Firestone, R.W. (1986). The “inner voice” and suicide. Psychotherapy, 23(3), 439-447.

The “critical inner voice” refers to an internal system of hostile thoughts and attitudes, antithetical to the self and cynical toward others. It reaches its most dangerous and life-threatening expression in suicidal acting-out behavior. Preliminary studies indicate that this partly conscious thought process is at the root of much depressive behavior and lowered self-esteem and that there is powerful negative affect accompanying the inner voice. The voice is described as a core defense that originated in family interactions. The dynamics and probable sources of the voice are analyzed, and the relationship between this destructive thought process and actual suicidal behavior is explored. Reprint