Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

Hello! Dr. Jill Levitt and I have an amazing full-day CE workshop on changing core beliefs coming up in a few weeks. If you've ever struggled with Perfectionism, Perceived Perfectionism, or the Love, Achievement, or Approval Addictions, you're going to love this all-new workshop called The Deeper Dimension in CBT. Sign up now at CBT-Workshop.com. 📅 Friday, April 24, 2026 🕛 8:30 AM – 4:30 PM PT CE Workshop for Therapists $195 Register Here: CBT-Workshop.com This workshop will include new teaching and treatment techniques, and we'll go much further than any previous presentations on Core Beliefs. Learning therapy is much like learning to ride a bicycle. You've got to get on and ride. Book learning won't help. That's why you'll work through your own Self-Defeating Beliefs during this highly interactive workshop. As you change, the tools for helping your clients will become crystal clear. We'll also answer the question: where do you go next once you decide to give up your Self-Defeating Beliefs? You'll walk away from this amazing workshop with concrete, easy-to-use tools you can apply in your very next therapy session and in your life as well. You'll also experience a profound and exciting shift in your personal philosophy.

#495 Stop Helping! Here's How. Featuring Thai-An Truong on Codependency Thai-An Truong, LPC, LADC is a Certified TEAM-CBT Trainer, Level 5 and loves sharing tools and processes to help other therapists feel more confident, effective, and joyful in their work with their clients. In her private practice in Oklahoma, she is passionate about helping people heal from past trauma and OCD. She also has a special interest in helping her clients improve their relationships and overall connection with their partners and loved ones. We often hear the word, co-dependency thrown around. Today's podcast will be unique: you'll hear a totally brilliant and lucid explanation of how to treat it within the TEAM CBT model. It will be explained and illustrated with role-playing demonstrations by Rhonda and Thai-An. These demonstrations are fantastic! You'll love them! But let's start with what codependency is. I'll give you my take on it first, as my understanding has been based on observation. I see it as the compulsive urge to help another person who appears to be hurting or struggling. Well, that's nothing wrong with that, for sure! But where it gets yucky is where there is an ongoing pattern of helping, followed by stuckness on the part of the person who is hurting, ending up with both parties feeling frustrated and angry. We've talked about this general topic a great deal on the show, and in fact, TEAM CBT emerged as a radical alternative to the compulsive, codependent "helping" we often see in the community of mental health professionals. And we've seen this too, among parents and their children. Rhonda and I have done many podcasts on the topic of "How to Help and How NOT to Help," (for example, #164: https://feelinggood.com/2019/10/28/164-how-to-help-and-how-not-to-help/). And we've done many, including a great recent podcast with Dr. Taylor Chesney, on how parents can talk to teens and children without trying to control or scold them—by forming a warm and respectful relationship, using the Five Secrets. According to a Google search, codependency involves "excessive emotional or psychological reliance on a partner, often characterized by neglecting one's own needs. The four main types of codependency are the Caretaker, Enabler, Controller, and Adjuster. These roles represent different ways individuals, often with low self-esteem, sacrifice their well-being to manage relationships." To get things started, Rhonda and Thai-An discuss he various definitions and meanings of co-dependency. Thai-An described an attractive woman she treated who ended up with an alcoholic man who gave her very little in terms of healthy emotional support or love. But she told herself, "He's the only one who's there for me. , , I won't be able to find anyone else." There's also a strong dimension of "I NEED to fix this person," as opposed to asking if they need help, and deciding whether you can actually meet their need. They also pointed out, with example, that "throwing help at people" (as I call it) actually forces them to resist. They talked about the shame involved in codependency, and then illustrated Option B: TEAM -CBT, where empathy is always a crucially important first step. Then you can move to the Triple Paradox, to help the codependent patient illuminate three crucial motivational pieces: Column 1: The positive rewards of trying to "help" this person. Column 2: The downside of changing and giving up this pattern. Column 3: What your codependency shows about you and your core values as a human being that's positive and awesome. Then after listing 20 to 30 or more powerful reasons to continue acting in a codependent manner, you can ask them if it's working for them, or if they can think of any reasons to change. So, right away, you are modeling a totally anti-codependent way of "helping" your codependent patient. Only then, if the patient can convince you that they really do want help, Thai-An and Rhonda modeled some kick-ass M = Methods that can be incredibly helpful, including, but not at all limited to: The co-dependency Double Standard Technique. The role play with Rhonda and Thai-An was eye-opening and jaw-dropping! The Devil's Advocate Technique when tempted to "help." The Decision-Making Tool The Externalization of Voices And many more. I want to thank you, Thai-An, and you, Rhonda, for a truly phenomenal podcast today. Awesome work! From Rhonda: Speaking for me and Thai-An, it was our pleasure and honor to be on the podcast with you David! And always a pleasure to learn with the brilliant Thai-An, one of the most phenomenal teachers and trainers in the TEAM community.

What if the old techniques don't work now? What can I do if I'm boring on dating apps? How do I balance TEAM CBT with Life? Do relapses come from out of the blue? Carlos continues with his question(s) first addressed on last week's podcast. He'd recovered from depression using TEAM CBT, but had a question about how to challenge his negative thoughts during a relapse, as well as how to balance TEAM CBT with life. Plus a dating question from a man who's never had a date! Today's questions begin here. Should I use a brand-new CBT technique to help me overcome my current negative thoughts? I've been using my previous solutions (Exposure Therapy and Daily Mood Log) however, they don't seem to help out as much as they used to. How do I balance Team CBT and life? I've been having a difficult time finding the right balance between Therapy and Life. Whenever I strictly do therapy, I feel good, but then feel sad that I sacrifice other activities in order to do the therapy. Inversely, whenever I do activities (while only occasionally doing therapy), I feel conned by my anxiety and feel as if I can't enjoy doing my activities. Can you relapse despite having no apparent issues in life? I'm currently on Christmas break, without much pressure to find a job. Yet despite this, I'm feeling more anxious right now than I was in university! How is this possible? Is there perhaps a hidden emotion or desire that I'm not expressing? Regardless of how negative I feel right now, I'm doing my absolute best to stay positive and keep working on myself with Team CBT. I'm looking forward to resolving my anxiety with the help of your awesome tools! It was an honor speaking with you, thank you for reading! -Carlos David's Answer Great question, and I'll give you a (hopefully) great answer on the podcast! But here's the quickie answer. Focus on one specific moment when you'd like to be feeling happier, or when you need help to become the person you want to be. Then use a Daily Mood Log, Habit / Addiction Log (HAL), or Relationship Journal, depending on what's needed. This is the exact same fractal concept we use in all of TEAM CBT! Warmly, david I am overly sincere and boring on dating apps. What can I do to correct this? Michael writes: Hi Dr burns I am 30 and never dated anyone. Whenever I start chatting on dating apps I seem very boring or sincere person how can I talk to someone in this? Regards, Michael (disguised name)

What can I do if I relapse? Good Morning Dr. Burns, I will make this email quick, as I'm sure you have several other emails to read through. First off, thank you so much for your research and contributions to TEAM CBT! My mother introduced me to this form of therapy in 2022, and it has been a big help in overcoming my extremely painful perfectionism anxiety. Unfortunately, after graduating from university, I've begun relapsing once again. As such, I would like to ask a few things Carlos: (His remaining questions will be answered on Podcast 494.) Is it harder to get out of a relapse than the first time? I feel as if my relapse has been a lot trickier to get out of, despite the fact I have more tools and techniques. David's response. This depends entirely on whether you've done Relapse Prevention Training to prepare for relapses ahead of time. You can read all about it in the last chapter of my most recent book, Feeling Great. You can also learn about RPT on a number of podcasts, and even hear me doing it live with many individuals at the end of their personal work. Here are two examples randomly chosen among dozens I have published. 427: https://feelinggood.com/2024/12/16/426-ask-david-dreading-the-day-solving-mother-daughter-problems-romance-and-more/ 389: https://feelinggood.com/2024/03/25/389-the-story-of-amy-part-2-of-2/ And you'll a great many more if you look. Just use the search function on my website and you'll find a wealth of podcasts on RPT. Short answer: If you HAVE recovered and done RPT (takes 30 minutes) it will usually be much easier for you to smash your negative thought(s), using the same methods that helped you the first time. If you HAVEN'T recovered and done RPT, it may be much more challenging. Thanks for the important question, Carlos!

Download the incredible Feeling Great app today for FREE at FeelingGreat.com! This is my $99 GIFT for you. - Dr. David Burns

Meet the Fantastic—and Controversial—Dr. David Healy Psychiatric Drug Companies-- What Are They NOT Telling Us? Today, we are thrilled to interview the famed and courageous Dr. David Healy. I have admired his work for many years, but never imagined I'd have the chance to meet him and chat with him. First things first. You may know Dr. David Healy for some of his highly controversial books, like "The Antidepressant Era," "Let Them Eat Prozac," and "Pharmageddon." But who is he, really? According to AI, Dr. David Healy is a prominent Welsh psychiatrist, psychopharmacologist, and critic of the pharmaceutical industry known for his research on antidepressants, their links to suicide, and exposing industry practices like ghostwriting and disease-mongering, operating through initiatives like RxISK.org to promote drug safety. He has a long history of challenging Big Pharma, facing academic backlash (like losing a University of Toronto post) for his views, and serving as an expert witness in legal cases involving psychotropic drugs, advocating for greater transparency and patient safety. Healy initially worked with pharmaceutical companies, gaining firsthand knowledge of how SSRIs were marketed despite their trial weaknesses, focusing on the oversimplified serotonin hypothesis. He then became a vocal critic, highlighting issues like ghostwriting articles and manipulating academic opinion to sell drugs, leading to conflicts with industry-funded institutions. He founded RxISK.org, a platform for patients to report adverse drug reactions, aiming to make medicines safer. His strong stance (on research linking SSRI antidepressants to increased suicidal thoughts and urges) led to intense and corrosive controversy, including losing a professorship at the University of Toronto (though later settled as a visiting role) and harassment, noted here and here. In recent years, he has acted as an expert witness in cases involving drug-related suicides and homicides, bringing issues to regulators. In essence, Dr. David Healy is a significant, often controversial, figure dedicated to drug safety, academic integrity, and patient awareness in psychiatry, challenging established narratives and industry power. Taking a deeper dive, AI has added this critically important information: David Healy has discussed numerous examples of conflicts of interest that mainly involve the influence of the pharmaceutical industry on medical research, publication, and practice. Key examples he has highlighted include: Ghostwriting of Articles: Pharmaceutical companies hire medical communication firms to draft research articles or reviews, and then get prominent academics or clinicians to put their names on the papers as the sole or primary authors, a practice known as ghostwriting. The named authors often have little to no involvement in the actual research or writing. Hiding or Misrepresenting Data: Drug companies have concealed unfavorable data or miscoded raw data on drug risks, such as the link between antidepressants and suicidal acts. This manipulation can make a drug appear safer or more effective than it actually is. Biased Clinical Trial Design: Healy notes instances where clinical trials are designed with "tricks," such as using inadequate or excessive doses of comparison medications to make the company's own drug look superior. Marketing-Driven Education: A large portion of continuing medical education (CME) classes for doctors are sponsored by industry. Healy argues this leads to a bias in the information presented to doctors, with an emphasis on the benefits of brand-name drugs rather than an objective assessment of all treatment options. Gifts and Payments to Physicians: Drug companies spend billions annually on marketing directed at doctors, including free samples, sales visits, and small non-educational gifts or lunches. Healy points out that while many doctors believe these gifts don't affect their own prescribing, studies show they influence prescribing patterns and create subtle biases. Industry Influence on Academia: Healy's own experience with a job offer being rescinded at the University of Toronto, which had received a large donation from a drug company (Eli Lilly), is a prominent case he uses to illustrate how industry funding can infringe upon academic freedom and stifle critical research. "Disease Mongering": Healy argues that the pharmaceutical industry often engages in "disease mongering," marketing conditions to the public and physicians to create a market for their products rather than simply addressing genuine medical needs. So that hopefully gives you some idea of the scope of his work, and his vision of transparency and integrity in the reporting one the effectiveness and risks of psychotropic medications. In our conversation today, he emphasized the importance of listening to patients who describe side effects of medications, such as SSRIs, in described the efforts of Big Pharma to suppress such complaints, giving psyc

Ask David, #491, featuring our beloved Dr. Matthew May. Can Introverts be helped? How can we enhance our happiness? What's the best movie to watch if your father rejected you? How can I identify my feelings? The answers to the first two questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question. Today's Questions Anonymous asks: Can an introvert become more extroverted? Or are these personality traits "fixed" and unchanging? Seve asks: I know that TEAM can be super helpful for negative thoughts and feelings, but what are the best tools to enhance happiness and become the person we want to be? I have a patient whose father rejected her when she was young. What would be a good movie that I could recommend for her? Anonymous asks: I don't know how to identify my feelings. Can you help? Today's Answers Question #1 Anonymous asks: Can an introvert become more extroverted? Or are these personality traits "fixed" and unchanging? Dear Dr. Burns, I hope this message finds you well. I would like to ask you a question regarding personality traits. Some articles suggest that introversion and extraversion are relatively stable characteristics—meaning that an introverted person cannot truly become more extroverted, and vice versa (or at least not to a great extent). They also propose that introverts tend to lose energy in social situations and recharge when alone, whereas extroverts gain energy from social interaction. I'm very curious to know your thoughts on this topic. Do you believe an introverted person can become more extroverted? And in your view, is an introvert's need for solitude more of a true "need" or a "want"? Thank you very much for your time and for the inspiration your work has provided to so many of us. Warm regards, Anonymous David's reply If you like, I can make this an Ask David question for an upcoming podcast! It's a cool question and raises many questions: Do "personalities" even "exist?" Is this like the question, "Do we have a self?" It also focuses on the issue of whether we can change and grow, or whether there is some invisible barrier beyond which we can grow any further, due to some inherent "limit" due to our "personality type." Best, david Question #2 Dr. Dear David: I know first-hand how helpful TEAM CBT can be to address negative thoughts and emotions but our path to a happier life and to the person we want to be never really ends. Are there any other tools that Dr. David may have come across and can suggest for someone's growth? Thank you, Steve David's Answer Great question, and I'll give you a (hopefully) great answer on the podcast! But here's the quickie answer. Focus on one specific moment when you'd like to be feeling happier, or when you need help on become the person you want to be, and then use a Daily Mood Log, Habit / Addiction Log (HAL), or Relationship Journal, depending on what's needed. This is the exact same fractal concept we use in all of TEAM CBT! Warmly, david Question #3 Hi podcast crew: I have a patient whose father rejected her when she was young. What would be a really good movie to recommend do her? David's Answer Sadly, I lost my notes from this podcast, but in general David and Matt found this question somewhat offensive, as it suggests you can chase a problem (father rejected me) with a method, in this case recommending a good movie. We, instead, would recommend TEAM CBT, which is real therapy, and not gimmicks. Movies can be rewarding, but that's not the same as effective therapy! Rhonda asked David and Matt what was wrong with recommending a movie in the same way we recommend books for clients to read. Have a listen to hear their response. Question #4 Anonymous asks: I don't know how to identify my feelings. Can you help? David's Answer Rhonda said one of her clients could not identify their feelings, unless they have the Feelings Chart in front of them. David thought that anyone could identify their feelings and explained. One simple way is to identify a specific moment when you were upset and wanting help. Think about what was going on, who wee you with, where were you, etc. Then review the Feeling Words charts, which I will link to, to see how many, and which ones, resonate with how you were feeling at that time, or how you may still be feeling. Feeling Words Chart with Five Secrets, v 2 Another way is to draw a Stick Figure of yourself, and put a bubble above its head. Then imagine the Stick Figure is upset and put the Stick Figure's negative thoughts and feelings in the bubble. They don't have to be your feelings and thoughts, just make some up. Do it now—on paper! DON'T just think about it. That never works! Have you done it yet? No? That's what I suspected. If you ever DO want the answer to your question, so the stick figure on paper and then write me back. Thanks! Finally, you can listen to the podcast on "I Feel" Statements, and spend one week telling five people a day how you feel

Sexting, Bullying, and Social Media-- A Compassionate, Practical Guide for Parents of Teens Today, we welcome back one of our favorite guests, Taylor Chesney, director of the Feeling Good Institute in New York City. Taylor specializes in TEAM-CBT with children and adolescents and brings a rare combination of clinical expertise and real-life wisdom as the mother of four. Parents everywhere are worried about social media, sexting, porn, bullying, and the fear that their kids are doing "who knows what" behind closed doors. In this episode, Taylor offers a refreshing and deeply practical message: the solution isn't better apps, stricter rules, or surveillance—it's connection. Why Blaming Technology Misses the Point Teen brains are still developing. They're impulsive, thrill-seeking, and wired for belonging and validation. Give teens instant access to peers and social media, and mistakes are inevitable. Taylor emphasizes that technology itself isn't good or bad—it amplifies what's already happening in a teen's emotional world. The real question isn't how to eliminate technology, but how parents can guide kids in using it safely and thoughtfully. The Real Protective Factor: Communication Parents often ask, "What app should I install?" or "How do I stop this?" Taylor suggests these questions lead to dead ends. What truly protects teens is a relationship where they feel: understood rather than judged supported rather than interrogated safe coming to parents after a mistake As Taylor explains, for most teens it's not if they'll face a difficult online situation—it's when. The goal is to make sure they come to you when it happens. How to Talk So Teens Will Open Up Using the Five Secrets of Effective Communication, especially the Disarming Technique, parents can shift from policing to coaching. Instead of: "Why were you on your phone?" Try: "Help me understand what was going on for you." This approach reduces secrecy and increases trust. Porn, Sexting, and Shame Discovering porn or sexting can trigger panic and anger in parents—but shaming almost always backfires. Taylor suggests responding with curiosity and empathy: "What was that like for you?" "What do you understand about the difference between porn and real intimacy?" Sexting often begins innocently—seeking connection, validation, or closeness—but once an image is sent, control is lost. Open conversations help teens think ahead without feeling judged or controlled. Parents can also teach teens simple, self-respecting responses like: "I care about you, but I don't need to send that to prove it." Bullying and Online Drama Online bullying mirrors real-life dynamics—but faster, more public, and more permanent. Taylor shares concrete skills teens can use: Pause before responding Don't engage when emotions are high Exit or mute toxic chats Involve an adult early Helpful phrases teens can practice include: "This chat is getting mean—I'm stepping out." "I'm not comfortable with this." "Let's take a break." The Big Takeaway Mistakes—by teens and parents—are inevitable. The real danger isn't errors; it's secrecy. When kids know they can come to their parents without fear of shame or punishment, they make better decisions and recover more quickly when things go wrong. As Taylor puts it: "The kids with the best relationships with their parents make the best decisions." Thanks for listening, and heartfelt thanks to Taylor for this wise, compassionate, and deeply reassuring conversation. — David, Rhonda, and Taylor

Download the amazing Feeling Great app today for FREE at FeelingGreat.com! This is my $99 GIFT for you. – Dr. David Burns

Meet Richard Lam-- Master TEAM CBT Teacher and Therapist! Today we chat with Richard Lam. Richard is a licensed Marriage and Family Therapist in private practice in Mountain View, California. He is a graduate of Palo Alto University. He currently provides short-term therapy for anxiety, OCD, habits/addictions, depression, and relationship concerns using Cognitive Behavioral Therapy. Richard also trains other therapists in David Burn's model of CBT called TEAM-CBT Therapy. He is a certified Level 5 Master Therapist and Trainer in TEAM-CBT Therapy. And today, Richard has gifts for you! They are fantastic! See below! I began by asking Richard how he got interested in teaching. When he was first learning, he was tutored by Dr. Angela Krumm, an advanced TEAM CBT practitioner and one of the three founders of the Feeling Good Institute. He was loving the training, but one day she said, "That's all I can teach you. Now you have to start teaching!" And that started the wagon rolling down the hill. Richard is particularly interested in developing free self-help tools for patients, but also runs a special training class for TEAM CBT therapists who themselves want to become trainers. It meets in-person at the FGI office on Mondays from 12 to 2 PM. If interested, contact Richard (contact information is at bottom of show notes.) Richard is one of our most articulate TEAM CBT teachers, and is renown for some of his live demonstrations of specific techniques, like Forced Empathy. He has created a series of multi-page interactive teaching guides for a variety of techniques, so you can learn exactly how to do the Double Standard Technique, or the Externalization of Voices in a simple, clear, step-ty-step manner. Here are links to several examples. Check them out and feel free to share them with your patients if you are a TEAM therapist. These links are all kick ass! Check them out and do the exercises. You'll be glad you did! Link to Double Standard Technique Link to Externalization of Voices Link to Externalization of Resistance Link to I Feel Statements, Part 1 Link to I Feel Statements, Part 2 Link to Feared Fantasy Link to Forced Empathy Link to Forced Empathy Handout Link to Future Projection, for Habits Link to Paradoxical Ultimatum Richard tells us that mental health works a lot like physical health. When we don't regularly care for our bodies, things start to deteriorate and the same is true for our minds. These tools give you a way to keep nurturing your mental health so you can maintain a strong, healthy mind. Richard and I also discussed Acceptance--one of the most difficult concepts for patients and therapists alike to "get." I was delighted to learn he has a five-point plan to help people grasp this concept. Richard's Five Steps to Acceptance 1. The Win-Win Principle: How can I see this loss as a win? In high school, Richard had a patient whose heart was set on making the varsity basketball team, and was heartbroken when he only made the junior varsity team. But then he got to thinking that it would be fun to be the start on the JV team because his best friend is also going to be in JV. He relaxed and started to enjoy his practices with the team. And He was promptly promoted to the varsity team! 2. Remember the butterfly effect! Richard described getting angry and frustrated when he was late for an important appointment, and the car in front of him was moving slowly and caused a delay at a red light. His first impulse was to get angry and insist it SHOULDN'T have happened. But then, in reflection, he thought: "Wait a minute. This delay will change the entire trajectory of the rest of my life. And who knows, this could have save my life from some future tragedy if the trajectory of my life had been on time." 3, Growth mindset I have always thought of this important idea in simple terms. There is really no such "thing," from a Buddhist perspective, as "success" or "failure." These are just experiences. But often things do not turn out as one hoped. Instead of caving in, giving up, or feeling depressed or frustrated, although those are perfectly reasonable human experiences, you can accept your failure and view it as an opportunity for growth and learning. Our 9 month old grandson has reminded me that when we are learning to walk, we "fail" constantly, falling over, etc. But these are steps in learning that eventually culminates in the ability to walk--which is a miracle! 4. The spiritual view Acceptance can be thought of as letting go of judgement. Richard treated a woman who was angry at God because she could not have children, and she had always dreamed of having a big family. But from a medical perspective, her anger and constant agitation were actually the main reason she couldn't get pregnant. Shen she began working on reducing her anger using TEAM CBT, she was able to relax, and accept her fate with greater in peace. And then she suddenly got pregnant! I, David, have seen this on many occasions. Check out Po

Let's face it. We ALL procrastinate. Attempts to "help" nearly always backfire. Dr. David Burns gets it. Procrastinators don't want help — they want something that actually works. In his upcoming free webinar on February 25, Dr. Burns introduces his paradoxical approach and ten powerful TEAM CBT tools that deliver results. Sign up now at FeelingGoodWebinar.com. Everyone is welcome! Therapists can purchase two CE credits if they attend the live event. See you there!

(featured photo shows David, his wife Yvonne, and son, Joey, when young) Meet the Incredible Dr. David Antonuccio, Part 2 of 2 Shrink, Songwriter, and Hero Today we continue our conversation with my dear friend and esteemed colleague, Dr. David Antonuccio, a true scholar, clinician, researcher, musician, and champion of scientific transparency. The Nicotine Patch Study David revisited his landmark research on the nicotine patch, a costly trial involving roughly 600 participants who were randomly assigned to receive either a real nicotine patch or a sham patch. The goals were to assess safety and efficacy. The safety data looked reassuring. However, the efficacy findings were unexpected: the placebo patch worked just as well as the active nicotine patch in reducing smoking. The sponsoring company published the safety data but refused to publish—and refused David access to—the efficacy findings, which showed no advantage for the nicotine patch. You can check the link to the NEJM article here. David writes: "Notice the 48 week follow-up data were excluded in this paper despite the fact that they were available. That really annoyed me. I also now believe that the original version of the paper was ghostwritten and ghost analyzed by the industry folks.in other words. I'm not sure that the authors ever had access to the "raw" data before they were analyzed." This was important because there was a decrease in smoking DURING the study among those wearing the patch, and getting their "fix" of nicotine that way. . . but what happened AFTER the study? David writes: "Here is the link to the follow up paper that emphasized efficacy and included the 48 week follow-up data." Notice that this paper was not published until three years later, when the Nicotine Patch had already been heavily advertised and sold on the market. This early experience in his career revealed the tension between marketing interests which focus on sales, and scientific interests which focus on truth and transparency—a daunting and frustrating pattern that would emerge again and again in his career. Expert Testimony in a Tragic Criminal Case David then described expert testimony he provided in a deeply troubling legal case. A 72-year-old woman, happily married for 50 years and a respected kindergarten teacher, had recently been prescribed Paxil, along with Ambien and Ativan. She abruptly, and without memory, woke up in the middle of the night and stabbed her husband 200 times and was subsequently arrested for homicide. There was no jury trial; instead, a plea bargain was used to determine sentencing. Dr. David Antonuccio was called as an expert witness in her defense. He described Dr. David Healy's research documenting a significant increase in both suicidal and violent urges among some patients taking SSRIs, especially Paxil. He argued that this woman's bizarre behavior was consistent with a drug-induced dissociative or fugue state. Based in part on David's testimony, the charge was reduced to manslaughter, and the judge sentenced her to time served, allowing her to return home to her children. For more on this topic: David Healy's Research on SSRIs and Homicidal Urge SSRIs Called on Carpet Over Violence Claims Black Box Warnings and Patient Rights David also emphasized the urgent need to revise Black Box warnings to reflect the full range of possible toxic or dissociative effects of psychiatric medications—not just suicidality. He has long advocated for a Patient Bill of Rights to ensure scientific transparency and informed consent. A Surprising Conversation with Dr. John Nash David shared a fascinating personal story about calling Dr. John Nash, whose life inspired the award-winning film A Beautiful Mind. In the movie, Nash's recovery from schizophrenia is portrayed as medication-dependent. However, Nash told David directly that this was not true—the medication narrative was added to the script, possibly out of concern that portraying his recovery without meds might discourage viewers from taking prescribed medications. Nash said: "What saved me was the support of family and friends." Music, Truth, and "Buzz" David is also a talented songwriter. One of his songs, "Buzz," addresses the emotional and ethical issues surrounding electroconvulsive therapy (ECT). The inspiration came from a man in the Midwest who was legally ordered to undergo ECT against his will. A widespread public outcry ultimately convinced the judge to rescind the order. Forgiveness and "In the Air Tonight" One of David's favorite songs is Phil Collins' "In the Air Tonight," which he sees as a deeply spiritual musical meditation on forgiveness—a theme David considers one of the most powerful psychological forces we possess. David explains that the Phil Collin's song is about forgiveness, but more indirectly and specifically about the songwriter's inability to forgive. And yes—David sang it live for us on the podcast! You might be interested in this chapter that David coauthored on

Stories from a Giant and Gadfly Discover the Protest Music of RainFall!-- like "The Antidepressant Blues!" Today, we are delighted to spend some time with a dear friend and highly esteemed colleague, Dr. David Antonuccio. David is a retired Clinical Psychologist and Professor Emeritus in the Dept. of Psychiatry and Behavioral Sciences at the University of Nevada, Reno, School of Medicine. In addition to his academic work, David had his own clinical practice for 40 years. He has published over 100 academic articles and multiple books, primarily on the treatment of depression, anxiety, or smoking cessation. Since his retirement from practice in 2020, he has been making music as part of a duo called RainFall, with his musical partner Michael Pierce. Their music can be found on Spotify, Apple music, and Soundcloud, among other streaming services. I first became familiar with David when a colleague recommended his article entitled: "Psychotherapy versus medication for depression: challenging the conventional wisdom with data," which was published in Professional Psychology: Research and Practice way back in 1995. The article blew my socks off. In the first place, he had come to the many of the same conclusions I had come to, that antidepressants had few "real" effects above and beyond their placebo effects. However, he also had incredible insights into some of the problems and loopholes with drug company research studies on antidepressants, so I tried to get as many colleagues and students as possible to read that article. Here is the article link Although I had never met David, he became my hero. One day, while I was giving one of my two-day CBT workshops in Nevada, I was singing his praises and urging participants to read that classic article, but, unexpectedly, some people started chuckling. At a break, I asked someone why people had been laughing. They said, "Didn't you know that David Antonuccio is here attending this workshop? He was out visiting the bathroom when you were singing his praises, so he didn't hear you!" And that's how we met! I couldn't believe my good fortune in meeting this brilliant and humble man in person. And to my good fortune, we became good friends right off the bat and eventually did a lot of fun professional work together, like our exciting conference challenging the chemical imbalance theory of depression which we called the Rumble in Reno. I was also proud to be included as a co-author in a popular article with David and William Danton reviewing the brilliant work of Irving Kirsch. Kirsch had re-analyzed all the data on antidepressants in the FDA archives and concluded that the chemicals called "antidepressants" had few, if any, clinically significant effects above and beyond their placebo effects. In that paper, we also emphasized the ongoing power struggle between the needs of science and the needs of marketing. Science is devoted to discovering and reporting the truth, based on research, regardless of where it leads, while marketing, sadly, is ultimately loyal to the bottom line, even if deception is required. Here is the link to our article: And here is the full reference: Antonuccio, D. O., Burns, D., & Danton, W. G. (2002). Antidepressants: A Triumph of Marketing over Science? Prevention and Treatment, 5, Article 25. Web link: http://journals.apa.org/prevention/volume5/toc-jul15-02.htm I was sad when David retired from his clinical, teaching, and research career a number of years ago in order to spend more time on creating and recording music because, a passion he'd put on the shelf during the most active years of his career. I felt we'd lost an important and courageous leader in the behavioral sciences, and felt an emptiness, like an important pioneer was suddenly missing. The following link provides a highly readable brief overview of David's career focus and interests. I was thrilled to learn just recently that David has partly resumed his role as gadfly of the behavioral sciences, rejoining the fight for science, ethics and for truth, regardless of where that leads or whose feathers are ruffled. And now, we sit down together to reminisce about his personal life and experiences with many of the greats in our field, like Dr. David Healey, Irving Kirsch, and others who have also stood up for the truth, based on their research, in spite of intense opposition from the establishment. And, today David also brings us his music, with his colleague, Michael Pierce, RainFall. Some of his music has psychiatric / psychological themes, like his "Antidepressant Blues," Some of David's music has humanistic and political themes. He said: Here's a song we just released yesterday that i will assume would not be relevant to the podcast. It is called Final Embrace and was inspired by a heart-breaking international wire photo of a Salvadoran immigrant father hugging his daughter, both deceased, in the rio grande in 2019. Here's the link to the original news story. David's two-man group, Rain

"Doctor, why won't you ever tell me how you really feel?" Therapist Self-Disclosure-- Featuring Dr. Carly Zankman This week, Dr. Carly Zankman joins us to discuss a really interesting and controversial topic—self-disclosure by a therapist. When is it helpful? And when is it an ethics violation? When I was a psychiatric resident, my supervisors (mainly psychoanalytic) cautioned me NEVER to share my feelings with patients. This felt really awkward at time, but is there some wisdom in that advice? And if so, what IS the wisdom? How does it work or help? And if that rule—never sharing your feelings or personal life--is too rigid, then when and how should we share our feelings and personal experiences with our patients? What is the goal, and what are the best practices? As most of you know, I have often been extremely critical of what I was taught as a psychiatric resident, thinking the teachings were based more on tradition than on science or data. And when it came to never share your feelings, I sometimes used to think about this issue along these lines: Let's assume that one of our jobs is to help our patients become more vulnerable and genuine, by sharing how they really feel inside instead of acting fake and always presenting a happy or professional face to the world. That goal seems reasonable, and it's a prime goal of a great many therapists. But how are we supposed to accomplish that goal by acting fake and hiding our own feelings? That just did not seem to make sense to me! But there are lots of traps when it comes to sharing your feelings. What if the patient is attracted to you, or vice versa? What if you do not like the patient, or feel turned off by them or annoyed with them? In today's podcast, we will try to sort out some of these questions, with help from the vivacious and brilliant Carly Zankman, Psy.D. (INSERT CARLY'S BIOSKETCH AND BRIEF DESCRIPTION OF HER TEAM CBT CLINICAL WORK IN MOUNTAIN VIEW, California. Carly described being taught similar things in graduate school, cautioning the students against opening up in a personal way during sessions. However, one of her supervisors listened to one of her sessions with a patient, and said, "the greatest gift you bring to therapy is just opening up and bringing your own, genuine and authentic self into the room." Carly described being taught similar things in graduate school, cautioning the students against opening up in a personal way during sessions. However, one of her supervisors listened to one of her therapy sessions with a patient, and said, "Your greatest gift is bringing your own, genuine and authentic self into the room," and from that point forward, everything shifted in how she viewed her role in the therapeutic relationship. Carly describes working with a patient recently and receiving a 19 / 20 on the Empathy scale at the end of the session. Although 9 out of 10 therapists would say that's a terrific, near-perfect score, on our scoring key it is rated as a failing grade. That's because the patient is telling you that you didn't quite "get" something about them, or didn't quite connect with them in a completely warm and supportive way. Carly's patient was a 40 year old recently re-married woman with a new baby, and struggling with a lot of regret, guilt, shame, depression, and anxiety. Carly decided on a hunch it might be a good idea to share her personal story, since she saw this woman as a mirror image of herself. Carly asked the patient if she wanted Carly to share her story, and this patient lit right up and was excited. It turned out to be tremendously helpful and was what she needed to believe Carly's empathy was real and not phony. The patient said that in the past she'd had many therapists, but none of them had ever share their personal experiences or feelings. Why was that so helpful? How does it work? And what are some red lines that you do NOT want to cross as a therapist? These are just a few of the ideas we discussed on today's podcast. We listed and briefly discussed a few of the many situations where it might NOT make sense to share our feelings or experiences with patients. Rhonda pointed out that if you've had a traumatic experience and you're feeling quite depressed, anxious, or angry, and have not yet had the chance to do your own personal work, it would not be the best idea to share it with your patient, because you might be using the patient as your own therapy or support network. You also would not share feelings of sexual or romantic attraction to a patient strong personal feelings of unresolved depression, anxiety, or anger Some feelings you might share with your patient, but only if you have the great therapeutic skill to do so in a helpful, illuminating way, such as feelings of dislike or anger toward the patient. We also discussed the danger of therapy degenerating into a paid friend relationship, and asked how that differed from the work of Dr. Irvin Yalom, the famous Stanford psychiatrist who taught us that