Battling the inner voice: a very personal case study
For my first article of 2025, I’m going to get vulnerable and share a situation I’m currently dealing with: not for sympathy, but because I think it makes a fantastic case study for the effectiveness of the techniques that I help others to master.
The radio edit version: I’m ill, and I might be very ill.
The album version: I’ve lived with a rare blood disorder for the last fifteen years, but over the last few months it appears to have deteriorated. I’m too fatigued to enter the 100 mile race I’d planned for the end of January, which has pissed me off beyond belief, but the bigger concern is that my illness may have become life-limiting. I’ve been in a state of limbo since November, and am waiting for a diagnosis as I type this.
Now, in the interest of total transparency, I have absolutely not been a picture of total optimism for the past two months. I’ve mourned lost opportunities: both ones that I should have taken, and ones I now can’t take. I’ve spend many hours imagining what the future might hold, both for myself and my family. And when I’ve tried to be present for my sons, the need to soak in every last detail of the experience, for fear that it might be one of the last, has left me emotionally exhausted.
In other words, I was a fucking delight at times over Christmas.
And just to be clear, I still don’t yet know how ill I am. Beyond a cancelled race and some annoying physical symptoms, all of the emotional turmoil I’ve experienced has been:
Created by me
Based on something that might not happen
Let that soak in for a moment. Now think to yourself: how many of your own mental struggles are purely of your own creation? How much time are you spending ruminating on the past or catastrophising about the future? How much of your mental energy is being wasted on things outside of your control?
If the answer to those questions is “LOTS”, fear not: you’re just experiencing life as a functioning human being. Thankfully there are a wealth of proven techniques to regain control of your thought patterns. What follows is a case study on the ones I’m using to tackle my own little ‘situation’.
Cutting myself some slack
It’s vitally important to appreciate that I, like the whole human race, am genetically predisposed to dwell on the past and look into the future. As a species we’ve spent thousands of years mastering this skill so we can learn from our mistakes, make plans to mitigate likely threats, and generally stay alive in hostile environments.
(Un)fortunately, those environments have changed at a far greater pace than that of human evolution. As a result we’re still hard-wired to think like cavemen in many ways. A skill that once allowed us to outwit predators is a bit overkill when being used to plan against ‘threats’ like stressful workplace demands - or, in my case, a diagnosis that may not come to pass.
Lesson 1: we must understand that, sometimes, our brains are going to act in unhelpful ways. They do so with the best of intentions.
Accepting this fact is useful because it encourages us to:
Gain emotional distance from our thoughts and feelings, so we’re not dominated by them
Stop engaging in a futile strggle against our own biology, thereby saving precious mental energy
In other words, when my mind has started to spiral, I have (mostly) chosen to respond with acceptance and curiosity rather than struggle, judgement and frustration.
Recognising the warning signs
At times it’s genuinely useful to consider worst-case scenarios or past mistakes. In the context of my situation, I’ve found it helpful to learn more about the possible prognosis so I can be prepared to ask pertinent questions about treatment options if the time comes. Pragmatism, and an acceptance that “life can sometimes suck, so be prepared for it” is a fundamental lesson from Stoicism that I’ve embraced since my military days.
However, even with the best intentions, sometimes I’m going to become hooked by these thoughts and feelings. I’ll lose the flexibility to bring myself back into the moment once I’ve exhausted all usefulness from the exercise; I’ll become dominated by the thought patterns; emotions will overtake rational thought; things will start to appear as truths rather than possibilities. This is the point where I need to take action.
Lesson 2: I need the knowledge to recognise when I’m hooked, and the discipline to then do something about it.
Unhooking
We’ve established that overthinking is an inevitable process linked to a primitive survival instinct, so it feels a bit pointless trying to eliminate a thought pattern we’re pre-programmed to do. But how do we respond when this little evolutionary hiccup causes misery?
In truth, there are hundreds of unhooking strategies; in fact there is nothing stopping you creating your own! They all however create emotional ‘distance’ from the unhelpful thoughts, as if you’re detached from the perspective of the person experiencing them. This gives you a sense of objectivity, which has a number of benefits:
The thoughts lose their control and emotional impact over you. They become just that - thoughts, not realities, that you can choose to engage with or not.
You gain a degree of clarity over your thoughts that allows you to differentiate between genuinely useful insight and unhelpful noise. It also enables you to start noticing trends in your thought patterns, which in turn makes it easier to unhook from them in the future
You develop a sense of curiosity and compassion about your thoughts, which develops mental resilience. If this sounds counter-intuitive, consider who is more likely to quit a difficult task: the person who beats themselves up for ‘being weak’, or the person who responds with self-compassion and support when their inner voice starts asking to quit?
This time and space from your thoughts allows you to take decisive action, usually by undertaking a more helpful behaviour that keeps you in the present moment. After all, what’s the point in living your life in the past or future?
Lesson 3: Learn - and practice - unhooking techniques, so that you can start living in the present.
Some techniques that I’ve used in the last few months include:
Labelling: By labelling a recurring thought pattern (for example “here comes the victim mindset”, or I’m noticing the “helpless” story again), I’m able to briefly move my perspective from that of the person experiencing the emotion to that of someone observing it. This is sometimes all I need to be able to recognise the issue and reengage with the present moment.
Characters: I personally love this one. I’ve created two alter-egos: “Nigel” is my infuriatingly pessimistic self, and “Tarquin” is my dangerously optimistic one. Nigel sees the worst in everything and everyone; he has a nasally drone and is utterly insufferable. Tarquin is the kind of incompetent buffoon who, if he was an Infantry Officer, would get all his men killed through a combination of recklessness and a desire to be seen as a hero.
When I start burying my head in the sand or catastrophising, I imagine that my internal monologue is being narrated by Tarquin or Nigel. This instantly helps me recognise when my mind is leading me astray.
Deepest apologies (sympathies?!) to any readers named Nigel or Tarquin…
ACE: This textbook mindfulness approach aims to create cognitive space by:
Acknowledging the thought (which links nicely with labelling)
Connecting with body for an extended period of time (through any number of activities, from breathing exercises like 5-5-5-5, to honing in on the sensations on the exposed parts of your skin)
Engaging with what you’re doing (ideally a helpful, value-driven behaviour that keeps you in the moment, like actively listening to your children)
Third person: This essentially means visualising yourself as an independent third party who is bearing witness to the narrative in your head. This can take any number of approaches: watching your internal battle play out on a battered old TV, interviewing yourself, imagining the scenario is happening to a friend… The options are only limited by your imagination. I do sometimes struggle with this approach however, because my imagination isn’t as visual or vivid as others.
Looking for the blank space in my thoughts: Another favourite of mine is to turn my attention away from the thoughts themselves, and instead wait to notice the gaps in my thoughts. At first this is impossible due to the constant barrage of thoughts (“did I put the washing on"?”… “is this a blank space?”… “Am I doing this right?”), but after a minute or so the silence between the mental noise grows longer. For the visual thinkers, you can imagine your thoughts parading past you like a carnival as you watch for the space between the ‘floats’.
The silver lining
It’s stating the obvious to say that the last few weeks haven’t been much fun. However, it’s been a hugely beneficial exercise in brushing up on the theory and practice of ‘cognitive defusion’, or in layman’s terms: “not living in one’s head, and instead focusing on the present moment”.
Ultimately, life will throw you script changes from the day you’re born until the day you die. You can’t control it; that’s the nature of existence. What you do control, and what gives your life purpose, is how you respond to these script changes.
No matter what happens with my medical condition, I’ll use it as as a vehicle to become a better person and role model for my kids. I’ll also continue to share the learnings from my journey with other ambitious people, so they can make the most of the precious time they have on this earth.
And who knows, maybe I’ll get back to the Cornish coast for that pesky 100 miler…