How To Deal With Patients’ Negative Self-Talk

We are all the living result of our own thoughts.

Most of what seems to happen to you, happens because of you – something you created, directed, influenced, or allowed to happen” – Shad Helmstetter, PhD in ‘What To Say When You Talk To Yourself

Negative self-talk is rampant. In fact, behavioural researchers have told us that as much as 75% of everything we think is negative and counterproductive. At its worst, negative self-talk is verbal abuse.

Repetition is a convincing argument. Unfortunately, when negative self-talk is repeated, it wires the brain so that it becomes even easier to think negative thoughts in the future.

Unless the unproductive programming your patients received – from themselves or others – when they were young is erased, or replaced with different programming, the pattern of negative self-talk will stay with them permanently. It can affect and direct everything they do, and it can jeopardise what you’re doing for them in your treatment sessions.

We are all the living result of our own thoughts. We become what we think about most. The brain simply believes what it’s told most often.

Your patients’ success in overcoming injury is inexorably tied to the words and beliefs about themselves that they have stored in their unconscious mind.

Have you ever noticed that patients who believe they will see improvement usually do much better than those who self-sabotage with disempowering self-talk?

They are embarking on a journey to overcome an injury that might be acute, chronic, mild or serious. You can give them all the physical support they need to change their situation but what about that underlying destructive self that many patients have?

Negative self-talk only becomes a problem if the internal chatter is entrenched, repetitive and disabling.

Examples of negative self-talk:

  • ‘It’s going to be one of those days’
  • ‘Nothing ever goes right for me’
  • ‘That’s just my luck’
  • ‘I don’t have the discipline to get better’
  • ‘Today just isn’t my day’
  • ‘No matter what I do I can’t get better’
  • ‘I never have enough time’
  • ‘I just don’t have the patience for this’
  • ‘That makes me really mad’
  • ‘Sometimes I just hate myself’
  • ‘I’m just no good’
  • ‘Things just aren’t working out right for me’
  • ‘I’m really out of shape’
  • ‘Why should I try? It’s not going to work anyway’
  • ‘I never get a break’
  • ‘I lose weight but then I gain it right back again’
  • ‘I get so depressed’
  • ‘I just can’t get with it today’
  • ‘I’ll never get it right’
  • ‘I just can’t take it anymore’
  • ‘I’m really at the end of my rope
  • ‘I just can’t handle this!’
  • ‘If only I had more time’
  • ‘If only I had more money’

… and so it goes on.

What do you do with patients whose current self-talk is destructive and disempowering?

Step 1:

Help them to become consciously aware of their current self-talk. It is very easy for the brain to have an unconscious undercurrent of negative self-talk. Patients might not even aware of what they’re saying to themselves.

Step 2:

Once patients become aware of what they’re saying to themselves, they have a choice: to continue with the current conversation, or to change it. You cannot make this choice for them. As frustrating as this might be, it’s the reality. If your patients decide they don’t want to work on changing their unproductive self-talk, you know your job will be that bit harder.

Step 3:

When patients decide to change their current negative self-talk, that’s when the work really starts. Their brains have an entrenched pattern of thinking that they’ve refined over many years. The situation won’t change just because patients want it to. They have to put the work in and repeat the new self-talk over and over again, until their brains begins to develop new wiring. Your job is to support and encourage them while this is happening.

As I mentioned earlier ‘Repetition is a convincing argument’. Patients don’t have to believe what they’re saying at first but they MUST persist.

They didn’t come into the world with the brain wiring they have now. They had to work hard to create their current reality, and they will also have to work hard to change it. But it is possible.

Let’s take some of the negative statements from the list above, and adapt them to be more empowering:

  • ‘I just can’t seem to lose weight’

‘I’m getting a little bit thinner every day’

  • ‘I can’t do this’

‘If I could do this, how would I feel?’

  • I just can’t take it anymore”

‘I’ve been in difficult situations before and have found a way to manage it’

  • ‘I just can’t seem to get organised today’

‘Today I’m committed to becoming more organised’

  • ‘Sometimes I hate myself’

‘There are times when I struggle with self worth but I am slowly getting better recognising that I’m an ok person’

  • ‘I’ll never be any good at this’

‘Have I ever taken on something new and gone through stages of learning?’ or ‘Who do I know that was an expert at the beginning of learning something new?’

Patients will have their own negative self-talk to deal with; the aim is to show them how to turn it into a statement of possibility.

I use an app called 5-Minute Journal to help me work on specific areas of my life. It really does only take 5 minutes. You write out three things you’re grateful for, three things that will make today great, and one daily affirmation. At the end of the day you write down three amazing things that happened, and how you could have made the day better.

It is a great tool that is simple to use. You will find in the iTunes app store, and it costs $7.99. I have no affiliation with it; I just use it and find it very beneficial – especially when I’m struggling. Perhaps suggesting it to struggling patients might help them just a little.

Self-talk will ultimately dictate whether patients experience success or failure in making major changes in their lives. If they choose not to deal with negative self-talk, there’s a high probability the result will be less satisfying than they expect. Unfortunately there isn’t a great deal you can do about it.

The most important thing is to listen for negative self-talk and help your patients go through the steps I’ve outlined above. The process will improve their treatment outcomes and also help them in their daily lives.

Addressing negative self-talk is just one way to help improve patient motivation. To learn more about motivational tools through effective communication download my eBook

“Improving Patient Motivation In Physiotherapy”

I wrote this eBook in response to the most common question I get asked and that is “How do I motivate my patients?”

If you would like to fine-tune your communication skills when working with resistant patients, you might consider working with a coach or mentor.

Or perhaps your staff would benefit from training in this area.

Contact us, and find out more about what we can offer you.

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