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Rachel Goldman, PhD, FTOSLicensed Psychologist and Consultant, Private PracticeClinical Assistant Professor, Department of Psychiatry,

NYU Grossman School of Medicine

DrRachelNYC@gmail.comIG: @DrRachelNYC

Twitter: @AskDr_Rachel

Silencing Your Inner Critic in a Noisy World: Building a Healthy self-esteem

July 24, 2021

• Visualization Exercise

• The Mind-Body Connection

• The Relationship between our Thoughts, Emotions, and Behaviors

• The Power of our Thoughts

• Mindfulness

• Breaking the Cycle and Learning to Reframe Your Thoughts to Work for YOU

• Summary and Practical Tips

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Overview

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Rachel Goldman, Ph.D. FTOS

• Think about your life • Think about where you are right now (work and personal)• How do you feel?• What thoughts come to mind? About your self/your body• What can you change in order to think, look, feel, and act the way

you want?

Rachel Goldman, PhD, FTOS3

Where Are You Now and Where Do You Want to Be?

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• What is OUT of our control?– Daily stressors

– Other people’s behaviors

– How other people react

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Focus on what is in our control

Rachel Goldman, Ph.D. FTOS

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• What is IN our control?– Our behaviors

– Our reactions

– How we cope

– Our thoughts

Mind-Body Connection• Our thoughts, feelings, beliefs and attitudes can either

positively or negatively affect our functioning.

• Our thoughts and behaviors can impact our mental state.

• Similarly, our mental state can impact our physical state.

Rachel Goldman, PhD, FTOS

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• Our thoughts, emotions and behaviors are all linked

• Neutral Situation until we interpret the event

• Lazarus --- the interpretation of stressful events is more important than the event itself. Our thoughts are what is important.

• EXAMPLE6

Thoughts-Emotions- Behaviors

Rachel Goldman, Ph.D. FTOS

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Rachel Goldman, PhD, FTOS7

The Power of Our Thoughts and the Mind- Body Connection

“I’m a failure”

“I know I’m not going to be able

to do it”

Feeling Lonely,

Down, and Isolated

Cancels the workout class, or

doesn’t try the new workout or

recommendation

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The Power of our Thoughts: Thoughts can be self-fulfilling

Rachel Goldman, Ph.D. FTOS

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Remember: All events start out as neutral until we interpret

them

• Our Inner Critic (negative self-talk)

– The inner voice of personal doubt and questioning

– Examples: “Am I good enough?,” “Am I ever going to succeed?”

• This may be the way you have been thinking for years

– Cognitive Distortions

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Why Can Choosing Positive Thoughts be Difficult?

Rachel Goldman, Ph.D. FTOS

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• Automatic Thoughts

• Tendencies or patterns of thinking or believing

• Exaggerated or irrational thought patterns• Thoughts that cause us to perceive reality inaccurately

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Cognitive Distortions

Rachel Goldman, Ph.D. FTOS

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Examples of Common Cognitive Distortions

Rachel Goldman, PhD, FTOS

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How do these thoughts make you feel?

How is this related to self-esteem and body image?

• Body image is how you view your physical self– your appearance

• Self-esteem is used to describe someone’s overall sense of self-worth– the opinion you have of yourself

• Both our body image and self-esteem are created by our thoughts (although of course external factors, and that “noise”, can contribute to how we perceive ourselves)

• It’s difficult to feel good about yourself if you have poor body image

• It’s also difficult to take care of your body (and mind) if you think poorly of yourself

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Body Image, Self-Esteem and Mental Health

Rachel Goldman, Ph.D. FTOS

12It becomes a vicious cycle

The Relationship Between Body Image, Self-Esteem and Mental Health

Rachel Goldman, PhD, FTOS

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Negative Cycle Positive Cycle

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So Now What?

Rachel Goldman, Ph.D. FTOS

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We know the impact our thoughts can have on our mental state. So if we can’t choose positive

thoughts, how about we identify them and then reframe them? We can increase our resilience, and overall wellbeing by counteracting the unhelpful

thoughts with more helpful ones

Rachel Goldman, PhD, FTOS15

Why Can Changing Our Thoughts be Difficult?

• Any change can be difficult• Before we can change the thoughts, we

have to be able to identify that they are not working for us and identify the unhelpful thoughts.

• BUT how do we do that if our mind is racing and there is all of this “noise”?

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Rachel Goldman, PhD, FTOS16

Mindfulness16

• Mindfulness is a state of mind.

• It is being fully aware and present with your experiences (your thoughts, feelings, body sensations and surroundings) IN THE MOMENT, in a nonjudgmental way.

– Not rehashing the past or even imagining the future

• Mindfulness is the practice of paying attention in a way that creates space for insight.

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What is Being Mindful?

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• To be mindful is to get out of “autopilot”• This can be difficult when “zoned out,” stressed or worried• Can also be difficult when we are thinking about the past

or obsessing about the future• For some this means to take back control of your mind, and

getting out of that “autopilot”

Rachel Goldman, PhD, FTOS18

What is Being Mindful?- Cont’d

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• Start by simply noticing.– Notice your surroundings. – Use all of your senses (what do you: feel, see, smell and taste?)

• Work on your breathing• Increase your awareness.

– “Tune in” to yourself, food, thoughts, experiences, habits, triggers etc.

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Mindful Tips

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• Observe and notice your thoughts and feelings– Watch and label your experiences from a distance– Label a thought as “just a thought”– It’s like watching yourself on the television screen– Don’t try to change the experience, just notice it

Rachel Goldman, PhD, FTOS20

Mindful Tips- Cont’d

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• Practice Mindfulness and Self-Awareness– Become aware of how your thoughts are impacting your emotions and behaviors.

– Observe your thoughts

– Ask yourself if this thought is helpful?

– What purpose is the thought serving you?

– How does the thought make you feel?

• Identify the Cognitive Distortion– Observe it and label it

– Not at all thoughts are facts. Rachel Goldman, PhD, FTOS21

Now What?Let’s Become Aware

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• Accept it for what it is– Take a breath

– Acknowledge it (it’s just a thought; thoughts are not facts)

• Challenge the Thought– Examine the Evidence. What’s the evidence for/against the thought?

– Where’s the truth to this ?

• Replace the unhelpful thought with a more helpful thought – What’s a more neutral (or more helpful) thought?

– A helpful technique could be to ask yourself what would you say to a friend

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How to Break the Cycle

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Thoughts- Emotions- Behaviors:Challenging Thoughts

Feeling Lonely,

Down and Isolated

Takes a deep breath

“I don’t know how it is going to be, but I am going to try my best”

Feeling Relaxed and

in control

INSTEAD

“I’m a failure”

“I know I’m not going to be able

to do it”

Cancels the workout class, or

doesn’t try the new workout or

recommendation

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• The voice inside our head has a huge impact on how we feel, who we are, how we see ourselves, and how we live our life.

• Our self-talk creates our reality.

• With practice, we can change how we think and the words we speak to ourselves.

• Be aware of the words you speak to yourself.

• Don’t believe everything you think. Our thought are NOT facts.

• If you catch yourself speaking negatively, say STOP, breath, acknowledge it, take a moment, and challenge it.

Positive Self-Talk: Be Kind to Yourself

Rachel Goldman, PhD, FTOS

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• Remember our thoughts, emotions and behaviors are all linked

• Be mindful of the words you speak to yourself

• Identify cognitive distortions

• Examine the evidence

• Reframe your thoughts to work for YOU

• This is not easy, be kind to yourself and practice self-compassion!

Rachel Goldman, PhD, FTOS25

Summary: Practical Tips

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Thank You 26

Rachel Goldman, PhD, FTOSLicensed Psychologist and Consultant, Private PracticeClinical Assistant Professor, Department of Psychiatry,

NYU Grossman School of Medicine

DrRachelNYC@gmail.comIG: @DrRachelNYC

Twitter: @AskDr_Rachel

Silencing your Inner Critic in a Noisy World: Building Healthy Self-Esteem

Paul Davidson, PhD

Self- View

There will always be someone who can’t see your worth.

Don’t let it be you.

Mel Robbins

Avoid obsessing

• Everyone makes mistakes

• Use them as learning opportunities and move on

• Beating ourselves up only leaves us more bruised

Distraction works

OCCUPY YOURSELF WITH SOMETHING

COMPLETELY DIFFERENT

GO FOR A SHORT WALK

BRUSH YOUR TEETH

CALL A FRIEND ANSWER AN EMAIL SHIFT YOUR FOCUS TO SOMETHING MORE

POSITIVE

The truth is somewhere in the middle

• Avoid extremes as reality is likely somewhere in the middle

• Words such as “never” or “always” are a clue that your thoughts are getting polarized

• Utilize words like “maybe”, “possibly” or “one explanation is”

Forgive yourself

• Nobody is perfect

• No one is completely imperfect

• Being overly negative with yourself won’t help things

• Cut yourself some slack

• Talk to yourself the way you talk to someone you care about who made a mistake

Keep things in perspective

• Recognize that problems aren’t the end of the world

• Note that things could always be worse

• Realize that you’ve overcome challenges in the past as well

Tomorrow is Another Day

• Problems today don’t mean tomorrow can’t be better

• We only control the moment

• We always have another chance to do something better

It’s probably not about you

• Most people are more focused on their own lives

• A negative interaction may be less about you than them

• People aren’t watching you as closely as you think they are

Plan for the worst but hope for the best

• Be prepared for something negative

• Think of how you would handle it or respond

• Hope for something good

• Imagining a positive outcome helps ensure one

Weigh the evidence

•With inner struggles, look at both sides of the issue

•Write evidence down, talk it over with a friend

•Come to rational conclusions which are fair

Focus on Wants, Not Shoulds

• Extreme or exaggerated phrases can be problematic

• “Should”, “must”, “can’t”, “need to”

• I must lose weight

• I can’t have any sweets

• “Shoulds” ↓esteem, ↑anxiety, ↑depression

• Wants/hopes/wishes are internal, not judgmental

• Internal drives are motivating

• I want to be healthier

• I hope to have sweets as a treat

Create a corrective experience• Be the parent or coach to

yourself you wished you had

• Channel one of your greatest teachers

• Be encouraging with yourself as well as others

• Recognize you have the power to change your future by focusing on the present

• Seek opportunities to shine

Avoid Comparisons

• With weight loss it is hazardous comparing yourself to others

• Be careful with social media

• Everyone has their own journey

• Any comparison should be with yourself

It is OK to say NO

• We may take on unnecessary challenges for fear of letting others down

• It is good to know your limits and create time for yourself

• Others will learn to respect such choices

Turn up Positive Self-Talk

• Talk to yourself out loud

• Hearing yourself changes neural processing

• “You’ve got this”

• “Time to get psyched”

• “Progress not perfection”

• “I think I can, I think I can, I think I can”

Body Image

• Bariatric patients tend to see improvement in image within 2 years

• Greater body dissatisfaction before surgery linked to more distress after surgery

Ortega et al., Predictors of psychological symptoms in morbidly obese patients after gastric bypass surgery. SOARD. 2012.

Body Dissatisfaction

• Some degree of this is very common after great weight loss

• Concerns: abdomen, breasts/chest, upper arms, thighs, buttocks

• Social media has a great impact on body image

Sarwer and Plonsky. Body Image and Body Contouring Procedures. Aesthetic Surgery Journal. 2016.

67% of men compare themselves to media images. 37% feel worse about themselves as a result.

88% of women compare themselves to media images. Half feel worse about themselves as a result.

https://fherehab.com/news/bodypositive/ 2020

U.S. Body Types and Social Media

Most Common

Least Represented

Least Common

Most Represented

Save one of your biggest outfits, get rid of everything else

Before and After Pics

Define Yourself by Your Abilities, not

Your Size

Narrative Psychology

• The stories we tell about ourselves help determine well-being

• We are both the main actor and narrator of our lives

• How we choose to frame events and stories is impactful

• “Contamination stories” vs. “Redemption stories”

• “I finally got the promotion I wanted, but now I’m totally stressed”

• “Declaring bankruptcy was hard, but brought us closer together”

Narrative Psychology Tips

• Make the prompt for your life story more positive

• Realize challenging people are there to teach us something

• Use distance in describing yourself in a difficult situation

• Write about difficult times to reframe meaning

• Share stories with ones you love and care about

A.M. Write something positive about yourself

P.M. Write something you were grateful for that day

In heaven, we will be judged on a scale of

our words and deeds, not our weight.

Pdavidson@bwh.harvard.edu @PaulDavidsonPhd