The Internal Critic

There’s an internal critic in my mind, a voice that judges me for lying on the couch and being unproductive during a migraine attack. This critic is a young, healthy person who has never had a migraine. That’s right, I constantly assess myself against a standard that has never applied to me.

Like a 50-year-old who looks in the mirror and berates herself for not looking like she’s a 20-year-old runway model, I evaluate myself against an entirely unrealistic standard. No wonder I’m forever falling short. I am not young and healthy; I never have been. Yet I regularly tell myself I should act as if I were.

I’m not alone in this. I shared a version of the first paragraph of this post with a chronic migraine forum and was shocked to see how many people identified with what I wrote. Not a day passes without a migraineur in my social media sphere saying they’re a bad parent for missing a kid’s sporting event or they’re lazy for letting dishes pile up or they’re weak for not being able to get through the day of work — all because of a migraine attack.

None of these people are stuck in bed because they are self-centered or weak or lazy or attention-seekers, but because they are ill. They aren’t staying home because they don’t want to participate in life, but because they are too sick to do so. Still, they constantly question their own illness, their own bodies, and their own day-to-day experiences. As do I.

Migraineurs are often frustrated by unkind, unthinking comments from the outside world. People who have never had a migraine seem to think they know better than those who live and breath migraine. We’re told that migraine is “only a headache” and “all in our heads.” We’re told that all we have to do is eat less [blank], drink more [blank], do [blank] exercise routine, “calm down,” or abide by some other current pop culture craze and our migraines will disappear.

The voice of the internal critic that I and many other chronic migraineurs possess appears to have developed out of these and other similarly ignorant beliefs about migraine that abound in our culture. We can easily scoff when someone tells us to stick cabbage to our foreheads (yes, this was a “cure” floating around on Facebook recently), but it isn’t so easy to brush of the implied meaning behind these messages. Instead, these insidious beliefs work their way into our self-perceptions until we, too, think that we’d get better if we only tried harder, that we’re somehow to blame for our illness.

It doesn’t matter that migraineurs constantly work our butts off at maintaining a schedule, minimizing stress, eating right, finding triggers, trying treatments, etc. We work tirelessly at improving our health — much harder than most people ever have to and more than they can possibly imagine. As if we weren’t already exhausted enough by the physical experience of migraine, we focus our limited remaining resources on trying to avoid future attacks. Despite all our efforts, we still think that we need to work harder, do more.

I’ve never cared much what other people think, so you might assume it wouldn’t matter to me that society treats illness as a sign of weakness and personal failure. The problem is that I internalized these beliefs long before I even knew they existed, let alone how harmful they are. I am not struggling against an outside force, but against myself. That’s the most painful part of all.

Chronic Migraine, Community, Coping, Mental Health

A Technique for Quieting Self-Criticism

Though I’m no public health expert, I feel well qualified to declare that self-criticism an epidemic among migraineurs. We blame ourselves for migraine attacks, berate ourselves for canceling plans, criticize ourselves for not keeping up with housekeeping. Actually, this negative self-talk seems pretty common among people with any kind of chronic illness. Toni Bernhard, author of the superb book How to Be Sick, recommends asking yourself what you would say to a friend who was criticizing herself in the same fashion.

In Befriend Yourself to Silence Self-Criticism, I wrote about her technique, then shared my experience of responding to my inner critic with kindness and compassion in An Experiment in Quieting My Inner Critic, both on That was a few months ago and was so positive and uplifting that I’m still doing it. Such a relief for my mental health — I can’t recommend the strategy highly enough!



Coping, Favorites, Mental Health

The Guilt of Letting Myself Down Over and Over

Guilt and I spend a lot of time together. It is my closest friend, a friend I happen to despise. This is one bad relationship I don’t think will ever end. I feel guilty when I let anyone down, especially when that person is me. Multiple times a day I make promises to myself and multiple times a day I break those promises.

Lists are essentially promises to oneself. You plan to do each item on the list: make a phone call, clean the kitchen, have dinner with friends, pick up the house, etc. Organized folks will assign realistic dates to tasks. I give deadlines too; usually leaving 48 hours to accomplish all 12 items. Then berate myself for not taking care of them.

I’ve always had high expectations for myself. Even after all these years of migraine and chronic daily headache impeding my success, I think I can do more than I’m physically capable of. I believe I should be able to do everything I want or need to do, even without realistic parameters. Thus starts the cycle of self-blame and guilt.

Letting myself down — and feeling horrible about it — day after day haunts me. Being self-critical is my way of life. I don’t think being hard on myself is the only problem here, but don’t know what else is at work.

Triage is more important than source-sleuthing for now. Not calling myself a flake is probably a good start! After that I’m stuck. I can’t stop setting goals; that would be giving up on my life and giving in to migraine and chronic daily headache. Where is the line between labeling something as unrealistic or as a goal to strive for?

Prioritizing is the most obvious solution. Even that is confusing. How to prioritize when I might not get to the priorities? How do I choose what I really need to do? When do I choose what I want to do over what I need to do?

Learning to let go when I can’t follow through with myself seems helpful — and impossible. Cognitive behavioral therapy, perhaps the ideal solution, isn’t going to make it into my schedule anytime soon. Any suggestions?

photo credit: Raul_d50

Coping, Mental Health, Treatment

Living From the Heart

Since yoga class yesterday, I have been in a terrific mood, even when my pain was bad. I’m loving the warmth of the shining sun, listening to music so loud that I can’t hear myself sing, admiring the pure happiness of the neighborhood kids.

My yoga teacher talks about living from the heart rather than always being led by your mind. We are guided to surrender our thoughts to the “heart center” (essentially your spirit or soul). While I agree with this idea in theory, believing in it is different than feeling it.

I spend too much time in my head. I’m a thinker who obsesses easily and am extraordinarily self-critical. The life changes of having a chronic illness have intensified and increased the frequency of all these thoughts.

Being in my head is not only in my mind, but in my brain. It literally directs one of the most prominent aspects of my life—chronic daily headaches and migraines. Living from the heart means thinking and obsessing less, but also keeping my illness from controlling my life. [insert raucous laughter here]

When I’m guided to send kind, supportive messages to myself, I give demands couched as encouragement: “Be nice to yourself,” “Worry less about if you’re a good person,” “Approach everyone with love.” Yesterday I unwittingly replaced these judgments with “Honey, honey, come and dance with me.”*

I got it. My heart invited my mind to celebrate with it. Love widely, be compassionate to yourself and others, care for others without neglecting yourself, accept who you are. It was an incredible feeling. The message was so clear that I haven’t thought about it much; I have simply lived from the heart.

*Maybe I should be concerned that lyrics from a Dave Matthews Band
song popped to mind while meditating. The song, Everyday, was originally written about the 1993 assassination of Chris Hani, the leader of the South African Communist Party who fought against the apartheid government. It’s all about love. I’m good with that.

Community, Coping

Balance & Illness: Tips for Slowing Yourself Down

“Holy Toledo Bat Girl.” You gotta respect any email that begins that! In response to Balance & Illness (and Always Pushing Myself Over the Edge), Carolyn sent me a caring, sympathetic note. She shared her experience with and tips for keeping herself from overdoing it.

About 4 years ago I got into rebound headaches for the second time, I had just started a new job, I had signed up for a class, and was started in with a new volunteer group. I think it was then with my migraines out of control and these things that I had to cancel-the class, the group, etc, I realized I had to find balance. I have found more through trial and error, what works best for me.

Here are my rules:

  • I don’t commit to do something on a weeknight, after working it’s just too much.
  • On the weekends we do chores, I do laundry and groceries and I try to cook a batch of something for the week (I like to cook too).
  • If I need to go outside the house for errands I limit that to about 2 stops or about 2 hours. And I would limit myself to one event a weekend.
  • I try not to double book. I tire easily. Social things tire me. I just don’t have the stamina that other people do.

(But I do understand the need to make “real” lemonade. I catch myself doing stuff like that. The need to have both families over at once. I cut that out. It was too much.)

Carolyn’s rules got me thinking about the constraints I’ve put on myself — ones that are obviously insufficient. I have to eat. I have to rest for a little while. If I feel myself going too far, I must sit down. I followed all these rules all three weeks. The problem is I didn’t see that three weeks of activities could wear me out, even if I rested.

When I told Carolyn that I have trouble convincing myself that I’m not lazy, she had another thoughtful response.

I think because we have a chronic illness when things go wrong (like when you ended up in bed for the day), you may have blamed yourself. We are always on the lookout for what is causing a flare up and what we did wrong to cause a flare up.

Living with a chronic illness is so hard because we are always trying to manage it by doing the right things. So when the illness flares up we tend to blame ourselves, when really, we are trying our best all of the time. If I look at my friends and family they aren’t nearly as careful as I am day in day out with diet, exercise, schedule, balance, etc.

Many readers have told me they learn a lot from The Daily Headache. What you may not know is that I learn just as much from you.