Sometimes, some of us may get into a self-talk as a means of processing thoughts, solving problems, preparing ourselves before giving any public speech, or simply verbalising our inner monologues. But when does self-talk cross the line into a sign of a serious condition such as schizophrenia?
Experts shed light on the crucial distinction between positive self-talk and a self-chatter that indicates a symptom of schizophrenia.
Unravelling the monologues
Dr Neelam Mishra, a clinical psychologist at Sir Ganga Ram Hospital in New Delhi, says people often talk to themselves as it offers them a sense of confiding in a non-judgemental companion.
“Through these inner dialogues,” she explains, “They find a platform to candidly express their thoughts and viewpoints, nurturing a sense of self-assurance and the conviction that their inner voice is genuinely attentive.” Moreover, self-talk sometimes even paves the way for individuals to stumble upon their own solutions to pressing questions.
Dr Mishra points out that self-talk is not inherently a sign of an underlying mental health condition. People from all walks of life engage in this for different reasons. For instance, during severe stress, anxiety or depression, individuals may find solace in talking to themselves.
“Also, high-intelligence individuals, especially those engaged in complex problem-solving tasks, often engage in self-talk as a tool to think through complex challenges,” she says.
Exploring the grey areas
However, Dr Somnath C P, consultant psychiatrist at Healing Minds Clinic, Kochi, says there is another facet of self-talk found in individuals with schizophrenia. These people indulge in a different kind of self-talk that may seem illogical, irrelevant or incoherent. In some cases, it may even be entirely detached from reality.
Dr Somnath emphasises, “In schizophrenia, individuals may mutter to themselves in ways that are out of tune with reality. They might speak of delusions, imagining interactions with individuals or personalities that have no basis in the real world. This is a sign of being in a delusional world.”
Dr Somnath explains that self-talk, primarily based on logic and reality, serves as a cognitive tool for individuals to make sense of their thoughts, emotions and surroundings. This form of self-dialogue is generally coherent, relevant and in tune with the individual’s perception of reality.
Jumbled thoughts and delusions
Dr Somnath explains that one of the hallmarks of schizophrenia is a disorganised way of thinking. These thoughts may appear blocked or jumbled. When spoken aloud, they may lack a logical order. This can manifest as the creation of new words or repetitive phrases devoid of context. This unique feature of self-talk is a red flag for schizophrenia.
Dr Mishra provides a broader perspective on the diagnosis of schizophrenia. It encompasses not only disordered self-talk but also consists of hallucinations, whether they are visual, auditory, tactile, or related to taste. Furthermore, individuals with schizophrenia may experience delusions, such as the belief that someone is trying to harm them or tamper with their food (i.e., paranoia). When these symptoms combine, the condition is diagnosed as schizophrenia.
Not merely a self-chat
The crucial distinction between positive self-talk and that associated with schizophrenia lies in the nature and consistency of the behaviour. Dr Somnath says, “When it is [mere] self-talk, you are in control, having a deliberate conversation with yourself. But if you are hearing voices in your head without intentionally starting the conversation, if there are multiple voices talking at the same time, or if you also experience sounds, smells or vivid images along with the voices, it is a matter of concern”.
Dr Somnath points out that the self-talk of a person with schizophrenia is typically characterised by its disordered, illogical and often delusional nature firmly rooted in a world detached from reality.
The `plain’ self-talk is a fascinating facet of human behaviour that varies widely in its form and function. While it is common to many, it becomes a concern when it shows the disordered and illogical characteristics associated with schizophrenia. It is imperative to recognise the fine line between positive self-talk and the symptoms of schizophrenia, and, if necessary, seek professional guidance for early diagnosis and treatment.
Dr Mishra stresses, not all self-talk is a sign of mental illness. It can be an expression for coping, problem-solving and creative thought. The key to the matter lies in understanding the context and the consistency of the behaviour.