Hearing Voices? "Listen to this one!"

www.edginglife.com                          New Perspectives on Reality

 Know someone who hears voices?  Schizophrenic! Schizotypic Personality Disorder!!   Get them on anti-psychotic drugs fast!!  Oooooh.  Call the shrink! Hurry!
Wrong.

Current research demonstrates that the majority of people's "hearing voices" is in fact not pathological, rather "hearing voices" is a coping and protective mechanism of the psyche.  Between 70-90% of people who hear voices develop them following exposure to traumatic events.

"Hearing voices" whether they be in children or adults, are most frequently associated with PTSD and exposure to emotional scenarios that are too intense for the psyche to bare.   Examples of traumas that can elicit voices include but are not limited to:

• the death of a loved one
• divorce
• job loss
• failing an exam
• being physically, emotionally or sexually abused (children 85% of cases)
• being bullied by peers or teachers
• being unable to perform at a certain level at school
• being admitted to a hospital for long periods 

 Aside from traumas, various drugs and/or heavy drinking can onset the hearing of voices.  This type of onset often dissipates within six months.

People may also begin to hear voices if they don't feel it is safe to discuss their true thoughts and feelings with others, thus opening up an inner world of talk different from thinking.  Hearing voices is often the mind and body's way of preserving psyche.  

Approximately 4-10% of people around the world hear voices, including bout 8% of children.  Aside from this statistic, there are many people who hear voices, but go unaccounted for due to shame and embarrassment of imagined stigmatization due to disclosure and expression of their inner world.  Furthermore, everyone has a unique internal emotional state of being and a unique relationship with the mind which is not only hard to compare to other, but an individual's perspective of self in comparison to other affects identification or non-identification of internal voices.  

Only 16% of voice hearers are actually diagnosed with schizophrenia.  

According to the Hearing Voices Network,  many voice hearers are not at all suffering from mental illness.  In fact, voice hearers who develop non-psychiatric explanations of their voices may live with them quite well.  This non-patholigical perspective to hearing voices and teaching people how to manage voices and co-habitate with them is creating a shift in interventions and outcomes.

Yet many old school professionals and/or people who are not "in the know" want to jump quickly to medicating those who hear voices due to their own fears and anxieties surrounding mental illness.

For those who aren't familiar with stories from anyone who has experienced hearing voices, hearing voices may occur within the mind, ears, outside of the mind, outside the ears, in the body and/or in the environment.  They can be male, female or have no identifiable gender.  They may be adult, child, human or non human.  People may hear one voice or many.  Whatever the scenario, voices reflect important aspects of the person's inner state of emotional being.  The voices have presented for a reason and it is important to investigate that reason such that the person can optimally integrate the voices into cognitive schematics.
 
There isn't a cure for hearing voices, just as there isn't a cure for getting angry and screaming.  When hearing voices cause difficulty, coping, management, understanding, normalizing and feeling safe are goals for decreasing difficulty.  Often, when one tries to negate or minimize his/her voice hearings, ironically the voices can result in occupying more inner room and or increasing in frequency, thus contributing to more difficulty.  Similarly, if one tries to not get angry, avoid anger, minimize it or push it down, often, the result is an increased anger eruption.

While there isn't a "cure" for hearing voices,  in 60% of children, their hearing of voices will go away over the course of time due to increased socialization, enhanced perspective awareness associated with aging and increased ability for emotional regulation and affect management.

When safe social reactions are created for individuals (children and adults) who are hearing voices by family, friends and/or support groups, these individuals will increase their chances of:

1. normalizing their behavior
2. talking, connecting in dialogue and decreasing isolation
3. decreasing associated anxiety, depression and stress
4. exploring voice onset, patterns and underpinnings for origination
5. finding solutions or management strategies (if the voices are creating difficulty)
6. befriending, decreasing or directing the voices to become more helpful
7.  identify purposes the voices are serving
8. applying inner knowings to real life external problems (past or present)
9. healing trauma

Can you hear voices and be healthy and functional in life?

Research and practice originating in Europe, developed in partnership with voice hearers and conducted over the last twenty years indicates that people who hear overwhelming and distressing voices can be healthy and live perfectly functional and connected, fulfilling lives. (Professor Marius Romme, President of the International Network for Training, Education and Research into Hearing Voices).

Most children and adults who develop psychological issues surrounding inner voices, develop these associated difficulties as the result of being exposed to negatively impacting social responses (tone, expression, behavior) including fear, judgment and pathologizing from family and friends.  These social responses are due to lack of public education.  They can much further hurt the voice hearer and exacerbate what could have been a neutral variance of normal human condition.

 If you don't yet know someone who has experienced internal hearings of voices, remember this non-pathological outlook with respect to traumas and/or other adjustment issues such that in the event you ever share time and space with someone who is adjusting, you can be of utmost support to him/her.  While 84% of the time, hearing voices is non-pathological, it doesn't meant hat it is easy for the person experiencing the change and attempt of trauma release.

Hey Molly - Try psychotherapeutic MDMA for your PTSD! (Coming Soon!!)

Molly and Trauma Therapy

In spring of 2017, the FDA will be moving into Phase 3 clinical trial investigations of psychotherapeutic Molly (in its pure form 3.4 no amphetamine or caffeine cuts) with respect to alleviating symptoms of trauma and PTSD.  In phase two clinical trials of psychotherapeutically administered Molly (2014), 136 participants were treated including: veterans (marines, army and air force who served in Afghanistan, Iraq, Vietnam and Korea), police and fire workers exposed to 9/11 and sexual abuse victims.  Phase three of the research study will include 200-400 participants over the course of 5 years. 

Thus far, in just 2-3 therapeutically guided Molly sessions, there is much promise of removing PTSD and trauma roots from affected individuals, allowing for individuals to live and engage in daily activities without being a hostage to their trauma.  In 2-3 Molly guided sessions out of 12 therapeutic sessions, 83% of patients recovered from PTSD, in comparison to one-third of patients do not benefit from Trauma therapy and experience no relief from PTSD. By removing PTSD and trauma symptomology, one can create safe and loving relationships, experience happiness, and establish functional routines in their lives. When PTSD and Ttraumas are untreated, it is not uncommon for inflicted individuals to isolate and become reclusive and socially disconnected.

As observed in PET scans, when one experiences Trauma/traumas and/or PTSD, his brain structures literally change shape.   Not only are neurotransmitter levels affected (Serotonin, dopamine and norepinephrine), but communication between the amygdala and hippocampus decreases.  These organic structural and biochemical changes make it difficult for an individual to experience safety, trust, empathy and connection.  As social beings, organic inhibitor factors make it more difficult for an individual to thrive.  

Without trust and empathy, trauma inflicted individuals can often read facial signals, tones of voice, spoken language, behaviors and other environmental variables as threats, when in fact they are not.  People who have PTSD can get easily triggered and alarmed from various associative elements that those without PTSD wouldn't perceive as anything "major." For that matter, person A with PTSD will get triggered by different things from person B with PTSD.  The important thing to be educated about and to realize with respect to Trauma, is that a person who has Trauma can easily become reactive and go into overdrive when they are triggered.  These trigger responses can result in attacking or withdrawing types of behaviors.

As one can imagine, an over-functioning nervous system and magnified social responses can easily lead a person to experience depression and anxiety.  Unfortunately, medications prescribed to assuage these secondary variables are not effective in terms of treating PTSD.

Not only are medications not helpful for Trauma manifestations, but even while under the care of a skilled trauma therapist, Trauma/traumas and PTSD are difficult to address and eliminate from the psyche primarily due to intense memory recall and the somatic activation response of an individual.

When the sympathetic nervous system gets activated, an individual can literally re-live and viscerally re-experience the trauma, resulting in further re-traumatization and feelings of hopelessness.  Elevated cortisol release imprints trauma memories in the mind more vividly than when cortisol isn't elevated.  If not careful, a therapist can quickly activate the somatic and mental trauma responses of an individual, resulting in deeper mental and somatic trapping of the trauma.  A therapist can even cause the Trauma to expand within the internal trigger map of the client.  Containers, breath-work, somatic signal awareness and visual imagery of safe places are often helpful processes to keep the client's biological change associated with traumatic memories and response recall from entering spaces of healing. 

While a good trauma therapist can facilitate the creation of a safe environment to eliminate Trauma and PTSD, the use of psychotherapeutic Molly provides a literal "chemical security blanket" for the client, such that traumas can be eliminated without reactivating the fight flight response.   MDMA decreases the visceral chemical activation associated with the recall of trauma thus allowing for an opportunity of safe un-activated healing to take place.  Molly actually reduces amygdala hyperactivity due to trauma, so that when an individual is in therapy recalling a traumatic memory, his associated emotional response doesn't go into "freak out" re-traumatization mode.   (Molly does not typically alter states or dimensions, nor does it produce visual-audio effects or hallucinations. It does not create interconnectedness, out of body and/or loss of self experiences).

It is so important to eliminate PTSD and Trauma/traumas from psyches, so that individuals are free to experience daily life without sensations that they are being chased by a tiger or caught in a cross-fire. Elimination of PTSD and Trauma allows for the transition of someone to move from a defensive life role to that of an offensive role.

As SSRIs and SNRIs are not proven to be an effective treatment of PTSD, a current mode of medication to alleviate PTSD symptoms is that of medical marijuana.  Medical marijuana helps to decrease deleterious social effects, increase empathy and aid in sleep.  Marijuana however does not allow for the root of trauma to be pulled.  Instead, marijuana deals with PTSD's secondary manifestations, which would be equivalent to the defensive player deflecting and or protecting his self (goal) rather than attempting to "score." (hahaha - not funny).

By 2021, it is expected for Molly to be integrated as a primary therapeutic method for treatment of PTSD, Trauma and traumas.

Blended Talk Soup

When people share time and space together, there are many conversations exchanged, many topics explored, many requests made and many “important” things to be heard.  There are many petes and repeats.  There are many petes and repeats. WHAT?

“Talk and listening” dynamics between two people occur in between the spaces of life in which we work, in which we are parents, in which we are friends and in which we play.     When people are in relation with each other over time and when they live together, it can become hard to differentiate among varying levels of valued importance with respect to expression.

Much dialogue blends together into “talk soup.”  Talk soup can create difficulty in relationships because one person might feel like she makes a clear and prominent request or statement to her partner.  Meanwhile, her partner hears that request or statement like all the other “blah blah blah” talk that is mumbled in the background.  The partner will often not remember what is said because he doesn’t realize it is important in comparison to the other talk.  As a result, either he will not follow through, or he will do or say something that reveals his not “remembering”.  Then he will get blamed for not being emotionally available, present or a good listener. 

The salient dynamics and aspects of talk need to be highlighted.  Time needs to be paused in communication and extra focus of attention needs to be brought to the ingredients of conversation that are important to bring attention.  A space for memory retention needs to be created. 

Digressing from the soup analogy for a moment and using a ‘season’al metaphor of another variety. . hot summer days might blend together into our memories.  If however, it hails on a given summer day and golf size ice balls fall to  ground, one will remember that day standing out in mind. . . .especially if one gets hit in the head . . .hahahah..  It’s not that we are that dense as human beings, not all the time anyway  . . . .lol . 

And it’s not that people aren’t good listeners or forgetful.  Sometimes those variables are the case, but often when an aspect of conversation gets missed, it’s equally the talker’s fault as the listener is to blame.  It is the talker’s responsibility to bring focus to the salt and pepper of talk soup.  If she doesn’t bring focus, by presenting the “Salient” and “Prominent” points, they will not be noticed.  It will not be remembered that these condiments are there or that they can or should be used again in the future.

If you take a look around you with your ears, you will begin to hear all the mundane “jibberish” people mumble.  So many of us fill minute after minute, hour after hour  with this opinion and with that opinion.  There is something to be said about her, some gossip to be had about him, a mumble about the colleague, a grunt about time of day, a complaint about the chores etc etc. .  The frivolous chit chatter becomes the blended talk soup that by default gets tuned out.

As the expression goes, “be impeccable with your word.”  In the literal sense of interpretation, this saying means to be honest.  I would suggest that being impeccable with word also means to selectively choose what you want to talk about, what is important to focus on and the impression you want to create of who you are and what values you have in the world.

Aside from choosing words that reflect who you are and/or who you want to be in the world, how you want to think and interact, it is also important to choose words that matter and are significant.  Each word, sentence and thought is external clothing of your soul.  Chicken Soup?  Hmmm.  Next time you open your mouth, ask yourself if you are sharing an ingredient that is worth digesting and mentally or emotionally ruminating on.  Is the flavor sweet?  Sour?  Bitter?  A wasted more’sal’???

Talking and filling time with chatter is often an external manifestation of internal attachment issues to other and/or existential relationship to purpose, reality and being. Furthermore, when one fills time with excessive talk, it often results in that person being less and less heard.  This tuned down volume results in the person talking even louder and it becomes a perpetual cycle of muted ingredients, all flavors simmered to blah blah blah blah.

Anyway, I guess selectively pruning all talk is a philosophical idealistic approach to communication – but remember when you can. . . . to pick and choose your word ingredients carefully – remember that slowing down time to appreciate and notice talk flavors is an important measure.  Intensify voice, affect and or repeat several times back to back the aspects of dialogue that you want to stand out in someone’s mind and psyche so that your relationship doesn’t turn into a “bowl full of mush”  . . . .or a quiet old lady might unconsciously whisper hush.  

For talk soup and other therapeutic suggestions, visit www.edginglife.com

Relational Trauma Mapping: Neurological Trauma Activation Response

 The below neurological diagrams represent:

• cognitive thinking patterns
• association routes
• emotional parallels and
• responding pathways

Colored nerve cells and messaging routes overlay the maps.  The nerve heads are made up of neurons with dendrites radiating off of them in star like patterns.  The axons are the long tails exiting the neurons that are covered by myelin sheeths.  The brain's communication messages (in the form of neurotransmitters and electrical charge potentials) travel down the axon pathways and make jumps or synapses from one to nerve cell to another nerve cell.  The messages are received by dendrites.  A synaptic transmission is like making a phone call to a friend and having him/her pick up and receive the call.

Neurological Map A 

The un-triggered self responds to people and situations in neurological ways and directions that are not "activated."

The untriggered self is neutral of "ego related emotional charge." In this space, the person is able to be rational, objective and open-minded to new content and connected, growing shared interaction and experiences.

The new content and experience will be attached to, or filtered through pre-existing neurological frameworks in order for the new content to be anchored, remembered and accessible in the future.  As new content is attached to a pre-existing framework, it is made sense of through that framework (represented blue by the blue neurological road maps above) in the present and in the referenced/reflected future.

It is important to be in an un-triggered neuronal map zone for clear perspective of understanding and in order for true connection, emotional presence and shared building of experience to happen.

Or, as you will read more about below, if you are in a neuronally "activated" space (usually from Trauma, traumas, PTSD, adverse memories and difficult emotions), it is important to know your associated: cognitive thinking patterns, associative routes, emotional parallels and responding pathways such that your triggered neuronal pathways don't run your thinking, interactions and responses.

Even in an untriggered neuronal zone as seen in "neurological map A," the neurological map of the receiver isn't always aligned with the latitude and longitude internal reference grids of the presenter, and a discrepancy in communication may occur as mental GPS coordinates are askew. 

Discrepancies often do not cause relational friction in the moment.  Discrepancy or "miss-communication" becomes realized at a later point in time due to a future exchange or revelation that references the original miss-connect, bringing the discrepancy into conscious awareness.

In an ideal world, conscious relational discrepancies or internal discrepancies should be explored as to where the possible erroneous neurological interpretation routes occurred.  Curious investigation and solution finding with respect to miss-communications will decrease patterns of friction and fighting.  This answer seeking is important to do because the dynamic of friction doesn't even involve activated triggers yet.  It is simply a matter of different mental internal imagery associated to shared language.

 Neurological Map B

When people intensely react, get triggered, emotionally reactive and/or charged, it is usually because something in the environment, event, transaction, talk, facial expression, tone, content etc. opens up a neurological network response of trauma, PTSD, or previously emotionally charged content of neurological patterns within the brain.  This trauma network response can be seen by the red neuronal responses to the trigger activator.

Neuronal pathway responses resulting from a "trigger activation" might include associations directly or indirectly related to the present environment (including people).  Regardless of how directly correlated the internal neuronal memory events  are with respect to the environment,  or perception of the environment, when Neurological Map B is activated, the response results in an increased affect response to the present environment usually manifesting in withdrawing and/or attacking.  These pull and push emotional directions are related to trauma activated tangential thoughts, memories, emotional states etc.

As you can see in the two diagrams, the neuronal response pathways between an untriggered response and a triggered trauma response are very different.   When Neuronal Map B is activated from an external stimuli or perceived external stimuli, connected and paralleling neuron bundles of association and trauma memories get elicited from a resting section of the brain into conscious awareness.  

Unless conversation is paused between two people and time is allotted for exploration of neuronal connectivity trauma associations, Neurological Map B will often result in relational friction. If it is difficult for the receiver to identify his own triggered neuronal associations, obviously, it is also difficult for the presenter (not that it his responsibility though it is supplementary form of loving - to help a partner identify his trauma neurological triggers).

There are times when a presenter will be able to identify a trauma activated neuronal pathway map of the receiver without the receiver knowing that he is being triggered.  As one might imagine, it takes artistic cognitive skill to lovingly guide the receiver into self-exploration and trauma mapping identification of associated memories and emotions affecting current activated response.

If one is aware of his internal body or mental cues (increasing heart rate, feeling hot, anxiety vibrations, starting to say mean things, malicious or destructive thoughts etc.) that signal increasing reactivity resulting from neurological trauma trigger activations, it is important to slow communication down in order to get off the platform of Neurological Map B and red associative synapses, allowing for return to a blue map of untriggered response. This slowing down is important in order to gain awareness of the trauma triggered response whether in communication with other or by the self.  Awareness will decrease the intensity and duration of Neurological Map B responses at future points in time.

 Once trauma neuronal patterns and pathways are recognized, it is easier to stay connected in relationships and or the surrounding environment because requests and/or internal or external adjustments can be made with respect to the situation that has activated the trauma response. This neuronal concept of activation is similar to the way the immune system of the body works.  When a pathogen enters the body, the body detects it and activates B cells, T cells, macrophages, lymphokines etc.

With respect to the immune system, if preventative steps are taken in order to avoid the acquiring of a cancer or pathogen etc. it is a much easier route rather than if resulting steps are needed to deal with the cancer manifestation.  These ladder steps often include chemo therapy, radiation and/or surgeries.  The same concept can be applied to Neurological Map B trauma activation in that it is easier to preventatively contain trauma activation than it is to deal with relational metastasis and the necessary repairs.

Neurological Map C

Just like Neurological Map B came with it's own internal response pathways associated with an environmental event or perceived environmental event, Neurological Map C has it's own internal response activation pathways that look, respond, act and feel differently from the B activated response.  The two examples: B and C neurological responses demonstrate that the same person can be triggered by different stimuli "trigger activators" and as a result, two very different neurological activation responses can occur, each with a unique set of memories, emotions, thoughts and responses.

One can do much individual trauma therapy healing involving awareness of B and C Map routes and  strategies of returning to Map A.  This stated, unless one works through traumas of the self with respect to how the they get interpersonally triggered and activated in a relationship, all the individual trauma work in the world will not help share love and lives with another person.  This fact may or may not be an issue for someone.

The biggest difficulty surrounding relational trauma activation arises when two individuals have trauma roads that overlay each other and both people become simultaneously ungrounded and blinded to self and other's trauma activation process resulting in unchecked triggers and escalating friction with no insight to put on the breaks.  This dual trauma activated dynamic can be resolved, it just takes time, effort, wisdom and dedication to reach a shared vision/goal.

Building of trust between people is formed through the understanding and mapping of neurological trauma maps.  Whether both partners are involved in the trauma mapping process or one partner becomes self aware of the interpersonal triggers that get neurologically activated, the conversation can be directed, redirected and re-routed as to help the person and the dynamic return to functioning on untriggered map A.

Aside from Neurological maps A, B and C, when addiction of any kind is involved, the person and/or interchange is not even about whether or not someone is activated via Neurological Maps B or C, and there is certainly not an ability for the person to think, act or interact on the untriggered neurological map A.

A person's who is actively engaged in addiction has a neurological system that operates on an entirely different switchboard from A, B or C.  Once that addiction switchboard is turned on, the neurological platform A has been "hijacked" and "slimed."  On some level, an addict has made the decision to no longer operate using life's neurological maps. Therefore B and C don't even exist.

To repeat, when in the state of ADDICTION, the self has been hijacked.  For an addict to connect with his true untriggered self and his trauma mapping routes B and C (which are the result of being alive +/- intensities of traumas), he must first reset his addictive neurological routes by clearing out the addiction.

Therapy related videos

Youtube Videos

Listen and watch some of Lily's perspectives on counseling related issues, family therapy solutions, relationship difficulties, trauma based solutions and life concepts via the above youtube link to gain a better sense of her therapeutic philosophy.

Lily Kotila, Marriage and Family Therapist works at San Diego Therapy, located in downtown La Jolla, California.  She focuses on marriage couples counseling and relationship counseling issues.

As a psychotherapist, Lily also addresses a myriad of individual therapy problems related to: trauma therapy counseling and PTSD therapy treatment which includes EMDR therapy. She has designed her own PTSD trauma therapy coaching referred to as NSI or Neuro-Somatic Integration.  It circumvents trigger talk which can activate a cortisol stress release related to the parasympathetic nervous system response.

Switching therapeutic topics, anxiety treatment counseling and therapy for depressive symptoms help to shift people into more calm and happier states of being and wellness.  Lily guides you with these processes.

Cognitive behavioral hypnotherapy is a powerful alternative therapy to talk counseling in terms of accessing the unconscious for purposes of re-scripting life story lines, gaining new perspective on relational dynamics and making sense of the past. Cognitive behavioral hypnosis transcends false rational ego constructs that have formed over the years.  Guided hypnosis also helps to provide secure grounding, synthesis of life content and awareness of self presence such that power and conscious choices become the underpinning of future directed movement (in comparison to being run by unconscious beliefs that cause the manifestation of the exact opposite of what you truly desire in life).

Lily also provides addiction therapy to help treat alcoholism, substance abuse counseling for alcohol dependence and therapy coaching for drug addiction issues.  She teaches aspects of non-violent communication to help with anger management issues and therapy for domestic violence problems.  Lily will fill out any court related therapy documentation pertaining to court ordered therapy and/or write personal request letters documenting therapy experience for people involved with probation cases and or other legal issues.

Aside from mental health therapy focusing on relationship coaching and individual counseling, Lily also works with family dynamic issues and co-parenting therapy skills training to optimize functioning of blended households, thus creating an ideal scenario for the child.

Lily provides therapy for teenagers and pre-teenagers who are dealing with family adjustment issues and social bullying.  Therapy for peer related difficulties and social skills coaching are provided, as well as counseling for academic difficulties.  Therapeutic suggestions related to IEP management and support are provided to teachers and school counselors. 

Again, to get more of a personal feel for Lily Kotila's therapy style and outlook, click on the link below.

Youtube Videos

DIY Emotional Freedom Technique

EFT Exercise

1.     Pick one issue in your life that you want to address today.  Write down @3 primary phrases that describe the problem. 

2.     What is the worst part about the life issue? 

3.     What is the negative belief about yourself you associate with this issue even though it isn’t really true?  (See list).

4.     If you gave this issue a “movie title,” what would you name it?

5.     What emotion do you feel? 

6.     On a level 1-10, 10 being the most intense, what emotional level are you with respect to the issue?

7.     Where in your body do you feel this emotion?  And/or if you don’t feel the emotion anywhere, take a moment to picture the life issue in your mind and then check in with your body.  Notate the first place in your body that calls your attention.

8.     Repeat the below phrase 3x while tapping on the outer side of hand

9.     “Even though, I (fill in the blanks with direct phrases from (#1, #2, #3, #4, #5, #6), ______________________, _______________________I truly and deeply love and accept myself.”  (Each repeat will be slightly different. This is ok.)

10. Do 1 somatic round of tapping on the acupressure points while repeating only the ____________________ , ________, _______________ (aspects of 1-7).  Omit the expression “Even though….. ” bold phrases of #9.

When 1 somatic round is done:  “Take a deep breath. Inhale and exhale, letting go of any tension in the body.   What do you notice now?  What number is your emotion?”

11. Identify the mental focus and emotional level of that somatic round and any new content that has arisen.  Repeat new content and/or previous content in the next EFT somatic round.

12. Continue to repeat EFT somatic rounds of tapping until the emotional number is down to 0-1. 

13. Have the client re-scan the “movie title” and all associated thoughts to make sure there are no missed energetic pieces.  Again, the number should be 0-1.

www.edginglife.com 
(619) 750 2218

Women and Anger Perceptions

Firm stance and anger expression. The conditioned female distortion of self view resulting in disempowerment of voice.

 Irregardless of whether or not women are angry, when they stand their ground and are firm with respect to an issue, they often reflect on their expression as being  mean, rude, abrasive or something of similar. 

Their 'internal perspective' of self is often not congruent with an outsider's experience or 'external perspective' of the same behavior. This discrepancy of affect interpretation is more easily noticed when the listener's personal ego isn't affected. Needless to say when a listener's ego gets affected, s/he can easily contribute to escalating expressive states.

When "external ego of other" is left out of the emotional equation, within that neutral space following firm expression, women's self reflection is often negatively  magnified. Why does this happen? I'm not positive though I do have some ideas. Any thoughts?

One possible reason that the internal experience of perceived expression is more intense than it actually manifests (out of mouth/talk) is that it is colored by internal emotional processing, internal somatic response, and internal thoughts that create a more intense milieu leading to magnified perception. 

The variance of inner perception versus outer world manifestation with respect to being firm and/or the expression of anger may also be a more pronounced difference in women due to gender social conditioning.  US culture emphasizes the importance of certain female personality characteristics such as being demure and reserved, and erudite with subtle assertion, which could affect the way one judges inner world milieu and external expression as these states are unconsciously compared to cultural standards.

The variance of inner volume and outer expression of anger emotions by the presenter may also not be appropriately assessed by the self as the presenter is both inside of her being and outside of her being (expression) at the same time. Furthermore, the internal world is distorted from linear time in that it involves memories, future ideas and many imagined angles of perception.  Therefore when and if in reflection, it's hard to discern what energy magnitude actually exited the being versus what magnitude remained internal. 

I wonder what internal tools one might develop to help ascertain the intensity of expression versus what  is experienced within? Thoughts? Of course the talker can check in with the listener to gain a sense of expressed magnitude, but it is important to not rely on 'other' for perception and monitoring of self. Other than the importance of self regulation, inevitably, different listeners will have different thresholds of firm/anger acceptance levels. While somewhat adjusting for levels of firm/anger expression in terms of listener's acceptance variances, it is important to have an internal guage of the firm/anger self so that its expression can have continuity throughout life. With continuity both  through time and with respect to audience, a more accurate perception of self can be formed with baseline dependable levels. If one were only relying on external cues of 'other' to gauge external expression of firm/anger or in which to judge self, the emotional regulation and sense of a self foundation would be quite fickle.

Not to blame other or make them at fault for their anger thresholds or emotional carrying capacity levels and resulting reactivity, identifying an acceptable internal gauge and external volume range for firm and anger is a good guide to differentiating between what is considered "his/her stuff" versus "self stuff."

Anyway, with respect to women, who often have a tendency to emotionally beat themselves up for having a firm and/or assertive voice, it is important to gain understanding of "right sized view" of self in order to avoid anger compensatory behaviors in any dynamic.

Without anger compensatory behaviors, (emotional seeking of other's reassurance, being overly apologetic, dismissing of importance of request, being "sideways nice" to compensate for perceived anger expression etc) interpersonal or relational boundaries are formed and respect is elicited.

Furthermore, quieted and pacified or channeled anger by women often results in addictions  . . .addictions: to please,  to drugs, to food, to emotionally beating up of the self, to approval to passive aggression to manipulation.

So, if you are a woman and reading this post, it is advised that you accurately learn to assess the expression of your firm voice and your anger so that you free yourself of all the distortions, flagellation and unnecessary compensatory behaviors in life. .  . not to mention that adequate self view allows for presentation and existence of full inner wisdom and power.