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Why am I pretending conversations in mind?

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Psychiatrist
Practicing since : 2003
Answered : 2190 Questions
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I am embarassed to go see a psychiatrist. I do not hear voices but I am constantly having pretend conversations with people in my mind. I know they are not real but it gets to the point where it is so intense that i can hardly even concentrate on anything else. This goes on every second I am awake. How do I make it stop and what is it?
Posted Sat, 3 Nov 2012 in Mental Health
 
 
Answered by Dr. Jonas Sundarakumar 1 hour later
Hello and welcome to Healthcare Magic. Thanks for your question.

I appreciate your initiative to seek help for your problem. In order to understand your problem better, I would like to have some more details and clarifictaions...

- How long have you been having these pretend conversations in your mind?

- Can you explain more about the content of these conversations? (i.e.) What do you generally converse about? Who are the people you imagine talking to?

- What purpose do these conversations serve to you? (i.e.) Do they make you feel less lonely, more relaxed, etc.?

- How much of a voluntary control do you have over this process?

- Do you have vivid imaginations or detailed fantasies during these conversations? If so, generally about what?

- How much is this problem affecting you in your day-to-day functioning?

- Can you describe about yourself in a few words? (i.e.) In general, what sort of a person you are, are you normally very reserved or outgoing, do you have a lot of friends, how is your social life, etc.

- Do you often have feelings of low mood, feeling inadequate and rejected, poor self-esteem, negative attitude, etc.

- Are you in the habit of taking alcohol or any other drugs?

- Have you suffered from any psychological problem in the past?

Please get back to me with these details so that I will be able to guide you better.
Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
 
Follow-up: Why am I pretending conversations in mind? 42 minutes later
ow long have you been having these pretend conversations in your mind?

- Can you explain more about the content of these conversations? (i.e.) What do you generally converse about? Who are the people you imagine talking to?

- What purpose do these conversations serve to you? (i.e.) Do they make you feel less lonely, more relaxed, etc.?

- How much of a voluntary control do you have over this process?

- Do you have vivid imaginations or detailed fantasies during these conversations? If so, generally about what?

- How much is this problem affecting you in your day-to-day functioning?
Hello,

Please see my answers below:

- Can you describe about yourself in a few words? (i.e.) In general, what sort of a person you are, are you normally very reserved or outgoing, do you have a lot of friends, how is your social life, etc.

-I am somewhat introverted I guess but I dont have trouble talking to people. My social life could be better I guess, I am single but I have some friends and I go out. I have a good job and I like all the people I work with.

- Do you often have feelings of low mood, feeling inadequate and rejected, poor self-esteem, negative attitude, etc.

No, my mood is pretty stable most of the time except when this happens then I get depressed as I dont know how to handle it. I suppose at times I do struggle with the fear of rejection and self esteem.-


- Are you in the habit of taking alcohol or any other drugs? Never do either of those things, maybe an occassional drink but rarely.

- What purpose do these conversations serve to you? (i.e.) Do they make you feel less lonely, more relaxed, etc.? I dont know, I suppose they are to relieve anxiety, if I am upset about something or worried it starts but then it keeps up and eventually I feel I have no control over it. It stays with me every second of the day.

- How much of a voluntary control do you have over this process? None

- Do you have vivid imaginations or detailed fantasies during these conversations? If so, generally about what? No, it isnt detailed fantasies, it is more like people talking to me, having conversations with me. I dont know who they are, they are like counsellors or doctors I think. I feel like they are trying to help me, they tell me everything will be fine, they try to get me to discuss what I am upset about. I dont know how to make it stop, its very annoying. I have asked them to leave and told them that I am fine, even though I understand they arent real, it is just me doing it. I dont know if I am supposed to figure out what they want, I just dont know. I feel like they expect me to tell them why I am imagining them the entire day, but I dont have an answer.

- How much is this problem affecting you in your day-to-day functioning? It really affects my concentration, it depresses me, I dont know I do it, I want it to stop. Does it mean something? If so, what does it mean?

Have you suffered from any psychological problem in the past? Just this similar type of issue, it happens when I am upset but then I am ok but it doesnt go away
 
 
Answered by Dr. Jonas Sundarakumar 12 hours later
Hello again and thanks for the details.

From your description, I think that you are sub-consciously using these imaginary conversations as an an alternative coping mechanism. Sometimes, when people find it difficult to resolve psychological conflicts or stress, their minds can 'dissociate' from reality and they can sub-consciously resort to such kind of imaginary conversations. You mention that these start at times of stress and the theme of these conversations is mostly about reassurance and anxiety relief. So, I think that you are probably suffering from a kind of Dissociative disorder.

You also seem to have a compulsive nature to these thoughts / imaginary conversations - since you mention that you try to resist them unsuccessfully and after a point it just keeps going on and on.

It's a positive thing that you have a reasonably good insight into your problem and you have taken the initiative to seek help. Now, there are indeed ways to help you overcome your problem. But I think you definitely need professional help and support. Treatment is available in the form of psychotherapy and medication. There are effective psychotherapeutic techniches which will be aimed at controlling these thoughts as well as teaching you more healthy coping mechanisms and stress management skills. Medication will be aimed at relieving your underlying anxiety (which triggers these episodes) as well as for the compulsive nature of these thoughts.

I am quite able to understand that many people find it embarassing or hesitant to visit a psychiatrist. But look at it this way - that you simply have a problem (and everyone has problems which they sometimes, can't handle on their own) which you need professional help to deal with. Moreover, when good therapy is available to help you get over this, why should you continue to suffer in silence...

So, I would strongly advise you to consult a psychiatrist for a detailed evaluation and further therapy.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by
 
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