Chronic Illness
How to Dismantle Self-Criticism in the Face of Chronic Illness
Learn to understand and modify self-attacks.
Updated June 15, 2026 Reviewed by Ekua Hagan
Key points
- Self-criticism in chronic illness often stems from emotions like shame, anger, and sadness.
- Modifying self-criticism involves enlisting healthy parts of the self to challenge negative self-talk.
- Cultivating self-protection and self-compassion counters the damage of self-criticism.
Living with chronic illness is hard. Symptoms can affect our ability to do seemingly simple tasks. They also can be embarrassing and difficult to talk about. In short, chronic illness can make us feel diminished, angry, sad, and ashamed.
Sometimes, people living with chronic illness take all of these challenging emotions and turn them against themselves (Trindade et al., 2019). For example, a woman living with multiple sclerosis berates herself when she loses her balance, calling herself "stupid and weak." A man living with IBD isolates from friends, thinking, “I’m no fun to be around.” A person with rheumatoid arthritis blames themselves for not being “a good patient” who can accept their diagnosis with equanimity.
This post examines the way self-criticism manifests in chronic illness. We will try to understand it together and look at ways to modify it.
When Self-Criticism Is Helpful—and When It Isn't
I want to differentiate helpful from harmful self-criticism (Sokova, 2025). Helpful self-criticism—which I would label “quest for self-improvement”—identifies places where we can improve our quality of life, set attainable goals toward that end, and implement changes that move us toward those goals. When we pursue self-improvement, we often feel purposeful and empowered. We are identifying issues within our control, making a plan that feels do-able, and acting accordingly.
By contrast, self-criticism that is detrimental does not feel empowering or purposeful. Rather, it feels depleting, frustrating, and shaming. Someone working to self-improve may say, “I would feel better with more exercise, even though my illness makes that challenging. I will start by walking for 10 minutes three times a week.” Someone inclined to self-criticism will say, “I am so lazy that I could never make an exercise program work. Even if I try a little bit, it’s a drop in the bucket. It’s pathetic that I am this weak. I’d be embarrassed for people to see me struggling with this.”
Types of Self-Criticism
Self-criticism is harsh. It blames the self for things beyond the self’s control; it sits in judgment of the self’s abilities and efforts; and it tells the self that change is futile. Self-criticism is strongly linked with depression, anxiety, and other mental illness diagnoses (Kannan & Levitt, 2013). Self-criticism presents in two main ways: the inadequate self and the hated self (Sokova, 2025).
The inadequate self is experienced as a flawed, damaged self who cannot do anything right. There’s a profound disappointment in that self; a belief that it is shameful. The hated self is experienced with anger and a wish to destroy. The self is seen as so bad that it needs to be punished or eradicated. Either or both of these experiences of self can occur in a person who is self-critical.
How to Modify Self-Criticism
The first step in changing self-critical patterns in chronic illness is to understand how and when self-criticism shows up for you. Keep a record for a week or so of self-critical thoughts, emotions, and behaviors. Write down how they show up (e.g., negative self-talk, deflated and/or angry feelings, behaviors like self-isolating or self-harming) and when they appear (e.g., what events cause them to arise).
When you have completed your log, see if you can find patterns. Maybe you notice that a particular type of experience makes you furious at yourself and another makes you feel deflated. For example, you may find that an increase in chronic illness fatigue causes you to berate yourself as lazy and worthless, while interactions with others spark a shameful feeling that your illness makes you unlikeable.
Once you’ve identified these patterns, try to identify them as a part of you, rather than as the whole of “who you are”. It may be helpful to name this critical part as “my critical self,” “the critical part of me,” or “the critical voice inside.” This is a helpful practice, as you now have two parts of yourself online—the critical self and the neutral, observing self.
Work with your neutral, observing self to be curious about your self-criticism. Evaluate the statements made by your critical voice. Are they true, or do they just feel true? Your neutral self can observe that feelings are not facts and that you are likely not the horrible failure that your critical self claims you to be. Your critical voice is also likely to be overly dramatic, making broad statements like “You will never amount to anything!” or “One mistake means that you are a loser!” Let your neutral, observing self notice and challenge that hyperbole.
Next, we’re going to bring another part of self online: the self-protective part. This part steps in to protect the self from the damage caused by self-criticism, saying: “I don’t deserve this, and you need to stop. I would not accept these judgments if you were saying them to someone I love, and I will not accept them about myself.”
Ready for the next part we’re going to enlist? This is the self-compassionate part of self. Once we’ve told the self-criticism to stand down, we’re going to move in to tend to ourselves. We’re going to say, “It is hard living with chronic illness. It brings up lots of feelings, including sorrow, grief, anger, and fear. But I don’t have to berate, judge, and criticize myself. I can feel my feelings without turning them into an attack against myself.”
Conclusion
Modifying self-criticism is challenging and important work. Hopefully, this has given you an overview of the process. Remember that therapists are trained to help you with this work. It’s beneficial to seek assistance, especially if you have difficulty finding and using your self-protective and self-compassionate parts of self. Understanding and treating self-criticism is vital in improving quality of life with chronic illness.
To find a therapist, visit the Psychology Today Therapy Directory.
References
Kannan, D., & Levitt, H. M. (2013). A review of client self-criticism in psychotherapy. Journal of Psychotherapy Integration, 23(2), 166.
Šoková, B., Greškovičová, K., Halamová, J., & Baránková, M. (2025). Breaking the vicious cycles of self-criticism: a qualitative study on the best practices of overcoming one’s inner critic. BMC psychology, 13(1), 266.
Trindade, I. A., Irons, C., Ferreira, C., Portela, F., & Pinto‐Gouveia, J. (2019). The influence of self‐criticism on depression symptoms among ambulatory patients with inflammatory bowel disease. Clinical psychology & psychotherapy, 26(6), 743-750.
