Reader’s Question

I’m a 30-year-old male. Ever since I was a kid, I’v had the habit of not actually talking to myself out loud but thinking something in my head and mouthing the words and thoughts without any sound actually coming out. I guess you could say that instead of talking to myself, I actually mouth words to myself. Does that make any sense? I not only do this consciously but also unconsciously. People stare at me and I feel like I’m always being talked about behind my back. I eventually became depressed, anxious, and shut myself out from family and friends, and when I was 20, I got treatment for it. I started taking Prozac and it helped with anxiety, but I still have the problem, and some depression and anxiety are starting to creep in again. I am a Christian and my faith has also helped me. But I just don’t want this to destroy my life or my family. I just want to be normal. Is there anything you would suggest?

Our Clinical Psychologist’s Reply

You can take heart in knowing that there are effective behavioral treatments for habits or behaviors that you don’t like. Behavior therapy is straightforward and specifically targets the behavior you’d like to modify. It doesn’t assume that there’s some underlying pathological reason for the behavior. Rather, it considers that the behavior serves some adaptive function and that it has been reinforced for a variety of reasons. So, good behavior therapy takes note of all of the positive benefits the behavior serves and helps you learn an even better way of deriving those benefits. All behaviors have their pluses and minuses. If the pluses outweigh the negatives, we’ll keep doing the behavior. When the negatives outweigh the positives and or we’ve found a better way to gain all the positives we used to get with the old behavior, we’ll replace it with a new and more effective behavior. Sometimes, a habit is so strong that it can’t be eliminated altogether. In these cases, learning to exercise better control over the behavior is the key so that we don’t display it in places or situations that are inappropriate.

Therapists and counselors over a wide variety of disciplines are familiar with behavior therapy techniques. Some psychologists have adopted Behavior Therapy and its close cousin Cognitive-Behavior Therapy as specialties. In any case, a counselor well-trained in behavior modification techniques should prove a valuable resource to you.