Burns developed this method while working with seriously depressed patients who were often suicidal, having given up all hope of having a normal satisfying life. The main symptoms of depression are feelings of hopelessness, helplessness, and worthlessness. Most—if not all—of depression is in response to internal voices that criticize, berate, and torment. In this context, rallying the patient to oppose their internal voices can be a huge step forward, and research does indicate that CBT gets results with depression that are superior to antidepressant medication and most other therapies.
Since then, Burns has applied the same method to quite a variety of other problems that result from troublesome internal voices, including anger, guilt, addiction to love and approval, and perfectionism. If someone who is suffering from one of these problems feels completely defeated, then mobilizing a rational response to it can be a very useful first step.
Although a battle between two voices might be somewhat better than only being a slave to a troublesome voice, it is still an inelegant solution that leaves the person split between the two. It is much better to reduce the impact of the troublesome voice before adding in a resourceful voice.
However, reducing the volume of the troublesome voice is only useful if it has no positive function or intent in the present. There is at least a possibility that a troublesome voice might have some useful information for you. Often an internal voice wants to protect you from some kind of problem or danger, even if this is hidden inside insults and criticism. It could be warning of an actual physical danger, "If you did that, you could get seriously hurt." Or it might caution you against being disappointed, embarrassed, or criticized by others — dangers to your status, or your idea of who you are. "Don't make a fool of yourself at the party tonight."
Often a voice once had a useful function in a past context, but it is now outdated and irrelevant. For instance, a voice may have once warned you not to anger Dad; now that Dad has been dead for years, it is no longer serves a useful function, so it can be safely reduced in volume. But at other times a voice wants you to notice a mistake, so that you can improve what you do. "Boy, you really screwed up that interview!" What a voice says may be unpleasant, and may even be counterproductive, but it usually has the positive intent of making your life better in some way.
If you just reduced the volume of this voice, you would also lose its useful positive intent — "throwing out the baby with the bathwater." Many people desperately need some kind of warning voice, because they keep making the same mistakes over and over without noticing. Losing a protective voice can have much more unpleasant consequences than hearing an unpleasant internal voice and feeling bad.
Bill's voice was apparently simply a result of his history with his critical and unhappy parents. Since it had no useful function in the present, its volume could be reduced without losing anything. When a voice still has a positive function, simply reducing the volume won't work well, and the voice is likely to stay loud or return. Although reducing the volume of a troublesome voice reduces potential conflict, it doesn't eliminate it altogether, so even this solution is not as elegant as it could be, and we will explore other better alternatives in following chapters.
Here is another nice example of adding a more resourceful voice to a troubling one, again from Ron Soderquist.
Tommy Bangs his Head
The mother, Julie, called me and related: "Our Tommy is five years old and we are worried about him."
"What does he do that worries you?"
"Whenever he spills milk at the table or makes any mistake, he gets out of his chair and bangs his head against the wall while saying, 'You are stupid. You are dumb.' " I invited them to come in as a family.
It appeared that the parents were a normal couple. There were no "red flags" in their relationship with Tommy. Nor was there anything of note in Tommy's body language. Julie reported that her son enjoyed kindergarten and played well with friends. He had no other strange behaviors. However, Tommy would bang his head a few times a week on average. This behavior had been going on for at least several months.
I first considered recommending testing for autism. But in my experience, behaviors can often be addressed by simple, self–hypnotic suggestions. I looked directly into Tommy's eyes, and began telling a story… .
"Once upon a time there was a little boy squirrel named Timmy who felt bad because he couldn't do anything right." Tommy nodded his head. "When Timmy climbed trees with his friends he would slip and fall down." Tommy nodded his head again. "When Timmy hid nuts he would forget where he hid them. He felt dumb." Tommy nodded his head again. I embellished the story in great detail so Tommy would fully identify with Timmy the squirrel.
"Timmy the squirrel's parents finally bring their little boy to visit the Wise Old Owl who lives in the big oak tree. Because owls have wonderful eyesight he saw them coming from afar, and said, 'I see you are a squirrel family, how can I help you?' Mommy and Daddy told the owl that Timmy banged his head against trees and called himself names when he made a mistake.
"The Wise Old Owl thought for a moment, and then he looked right at little Timmy and said, 'Little Timmy the Squirrel, do you have a belly button? Let me see your belly button.' At this command, Tommy pulled up his shirt and looked at his belly button.
"The Wise Old Owl continued, 'Little Timmy, take a good look at your belly button, because everyone who has a belly button make mistakes. From now on, whenever you make a mistake, just look at your belly button and say, 'It's OK. Everyone who has a belly button makes mistakes.'
"Then I told him, 'Now you and your Mommy and Daddy go home and enjoy being part of a loving family.' " At that, I ended the session.
Julie called the following week to report Tommy had stopped banging his head.
Ron Soderquist, http://www.westlakehypnosis.com/
Like the previous example of the man with a critical attitude, Tommy's voice apparently had no positive function in the present. Some of the things that we learn are pretty much random. Tommy may have heard something like his voice at school, or on the playground — kids can sometimes be even more cruel and unthinking than adults. Somehow it stuck with him as something very important. All he needed was some skillful instruction in how to think differently. In this case, the instruction was embedded in a story about a squirrel.
I'd like to point out the importance of telling Tommy to look at his belly button. If Ron had instead said something like, "Everyone makes mistakes," it wouldn't have had nearly as much impact, because it would be too abstract and general. It might not necessarily apply to Tommy, and he might not remember it at the appropriate times. Having him look at his belly button provides a specific visual cue that both triggers the thought, and also applies it to him specifically. Every time Tommy looks at his belly button — or imagines seeing his bellybutton — he will think of the instruction, "It's OK. Everyone who has a belly button makes mistakes."
Another way of thinking about what Ron did with Tommy is that he taught him a way to be more self–accepting. Making mistakes is something that everyone does. Recognizing that something is a normal thing to do is a process that is often called "normalization." Let's explore self–acceptance in more detail.
Whenever someone doesn't like something about themselves, they are likely to criticize and reject themselves, which is the opposite of self–acceptance. Then if they learn about affirmations, they may try saying something like, "I deeply and completely accept myself." That sets up a direct conflict between the self–rejection and the self–acceptance, as I have discussed earlier.
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