How do I work with intrusive thought loops, internal dialogue, paranoia, and self-criticism? Will these thought patterns ever change from doing this work?

The first thing to know about this, is that these thoughts are just another symptom of the underlying activation and dysregulation. It is the threat response living in the mind and presenting as worry, fixation, looking for threat, etc… So yes, as we get more and more regulated, these mental manifestations become less of a problem.

First, they become less convincing, where we still have the same patterns but they don’t hook us in so much as we learn to direct our attention elsewhere. As we get more and more regulated they will often disappear entirely, though an echo of these patterns CAN persist long after regulation is established and trauma is healed, kind of like a slightly annoying mosquito that’s easy to squash.

The best way we have found to work with these mental experiences is a twofold approach. 

1. Name it for what it is. Consciously say to yourself, ‘I have the thought that xyz…’
2. Redirect your attention to the body. What are the sensations and emotions happening in the body while these thoughts are happening? Focus on those and work at that felt-sense level with the somatic tools you are learning. 

This takes a LOT of repetition and practice. Those mental experiences are often VERY well worn grooves, and it takes a lot of repetition to drag our energy out of those tracks.