Do you talk to yourself?

The habit of talking to oneself or engaging in self-directed talk is often one that turns heads as you pass people by. Around you, people are most likely to conclude that such a person is suffering from some kind of mental health challenge or is perhaps frankly mentally ill. However, this is not necessarily the case as various researchers have concluded over many years that this habit is actually normal. It is therefore considered a normal behaviour, and one that may help people stay rooted to their environment. In that way, such conduct could help such persons understand instructions more clearly and lead them to find items that they have misplaced around the home. This habit is believed to occur at any age. This is an engagement you are likely to see around your home, on the street and in public transportation, not to mention in places of worship and in the market. This form of verbal expression involves a situation in which various people essentially talk to themselves in a range of ways. When the expression is of a positive kind, it is usually because the person is working hard to encourage himself or herself. When the opinions or thoughts expressed are negative, it is usually because something bothersome is disturbing the person’s inner peace. The concern about whatever it is usually affects the person so profoundly that one of the ways to deal with it is to talk to oneself.

Therefore, self-talk is variously defined as a condition in which the person gives a verbal expression to an internal conflict or belief. In this way, the person expresses inner feelings, thoughts and intuitions about a particular situation by talking about it. The difference between this condition and what the rest of us would consider normal is that this form of speech is directed at oneself. It is only when this kind of situation is associated with flights of ideas or hallucinations that there should be concern about the mental health status of the person. In many cases, when these associations exist, the affected person is often suffering from such a condition as schizophrenia. Any person who is suffering from schizophrenia may experience behavioural changes and some changes in thought patterns too. Hallucinations or delusions will cause the affected person to see, hear, feel, smell and taste things that are present only in their minds and thoughts but not in their surrounding environment. Therefore, hearing voices and responding to such voices is a common complaint among these patients. These voices and visions would normally seem real to the person experiencing them to the extent that they are likely to hear news broadcasts on radio and television. As a result, these people would respond to these stimuli as if they are relating with real people and real objects.

Now, even children talk to themselves and that is not considered harmful. They will do this often especially when playing either alone or with their peers. This should not constitute an object of worry to parents and those who look after other people’s children. It is a way of developing a speech pattern around a language and staying in control of what you are doing. This can help improve concentration on a particular task and enhance performance. This is a habit, if you like, that can therefore be carried on into adulthood where it is now recognized as a possible accessory skill to solving problems. In the operating room, one has come across surgeons who speak to themselves by gently saying what the next step in their work is. You will be mistaken if you interpret this act to mean that the person is not confident about what he is doing, but it is not that. It may be a default position that helps him to avoid making mistakes. The same thing can often be seen amongst athletes and other sportsmen and women who do this as a sort of personal motivation at key points in their games. This kind of self-exhortation delivered in a motivational way can improve performance and endurance. On the other hand, negative self-talk is not known to improve performance. Such speech may be overt or covert. The former is the kind of speech that people around the individual can hear, while covert speech refers to that which is not expressed in an audible manner.

There are several types of self-talk described and these depend on the tone used in such speech. The first of these is positive self-talk, which generally uses an encouraging tone to coax enhanced performances from the person even though it is directed at oneself. This kind of engagement could help decrease anxiety and fear while helping to improve focus and concentration. On the other hand, negative self-talk usually promotes discouraging and critical dialogue that is inimical to constructive work. The third type of self-talk is neutral self-talk which generally means a speech which is neither encouraging nor critical. People who belong to this group do not reinforce or encourage any particular type of belief or emotion. Talking to yourself, as we frequently say when we come across people who do so, often invokes negative stares from people around us but those who do it may be doing themselves a lot of good when they find that they are able to focus their energy more consistently such that there is an overall improvement in their nervous status. They are then able to manage their anger and fear. They can better control their emotions and they often think deeply about how to respond to their feelings when they are in such a state. The bottom line in this particular condition is that if it is found to be interfering with a person’s normal life, it may be time to seek help and curb it.

In the final analysis, it is not harmful to be talking to yourself as long as it is not associated with such emotions as hallucinations. It does have benefits and is engaged in by people of all age groups. It is certainly not a disease and does not merit the stigma often associated with it when people around you point fingers at you to say “he is always talking to himself”. Instead, what has emerged as a uniform finding in several kinds of research since the 1880s, which is 150 years ago since this occurrence fascinated healthcare workers, is that engaging in the practice is usually helpful. In some individuals, however, this behaviour could start as part of a way to handle challenges. Over time, and especially if the self-talk is largely negative, it could begin to affect the person adversely. This happens only in a minority of people and if it does manifest, it is a good enough basis to seek help at the hands of a clinical psychologist. They are not mentally ill.

Questions and answers

Dear doctor, may God continue to bless you for the good job you are doing for humanity. It is interesting and comforting reading through your column. Sir, recently I had some malaria symptoms and I was advised to run some tests which revealed malaria parasites ++ after which I was placed on malaria treatment. After completing the treatment, the symptoms persisted with complaints of frequent urination so I was told to do an abdominal ultrasound scan which revealed an enlarged prostate, so I was placed on Duodart. I couldn’t find this drug but it was an alternative drug that I got——-Tamiflo (Dutasteride/Tamsulosin). Ever since I have been on this drug, I still feel the earlier malaria symptoms like weakness, headache, tiredness after a little stress, and so on. I stopped taking the drugs for a couple of days but during the stoppage, I was still feeling these symptoms. Sir, is it the malaria that is still causing these or could this be symptoms of an enlarged prostate as well? Should I continue with this drug or what other test will you recommend? Thanks and God bless.     –Adeyemi

Thank you very much for your kind words and prayers. Unfortunately, you didn’t tell us your age or for how long you have taken these medications. Your age is important in dealing with a problem such as yours because even if you have an enlarged prostate, it is the degree of enlargement that ultimately determines whether or not you should have treatment. Looking through your list of symptoms, it is important to emphasise that an enlarged prostate will not cause those kinds of symptoms except there is an associated urinary tract infection. It is a bit odd that you were just placed on medications to control the symptoms of prostate enlargement, going by your account, without fully conducting the relevant investigations that will aid a diagnosis to be made. Malaria is most unlikely to be the cause of these symptoms and it is much better for you to see a urologist who will examine you in full and determine what kind of treatment you should take.

Dear doctor, thanks so much for the job you are doing for humanity. The Lord will continue to preserve you in good health and reward you richly to enable you to continue your excellent services to God and humankind. Having said that, I have discovered recently that my sexuality or sexual performance has drastically diminished to an embarrassing level and this is giving me big concerns/worries. I am 70 years old. My erection is always weak whenever I have one and I come too quickly as well. My GP has recommended Viagra 50mg to me but I took it after much hesitation on my part and there has been no improvement. I have been advised to stop sex completely by my friends in order to save myself from worries and anxiety. Do you subscribe to this, sir? I dread to go to the local herbal people hence I have come here for expert advice. I do not have either hypertension or diabetes. What can I do to remedy and resolve this nagging problem? Once again, thanks so much as I await your response.

Thank you sir for your prayers and kind words. It is important to know that you have no major systemic illness and that you still gain some kind of erection even if it is weak. It is not logical to advise you to stop having sex if you still want to keep on having it. Viagra is likely to fail if your problem is due to a low testosterone level which is the most likely scenario for you considering your age. It is therefore necessary for you to have a hormone analysis done so that this can be confirmed or discarded. If the testosterone level is lower than expected for your age, it is possible to provide you with the relevant treatment and normal erections could return.

Dear doctor, I am a 63-year-old man and a regular reader of your Sunday feature in Sunday PUNCH. Beans is a regular food on my menu but a reader of this column complained three weeks ago about the problems he was experiencing after eating beans. I experience similar symptoms of excessive farting, bloating and pains radiating from my stomach to the right side of my lower back. You advised him to stop eating beans or that if he must eat it, to remove the skin before cooking it. For me, I stopped eating beans and to my surprise, all the symptoms of pain and farting disappeared. This mail is to appreciate your positive contribution to human health.

Thank you very much for this contribution and your kind words. Have a pleasant week ahead.

Dear doctor, I have this pain in my left shoulder. I am a man and 46 years of age. I have had this pain since last year and the pain has been there until now. I work out but I am not able to sit or lie on my left side because of the pain. If I try it, I will have to get up within 30 seconds because of the severity of the pain. There is no swelling and no pain around the shoulder but it is inside the joint and it even affects my ability to raise my left arm. Please help me out with this pain because I don’t want to be swallowing drugs anyhow. Thank you, sir and greetings to your family.

Thank you very much sir for asking about my wellbeing and my family. We are all fine. The likely problem based on your complaints is osteoarthritis of the left shoulder joint. It could also be some form of tendon inflammation since you work out. The symptoms can be very similar and the minimum that is required in terms of examination of that joint is an X-ray. However, for a proper evaluation, you need an orthopaedic surgeon to fully examine the joint and treat you based on what they find.

Dear doctor, for many years I have been having an ear problem but these days, it is only itching me. What is the cure for it? 080667****

The term ear problem does not make clear what kind of problems you have been dealing with in your ear. However, the main problem now is itching. In order to make a diagnosis, you will need to get to a hospital and get a proper examination by a doctor who will look into the ear or ears. When he has determined what could be the reason for such itching, then you will get the treatment that will solve the problem.

Dear doctor, this is my third time enjoying you on this medium with full satisfaction of your medical advice. Please keep it up; the Lord is your strength. My problem this time around is that I was descending the staircase of a building in the night and I misjudged the distance between the last step and the ground floor. I did not know that the distance was a bit much and so I had a forced landing on the ground floor. If not for the handrail that supported my standing, I would have fallen flat on the floor. I experienced very sharp pains in the veins at the back of my right knee. Before I got home coupled with the trekking I did that day, I haven’t felt comfortable till now. I have used Neurogesic ointment to massage it and Dolometa-B tablets 50mg and yet the pains have not gone. This morning, I started using electric infrared warmer to massage the leg. If the pains persist, what other painkiller can I use or is it likely that I have had a dislocation because of my age? I am 75 years old. 080244****

Thank you very much for your comments sir and for keeping faith in our service. The kind of experience you had may have caused a sprain or a tendon injury. The veins in that part of the body will not cause these kinds of symptoms. There is no substitute for a proper examination in the hands of a doctor. This will help determine if the above possibilities are correct and it is only then you will be able to get good and effective treatment. As for other pain relievers, there are many of them which are far more effective than Dolometa-B. Also, different analgesics can be effectively combined at your age to give you an optimum result.

Dear doctor, when I walk, it appears as if my walking is controlled by air. It appears I will fall down. Your advice, please! I have low testosterone.                                               080231****

Thank you for your question. You did not disclose your age although your name, which I cannot, indicates that you are male. Low testosterone can make you feel powerless but you did not disclose how you found out that you have low testosterone. There could be other problems besides low testosterone. You should go to a hospital and undergo proper examination and investigations to find out what else might be wrong.