of tea to feel better. I comb my hair slowly so the knots don’t give me a headache. I run the hot shower early in the morning to calm my cramps during that time of the month.

I remember doing terribly in one of the tests last year and it had taken a toll on me. Because I studied my ass off for it. My friend and I were on the same boat, and it was one of those experiences where you want to find someone to blame but at the end of the day you’re the only one standing next to you.

That was a rough week for the both of us. Half the class had failed the test and some really terrible things had happened around that time. So one day when our postings batch was quietly studying in one of the cramped up demo rooms, waiting for someone to come take our class, we began talking.

And while unloading all the stress on each other, in this heavy silence, a string of sentences came out of my mouth.

“Look, Honey (for the sake of privacy and that’s her nickname) we know how much hard work we put into this. We have nothing to prove to anyone here. We know how truthful we are to ourself. We will come out of this situation and we’ll do better next time. We just have to believe in ourselves.”

In that moment we had both nodded, slightly embarrassed to be heard by 20 other students but we had moved on in that one moment of shared confidence. When I got back home, it struck me.

Where did that come from? I had spent days hurt and distressed about that single small test. But when it came to it, my mind spoke for me.

Yes. I didn’t have anything to prove to anyone. I knew who I was and I didn’t need anyone to define it for me.

That is the benefit of talking kindly to yourself. It seeps into your subconscious. It shows up for you on the days when you shut down your brain and lock the world out.

So practice it. Start small. Before you go to sleep, tell yourself, “today may have been difficult, but not all days are going to be this way.” The few minutes before you go to sleep is when your subconscious is the most active.

Your tldr: your inner monologue matters because it frames who you are at the core. Polish it to say something kind to you everyday.

Same time, next week? Ciao.

Part of ‘dear almost everything’— a series of letters on becoming.