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

The Story of My Life, Part 1 David is interviewed by Joshua Gibson, Host of the Psychological Weightlifting Podcast Hi! Today will be a bit different. I appeared as a guest on a cool podcast called Psychological Weightlifting, hosted by Joshua Gibson. I kind of described the trajectory of my career, starting with my post-doctoral depression research at the University of Pennsylvania School of Medicine, with an intermediate stop at the former Presbyterian University of Pennsylvania Medical Center, where I had a run-in with a violent individual named Bennie, and culminating in my work refining TEAM-CBT in my years on the adjunct faculty at the Stanford Medical School. Joshua and I really hit it off, and at the end of the podcast, he asked me if I could briefly illustrate some of the techniques I've developed in TEAM-CBT. I asked if he had an negative thoughts that we might work with, and boy, was I in for a big surprise. In fact, you'll hear all about it next week! Thanks for listening today! Joshua, Rhonda, and David

Waking Up Dreading the Day Mother-Daughter Problems Patients Who Are Afraid of Their Feelings Romantic Problems, and More Questions for today: Rose asks: I wake up dreading the day. What can I do?! Maggie integrates TEAM-CBT with prayer and asks for help with mother / daughter issues. Simon asks: "How can we deal with patients who are afrad of their feelings?" Amanda asks: "Help! I have a romantic relationship conflict! What should I do?" Aaron asks: Why are feelings of depression and anxiety correlated? In other words, why do they frequently go hand in hand? The following questions and answers were written prior to the live podcast. Make sure you listen to the podcast to get the full answers, including role-play demonstrations, and so forth. Rose asks: I wake up dreading the day. What can I do?! Hi David, I've been reading your book, "Feeling Good," for help with my anxiety ever since my 100-year-old mom moved in with me. Your techniques are helping, but every morning I wake up anxious, dreading starting my day. Is there a technique to help with this? I really am working to change my thoughts from negative to more positive thanks to you. I look forward to hearing from you. Rose David's reply In my book, Feeling Good, I urge people to write down your negative thoughts, and emphasize that it won't work very well unless you do this. Many people refuse. How about you? What were the thoughts you wrote down when you woke up feeling upset and dreading your day. Could use as an Ask David on a podcast if you like. Best, david Rose wrote: Thanks for your speedy reply. I'm new at this and just started reading the book yesterday, but I will start writing down my thoughts. Thanks for your help. Maggie integrates TEAM-CBT with prayer and asks for help with mother / daughter issues. Dear Dr. Burns, I want to begin by expressing my deep gratitude for your work, which has had a profound impact on my life. Your book Feeling Good: The Workbook helped me overcome a very dark period of depression after being diagnosed with infertility. It truly transformed my mental health, and I continue to rely on your techniques—especially your list of cognitive distortions, which I use often to stay grounded. Your podcast has also been a great resource for me, and I've noticed recent episodes touching on the self and spirituality, which caught my attention in a special way. I felt compelled to share something personal with you. While your methods gave me the tools to change my thinking, I also found solace and strength through my faith. Prayer was an essential part of my healing process, and for me, it provided something beyond my own power. In moments when I felt I couldn't make it through on my own, the belief that there is a God I can turn to brought me peace and comfort. Both your work and my faith were crucial in my journey. Your research and teachings helped me take control of my thoughts, but my relationship with God gave me hope when I needed it most. I believe that the combination of these two—your scientifically backed methods and the power of prayer—made a tremendous difference in my recovery. I'm also excited about your app, but as someone living in Honduras, I was unable to download it. I would love to know if there are plans to make it available outside the U.S. in the near future, as it would be an incredible resource for me and others in similar situations. Lastly, can I make a suggestion for a podcast subject? Mother daughter issues. I really need help in this area of my life. Thank you for your dedication to helping others. I hope that sharing my experience offers some insight into how both your studies and faith in something greater can bring peace and healing. With gratitude, Maggie David's reply Thanks, and we'd love to read part of your beautiful note, with or without your correct first name, on a podcast. If you can give me a more specific example of the mother daughter issue you want help with, it would make it much easier to respond in a sensible way! Warmly, david Maggie responded Dear Dr. Burns, Thank you so much for your thoughtful response and for asking me to clarify my suggestion regarding mother-daughter issues. I deeply love my mother, and I know she means well, but our relationship has become increasingly challenging as she gets older. One of the major difficulties I face is her tendency to offer passive-aggressive criticism, which leaves me feeling undermined. I've always known her to be this way—she was never very affectionate, and I've gotten used to that. However, lately, it feels like it's getting worse. She's hard of hearing, even with a hearing aid, and often adopts a "my way or the highway" attitude, which makes conversations with her exhausting. Simple moments where I hope to share something exciting are often met with dismissive or critical remarks. Here are three examples of the kind of interactions that affect me: I recently purchased tickets for a trip to Australia with friends, and her respon

How to Give Critical / Negative Feedback In a Loving, Constructive Way AND How to Avoid the Common Traps Today's podcast features Dr. Jill Levitt, Director of Training at the www.FeelingGoodInstitute.com in Mountain View, California and co-leader of David's weekly TEAM-CBT training group at Stanford. Rhonda and I are psyched, because every podcast or teaching event with Jill is almost certain to be fabulous. And this podcast is no exception! Rhonda asks members of her Wednesday training group (see below for contact information of you think you might want to join) to take turns teaching the group. One week she was puzzled because almost no one filled in their feedback forms, and when she asked them why, they said that they had some concerns about the teaching but didn't feel comfortable criticizing the person who taught. Some of the criticisms they share with Rhonda were: It was boring. I didn't learn anything new. The teacher didn't explain anything in a way that I could understand. Is this a problem that you have as well? Do you find it hard to criticize others, and keep quiet on the assumption that saying nothing is better than opening your mouth and saying something hurtful? If so, I have some good news and some bad news for you. First, the bad news. Tonight, you'll discover exactly why and how saying nothing is actually a pretty hostile and mean thing to do. But here's the GOOD news. You'll also learn the secrets of how to deliver criticism in a way that's loving, authentic, and helpful if—and that might be a big IF—that's something you're willing to do! A sage—cannot remember who—once said that "When you say nothing, you're actually shouting quietly. What in the world does THAT mean? And Robert Frost, in his famous poem, Fire and Ice, wrote: Some say the world will end in fire, Some say in ice. From what I've tasted of desire I hold with those who favor fire. But if it had to perish twice, I think I know enough of hate To say that for destruction ice Is also great And would suffice. Essentially, Frost is saying that if you're angry, there are two classic ways of being aggressive; you can be fiery and agitated and attack the other person, verbally or physically, or you can be cold and withdraw, saying nothing, so as to freeze the other person out. These are opposite extremes but are equally destructive. And, for most of us, difficult impulses to resist. But there's a third alternative, which might be, according to Robert Frost, the "road less traveled by." You can express your negative feelings, including anger, in a respectful, or even loving way. And that's the focus of today's show. My show notes will only give an overview, but the richness of this particular podcast is in the actual dialogue and role-play demonstrations with critical feedback. We began with an overview of some of the key techniques when giving someone negative feedback, including stroking and "I Feel" Statements, but emphasized that your tone, goal, and spirit is the entire key to how you come across, and how the other person responds. Jill told a moving and dramatic story of an interaction with her mother, who has been quite ill, and she'd been having a really hard week. Her mom sent Jill a lengthy text outlining all of her problems and ending with, "you guys don't really know how I'm hurting," and the implication was, "you don't know--or care." This was understandably hurtful to Jill. Jill's about the most awesome daughter any mother could have. Jill wanted to clear the air and tell her mom how she'd felt, rather than keeping her negative feedback hidden. Her mom clearly felt lonely, so when Jill saw her in person, she said something along these lines: "I know you've been struggling, but I felt hurt and discounted when I read your note. I felt like the things I've done didn't matter, and I felt hurt." Her mom began to cry and said, "the last thing I want you to feel is that I don't appreciate you." This conversation was challenging, but brought them much closer together. The podcast crew discussed the important question of our mixed motivations about sharing our feelings, and our confusion about how to do this in an effective, loving way, if you do decide to open up. Rhonda confided that she'd never had those kinds of open conversations with either of her parents, and that these kinds of difficult conversations can come from a place of love. You can review the Five Secrets of Effective Communication if you click HERE. The Five Secrets are all about talking with your EAR: E = Empathy, A = Assertiveness, and R = Respect. However, there's a lot of intense resistance to using the Five Secrets, so I promised to include my list of 12 GOOD Reasons NOT to Listen (E = Empathy) Share your feelings (A = Assertiveness) Treat the other person with respect (R = Respect) That makes 36 reasons in all! You can link to the list HERE. People want to feel understood, and the best way to make that happen is by giving what you hope to receive. And you

The Feared Fantasy Festival! Featuring Jill Levitt, PhD Rhonda asked about the differences between the four Feared Fantasy Techniques and what each one is used for. So we're dedicating today's podcast to answering that question and bringing them all to life. We are honored to be joined by our beloved and brilliant Dr. Jill Levitt, the Director of Clinician Training at the Feeling Good Institute in Mountain View, California. Below I have listed the four Feared Fantasy Techniques. As you can see, each one targets a different Self-Defeating Belief. Approval Addiction: I need everyone's approval to feel happy and worthwhile. Perceived Perfectionism: I must impress others to be love and respected. People will not love or accept me if they see my flaws and shortcomings. Achievement Addiction: My capacity for happiness and my worthwhileness as a human being depend on my achievements, intelligence, success, and productivity. Love Addiction: I need to be loved to feel happy and worthwhile. Submissiveness: I must make others happy, even at the expense of my own needs and feelings. Here are the Feared Fantasy Techniques used for each SDB: Approval Addiction / Perceived Perfectionism: "I judge you." Achievement Addiction: "High School Reunion." Love Addiction: Rejection Feared Fantasy Submissiveness: No Practice During the live podcast, we did a deep dive on each of the four Feared Fantasy techniques, and emphasized that the goal is actually enlightenment, and it's based on the teachings Tibetan Book of the Dead that when you finally challenge and confront the monster you've feared and run away from in all of your previous reincarnations, you will discover the the monster has no teeth, and that your fears throughout all of those reincarnations were based on a cosmic joke. This can create something called "laughing enlightenment," so you no longer have to go through the life death cycle, but can go instead to Nirvana--or something along those lines! You really must listen to the podcast to "get" the impact of these Feared Fantasy role plays, and role-reversals, to see how simple, easy, and obvious self-acceptance, and enlightenment really are, and you will see and hear how we fight to protect and defend ourselves from attack, and end up feeling trapped yet again in our needs to be "special" or "worthwhile." David pointed out that when you let go of the idea that you have a "self," your suffering can disappear because you will no longer have to wonder whether your "self" is good enough, or worthwhile enough. Jill complemented this line of thinking by pointing out that the technique, Be Specific, is one important key in most of these techniques. We can be flawed in all kinds of specifics, but that will never hurt unless you generalize to your "self." No self, no problem, as some mystics have said. And that is SO TRUE! David also discussed throwing away the idea that you are worthwhile, or that you need to be more worthwhile, and described how he and his wife saved a mouse that had somehow gotten into their house, but the poor thing was terrified and heroically tried to survive, hiding out in their kitchen. Instead of trying to kill it, they fed it nuts and grapes. Eventually, they caught it in a safe trap, and set it free, and left a last meal for it outside, which it found and happily ate. It was a deep dive on Feared Fantasy and lots of spiritual and philosophical topics, and we hope you enjoyed it! Although we did not cover this topic in the podcast, there are quite a number of additional role play techniques in TEAM-CBT, too, as you know, including: to help with Self-Critical Thoughts: Paradoxical and Straightforward Double Standard Externalization of Voices to help with Uncovering Techniques, like the Individual Downward Arrow Man from Mars To help with Tempting Thoughts Devil's Advocate Technique Tic-Tok Technique to help with Resistance Externalization of Resistance How Many Minutes? to help with the Five Secrets / Relationship Conflict Intimacy Exercise One Minute-Drill Perhaps you can think of more, too! The generous use of role-playing techniques is one of the unique features of TEAM, but for whatever reason it seems like few therapists use them. This is perhaps unfortunate because they tend to be more potent, emotional, and fast acting than many if not most other techniques. Warmly, david

Ask David: Getting Off Benzos How Does Music Stir Our Emotions? Combatting Negative Thoughts about the World Treating Schizophrenia with TEAM The Four Feared Fantasy Techniques and more! Questions for today: Mamunur asks: What's the best way to withdraw from benzodiazepines? Gray asks: How does music evoke such powerful emotional reactions? Josh thanks David for techniques that have helped in his personal and professional life. Harold asks: How do you respond to negative thoughts about the world, as opposed to self-criticisms? For example, "The world is filled with so little joy and so much suffering." Moritz asks: How do you help people with bipolar, schizophrenia, etc.? John expresses gratitude for our answer to his question on Positive Reframing, which triggered an "ah ha moment." Rhonda asks: What are the four Feared Fantasy Techniques? The answers below were written prior to the podcast. Listen to the podcast for the dialogue among Rhonda, Matt, and David, as much more emerges from the discussions! Mamunur asks: What's the best way to withdraw from benzodiazepines? Ask David, Bangladesh question Dear Sir, I am writing to you from Bangladesh. Your book Feeling Good is a phenomenal work, and it has greatly helped in promoting the development of a healthy mind through logic and reason. Sir, I have a question regarding benzodiazepine withdrawal, which is often prescribed for mental health disorders. Is there a specific CBT (Cognitive Behavioral Therapy) approach that can help in withdrawing from benzodiazepines? Your guidance on this would be invaluable, as many people have been taking it for years, either knowingly or unknowingly, without being fully aware of its severe withdrawal effects. Thank you, sir, for your kind contributions to humanity. Sincerely, Mamunur Rahman Senior Lecturer David's reply Dear Mamunur, Thank you for your important question! I am so glad you like my book, Feeling Good, and appreciate your kind comments! As a general rule, slow taper off of benzodiazepines is recommended. This might involve slowly decreasing the dose over a period of several weeks. When I was younger I used to take 0.25 mg of Xanax for sleep, because it was initially promoted as being non-addictive, which was wrong. It is highly addictive. The dose I used was the smallest dose. When I realized that I was "hooked," I tapered off of it over about a week, and simply put up with the side effects of withdrawal, primarily an increase of anxiety and difficulty sleeping. These disappeared after several weeks. Abrupt withdrawal from high doses of any benzodiazepine can trigger seizures, as I'm sure you know. That is the biggest danger, perhaps. I do recall a published study from years ago conducted at Harvard, I believe at McClean Hospital. The divided two groups of people hooked on Xanax into two groups. Both groups were switched to Klonopin which has a longer "half-life" in the blood and is supposedly a bit easier to withdraw from than Xanax, which goes out of the blood rapidly, causing more sudden and intense withdrawal effects. After this initial phase, both groups continued with slowly tapering off the Klonopin under the guidance of medical experts. However, one of the groups also attended weekly cognitive therapy groups, learning about how to combat the distorted thoughts that trigger negative feelings like anxiety and depression. My memory of the study is that the group receiving cognitive therapy plus drug management did much better. As I recall, 80% of them were able to withdraw successfully. However, the group receiving drug management alone did poorly, with only about 20% achieving withdrawal. My memory of the details may be somewhat faulty, but the main conclusion was clear that the support of the group cognitive therapy greatly enhanced the success of withdrawal from benzodiazepines. I decided early in my career not to prescribe benzodiazepines like Ativan, Valium, Librium, Xanax, and Klonopin for depression or anxiety, because the drug-free methods I and others have developed are very powerful, and the use of benzos can actually make the outcomes worse. Years back, a research colleague from Canada, Henny Westra, PhD, reviewed the world literature on treatment of anxiety with CBT plus benzos and concluded that the benzos did not enhance outcomes. Here is the link: https://pubmed.ncbi.nlm.nih.gov/12214810/. I hope this information is useful and I will include this in a future Feeling Good Podcast. Gray asks: How does music evoke such powerful emotional reactions? Subject: Re: Podcast question: love songs Hi David, That's a really tough question. Music has a unique way of cutting straight to emotions for me, and it makes it especially hard to identify the thoughts behind them. My best way of explaining is with these two thoughts, which have to be viewed as a pair to get that emotional reaction: My life would be perfect if I had that I'm so far away from that These thoughts don't resonate quite right for me, bu

Meet Tahn Palmetto Theravada Buddhism--the Thai Forest Tradition Our dear colleague, Jason Meno, generously invited five high-profile Buddhist monks / teachers, to appear on our Feeling Good Podcast, hoping we could feature one every week during our "Enlightenment Month." He included his dear friend and ordained Buddhist monk, Tahn Palmetto. Happily, Tahn accepted Jason's invitation, and we are thrilled to chat with him today about his feelings of depression as a young man in the army to his search for happiness and peace through meditation. Tahn began his journey when we was young, 20 or 21 years old. After he enlisted in the army, he was lying on the floor, staring at the ceiling and realized he was depressed. He also realized that he didn't actually want to go to war, and saw that the best of good intentions often lead to pretty terrible outcomes. Jason and David described the basis of cognitive therapy, confirmed in Jason's recent research on meditation, that the degree of upset from any negative thought depends on how strongly you believe it to be true. Tahn said he also realized that his negative feelings did not depend so much on what he was doing, but how much he believed his thoughts. He got out of the army and searched for spiritual teachers, and eventually settled on Theravada Buddhism, also known as the Thai Forest Tradition. He said, "I found that you can have a lifestyle that triggers feelings of unhappiness, and committed my life to achieving happiness and peace." He said that some people who come to the monastery discover that they don't want to commit themselves to the monastic life, and some commit to it but do it poorly. He said that your commitment will depend on how strongly you want to feel happy and enlightened. Believing that this is possible requires a paradigm switch. It is possible to have a mind that is clear, but even on a clear day, there will be clouds. The clouds, however, are only temporary. Our suffering comes and goes. If you twist your knee, it may hurt for life. But if you have a cold, you can recover completely. Even in a monastery, people have their squabbles. Within the Buddhist practice, Than explained that it is important to try to identify the disease and only then prescribe the effective treatment. Jason mentioned that some people come to the monastery but leave feeling hopeless. Others stay and are successful. Tahn explained that in Asia it is common for someone to enter the monastic life for a brief period, for example when they are experiencing grief. He said that if you grieve over the loss of a loved one, time alone will heal your grief, and once the suffering is relieved, they leave the monastic life. Rhonda asked if mindfulness meditation could be harmful to some people. Tahn explained that mindfulness does not cause negative feelings, but often reveals the presence of negative feelings. If you have a condition that prevents you from experiencing enlightenment, the condition is getting in the way. Sometimes the practice will give you the stability and the peace of mind to deal with it. If you come to the practice of mindfulness or the study of Buddhism for the wrong reasons, you might stay for the right reasons. If it does not work or help, you can always seek some other type of treatment. Tahn explained that mindfulness or Buddhism addresses unhappiness caused by mental or physical pain, and that people are often surprised by how it helps them. He believes that mindfulness meditation is "the thing" that treats someone's stress. It treats the "dukka," which is a fundamental Buddhist teaching that refers to (according to the internet) the "suffering" or "unhappiness" of life. It is one of the first "noble truths" of Buddhism; namely, that suffering cannot be avoided. Apparently dukka comes in three flavors: Physical and emotional pain and discomfort Suffering from the inability to accept change The profound dissatisfaction of existence. Tahn said that you develop greater resources when you meditate. Then you may have extra resources to help others: You learn to deal with everybody's stuff. You learn to be aware of your body. This is your perspective for everything you do. It makes me happy to think about my eyeballs. When I meditate on this, it becomes funny, and I laugh. Tahn suggested that when you meditate, you learn to be aware of your body, because that is the center point of your world. This is your perspective on everything that is going on in the world. When you become aware of your body and what it is doing, you know the context of everything in your life. What does his day look like? Tahn said: I answer emails, I troubleshoot problems. Lately we've had a problem with scorpions. But we don't try to kill them. Tahn talked about how Buddhism defines Truth as reality, and that the definition of happiness is "non-suffering." There are three patterns that lead to unhappiness: Attachment, which he defined as greed and desire, especially when you seek some

The Mindfulness Mystery Tour! And Two Mind-Boggling Discoveries about Meditation! Featuring Jason Meno Today, Jason Meno, our beloved AI guy on the Feeling Great App team, shares some incredible and innovative research he recently did on the effect of meditation on how we think and feel. As you know, basic research is a high priority of our app team, and our major focus is to make basic discoveries in how people change, and especially on what triggers rapid and dramatic change. We use that information to develop and refine the app on an ongoing basis, and also to contribute to basic science. Jason recently created a "New Cool Tools Club" which has 160 members who Jason can notify whenever he has a cool new app tool that he wants to test. If you are interested in joining, you can find his contact information at the end of the show notes. There is no charge if you'd like to join this group! Jason had a strong background in Buddhism and has been working with our company for several years, focusing in the last year on the AI chat bot portion of the Feeling Great App. He has meditated for many years, and uses TEAM-CBT as well to deal with his personal moments of stress and unhappiness, something that most if not all of us experience at times! Introduction Jason was interested in evaluating the short-term impact of meditating, and did a literature review but found that most or all of the published studies had a focus on the effects of daily meditation over longer periods of time, like two months for example. He was also interested in how long and how often people should meditate, and what types of meditations, if any, were the most effective. So, he decided to test a one-hour meditation experience consisting of five ten-minute recorded meditations, including A body scan meditation, systematically relaxing various parts of your body, beginning with your feet and toes. A breathing and counting meditation, where you focus on your breathing and count the breaths going in and out. A loving kindness meditation, starting with sending feelings of love, happiness, and health first to someone you love, then to yourself, then to someone you aren't especially close to, or don't particularly like, and on and on until you are projecting love and kindness to the entire universe. A mindfulness exercise where you notice if you are thinking, hearing, watching, remembering, and so forth as various thoughts pass through your mind. A "Do Nothing" meditation where you are instructed to simply "do nothing" for ten minutes. Because previous research on meditation did not use scales that assessed specific kinds of negative feelings in the here-and-now, he decided to use the highly accurate 7-item negative feelings sliders as well as the 7-item positive feelings sliders prior to the start of the medicine, after each meditation, and at the end of the app. He also asked many questions about motivation and expectations prior to the start of the meditation experiences, all answered from 0 (not at all) to 100 (completely), including How familiar are you with David's work? How familiar are you with meditation? How strongly do you believe that meditation will make you feel better? How strongly do you believe that meditation will be rewarding? How strongly do you believe that meditation will only have a small effect? How strongly do you believe that meditation will be a waste of time? How strongly do you believe that meditation will make you feel worse? How strongly do you believe that it will be painful or difficult? You can find these data at this link. He also asked every participant to generate an upsetting negative thought, like "I'm a loser," and use 0 to 1000 sliders to indicate how strongly they believed that thought, and how upsetting it was. 60 individuals started the experiment, and 35 completed it, with 25 dropping out prematurely before they completed some of the meditations. He presented the data as a two-group analysis, those who completed and those who failed to complete the hour of meditation. Here, are just a few of the preliminary findings, and more refined analyses are planned so we can look at causal effects. Both groups were moderately to very familiar with David's work and with meditation. The completers had higher scores on the questions about positive expectations than the dropouts, although the differences were not great. The dropouts had substantially higher scores on four questions about negative expectations for the experience, like "it will be a waste of time" or "it will be painful or difficult." The initial scores on the belief in the negative thought were similar in the two groups (76% and 74%, respectively), but the Upsettingness of the thought was a bit higher in the completers (83% and 79%. The mean of the initial scores on the 7 negative feelings sliders was significantly higher in the dropouts (37% and 46%, respectively), while the initial scores on the 7 positive feelings sliders was somewhat lower in the dr

Ask David How Can I Change an SDB (Self-Defeating Belief)? How Can I Cope with Intense Public Speaking Anxiety? Featuring Rhonda Barovsky, Psy.D., Matthew May, MD, Jason Meno and David Burns, MD (Jason is an AI Scientist on our Feeling Great App Team) Anonymous asks: How can I change an SDB (Self-Defeating Belief)? Hiranmay asks: How can I deal with my intense anxiety before public speaking. Answers to Your Questions Note: These answers below were written BEFORE the podcast, and the live discussion always adds new and different angles. Today, Jason Meno, our beloved AI guy on our app team, also chimes in on the many super questions submitted by Andrew (#3 - #10.) 1. Anonymous asks: How can I change an SDB? Dear Dr. Burns, I'm an avid listener of the Feeling Good podcast and for the past few weeks, an avid user of the Feeling Great app. Thank you for your incredible work and dedication to making people everywhere feel better about themselves. I have a question about self-defeating beliefs that I'm hoping you can address, either on the show or on your website. You have mentioned on several occasions that SDBs are the root cause of negative thoughts and consequently of negative feelings. Yet, to me it doesn't feel like SDBs are really addressed enough on the podcast. There seem to only be a handful of episodes covering the topic. It also seems there is a very limited toolbox of methods to use on SDBs, almost like dealing with them is considered an afterthought. If SDBs really are the cause of it all, shouldn't the primary focus be on defeating them first and only then, on defeating negative thoughts? I'm just a little bit lost when it comes to defeating SDBs, which seem to be way harder to deal with than negative thoughts. Any insights or thoughts on the subject will be greatly appreciated. Sincerely, Anonymous David's reply Dear Anonymous, Will start a new Ask David with your excellent question. Thanks, david First, you can look up Self-Defeating Beliefs in the search function on my website, and you'll find many great examples. Here's what I got just from "Self-Defeating Belief." You could also search for a specific type, like Perfectionism, Perceived Perfectionism, Achievement Addiction, Love Addiction, Approval Addiction, Submissiveness, etc. In general, there are two approaches to any SDB. Four approaches can be used in this order: Do a Cost-Benefit Analysis of the SDB. If Disadvantages outweigh Advantages, use Semantic Technique to modify the SDB. Do an experiment to see if the SDB is actually valid. Use the Feared Fantasy Technique to put the lie to the SDB at the gut level. Here's our latest thinking, which is a step beyond the four steps above. Do a Daily Mood Log on one specific moment when you were struggling with your SDB. We will discuss these ideas in greater depth on the show, of course! You can also find a great deal on SDBs in my books, like Feeling Good, the Feeling Good Handbook, and more. But right now, I don't even know what SDB you might want help with / more information about. Also, in the Feeling Great App, there's a terrific class called "Your PhD in Shoulds." It includes a lesson on perfectionism. 2. Hiranmay asks: How can I deal with my intense anxiety before public speaking without working on the negative thoughts I have afterwards, like "I am going to mess this up" "People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool." "This talk is important, it must go well! Here's his email: Dear Dr. Burns, I love your books and the feeling good podcast. They have made such a huge difference in my life (in a good way of course). I have an "ask David" question on acute anxiety: If I have to play a badminton match or give a presentation, I usually get some or a lot of anxiety the day before the big event as well as the morning of. I then use all the methods you have taught, and the anxiety reduces. However, it usually comes back with a bang just before I give the talk or play a match. Cognitive techniques are not very helpful to me 30 minutes or 5 minutes before the presentation or match. I don't have the time to sit down and write my thoughts or cannot focus at all on my thoughts. Are there any strategies to reduce this form of acute "relapse" or nerves. Here are some more details: Event: 30 minutes before my presentation. I just entered the seminar room, and the first speaker is about to start their talk. I am next. I can feel my heart starting to pound and I am getting the familiar sense of anxiety and nerves. Thoughts: "I am going to mess this up". "People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool". "This talk is important, it must go well". Although to be honest, this is my analysis of what my thoughts were after the fact. 5-15 minutes before the presentation, I usually just notice my thoughts racing. To reiterate: I am not looking for help with working on these thou

418 The Fear of Driving Featuring Werner Spitzfaden, LCSW and Rhonda Barovsky, PsyD Today, we feature Werner Spitzfaden, LCSW, a Level 3 certified TEAM-CBT therapist who recently treated Rhonda, who's driving phobia returned during the pandemic because she did very little driving at that time. After you overcome any fear or phobia, it has a way of returning if you don't continue confronting your fear. Werner describes his skillful and compassionate work with Rhonda! Werner is a dear colleague and friend with over 35 plus years of clinical experience treating phobias, such as the fear of flying, claustrophobia (the fear of being trapped in small places), and driving (especially over bridges and overpasses). He also treats depression, panic and other forms of anxiety, and works in corporate environments to improve communication and teamwork. Let's dive right in, Please take a look at Rhonda's completed Daily Mood Log, As you can see, the upsetting event was thinking about driving over an overpass, and she rated her initial anxiety cluster at 100%, indicating extreme anxiety. She was also 90% ashamed, and 80% Inferior, worthless, inadequate, defective, and incompetent. She was also feeling 99% embarrassed, foolish, humiliated, and self-conscious, and 85% hopeless, despairing, frustrated, stuck, angry, annoyed, irritated, upset, and devastated. Her sadness was only modestly elevated at 25%. There are several teaching points. First, most of Rhonda's negative feelings were severely to extremely elevated. Second, although she is asking for help with a phobia, anxiety often goes hand-in-hand with a wide variety of negative feelings, including shame and inadequacy. This is because anxious individuals often feel like there's something terribly and shamefully wrong with them. Rhonda's feelings of shame are not unusual. Shame is a central feature of anxiety, whereas a loss of self-esteem is a central feature of depression. Werner added that the fear of driving often goes along with the fear of heights as well as claustrophobia. Rhonda admitted to engaging in many "safety behaviors" which typically make anxiety temporarily better but worse in the long run. Rhonda's "safety behaviors" included going out of her way when driving to avoid scary overpasses as well as asking her husband to drive her many place. As you can see, these totally understandable "safety behaviors" relieve your anxiety in the here-and-now because they are forms of avoidance, but that's why they makes anxiety worse in the long run. The urge to avoid of the thing(s) you fear is universal among individuals struggling with all forms of anxiety. Werner emphasized the importance of empathy in the initial phase of treatment, and throughout the treatment, since trust and the courage to face your fears is so central in the treatment of all forms of anxiety and, of course, depression as well. Rhonda invited Werner and another TEAM-CBT colleague, Lee Flowers, to stay with her in Berkeley during the recent TEAM intensive that David and Jill Levitt directed at the South SF Conference Center near the airport. She drove the group to and from the workshop to face her fears and get some motivation and support at the same time. You can see many of her negative thoughts about driving on Rhonda's completed Daily Mood Log, including these: The bridge will collapse. 95% Other cars will make the bridge unstable. 100% I'll have a heart attack. 95% I'm so dumb for not driving on this overpass. 1005 I'm an ass. 100% I can't do this. 100% I'll die. 100% Lee and Werner will see me at my worst. 100% I need to study the exact route before I start. 100% I'll get into an accident. 100% As you can see, the list includes a mixture of fear-inducing thoughts as well as self-critical thoughts and shame-inducing thoughts, like "Lee and Werner will see me at my worst." Whenever you are working with anyone with anxiety, you have to emphasize first, to create trust, warmth, and understanding. This won't cure anyone of anything, but will give your patients the courage to face their fears when you get to the M - Methods portion of your TEAM session. After you get your A in empathy, you can move on to A = Paradoxical Agenda Setting. That where you bring Outcome and Process Resistance to conscious awareness. Then you melt them away using a variety of TEAM-CBT techniques. Outcome Resistance means that Rhonda may have mixed feelings about a "cure" for her driving phobia. In other words, although she WANTS to get rid of this fear, she may subconsciously NOT want to get rid of it. Can you think of why? Take a moment to think about it, and make a guess. You'll find the answer at the end of the show notes. Process Resistance means she may WANT a cure for her driving phobia, but may not be willing to do what it takes to defeat this fear. What will she have to do? Take a moment to think about it, and make a guess. You'll find the answer at the end of the show notes. Werner and Rhonda described a number

Podcast 417 Bullying Featuring Manuel Sierra, MD (pictured above) Today, we welcome an old friend, Manuel Sierra, MD, who practices pediatric psychiatry in Idaho, and Dr. Matt May, a familiar and beloved colleague, to discuss bullying. Below you'll find a great list of questions Dr. Matt May submitted just prior to today's podcast, along with some links you may wish to explore for more information. We addressed some of the questions, but certainly not all, during the podcast! Manuel described bullying, and said the ¼ of children and adults have experienced bullying. The consequences can be severe, including suicidal urges or completed suicides, along with shame and a severe loss of self-esteem, and more. He pointed out that bullies are good at zeroing in on aspects of ourselves that we feel insecure about, including how we look, our ethnicity, our aptitudes, and more. He provided links to resources on bullying. The bully picks on someone who is weak, so there is a power imbalance, and does the bullying to gain popularity and power, at the expense of the victim. David and Manuel emphasized that the bullying per se cannot cause the depression, shame, and so forth, but rather the victim must buy into the bully's mean-spirited statements, like "you're weak," or "you have an ugly zit on your nose," "your mother is a dirty whore," and more. Then, the inner dialogue of the victim often goes like this: I must be a terrible and horrible person to get bullied like this. I'm worthless. All the kids are looking down on me. Everybody hates me! Everyone is laughing at me. I'm just a loser. And that, of course, is the voice of the "inner bully" who does all the emotional damage. Manuel and David both emphasized that the goal of treatment is to help the victim see that the "badness" is not with them, but rather with the kid (or adult) who's doing the bullying. Because the victims nearly always feel ashamed, they will often suffer in silence, keeping the bullying a secret. David described what he calls the "abuse contract" that many, and perhaps most, humans buy into when being hurt or exploited. It's really a contract between the abuser and the abused, and there are there parts to the agreement. I get to hurt you for my own pleasure. This might include sexual, physical, financial, or psychological torture or abuse. You, the victim are entirely to blame for this. You are the bad one. I am superior and totally innocent. You deserve what's happening to you. We have to keep this a secret, even from ourselves. You cannot even hint that I am doing something wrong. If you try that, I will REALLY hurt you. David emphasized that the tendency to "accept" this type of horrible contract is not limited to children, but includes adults as well. He emphasized that sometimes the child who is being bullied will tell parents, who then tell the teacher or school officials, who will tell the bully to stop. This is rarely effective, and often makes the situation worse, since the bully tells the victim that they are a snitch and now they will REALLY get what they "deserve." Matt described many types of bullying, including physical, psychological, and cyber bullying. Manuel described some of the signs to look for if you suspect a problem with your child, including: Not wanting to go to school. Saying things like "everyone thinks I'm terrible." Changes in sleep, eating habits, and energy. Somatic symptoms such as stomach aches and headaches. Manuel emphasized that the goal is not to eliminate negative feelings entirely, but rather to reduce the time you spend feeling anxious, humiliated and upset after being bullied. He also emphasized that ongoing practice talking back to your own negative thoughts is an important key to change, in exactly the same way that athletes must commit to ongoing daily practice to boost their physical skills and stamina. Manuel emphasized the importance of empathy and support, as well as asking victims if they'd want some help combatting their automatic negative thoughts and feelings. He shared that he endured considerable bullying as a kid, and was bullied because he was poor, of Mexican heritage, short, wearing glasses ("four eyes"), and young, and sometimes called "a fag" and other hurtful things. He said that reattribution is one useful strategy, among many, for combatting automatic thoughts and negative feelings. Instead of automatically blaming yourself for the bullying, you can ask questions like this: "What is it in their life that makes them want to do things like this.?" And "They are trying to hurt and embarrass me. Why are they doing that." The goal is to help the victim see that the "badness" and shame really reside within the bully, and not with them. The bully is trying to tear you down. Ask yourself why? The bully thinks that this is the best way for them to gain popularity, power, and importance. Toward the end of the podcast, I, David, again emphasized that the Outer Bully can hurt us physically, by hi

Podcast 416 Ask David is it reckless to question the existence of the "soul?"' How can I make myself accountable? Do we have a "personality," or is that just another illusion? Do questions about the "self" and "free will" involve All-or-Nothing thinking? The answers below were prepared prior to the podcast, and simply based on email exchanges. Be sure to listen to the live podcast discussion to get a variety of opinions and comments! Questions for today's podcast. #1: Weren't your comments on the self a bit reckless, given that the existence of / or belief in the "soul" is a prerequisite for most religions? #2: How can I make myself accountable for doing the exercises in your books? #3. Holy asks if the concept of having "a personality" is the same as the question of having "a self?" #4. Could questions about the "self" and "free will" involve All-or-Nothing Thinking? Question #1. (not question, just a comment worthy of a response) Your comments on the "self" were shallow, mocking and restless. The recent episode on 'Do I have a self?' (Episode 406) was very shallow and mocking of people who thought there was a soul/self. Given a soul is a prerequisite for most religions, dismissing it out of hand without meaningful discussion seems reckless. David's response Thanks, there's a lot of truth in your comment and we'll definitely include this on an upcoming Ask David! To give a brief response prior to the show, I would say that I am not trying to defend or attack any religion, but don't want to give up my right to freedom of thought. I, David, am not saying that the "soul" does not exist, but what I am saying is hard to convey, and I probably won't be successful now, either. But, when you talk about a "soul," I do not have any idea what you mean by that word, or what you are referring to, if anything. To me, words like "self" or "soul" are simply language that is "out of gear," as Wittgenstein might say. Meaning can only occur in a specific concept. It is not the case that there are "pure meanings" for abstract concepts. Thinking along those lines was the huge error that Plato and Aristotle made. Now, let's say I go to YouTube and listen to some really kick-ass music that I totally love. I might say, "Wow, that guy (like James Brown, for example) really has soul!" What I'm saying is that I tremendously admire and appreciate his talent, his energy, and so forth. I am not referring to something metaphysical. My concern about your comment is that it sounds scolding, at least to my ear, like the "morality police," perhaps. Personally, I have seen a great deal of evil done in the name of this or that religion, and I have no doubt that you have, too! Still, I am sure you have strong religious beliefs, which I respect, and apologize for having offended you. But I admit I am ambivalent, and partially happy that you are offended, and speaking out, because I believe that critical thinking is also tremendously precious, just as your religious beliefs are precious to you. In a selfish way, I have to confess I am also happy for the criticism, because controversy stirs up interest, and I am trying to interest people in our podcasts, which are ultimately dedicated to healing and relief of suffering. Still, I cannot deny the truth in your comment, that my "critical thinking" can be a disguise for a put down. When I wrote Feeling Good, I was very aware already (in the 1970s) that the chemicals categorized as "antidepressants" had few or no clinically significant effects above and beyond their placebo effects, and subsequent research has validated this. But I did not emphasize this in that book because I did not want to pull the rug out from anybody, and hurt anybody's feelings. After all, if you are getting a nice "placebo effect," that's a good thing, at lest to some extent. Now, I'm older, so I'm more willing to speak my mind, and let the chips fall where they may. And you have bravely spoken your mind, too. Kudos to you! And that's the end of my prayer! Keep those good thoughts rolling along. Amen Best, david (PS I'm sure you'll get way better answers from the others on the podcast tomorrow!) Question #2. How can I make myself accountable for doing the exercises in your books? Good to have Fabrice back. Regarding your books I have a question. I have trouble holding myself accountable doing the exercises in the book. Do you have any advice on how to prioritize doing the homework and being disciplined with it? How did other depressed people get better using your books? I already filled out multiple notebooks but appear to be stuck. Any help appreciated! David's Response Thanks, we will address your question on a future Ask David podcast, if that's ok. Question #3. Holy asks if the concept of having "a personality" is the same as the question of having "a self?" @HolyLoveQuest • 1 day ago Thank you for this video on this topic, it was very clear to me! It's a shame that this chapter of your Feeling Great book was removed, becau

Question #1: John asks: Can you do TEAM on your own? Question #2: John asks: Can you provide more insights or instructions on how to do Positive Reframing on your own? It seems to be an incredibly important key to TEAM-CBT. Question #3: Ann asks: What can I do when I blush and my face turns bright red? Question #4: Dylan asks: Can you have a delayed reaction to the CBT exercises? #415 September 23 Ask, New questions Question #1: John asks: Can you do TEAM on your own? Oh, one other point that occurred to me, the people doing personal work on your podcasts are generally TEAM CBT therapists or people familiar with the TEAM model. They are obviously very familiar with the steps and techniques in TEAM, and yet they seem to require the insight and guidance from yourself and Jill. Why do you think that is if they are so well versed in TEAM already? Does that mean that a person from the general public doing their own work using your books without the guidance of a TEAM therapist is futile? Or would you always recommend someone using a therapist? Kind Regards John David's response Can we include it in another podcast? Would love to just read it and jam on it with R and M. Warmly, david Question #2: John asks: Can you provide more insights or instructions on how to do Positive Reframing on your own? It seems to be an incredibly important key to TEAM-CBT. On Mon, Aug 5, 2024 at 9:24 PM John Macken [email protected]> wrote: Hey there David and Rhonda, I hope you're keeping well, this is John from Ireland, we had a previous correspondence on Should statements! David, thanks very much for asking for access to the beta app, I'm really enjoying the modules! I heard you say on one of your apps that you are planning some workshops in relation to the app, will they be available online do you think? Would love to tune in if possible! I am always grateful for your inspiring work! I love your passion for the work that you and Rhonda do and that comes across from both of you during every podcast episode. Your FG community sounds amazing! Who knows, maybe one day I'll ditch the corporate career and join the cult! I have another question on Positive Reframing! As someone who is still trying to find my own journey to enlightenment following many months of anxiety and depression, I feel I am falling at this positive reframing step. I still find I am bumping up against resistance and I feel that my positive values and benefits don't count. It's almost as if there is some kind of discounting the positive going on like my negative points vastly outweigh my positive points. It's like there is such a negative filter there is no space for recognizing positive qualities. I was listening to the beginning of Episode 310 where a listener had an excellent contribution on Positive Reframing from your live work with Nasli. That got me thinking, would it be possible to hear more insights and detail on how to perform your own Positive Reframing work? Or do you have guidelines or a worksheet anywhere? It feels like the most powerful of all the steps! Among the many incredible tools that have been created under TEAM it seems the Agenda setting piece is probably the most powerful and innovative. I have listened to many of your Live Sessions intently and it seems that your gift and that of Jill Levitt is in convincing the patient of the beauty of their depression and anxiety. It feels that they are almost recovered or very nearly once you go through that step. On the face of it, it looks like what you're doing is very simple but there is a nuance and complexity to it that is incredible and without sounding too grandstanding or over dramatic this "gift" seems to be where the healing power lies. If you could bottle that gift you would change the world or be a billionaire or both! It is astounding to listen to. I would love to hear more about your insights into this area and how people can unlock this for themselves. For example, I found podcast 387 on Acceptance and Daring to be average incredibly powerful and insightful and convincing and these are pieces I'm trying to implement in my life. Love and admire your work and would love to make it over to one of your in person workshops someday when they are available to the general public, Warm regards John David's response We will address positive reframing on the show. Question #3: Ann asks: What can I do when I blush and my face turns bright red? Dr. Burns, I hope you're both doing well. I wanted to share with you that you have changed my life dramatically. I have always thought that everyone else had a problem as far as attitudes and behaviors. But you have taught me through all three of your books and podcasts that my thoughts are why I've been so anxious and depressed. I have been on medication since I was 20 years old. Now, I'm weaning off of my medication because of all of the work I've done with your book and a therapist trained in TEAM therapy. My relationship is much better with my husband and

Feeling Down? Try the Feeling Great App for Free! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com! Life Coaching: A New Dimension in Counseling Today we discuss the recent upsurge in life coaching, and feature one of the leaders in this emerging field, Angela Poch, and one of her wonderful students, Lorna Bird. Lorna Bird Angela Poch (see featured photo) is a Registered Professional Counsellor (RPC) with the Canadian Professional Counselling Association, certified Master Life Coach, and TEAM-CBT Level 4 Advanced Therapist and Trainer. She has been teaching health and wellness for over 30 years and was Vice President of Education with the Adventist Association of Health & Wellness Coaching. She has written several articles and books on health and wellness including, "The Truth Will Set You Free." She has a YouTube channel (@talkingteamcbt) interviewing clinicians about their journeys with TEAM-CBT. She also has a channel on psychology and health (@bodymindhealth4u). Lorna Bird holds a Diploma of Counseling from Australia and is a certified Life and Health Coach. She is also a Level 3 certified TEAM-CBT therapist https://www.yestohealth.com.au/ Angela and Lorna will give us the true scoop on coaching. To get started, what IS coaching, and how does it differ from psychotherapy? I am aware that our podcast goes worldwide, so the answer may differ depending on the country or state where you live. According to AI, "In California, the term "psychotherapist" is defined in the Civil Code to include a number of mental health professionals, including psychologists, psychiatrists, and clinical social workers. In general, anyone who provides psychotherapy or counseling in California, whether in person, by phone, or online, must be licensed.in California." Coaching is quite different. Again, according to AI, "In California, there are no specific state-mandated requirements for individuals to use the term "coach" or practice life coaching, meaning anyone can technically call themselves a coach without obtaining a specific license." Angela Poch resides in Canada, and she has been a leading and beloved member of the TEAM-CBT community. She emphasized several differences between a "coach" and a licensed mental health professional: Diagnosis: A coach does not diagnose clients into the familiar DSM categories of "mental disorders," such as "Major Depressive Illness," "Bipolar Disorder," "Schizophrenia," or any of the hundreds of "mental disorders" listed in the DSM. In the same vein, licensed mental health professionals will typically screen for suicidal thoughts and urges, and will treat suicidal individuals, but this is forbidden territory for coaches. Purpose / aims of coaching: The purpose or aims of coaching do not, as a rule, involve delving into your past to search for the "cause(s)" of your problems, such as adverse childhood experiences or traumas. Instead, the focus of coaching is primarily on making changes in the here-and-now in how you think, feel, and relate to others. This might involve learning to challenge distorted negative thoughts so you will think and feel more positively about your life, as well as how to relate to others more skillfully. Coaching is goal-oriented and forward-moving rather than dwelling on the past. Of course, good counsellors and licensed mental health professionals may also provide tools to move forward as well, so there can be overlap. Training / credentialing: Because coaching is so new, there are not yet any widely accepted standards or requirements for calling yourself a "coach." There is a varying degree of training to be "certified," which might just consist of watching a couple videos to 100's of hours of supervision with the ICF (International Coaching Federation), and everything in between. Here's a generalized diagram Angela created to help with further clarification. NOTE: many TEAM-CBT therapists also are client/goal focused as well as and will often use coaching-style tools. Angela described a 20-hour "Feeling Great Coach" certification program she has developed. Her program is based almost entirely on TEAM-CBT and includes a final exam you must pass to get certified. She also offers a TEAM-CBT Masterclass & Mentoring Program for both coaches as well as therapists that includes live training twice a month, online practice groups, case consultation in small groups, one-on-one mentoring sessions, and personal work as well. She said this integrates seamlessly with FGI's Fast Track program, any of David's intensives, or the Tuesday group for those who want more individualized support and training. Lorna enthusiastically described her experiences learning from many of Angela's training programs. I (David) have had the pleasure of knowing and working with Angela for many years now, starting with her attendance at a number of my intensives an

Ask David Disturbing Intrusive Thoughts-- where do they come from? Alone and Liking It--is that Okay? Help with those darned Shoulds, and more! The following show notes were written before the show. The actual live discussions will vary somewhat from the answers you will find here, which simply included David's email exchanges with those who asked the questions. . Rodolfo asks about disturbing and unwelcome intrusive thoughts. Brittany asks if it's okay to enjoy / prefer being alone. John, from Ireland, asks, "Help! I'm shoulding on myself again! What can I do? Please do another podcast on Should Statements." Rodolfo asks about disturbing and unwelcome intrusive thoughts. 1. Rodolfo asks about ADHD & Intrusive Thoughts Hello Dr. Burns, my name is Rudy. First and foremost, your writings and podcasts have been life changing for me. You're AMAZING! I was recently diagnosed with ADHD and I started experiencing intrusive thoughts around November of last year. I thought I had OCD, but apparently intrusive thoughts are a common companion in ADHD. What would be the best course of action in defeating them? How would I apply TEAM to them? David's Response In all my books, like Feeling Great, I outline a step by step approach to writing down and challenging thoughts. You can also listen to the podcast on the four models for treating anxiety. Can we use your great comment on a podcast, and add your question to our next Ask David podcast? Can you send me an example of the types of intrusive thoughts you're having? Sometimes writing them down and challenging can be helpful, but need to see what we're talking about. Best, david Rodolfo responds Thank you for the swift response! Ok, so writing down my intrusive thoughts, regardless of their nature, and challenging them. I don't, however, know which method/route to challenge them with. I have Feeling Great, so I will read through it again. I will also check out the podcasts. My intrusive thoughts have been disgusting violent acts involving my wife and son. ***I HAVE NO INTENTIONS OR DESIRE TO COMMIT ANY OF THEM***. I've had images of my wife getting shot, not necessarily by me. Sometimes I'll see my arms give out and my son will fall. I've seen my wife sitting down, and she gets hit in the back of the head. When they appear, I begin to freak out immensely because they are the complete opposite of who I am and what I want to do, which is protect them. I know I'm not doing something right when it comes to your methods because I still freak out. David Responds Thanks! Although disturbing, this is a very common and often easily treatable OCD type of problem. Best, david Rodolfo responds What a relief. I thought I was going insane here! I would be honored if you all covered it in a podcast. All I listen to in my car now is the Feeling Good podcast! David Responds Often, intrusive OCD thoughts reflect suppressed problems / feelings people have, especially when the person is exceptionally "nice," and used to sweeping feelings under the rug, so to speak. I cannot treat you in this medium, obviously, but I'm wondering if you have some negative feelings, like anger or frustration, toward your wife and child? When these are "squashed," they can come out indirectly, disguised as anxious thoughts and feelings. This is called the Hidden Emotion Technique, which you can look up using the search on my website, if curious, or read about it in my book, When Panic Attacks. Best, david 2. Brittany asks if it's okay to enjoy / prefer being alone. Hi Dr. Burns, I was listening to your podcast on self-acceptance, and it was really interesting hearing the results. I like how you said that just because we accept something about ourselves doesn't mean we aren't still working on it. I think people confuse that a lot. One thing I've accepted about myself is that I really do enjoy being alone. I think in the past I would try to find a buddy in uncomfortable situations like the first day of work or orientation or going to a baby shower alone etc. but now I find that I am most comfortable when I'm not included with everyone else. However, I think it can come across as off putting to some. Sometimes I get the feeling they see me excluding myself as rejection to them. That's not my intention and nobody's ever actually said that but it's a thought that pops up. Just wondered if you think this form of acceptance is good or bad? I mean it's been good for me. Just maybe it's bad for others? -Brittany David's response This is a cool question and nice comment, too, about our podcast. Can we read this on a podcast and use it for an Ask David? Personally, I am trying to say "no" more often when asked to do things with other people, and sometimes it's hard. But if I don't say no, I get way too much on my plate and can't keep up! Warmly, david Brittany's reply That makes perfect sense to me. I've kind of taken the position where I don't really want to make more friends because I feel like I'm already falling short w

Feeling Down? Try the Feeling Great App for Free! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com! What's a Give-Get Imbalance? What's the Best Treatment for Anxiety and Dysthymia? Can you do Externalization of Voices on Your Own? The show notes for today's podcast were largely written prior to the show. Tune in to the podcast to hear the discussion of these questions by Rhonda, Matt, and David. And keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks! Suzanna asks: What's a "Give-Get" imbalance? And how can you get over it? Martin asks: What's the best treatment for anxiety and dysthymia? Eoghan (pronounced Owen) asks: Can you do Externalization of Voices on your own? 1. Suzanna asks: What's a "Give-Get" imbalance? And how can you get over it? Description of Suzanna's problem. Suzanna is a woman with a grown daughter with severe brain damage due to a severe brain infection (viral encephalitis) when she was an infant. Suzanna was constantly giving of herself and catering to her daughter. She explains that her daughter can be very demanding and throws tantrums to get her way, and kind of controls the entire home in this way. She can only talk a little and has the vocabulary of about a two-and-a-half-year-old. She can mostly express the things she wants or doesn`t want on a very basic level. She mostly understands what I want from her, but mostly does not want to do what I ask her to do. She can be very stubborn. And I cannot reason with her because she has her own logic and, in her eyes, only her logic is valid. Maybe all a little bit like a two-and-a-half-year-old. Suzanna struggles with negative feelings including guilt, anxiety and depression, because she is constantly giving, giving, giving and feeling exhausted and resentful. And she tells herself, "I should be a better mum." Can you spot any distortions in this thought? Put your ideas in the text box, or jot them down on a piece of paper, and then I'll share my thinking with you! What are the distortions in the thought, "I should be a better mum"? There are many distortions in this thought, including All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Magnification and Minimization, Emotional Reasoning, Self-Directed Should Statements, and Self-Blame. There may be one or two more, too! The first step in change nearly always includes dealing with motivation and resistance. Suzanna decided to do a Cost-Benefit Analysis, as you can see below, and a revision of her Self-Defeating Belief, as you can see below. Another helpful step might include "No Practice," which simply means saying "no" so you don't constantly get trapped by "giving," as well as "giving in." A third critically important strategy involves the mom and dad making the decision to work together as a loving team in the management of a troubled child, rather than fighting and arguing with each other, as we've discussed on previous podcasts. However, in many, or possibly most cases, the parents are not willing to do this. They are more concerned about being "right" and so they continue to do battle with each other, as well as the child who needs a more loving structure. David Cost-Benefit Analysis Self-Defeating Belief: I should be a better mum to my daughter Advantages of this belief(How does believing this help me?) Disadvantages of this belief(How does believing this hurt me?) This thought motivates me to: Put myself out. Push myself to give what I have. Find ways to advance her development. Find ways to involve her in everyday life. Invest myself into her and her life as much as I can, physically, emotionally and time wise. Try to find ways that my daughter can have a fulfilling life. Try hard to connect to her, her pain, her needs, her sadness and her frustration. Try to make her life as easy as possible. Try my hardest to see her world through her eyes and gain deeper understanding of how she feels. Try to understand what is upsetting her when she throws a tantrum. Stay healthy and fit to have energy for her. Try to make her life rewarding and meaningful. Fulfill my duty as a mum to my daughter who needs my support. I can feel good about myself. I satisfy other people's expectations of me. Protects me from criticisms from my husband I am a prisoner to my daughter. No matter how hard I try I don`t seem to make a meaningful difference to her life and to her development. I am a "Siamese Twin" to her. I cannot move or do anything if she doesn`t want to. I reason with my emotions instead of thinking rational at times. I let my daughter get away with "murder". I find excuses for her behaviour. I find excuses for her why she cannot behave differently. I beat up on myself when I feel I failed her. I take all responsibilities away from My daughter and make them my own. I blame myself when I cann

Ask David: What's Self-Esteem? What's Self-Acceptance? In today's podcast we address six common questions about self-esteem, including: What is Self-Esteem? How does it differ from self-confidence? How does it differ from self-acceptance? What's the difference between conditional and unconditional self-esteem? What's the best way to develop self-esteem? What do you mean when you say that once you develop unconditional self-esteem, you should get rid of it as fast as possible? Please keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks! Brandon Vance and Heather Clague begin today's show with a pitch for their upcoming Feeling Great App Group, an 8 week experience that will begin in September. If you use the Feeling Great App, or plan to get it, this group would be an inexpensive and incredible enhancement, so you can meet with like-minded people once a week to schmooze, practice the techniques in the app, and get your questions answered by compassionate and personable experts. For more information go to www.FeelingGreatTherapyCenter.com/appgroup. Feeling Great App Group Sept-Nov 2024 Led by Brandon Vance MD and Heather Clague MD, meets online for 80 minutes for 8 weeks, offered Mondays 4-5:20pm Pacific Time, September 23rd - November 11th. Cost is $12 per session ($96 total) plus the cost of the app ($99 per year after 7 day free trial). Sliding scale for both the group and the app are available. No one turned away for lack of funds. Feeling Down? Try the Feeling Great App for Free! It's now in the IOS and Android app stores, and you can check it out for free. It's works super fast. Let us know what you think! Thanks! Rhonda, Matt, and David appreciate your support. Keep your questions and testimonials coming. They mean a lot to us!

Feeling Down? Try the Feeling Great App for Free! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com! What's the Meaning of Life? Before we start today, I have a special shoutout to Max Kosma, our new colleague, friend and brilliant technical guru who helped make our new video studio possible! Next week, we'll see if we can pipe him in to say hello to all of you. His spirit is joyous, infectious, incredibly generous and supportive. Thanks, Max! Rhonda opened today's podcast with a vibrant and inspiring endorsement from Jeff, a podcast fan who was raving about the Feeling Great App. Thank you Jeff, and please check out our new app at FeelingGreat.com. Important Announcement Rhonda, along with a group of dedicated TEAM Therapists, including Amy Berner, Brandon Vance, Leigh Harrington, Mariusz Wirga, and Mark Noble, has just created a new non-profit organization called TEAMCBT International (TCI). TCI will provide seed money in the form of no-or-low-interest loans for groups around the world who want to offer TEAM-CBT intensives for therapists in your country. Rhonda has been instrumental in the organization of successful intensive workshops in India, Poland, Mexico, England and Ireland. They have been well received, but can be somewhat costly to produce, so Rhonda's new group is ready to provide a helping hand. I've had the honor of presenting keynote addresses, live therapy demos, and Q and A sessions in many of those programs, and have totally enjoyed them. A big hug and THANKS to Rhonda once again! To learn more, just go to TEAMCBT.International. Today, Matt joins us for a discussion of the meaning of life, something young people often worry about, but people of any age can be concerned. So, today, you may finally find the answer to that lofty question! But first, I (David) mentioned a little about one of last week's questions, "Is the universe real?" I provided the type of answer the famed philosopher, Ludwig Wittgenstein, might have provided. Namely, that the question is nonsensical, it is language "out of gear." So, we can dismiss the question, as opposed to trying to answer it. HOWEVER, the question DOES make a ton of sense when we ask if human beings are "real." And I am not referring to some metaphysical nonsense, but rather the tendency of many people to present a happy or confident false front, all the while feeling empty, lonely, anxious and ashamed inside. Two of the now more-than-140 TEAM techniques include Self-Disclosure and the Survey Technique, where you take the chance of opening up about some of the secrets you've been hiding, and ask others what they think about you. Although this takes tremendous courage, it often results in tremendous warmth and connection to others. I provide a description of a young man who disclosed a tremendous amount he'd been hiding in our recent Tuesday group at Stanford, and he was convinced the group would judge him and look down on him. But just the opposite happened. He encountered a flood of warmth, admiration, and respect from the people in our group. A small miracle, perhaps, but a real and meaningful miracle at the moment when his universe suddenly became "real" and radically different from the dangerous and critical world he'd feared and imagined. Then we tackled today's philosophical question: "What's the Meaning of Life?" As usual, our brilliant and beloved Matt May began with a description of an extraordinarily depressed patient he once treated who'd been hospitalized for 180 days with no improvement, including a very dangerous suicide attempt. Matt was worried for the patient's safety, so told the referring doctor that he'd been willing to talk with the patient while the patient was still in the safe environment of the hospital. The patient called Matt and, after some listening and empathy Matt said he would like to help and that there would be committed to helping the man and thought he could help him make a complete recovery, work with this man, and thought there was an excellent chance for significant progress, perhaps even complete recovery, but the patient probably wouldn't want to work with him.as long as he'd be willing to give Matt what he needed in order to work together effectively. Matt suggested the patient give him a call. On the call, Matt told him he might not be able to afford treatment, since part of the "cost" of therapy was that the patient had to make a commitment to life, and that he must agree never to attempt suicide no matter what, for the rest of his life. After a couple days of reflection, the man convinced Matt that he WOULD make that commitment. Then Matt described the man's problem. Both of his parents were world famous, successful scientists, and during his upbringing, his parents emphasized how fantastic and rewarding a career as a scientist could be, and he was convinced that his par

Feeling Down? Try the Feeling Great App for Free! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com! Is the Universe One? Is the Universe Real? Is the Universe Real? These two philosophical problems used to seem nonsensical to me, and certainly not relevant to much of anything in my life—or anyone's! But now the picture has changed a bit! When I was a student at Amherst College, I majored in the philosophy of science. On this show, I've often talked about my hero, Ludwig Wittgenstein, who attempted (successfully in my opinion) to "solve" all the problems of philosophy. He wanted to help those of us who were "afflicted" by an attraction to philosophical problems to see through them and understand precisely how and why they were nonsensical. He hoped to provide a "treatment" for philosophers so we could give up the need to obsess about nonsensical philosophical problems. Once you see through the these problems, they become kind of like a joke, and you can use jokes to help other people see through them. For example, here's a kind of lame joke about the question of whether or not the universe is "real." Wittgenstein said that before we try to answer questions like that, we might want to ask ourselves if these questions even makes sense! And if it a philosophical problem doesn't make sense, it isn't a real question, so we won't need to deal with it. In other words, questions that don't make sense don't need to be answered because they're not real questions. Take the question, "Is the universe real?" You could ask, "Well, what would it be like if the universe weren't real? What would that look like? How would things be different?" If you can't answer that question, the question might not make sense. To most of us, philosophical questions wound nonsensical because we are taking words, like "real," out of the contexts in which it DOES make sense. For example, we can ask : "Is this painting real? Or is it a fake?" That question does make sense. It has an obvious meaning, since many valuable paintings are copied and are fakes, and they try to pass them off as the "real" thing. But what would a "real" or "fake" universe look like? How would it differ from our universe? Now let's think about another example that is mildly humorous. Let's imagine you're driving through Iowa in the summer, and you spot a farmer working in his corn field. You're interested in speaking to him because you are writing a story about your travels in Iowa, and want to talk about the lives of farmers. So, you pull your car over to the side of the road and shout, "Howdy! What are you doing in the field?" The farmer seems pleased and grabs a gorgeous stalk of corn and holds it up and proudly shouts, "I'm growing corn, and it is real!" Well, that's great that he's happily growing corn, but what does the tag-on, "and it is real" mean? It doesn't actually mean anything, because farmers don't grow "unreal corn." So, in this context, the word has no meaning. Now, if you were on a movie set, they might actually be using artificial corn as a prop, so now the contrast between real and unreal corn becomes meaningful. This is a very humble point, but it's the very heart of what Wittgenstein was trying to make us aware of. Philosophical problems kind of sound meaningful and puzzling, but most of the time, they are simply a kind of nonsensical use of language. Now, in personal relationships, we might also have a notion of when people are being "real" or fake. And we often act fake because we don't think we're good enough just the way we really are. So, for example, you may hide your shyness in social situations because you're ashamed, and telling yourself that your shyness is incredibly weird and abnormal, and makes you "less than" other people. One method of helping people overcome shyness is simply to disclose it to others. This TEAM-CBT technique is called "Self-Disclosure." Instead of hiding your shyness and feeling awkward and ashamed in social situations, you share your feelings openly. Shame depends on hiding, so when you open up, the feelings of shame will often disappear. For example, in a recent podcast of a dramatic, live therapy session, a man named Chris revealed many troubling things about his teenage years that he'd been hiding for years. When he opened up, he began sobbing intensely, thinking he'd let his father down with his wild behavior when he was a high school student. His grief, he was incredibly compelling, and his courageous self-disclosure was appealing to most of us who were privileged to witness that session. Showing us his "real" self became his path to enlightenment, joy, and deeply meaningful relationships with himself and with all of us who witnessed that amazing session. So, although the question, "is the universe real" is silly and nonsensical, the question, "are we being real with each ot

Special Announcement #1 The Legendary Summer Intensive Starts on Thursday of this week! Featuring Drs. David Burns and Jill Levitt August 8 - 11, 2024 Click for registration / more information! This workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Podcast #408-- Does God exist? We started today's podcast with a beautiful testimonial and a shout out for the intensive from August 8 to 11, 2024 at the South San Francisco Intensive in person or virtually if you prefer. To learn more, contact www.CBTintensive.com. Act fast because the intensive is on Thursday of this week when today's podcast will be published. Today, we tackle another popular and intensely debated philosophical / religious puzzle: Does God exist? People have very heated views, one way or the other. I (David) will start with a brief explanation of a Wittgenstein answer to this question, and then for the most part, we will focus instead on the question of how we all incorporate spirituality into TEAM-CBT. Wittgenstein emphasized that philosophical problem exist when we debate about the meanings of words or terms that are vague, or poorly defined. Traditionally, we think there are three positions one could take: Theism: You believe that God exists. Atheism: You do not believe in God. Agnosticism: You say that you do no know whether or not God exists. My own thinking, which is strongly influenced by Wittgenstein, would be that I don't understand any of those three stances because I have no idea what you mean by your use of the word, "God." What is it, exactly, that I'm supposed to believe in, or not believe in? To me, the question, "Do you believe in God," is nonsensical, so I simply do not deal with it. All of the three positions listed above are based on the idea that the word, "God," has some kind of clear meaning that we can all agree upon. But it clearly does not. You might define "God" as the "creator of the universe." Well, there is certainly something magical and mysterious about the existence and creation of the universe (assuming it did begin with some kind of "big bang.") Some questions might include "Where did all the energy come from all of a sudden?" Or "Are there many universes?" These are valid questions, and physicists are pursuing the answers, which is very exciting and fantastic. But they are generally not invoking the concept of a "God," although some undoubtedly would say that they do "believe in Gad." Regardless, I cheer them on and find every new discovery about the nature of the universe, and how the universe works, endlessly fascinating! For today, we will ask a much simpler question of whether and how we include some kind of spiritual dimension into our work as shrinks. This is a topic that is equally exciting, and definitely meaningful. Rhonda got us started by explain that she sees the belief in God as a matter of faith, and is not something that can be tested empirically, which is certainly true. She says she does believe in God, or some "higher power," but does not believe in a God who "rules over things." She was raised in the Jewish religion, and says that many Jews believe that God exists in everyone . This sounds a little like Hinduism, which traces back at least 2500 years ago, and possibly as early as 5000 years ago. I believe that the Hindus believe that God exists in everything. The practical impact of the belief that God exists in all of us, is that we will treat each other with love and respect, since we are all an expression of God. She also said that we can "create God among us as a community." Matt said that he was raised as a Christian and that when he was growing up he had heard about miracles, like Jesus raising Lazarus from the dead in the New Testament on the Gospel according to John. He said that he views our work with individuals who are severely depressed as a kind of spiritual healing, even though we are working with purely secular methods. This is especially true when we are working with individuals who appear to be paralyzed by depression, claiming they are unable even to get out of bed, people who bombard themselves with harsh criticisms, and feel hopeless and ashamed. Matt said that self-acceptance (accepting ourselves exactly as we are) is one of the many tools we use, and that he (Matt) loves to think about the ripple effects of our work, which not only transforms the l

Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Podcast Practical Philosophy Month Part 2, Do Humans have "Selves"? This is our second podcast in our Practical Philosophy Month. Last week, in our first episode, we focused on the "free will" question. As humans, we all feel like we have "free will," but is it just an illusion, especially if all our actions are the result of the physical processes in our brains and the laws of the universe? The Bible certainly dealt with this in the book of Genesis, where we learn that the first humans, Adam and Eve, were given a wonderful Garden of Eden to live in, but they had to choose whether or not to obey God's rule NOT to eat the forbidden fruit from the tree of knowledge of good and evil. They chose to eat the fruit, implying that humans have free choice. But the philosophical arguments rage on. In today's podcast, we are joined by two beloved and brilliant colleagues, Drs. Matthew May and Fabrice Nye, as we explore the question of whether or not the "self" exists. We all feel like we have a "self," but is this real or just an illusion? When you try to define your "self," you may run into problems. For example, you might think that the "self" has to be the part of us that does not change from moment to moment, and is always 'the same." For example, I might think back on my childhood and feel convinced that I was the "same David Burns" then that I am now. And, if you are religious, you might also be comforted by the idea that your "self" is the same as your "soul," and that you will therefore live on after you die. This concept of a "soul" is a core belief in many religions. But are we fooling ourselves? And what was the Buddha thinking about 2,500 years ago when we talked about enlightenment as resulting from the "Great Death" of the "self." He seemed to be hinting that something wonderful can happen when you give up the idea that you have a "self." In the original draft of my book, Feeling Great, I had a chapter on entitled, "Do you need a "self?" Join the Grateful Dead." I tried to persuade readers that the existence of a "self" is nonsense, based on the philosophy of Ludwig Wittgenstein in his famous book, Philosophical Investigations. But readers found the chapter so upsetting that I decided, on their urging, to delete it from the manuscript, which I did. My goal is not to disturb people, but to provide a path to joy and to loving connections with others. But to this day, I still get emails from people asking me to offer that chapter, or to deal more deeply with this concept of the "self" vs "no self" in a podcast. So, here is my attempt today. I will start with my own take, and then summarize some of the views about the self that were expressed by Fabrice, Matt, and Rhonda during the show. Here's my thinking. There are many key questions you could ask about the concept of the "self?" including: Do we have a "self?" And if so, what is it? Does the first question even make sense? I'm sure you would agree that if a question doesn't make sense, then it isn't a "real" question, and there really isn't anything to talk about. Then we can just stop feeling frustrated and perplexed, and move on with our lives. That is the precise position that the late Wittgenstein would probably have taken. He stated that words have no ultimate or "true" meaning outside of the various contexts in which we use them in daily life. Most words have many meanings, because they are used in different ways, and you can find most of the meanings in any dictionary. So, if you think of the word, "game," you will quickly realize that it does not have one "true" or essential meaning. It can mean a sports competition, with two teams competing against each, like soccer. But you can have two teams competing in some way other than a sport. And you don't even need two teams to have a "game." For example, some games are played by one individual, like solitaire with a deck of cards. Or you can think about the "dating game," or refer to "game birds," or a "game b

Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Podcast Practical Philosophy Month Part 1, The Free Will Problem Welcome to Practical Philosophy month. For the next five weeks, we will discuss some of the most popular and challenging problems in philosophy, such as these: Do human beings have free will? Or is free will just an illusion? Do human beings have a "self?" Or is the "self" just another illusion? Is it possible to be more or less "worthwhile?" Are some humans "better" or "worse" than others? Does God exist? Is the universe "real" or "one"? What's the meaning of life? What is "self-esteem"? How does it differ from self-confidence? What's the difference between conditional and unconditional self-esteem? What's the difference between self-esteem and self-acceptance? What do you have to do to experience joy and feelings of worthwhileness? We will try to complete the list in five weeks, so some weeks we may include more than one topic, since many of these topics are related to one another. Rhonda and David will be joined by our beloved Dr. Matt May, a regular on our Ask David episodes, and for the first and second sessions we will be joined by our beloved Dr. Fabrice Nye, who created and hosted the Feeling Good Podcasts several years ago. Each week, you will also hear about the linkage between these philosophical dilemmas, and emotional problems, like depression, anxiety, and relationship conflicts. For example, nearly all depressed individuals believe that they aren't sufficiently "worthwhile." I see my goal as a psychiatrist not as helping people feel "more worthwhile," but rather showing people, if interested, how to give up this notion entirely and become free of certain kinds of damaging judgments of the "self" and others. You will also learn how these types of philosophical problems continue to play a large role in psychiatry and psychology, including the DSM5 diagnostic system. For example, is the diagnosis of "Generalized Anxiety Disorder" a true "mental disorder" that you could "have" or "not have?" And might some or most of the so-called "mental disorders" listed in the DSM be based on faulty philosophical / logical thinking? And if many or most of the "mental disorders" are based on goofy, faulty thinking, is there a more productive and effective way to think about most emotional problems? And how did we get into this mess in the first place? Worrying certainly exists, and we all worry at times. But how much or how often do you have to worry before you develop or have a "mental disorder" called "Generalized Anxiety Disorder" that can be diagnosed like any medical illness and treated with drugs? Or is "Generalized Anxiety Disorder" (and hundreds of other "mental disorders in the DSM" based on a certain kind of nonsensical thinking? And if so, why? What is the goofy, faulty thinking in the DSM? And are there some "mental disorders" that are valid and real? We HAVE touched on all of these themes in previous podcasts, but I thought it would be nice to put them all in one place and bring in a variety of "solutions," controversies, and experts. I David, will often represent (hopefully, and to the best of my ability) the thinking of Ludwig Wittgenstein, as expressed in his famous book, Philosophical Investigation, published in 1950 following his death. That book consists of a series of numbered brief essays (a few paragraphs each) that were based on notes found in a metal box under his dormitory room at Cambridge University. He'd written these in preparation for his weekly seminars in his dormitory room. Wittgenstein, although now widely regarded as one of the greatest philosophers of all time, did not think he knew enough to teach in a classroom. In fact, because of his feelings of depression and self-doubt, he sadly never tried to publish anything when he was alive. Wittgenstein's philosophy also played an indirect but significant role in the evolution of several modern psychotherapies. His philosophy created new ways of thinking that gave rise to the

Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Ask David Podcast We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes. We love your questions. Remember to send them to [email protected]. Ask David Questions for Today Bosley asks: My father can be very critical of my plans for the future. What's the best way to respond to him? Willie asks: I have a dating questions. Why do women keep ghosting me? Should they be more willing to work out differences with the Five Secrets of Communication? 1. Bosley asks: My father can be very critical of my plans for the future. What's the best way to respond to him? "To explain somewhat concisely, I just want to move to the nearest major city (Seattle) since I feel really really happy there. I also love volunteering for a specific organization and have some community there that I care about, and I feel very isolated having been away from for months. I'm willing to carry the load of all the work I would need to do to make it happen, and do a business training my dad wants me to complete. He has other thoughts. He looks down on volunteering and his thoughts on friends are simply that I can make new ones anyway. He is very aggressive and intimidating in his arguments, full of insults and many factually incorrect statements that are difficult to disarm on the fly. He shoots down the idea upon mention, so it's difficult to collaborate to find mutually beneficial solutions. He is a successful businessman, despite recent financial issues, and has a sort of strict plan for me that he has wanted me to follow, although I really don't feel this conflicts with his goals to have me run things in the future. I'm just worried since he has a long past of being emotionally abusive and of going back on his word. Plus, I just want some autonomy. In the end, it's his way or the highway. He says "You keep scheming and going down a twisted path instead of doing what I tell you." David's reply I suggested he might complete the first four steps of the Relationship Journal so we could see how he's communicating with his dad. Here is Bosley's partially partially completed Relationship Journal (showing steps 1 to 4, but not 5.) Step 1 – S/he said: Write down exactly what the other person said. Be brief: You keep scheming and going down a twisted path instead of doing what I tell you! Step 2 – I said: Write down exactly what you said next. Be brief: What? Circle or bold the emotions S/HE might have been feeling Circle or bold the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated Angry, mad, resentful, annoyed, irritated, upset, furious Angry, mad, resentful, annoyed, irritated, upset, furious Other (specify) Other (specify) Step 3 – Good Vs. Bad Communication: Was your response an example of good or bad communication? Use the EAR Checklist to analyze what you wrote down in Step 2 Step 4 – Consequences: Did your response in Step 2 make the problem better or worse? Why? It probably made things worse. I came off dismissive, which probably confirmed for him that I automatically ignored any advice or direction that he gave me. I wasn't assertive in fear of escalating anger or just being

A Riveting Story of Raw Emotion. . . "Dad, I let you down!" Part 2 of 2 Special Announcement The long awaited Feeling Great App is now available in app stores. IOS and android! Check it out. Take a free ride! And now, on with the exciting conclusion of the personal work Dr. Jill Levitt and I did with Chris, along with a fabulous followup interview you will hear at the end of the session. I hope you enjoyed the session with Chis, and hope you found it inspiring. His message of hope and joy could be helpful and inspiring to any of you who may be struggling, and feeling, as he was, that you're just "not good enough." His work is, of course, important from a psychological perspective, because it illustrates the powerful steps of TEAM in a sequence that brought Chris from the depths of despair to the peaks of enlightenment. However, as you will hear in the postscript dialogue, the work for sure takes on a spiritual and mystical quality for sure! When you hear Chris live during the follow-up interview at the end of Part 2 of this two-part podcast, you will not be disappointed! Postscript As I mentioned earlier, I was overjoyed when I learned that Chris had unexpectedly changed his mind and offered us the chance to publish his personal work and provide a follow-up recording of how he's doing now. Here's my email to him just prior to the follow-up recording. Hi Chris, I'm assuming that Rhonda will coordinate this and she has us scheduled for this Friday, I believe. When it is 4 PM in your time zone, what time is it in our time zone? Are you two hours later? I just reviewed my chart notes from a year or so ago, and it will be terrific to reconnect with you. I deeply appreciate the chance to share your session with our many listeners, as it is full of raw emotion and is riveting. You are making a super strong statement to the world, to my way of thinking, and it takes incredible courage to say, "This is me! I am very real, and sometimes very raw!" I think many people suffer due to thinking that everyone else is somehow "better" than they are, and that they are somehow "not good enough." That is perhaps the main theme I hear when doing clinical work, and that includes my work with mental health professionals who are equally vulnerable to this kind of thinking. What triggered your decision to go public, so to speak. And how might this impact your students, and their parents, and so forth? Hopefully, we can chat this Friday about those and any other questions or topics that touch or interest you. It will be great to get caught up on your past year! If Jill or Rhonda want to add your thoughts, please do! To me, this is a very significant occasion to have the chance to connect with you, Chris, again! The work you did is among the most powerful and impactful ever in my memory, although every time we do live work it is pretty incredible to my way of thinking, especially when people become "real," whatever that means! Humans have a dark side, to be sure to my way of thinking, but something incredibly beautiful and amazing can emerge. I am babbling so will stop. But I am so excited to talk to you again, Chris! Warmly, david Thank you for listening, and please let us know what you think. if you are a therapist, and want to learn how to do this, consider attending the summer intensive from August 8 to 11, on line, or in person at the South San Francisco Conference Center (ten minutes from the SF airport.) See the details and a link below, or go to www.cbtintensive.com. Chris, Rhonda, Jill, and David Click for registration / more information!

A Riveting Story of Raw Emotion. . . "Dad, I let you down!" Special Announcement The long awaited Feeling Great App is now available in app stores. IOS and android! Check it out. Take a free ride! And now, on with today's podcast! Part 1 of 2 Our work with Chris started with this email: Hi David and Jill, I am 40 years old and have never been in a relationship. I've only had a handful of sexual experiences. I used to carry a lot of shame around this, but have done some work on myself, have more or less come to terms with where I'm at, and actually really enjoy my life and am pretty happy most of the time. However, I recently developed some strong feelings towards a coworker, and this led me to re-evaluate my stance on being single. The DML (LINK) details an incident from last week concerning this coworker. I haven't had extensive interactions with her and she works at a different site. Our clinical team meets twice monthly for online zoom meetings. She recommended a book to the team a few months ago, I read the book and enjoyed it, and was hoping to meet up with her and talk about it sometime. I was feeling a little terrified and didn't know if it was the right thing to do, but ultimately sent her an email asking if she'd like to speak with me about the book sometime. She politely declined the invitation. The daily mood log documents the hour or two immediately after I sent the email, as well as some of the thoughts that happened after I received her reply. There were a lot of negative thoughts, so I only included a few. There were also a number of hidden thoughts/beliefs that occurred to me over the last few days, which I have not included. It seems worth noting that for 2-3 hours after I sent the email, I experienced a lot of emotional turmoil. However, at 4pm when I got off work, from the long drive home until I went to bed, I was in a euphoric state. I was happy about what I did, how I responded to the rejection, and was optimistic about my future. I was working out at the gym and had a hard time keeping a smile off my face. I went to bed feeling great, but woke up in the middle of the night and felt terrible again, the painful sting of rejection kept me from sleeping. Since then, I've mostly felt just fine about it, only a few brief moments of really feeling that sting and they don't last long. My goal isn't to necessarily get into a relationship or have more sex; it's to feel more confident in my interactions with women. After being rejected, I think 15 seconds of agony is enough, no need for more than that. In the past, when I've developed strong feelings towards a woman, I notice that I am prone to both negative and positive distortions, some version of: "It's the end of the world if she isn't attracted to me," or "She's perfect for me; there is no one else like her," or "Sex with a beautiful woman will complete my life, or completely fulfill me". I think I'd be better off without these distortions, but find the positive distortions to be somewhat addictive. They also make it hard for me to let go and move on. I still feel somewhat attached to this woman and haven't been able to let go and move on. Also, I want to note that there are a few experiences from high school that really impacted my sexuality, relationship with women, and probably inform some core beliefs on these subjects that have recently come to surface. I'm not sure how much to share about this or whether it's even necessary to, but I suppose that could be addressed in the empathy phase on Tuesday. One other thing that I didn't include in the DML, is when I'm in that negative state, sometimes I have intense thoughts directed at me that come in the form of the second person, like You're a piece of shit. I fucking hate you. Cut your throat You don't deserve to be alive. I'll fucking kill you. I don't really believe these thoughts, but they do make me sad. Hope this all makes sense, let me know if you have questions or if I'm missing something. Looking forward to working with you. Thanks, Chris This email led to personal work with Chris in our Tuesday TEAM-CBT training group, roughly one year ago. Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California, was my co-therapist. It was one of the rawest and most riveting sessions that I can recall. Here is the Daily Mood Log he sent, along with his Daily Mood Log: Daily Mood Log Due to the intensely personal, explosive revelations Chris shared with us during his session, he decided he did not want us to publicize his work as a podcast, which was totally understandable. Our highest priority is always the peace, safety, confidentiality, and well-being of the people we work with. However, roughly a year later, Chris contacted us and said he'd changed his mind, which was fantastic news. He said he'd changed his mind because he had a relapse, and decided to listen to the recording of the work you're about to hear. He said it was extremely helpful, and so

Ask David Unfairness Worthwhileness Erasing Depression with Lasers TEAM in the UK What's the Most Powerful Technique? We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes. We love your questions. Remember to send them to [email protected]. Special Announcement Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. But there's some good news, too! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out! Today's Questions Kiernan asks about "unfairness" and the connection between worthwhileness and achievement. Brittany asks: Can you "erase" feelings of sadness and depression by shining lasers in the patient's eyes? James asks about the use of TEAM methods in the NHS in the UK Brian asks: Is positive reframing the most successful technique you have used with your patients? 1. Kieran asks (slightly edited for clarity): How would you talk back to negative thoughts like this one: "It's not fair that I can't afford quality food when there are millionaires that will have access to better food and a healthier lifestyle which has an effect on overall health and longevity'"? Or what if you feel like it's unfair that you should have to pay a lot of money for an expensive dental treatment that you can't afford? Kieran also asks (slightly edited by david): What if worthwhileness is not based on achievement but there are still things you would like to have and enjoy? They would buy and own things that they happen to like and not to impress others. Hi David and Ronda, and if Matt is on I have been listening to your wonderful podcast for about the last 3 years as I drive to work. It has really opened my eyes about how your thoughts create your interpersonal reality. Loved the podcasts on jealousy addiction, perfectionism, achievement addiction and many more. My questions would be: What about if someone wants to achieve more but it isn't based on worthwhileness? They would buy and own things that they happen to like and not to impress others. Let's say they wanted to be able to afford a nice house, healthier higher quality food and water. As the quality does have an effect on health especially in the US as the regulations are not the greatest. However, the fact that they couldn't afford to buy these upsets them? Thoughts: 'It's not fair that I can't afford quality food but there are millionaires that will have access to better food, lifestyle which has an effect on overall health and longevity' Or if someone has to pay for unexpected expensive dental treatment. Thoughts: 'It's not fair that I have to pay £14,000 for this treatment'. 'It should be more affordable to lower income households, as it is essential to have functional teeth' I hope I have explained this well, I would love to hear your thoughts. Keep doing what you are doing and all the best. Kieran David's response Sure Kieran, if you like I will make this an Ask David question for a podcast. LMK if that's okay, and if it is okay to use your first name. Great question, and has to do with the theme of acceptance: should I or shouldn't I? Here are the quick versions, but we can discuss in more detail on the live podcast. First, I do not find it useful to base my worthwhileness on my achievements or on my failures. I do work hard and like creating things that are helpful to people, and I enjoy earning money to support my family. I can be motivated to work hard to get things we want or need, but I don't base anyone's worthwhileness on how much money they have, or anything, to be honest. In fact, I could also easily accept wanting to buy something really cool, not just because I like it, but because it might impress others, or because they might find it fascinating, too! I don't try to regulate my life with a lot of shoulds and shouldn'ts, and find that I am happier and more peaceful without lots of shoulds. In the Feeling Great App I have created a class called "Your PhD in Shoulds." You might enjoy it! Second, you can say that it is unfair that some people have more

Ask David Bipolar, the Dark Side, Changing Behavior We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes. We love your questions. Remember to send them to [email protected]. Announcement: Our awesome summer intensive is returning after a long, five years due to the pandemic. It is typically the most outstanding and rewarding TEAM-CBT training of the year, and it will take place again and the wonderful South San Francisco Conference Center from August 8 – 11, 2025. You can attend in person if you register soon, since in-person seating will be strictly limited and only a small number are still available. You can also attend the online, live-streamed version of this program at a substantial discount. The online experience and small group exercises will be similar for the in-person and online participants. Check out the details, including early-bird discounts, at www.cbtintensive.com www.cbtintensive.com Hope to see you there! Warmly, david Today's Questions Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I'm suffering. What can I do NAME WITHHELD asks: Can or should a person really and truly accept their dark side? Trainor asks: In TEAM there is a strong emphasis on changing the way you think. But is it sometimes also important to change your behavior, or to make real changes in your life, or to help others who need help changing their circumstances==for example, people who are struggling in poverty. 1. Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I'm suffering. What can I do? Hi David, Many years ago I used your book to beat depressive thinking… in the last three years I've been diagnosed with Bipolar Disorder and have found my depressive thinking too difficult to budge with your book. I'm really suffering; any ideas about what I could do? Thank you for your service to humanity. I always recommend your book. David's response Hi Alison, A therapist could help. The new Feeling Great App could help. And tons of free resources at www.feelinggood.com. In addition, can you please give me an example of the negative thoughts you can't budge. Then we can point things out in the podcast and try to figure out why you're getting stuck! I have found that doing cognitive therapy / TEAM-CBT with individuals with Bipolar Disorder is exceptionally helpful during the depressed (not manic) phase, and works pretty much the same way as with anyone who's feeling down. Best, david 2. NAME WITHHELD asks: Can or should a person really and truly accept their dark side? Hello David, My name is NAME WITHHELD and I am doing my PhD degree in Neuroimmunology in LOCATION WITHHELD. I had come across your book feeling good and your podcasts by one of my therapists - they have had an immense impact on my way of thinking. I really love disarming and using "I feel" statements to connect! I had also realized that by finding some genuine truth in a person's belief even if it sounds ridiculous, I would automatically develop certain level of respect for that person! I really love that! I feel really happy that I can respect a person even without accepting his/her beliefs!! I am now working on my distortions. I really love working on my mind that way. Anyway, I have wanted to ask you if a person CAN accept his/her dark side? I seemed to have loathed myself for quite a long time and couldn't stand living alone without a partner or a person around. I hated myself for disrespecting my mother whilst growing up. But, sometime during Dec last year, I had had an epiphany of why things happened the way they did and somehow, I learnt that the reason why I had disrespected my mother was because my father, after their separation, kept filling my mind about how wrong my mother was for breaking up the family and I believed him because I had a good rapport with him, than I had with my mother. Also, my mother was very awkward in building a relationship with me and I had misconstrued that with her indifference towards me. After that, I stopped hurting myself over it because I had learnt to empathize with myself then. I sobbed profusely that day. Is it really possible to truly accept yourself? I feel at ease a lot more these days than I used to before. But I also have to battle my distortions too on a regular basis! Please help me out here! Thank you so much for everything that you have done!! I really love your work!! Regards, NAME WITHHELD David's reply Thanks so much. I hid your name and location, and hope that's okay, and we WILL include your excellent question on our upcoming podcast. My brief reply is that all human beings have a "dark side," and that we are far better off accepting it, as opposed to denying it and seeing ourselves as "totally good," because then we might see

#400! Yippee! Today, Rhonda has prepared a special celebration for our 400th podcast, and still going strong! She has invited a number of our favorite people and podcast guests to celebrate with us, starting with our beloved friend and frequent Ask David contributor, Matt May, MD, who officially joined us in early 2000. Matt's presence on the show had meant a great deal, personally and professionally, because I supervised Matt when he was a Stanford psychiatric resident, and had been missing our weekly chats! Our reunion via the Feeling Good Podcast has been special for that reason, but also because of Matt's kindly but scholarly answers to the many questions all of you submit. Keep them coming, and send them directly to Rhonda or David. We love reading and answering them! Next, we were joined by two more extraordinary psychiatrists and human beings, Drs. Heather Clague and Brandon Vance, who song their rendition (with guitar accompaniment) of "Help Dr. Burns!" (Based on Beetles' Help, I need somebody!" With their kind permission, here are the brilliant lyrics! Help! I need a podcast! Help! Not just any podcast! Help! Pushing the Magic Button for .... Help! When I was younger, 8 years younger than today I thought I could help everybody; help them in every way. I got so grandiose; I was so self-assured. I'd push my brilliant techniques, but my patients were never cured. So, Help me not to Help oh Dr. Burns Will they like me if they have to do the work? If I set an ultimatum, am I a jerk?! Won't you please, please stop me?! So many times, I tried to help, but then got stuck I didn't know but my patients were also thinking what the #?@! Your podcast said to test at the start and after every session. And then my eyes they opened wide Boy, was that a lesson! Oh Help me not to help, oh Dr. Burns! Help me unlearn the bad habits I have learned I'll do homework when my urge to help returns Won't you please, please help me?! Now I explore my patients' reasons not to change. I learned to sit with open hands if they choose to stay the same. Only when they fight for change and want to do the work, That's when I offer tools, and know the changes will endure. You've helped me not to help, oh Dr. Burns 'Til my patients show me that they really yearn To do the work and ask me really firmly Won't you please, please help me? Your podcasts helped ME! Oooooooh! Much warmth to each of you! Heather and Brendan Our next guest was the brilliant and beloved Dr. Jill Levitt who joined my weekly Stanford training group when she and her husband, Brian, and two boys moved to the Bay Area from New York in 2007. Jill has moved up in the ranks and now co-leads the Tuesday group with me, and also joins me as co-therapists in a great many live sessions we have published as two consecutive podcasts. The idea is to document exactly how TEAM-CBT works, and how we can nearly always get such blow-away results in a single, extended session. That was my dream as a young man, since the methods I was taught as a psychiatric resident almost never got rapid results, or even any noticeable changes in my patients. Now that dream has become a reality, and a great many people in our TEAM-CBT community have contributed to that evolution. Next we were joined by our beloved Dr. Amy Huberman. Her riveting personal work on perfectionism was published recently on two consecutive Feeling Good Podcasts. Amy was glowing and filled with joy, which gave us great feelings of joy as well! And then we were graced by a visit from Mina, who has starred in many Feeling Good Podcasts on a number of personal issues. I will be seeing Mina and her beloved husband in a few minutes for our Sunday morning hike and dim sum feast afterwards. It is always a highlight of my week! Next was another Amy Berner who reported on her recent and wildly successful Intimate Connections Book Club with yet another psychiatrist, Dr. Leigh Harrington. Amy did some personal work with me on dating and sex appeal three years ago, when we discussed the Queen Bee phenomenon. Apparently, it was successful, because she brought her fantastic husband, Randy Kolin, as proof of the effectiveness of the many dating strategies and tips in that book. Randy is also a mental health professional who works with stressed-out scientists working on nuclear fusion at the Lawrence Livermore Laboratories. We wish him all the best since the work of those scientists is well on the road to creating commercially viable nuclear fusion, which will transform life as we know it on the surface of the earth by supplying unlimited, clean, low-cost energy. Their visit was followed by Zane Pierce, whom I hadn't had the chance to chat with much for a number of years. He led a recent "delight" and "gratitude" hike that we published on podcast # 361entitled "Finding Joy in Everyday Life," with Dr. Angela Krumm from the Feeling Good Institute in Mountain View, California. We have done previous podcasts with Zane, and his lovely wife, Dai

FROZEN: Part 2 of 2 Featuring Personal Work with Cody Today, you will hear the exciting conclusion of the work that Jill and David did with Cody, a young man who sometimes freezes in social situations due to feelings of anxiety. He actually froze up when Jill and David were working with him in part 1 last week. What will they do? Tune in today and you'll find out! Before I describe Cody's session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements. For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at Intensive Information / Registration The online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year! But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree! In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Beginning of Part 2 with Cody You will hear some of the tools that seemed especially helpful, including Self-Disclosure Positive Reframing, not only for his negative feelings but also for his freezing Identify and Explain the Distortions Externalization of Voices with Acceptance Paradox the Feared Fantasy the Experimental Technique And more. Whether you are a shrink or general citizen, I think there might be a lot for you to learn from Cody, not only about techniques to treat social anxiety and feelings of inadequacy, but also about enlightenment as well. ' That's because the goals of a TEAM-CBT session are not just the reduction of negative feelings, but the complete obliteration of negative feelings, along with jumping on a psychic trampoline that catapults you into a state of profound self-acceptance and enlightenment. At least, that's my take on it! Did it really happen? Here's how Cody was feeling at the start of the session, along with his goals for each feeling at the end of Positive Reframing, and his feelings at the end of the session. As you can see, all of his negative feelings went to zero. Emotions % Before % Goal % After Sad, blue, depressed, down, unhappy 40 10 0 Anxious, worried, panicky, nervous, frightened 95 15 0 Guilty, remorseful, bad, ashamed 20 5 0 Inferior, worthless, inadequate, defective, incompetent 40 10 0 Lonely, unloved, unwanted, rejected, alone, abandoned 50 10 0 Embarrassed, foolish, humiliated, self-conscious 100 30 0 Hopeless, discouraged, pessimistic, despairing 50 15 0 Frustrated, stuck, thwarted, defeated 50 15 0 Angry, mad, resentful, annoyed, irritated, upset, furious 30 5 0 Confused 60 10 0 What explains these seemingly impossible changes in a single therapy session? And are they real, or is this all just a bunch of hype? Stay tuned and let us know what you think at the end! Early, I had a challenging exercise to do on Cody's SDBa. Here's the solution. To my way of thinking, Cody's Downward Arrow chain of thoughts suggest a number of related Self-Defeating Beliefs, including: Perfectionism: I should always try to be perfect. Perceived Perfectionism: Others will not love and accept me if they see that I'm flawed or if I screw up. I must earn the respect of others. Approval Addiction: I need everyone's approval to be worthwhile. Achievement Addiction: My worthwhileness and capacity for happiness are based on my intelligence, achievements, and productivity. Fear of Rejection. Being rejected and alone would be devastating. Worthlessness Schema (pos

FROZEN: Part 1 of 2 Featuring Personal Work with Cody In today's, and next week's, podcasts. we present the next episode of live work with Cody. The first, which featured Rejection Practice for social anxiety, was published as Podcast #326 on January 9, 2023 at this LINK. My co-therapist for this session was the wonderful Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mt. View, California (LINK.). Before I describe Cody's session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements. For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at Intensive Information / Registration The online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year! But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree! In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Now, back to the podcast, in which you'll hear some additional TEAM-CBT magic. Cody asked for help with a problem that's been bugging him for some time. He sometimes freezes up when asked to do a role play or answer a question during psychotherapy training sessions. This typically leads to an awkward silence, and feelings of intense anxiety, inadequacy, frustration, embarrassment and more. Here's how he described it: Upsetting event: I was doing a suicide screening role-play with our clinical supervisor and other therapists. After working through the first step of the role-play, I froze and did not say a word! Here's how Cody was feeling. Emotions % Before % Goal % After Sad, blue, depressed, down, unhappy 40 Anxious, worried, panicky, nervous, frightened 95 Guilty, remorseful, bad, ashamed 20 Inferior, worthless, inadequate, defective, incompetent 40 Lonely, unloved, unwanted, rejected, alone, abandoned 50 Embarrassed, foolish, humiliated, self-conscious 100 Hopeless, discouraged, pessimistic, despairing 50 Frustrated, stuck, thwarted, defeated 50 Angry, mad, resentful, annoyed, irritated, upset, furious 30 Confused 60 As you can see and might imagine, the most intense feelings were anxiety and embarrassment, but several other feelings were fairly intense as well: such as feeling alone, discouraged, frustrated, and confused. These were some of his negative thoughts on the Dailly Mood Log that he brought to the session, and the percent he believed each one. Thought 5a, b, and c are an Individual Downward Arrow series, designed to get at the Self-Defeating Beliefs underneath the Negative Thoughts. What do you think Cody's SDBs are? Take a guess, and then you can look up the answers, or at least my own thinking, at the end of the show notes. Negative Thoughts % Belief 1. I shouldn't have screwed up. 80 2. I'm not good enough. 80 3. I don't belong here/I shouldn't be here. 50 4. Something is wrong with me (my brain) 100 5a. Everyone thinks I'm an idiot ↓ 100 5b. I should not be in this ↓profession ↓ 70 5c. I failed to find something I'm good at. ↓ 70 6. I'm worthless 60 Although freezing in social situations is fairly common, it can be incredibly challenging and painful for those who experience it. Cody said: Sometimes they try to help, or may switch to someone else. It sucks, and everyone feels awkward. The hangover can last a few hours or a day, and keeps me up at night. Over time, some emotions get worse, especiall

Ask David, Rhonda and Matt Assertiveness, Suppressing your Feelings, and the "Miracle Cure" question Questions for today's Ask David podcast. Chris asks if I have a book about assertiveness. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Matt asks about the "Miracle Cure" question in the Assessment of Resistance portion of a TEAM therapy session. Rhonda began with a lovely endorsement and a cool reminder of the classic book, Robinson Crusoe, who created cognitive therapy (the double column technique) when he was stranded on a deserted island! I believe I wrote about it in one of my books, possibly Feeling Good. It's pretty cool! You will hear Matt playing the role of the "evil" thoughts, like, "I am stranded alone on a deserted island," and Rhonda will play the role of the "good" thoughts, like, "Yes, but my life was spared, and all of my shipmates died." Here's what it looks like in the novel: Evil. Good. I am cast upon a horrible, desolate island, void of all hope of recovery. But I am alive; and not drowned, as all my ship's company were. I am singled out and separated, as it were, from all the world, to be miserable. But I am singled out, too, from all the ship's crew, to be spared from death; and He that miraculously saved me from death can deliver me from this condition. I am divided from mankind—a solitaire; one banished from human society. But I am not starved, and perishing on a barren place, affording no sustenance. I have no clothes to cover me. But I am in a hot climate, where, if I had clothes, I could hardly wear them. I am without any defence, or means to resist any violence of man or beast. But I am cast on an island where I see no wild beasts to hurt me, as I saw on the coast of Africa; and what if I had been shipwrecked there? I have no soul to speak to or relieve me. But God wonderfully sent the ship in near enough to the shore, that I have got out as many necessary things as will either supply my wants or enable me to supply myself, even as long as I live. I know this novel is a couple hundred years old, so it certainly deserves nomination of the earliest cognitive therapy! Now, for the answers to today's Ask David questions. Keep in mind that these answers were written BEFORE today's recording, so the actual live answers will differ in some regards from the written answers below. 1. Chris asks if I have a book about assertiveness. Hi Dr. Burns, I hope you're doing well. Do you have a book on assertiveness training? I've used your books to help me with my hidden "should" statements, which has enabled me to be less angry or anxious whenever someone treats me less than satisfactorily. While this has helped immensely, I realize it's still in my interest to reduce the behavior I disagree with. For example, my sibling scheduled an early morning shift after I had a long day of work. Because they can't drive, they expect me to take them to work, which means I'll only get about 5 hours of sleep; this in itself isn't a bad thing... except this is the 3rd time in a row they've done this. After using your techniques, I'm less angry and anxious, but I still want to address the behavior to reduce the likelihood that they do something like this again, which is why I'm reaching out. Thanks for your help. Kind regards, Chris David's Reply Sure. I like my own book, Feeling Good Together, and have often recommended Manuel Smith's When I Say NO I Feel Guilty. There is a LOT to be said about assertiveness training, including the fact that it doesn't always work! I can give a great personal account of that! Sometimes, or always, skillful listening is also effective. Assertiveness without listening makes it sound like only your own feelings are important, which is obviously pretty self-centered. One of the most helpful things to me is the difference between healthy and unhealthy anger, and how to express tough messages in a loving, respectful way. Can discuss more on the show. For example, what are the problems with the assertiveness movement? And where can it be helpful? And what mistakes do unassertive individuals make when trying to be more assertive? Do they sometimes overdo it? Warmly, david 2. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Thanks!! David's reply. Thanks, Brian. Great question! You can listen to the podcasts on the Hidden Emotion Technique, or read about it in my book, When Panic Attacks. Will make this an Ask David question if that's okay! 3. Matt asks about the "Miracle Cure" question in the Assessment of Resistance portion of a TEAM therapy session. Hi David, I've noticed that when I ask the 'miracle cure' question or 'magic wand' question, I'll sometimes get a response that isn't all that useful and I might waste time trying to figure out what the person is really asking for. An example might be, 'I want to be able to support and understa

Incredible Voices from the Past! Plus: David's Amazing Summer Intensive Returns August 8 - 11, 2024 Today, David and Rhonda are joined by Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mountain View, California, and two incredible voices from the past: Dr. Karen Radella, a clinical psychologist who volunteered to do personal work at the 2013 summer intensive at the South San Francisco Conference Center, and Jacqueline Ong, LCSW, who volunteered to do personal work at the 2019 summer intensive. That was the last summer intensive, due primarily to the Covid pandemic. Karen Radella, PhD But here's some fantastic news. The intensive returns again this summer, from August 8 to 11, 2024, at the same location. And Karen and Jacqueline give testimonial today, along with Rhonda, to the magic of the intensive, by describing the phenomenal impact of the personal work they did years ago, and the tremendous impact that work has had on their personal and professional lives. Both Karen and Jacqueline had been suffering from the devastating emotional impact of severe personal trauma for many years. Nine years earlier, when Karen's daughter was 12, she asked Karen if she could go out to play after dinner. She'd done this for years, but Karen had the thought that it was late and cold outside, but gave in and let her daughter go out to play. Minutes later, some neighborhood boys snuck up on her and shot her in the mouth with a high-powered pellet rifle that blew out one of her teeth and did considerable damage to her mouth which triggered PTSD and required many dental surgeries to correct. Both Karen and her daughter had been suffering emotionally for the nine years since that incident. Karen was telling herself that she was a bad mom, that she "shouldn't have" let her go out to play on that particular night, and that her daughter's horrific trauma was her fault. She was also convinced that other people, including the 100+ in the audience that evening, would be judging her as harshly as she was judging herself, and her feelings of fear and despair were palpable at the start of her live work. Karen described the techniques that were so helpful to her in her fantastic recovery that evening during her two hour session with Jill and David, including the Survey Technique, which she said was the "coolest experience of my entire life." She was also helped by other techniques, including Explain the Distortions, the Double Standard Technique, and the Externalization of Voices. Jacqueline had suffered a different but equally severe traumatic event of a personal nature, but also disclosed it and worked it through with great courage in front of an audience of the same size in 2019. Like Karen, she experienced a complete elimination of her symptoms in the 2 hour session with Jill and David. She describe the keys to her suffering and recovery involved perfectionism (the need to be flawless) and perceived perfectionism (a term David coined that refers to the belief that others expect us to be perfect in order to be loved and respected.) Jacqueline emphasized that "failing as fast as you can" is one of the keys to the rapid recovery we so often see in TEAM. Instead of meeting once a week for an hour, which sets you up for very slow progress with relapses between sessions, you use technique after technique in one session until you find the one that works. Of course, following "recovery," your negative thoughts will return over and over throughout your life, because no one is entitled to be—or would even want to be—happy all the time. But once you've experienced your own enlightenment, you know the tools that work for you, so you get better and better at heading off the relapses at the pass. Jacqueline and Karen both said they'd heard that the personal work at an intensive can be life-changing, but they "wouldn't have believed it" until they experienced it. Rhonda said, "I saw both live demonstrations. My first intensive was also the 2013 intensive when Karen did her personal work and saw Jackie's work at the 2019 intensive. I cried my eyes out with both of you at those intensives. After watching David and Jill's personal work with Karen at the 2013 intensive, I decided that TEAM was the therapeutic method I wanted to learn, and that's why I've dedicated my life to learning, practicing and teaching TEAM." David, Jill and Rhonda hope YOU can attend the magical intensive this year. To learn more, you can just go to www.CBTintensive.com. This year you can attend in person OR online, since the program will be live-streamed. In the past, David has done all the teaching, but this year, David and Jill will do their dynamic "tag team" teaching made famous by their weekly free training group at Stanford. It is now online and is free for therapists around the world. It is Tuesdays from 5 to 7 PM west coast time. If you are interested in joining, contact Ed Walton, [email protected]. You could also join Rhonda's W

Ask David, Rhonda and Matt More on Insomnia; Porn Addiction Guilt; Rage Questions for today James asks for help with insomnia. Arjun Asks: How can I stop blaming myself for my porn addiction as a teen? Stephan asks: How do you treat feelings of rage? And what if you are simply very angry, but you don't have any thoughts? James asks for help with insomnia, Hi Dr. Burns, I enjoy your newsletter and have experienced moments of clarity with your book. However, my current struggle is that I have developed terrible sleep anxiety. I feel nervous tension in my stomach and trembling limbs as nighttime approaches. Some nights I can put these feelings aside and dose off and others I just cannot stop dwelling on the negative body sensations and it does not allow me to sleep. I wonder if you can offer some advice on how to get over this fear and accompanying sensations. Best, James David's reply Thanks, James. Sorry you're struggling with trouble sleeping. Yes, a Daily Mood Log can help, to find out what you are telling yourself that makes you so anxious about not sleeping. Also, the Hidden Emotion Technique may be important to find out if there's a problem in your life that's bugging you. There are also the typical sleep hygiene tips that can be useful for some folks, too! You can find these with an internet search. Can I use this as an Ask David question for a podcast, with your first name or a fake name? Best, david Arjun Asks: How can I stop blaming myself for my porn addiction as a teen? Hi Rhonda, I Really appreciate the work that you guys do and I listen to most of the feeling good podcasts. I'm 27 and have struggled with depression and anxiety since my teens. I'm currently in therapy with a TEAM certified professional from India, but I'm still grappling with feelings of being stuck in my past. During my pre-teen years, I battled a porn addiction for about a year, which has left me with ongoing feelings of anxiety, guilt, and depression. Despite trying various therapies, I haven't found relief. I keep fixating on the thought: "I shouldn't have indulged in porn addiction in the past. It's led me to develop anxiety and depression." How do I debunk this thought, reduce its hold on me, and cope with the regret it brings? It feels like I'm trapped in my past. and constantly blaming myself for that one mistake. because that indulgence in porn really did change my life. I wasn't the same as before. and never could go back to being who I was. How do I put the lie to this thought? Any methods you'd recommend putting in the recovery circle? Your insights would be invaluable in helping me move forward. Thank you, Arjun David's reply: The key concept is that the problem is perfectionism, plus the beating up on yourself in the here and now, and not the behavior or misbehavior in your past. In the live podcast, we can discuss the importance of T = Testing (with DML), E = Empathy and A = Assessment of Resistance, and M = Methods, like explain the distortions, Perfectionism / Self-Blame CBA, D. Standard, EOR, EOV, etc. etc. The issue, as I see it, is that you are looking for a technique to help you accept yourself, but in reality, it is a decision for you to make. The choice is to accept yourself with compassion or continue to beat up on yourself. There are many really GOOD reasons to beat up on yourself, and we can perhaps outline some on the podcast. You would then have to explain why you'd really want to accept yourself, given all the good reasons to keep beating up on yourself, and given all the positive things your self-criticisms show about you. Also, I will try to remember to tell one of my favorite Buddhist stories that relates to this problem. Stephan asks: How do treat feelings of rage? And what if you are simply very angry, but you don't have any thoughts? Hello Mr. Burns, I hope this email finds you in good spirits. I've just begun your book "Feeling Good" and I have just reached the point where you begin to speak about cognitive distortions and how to get over your thinking. I've been doing your exercise on the days that my thoughts are heavily saturated in my mind and I've realized something within doing this exercise. A lot of my thoughts do focus on the cognitive distortions that you've outlined in your book, but the other 75% of my thoughts focus on pure trauma of past situations and experiences that channels pure hate, anger and rage that pours out of my thoughts about the past situations. For example, one situation was someone purely scamming and taking advantage of me for years. And while doing your exercise, my hate and rage for that situation really comes out to where I wrote down "F*** that stupid a** b***** I hope she continues through her life being scammed as the fraud she is". A lot of my thoughts surround things like this with situation that I've been in. Or another example "This stupid a** girl gonna be married and divorced five times before I get married once And I went the wrong path. Ha." Most of

Featured photo is Dr. Jacob Towery Report on the 2nd Annual Social Anxiety Marathon Finding Humans Less Scary 2.0 Led by Jacob Towery, MD (above) and Michael Luo, MD (below) Today, Drs. Jacob Towery and Michael Luo report on the second annual "Finding Humans Less Scary" 2-day marathon in March of this year. As you all know, I am partial to offering valuable experiences for therapists and the general public for free, and my website (feelinggood.com) and life are focused pretty strongly on this goal, although I realize it isn't always possible since we all have to support ourselves and our families. That's why Rhonda and I are so proud of our colleagues, Jacob and Michel, who have now completed their second annual social anxiety marathon, which was open to therapists and the general public alike—in fact anyone struggling with shyness, public speaking anxiety, and other forms of social anxiety. And the total cost of admission both years had been a simple, $20 tax-deductible contribution to one of the charities listed on the FHLS website. That's pretty darn cool, since the leaders are among the world's top experts in the treatment of social anxiety, and there were, in addition, numerous highly trained TEAM therapists providing small group supervision and mentoring as well! They described a number of highlights from the event, including group exercises, both within the auditorium and also outside, on the streets of Palo Alto, doing exercises designed to help participants overcome fears and build feelings of confidence and self-esteem, including, but not limited to: Smile and Hello Practice Talk Show Host Rejection Practice Shame Attacking Exercises Feared Fantasy The Vulnerability Ladder Primary vs Secondary Characteristics Self-Compassion Enthusiastic Verbal Consent Internalizing a Compliment Flirtation Training Cost-Benefit Analysis of Maintaining Social Anxiety Exposure (public speaking on stage) And many more Michael explained that the program was sold out, and that participants came from a wide variety of backgrounds, and many had life-change experiences. Many provided testimonials on what the experience meant to them, including: "I grew as a person and experienced a dramatic increase in vulnerability and genuineness in my interactions with others." "My son attended Jacob Towery's two-day social anxiety workshop, Finding Humans Less Scary, and found it life changing. He asked me to come along for moral support, which meant I witnessed the transformation in real time. I have never seen anything like it in my life! Quite literally, one person went into the conference room that morning and a different person came out at the end of the day. He was elated. He met amazing people and had transformational conversations. He walked down the street hooting like a bird. He looked and acted like he had thrown off some old moldy coat. "Day two seemed to deepen and solidify the gains. On our drive home he taught me what he had learned (I got some trickle down wisdom!) and he was able to trace how the roots of his social anxiety got started and grew. He reflected on the fact that some people in the room were nearly 70, and that he felt lucky to be learning this stuff at 23. "I can highly recommend this experience to other people who are struggling with social anxiety and want to try a novel approach to breaking the pattern." I'm of the belief that, in a sense, we're all one. That means that you can't bring joy to another person without bringing joy to yourself. And Jacob and Michael both seemed to be on a high from their efforts to touch so many people. If you're also excited, make sure you register next year well ahead of time so you, too, can have this life-transforming experience, which is (almost) totally free! Thank you for listening today! Rhonda and David

393 Marina Dyck on TEAM for Insomnia Today we feature Marina Dyck, a TEAM-Certified Clinical Counselor in private practices in Swift Current, Saskatchewan, Canada. She works with individuals and families struggling with trauma, anxiety, depression, and relationship issues. She combines the latest research in neuroscience, powered by TEAM-CBT, and what she calls the "whole person" approach. Marina describes her innovative TEAM-CBT treatment for patients with trouble sleeping. Many of them toss and turn at night, unable to turn off their anxious and agitated brains, so they ruminate over and over about problems that are bugging them. Sound familiar? Here's David's quick, step by step overview of Marina's treatment approach, which is based on the steps of TEAM and the Daily Mood Log. Step 1. Let's imagine you're the patient (or the shrink), so you start with a brief description of the Upsetting Event at the top of the Daily Mood Log. It could be something as simple as "Lying in bed for several hours, unable to get to sleep because I keep ruminating about a report I have not finished for work," or some other problem. Step 2. Identify your negative feelings and estimate how intense each one is on a scale from 0 (not at all) to 100 (the worst.) For example, you may be feeling: Sad, down: 80% Anxious, panicky: 95% Guilty, ashamed: 70% Inadequate, incompetent, inferior: 90% Alone: 100% Discouraged: 80% Frustrated: 95% Angry, annoyed: 100% Step 3: Record your negative thoughts and how strongly you believe each one from 0% to 100%. For example, you may be telling yourself: I have to get to sleep! 100% If I don't get to sleep, I'll never be able to function tomorrow. 90% I should have completed my report for my boss today. 100% I should get out of bed and work on it. 90% There must be something wrong with me. 100% etc. etc. Step 4. Identify the distortions in these thoughts, like All-or-Nothing Thinking, Fortune-Telling, Should Statements, Emotional Reasoning, Magnification, and more. Now, if you're a shrink, after you've empathized, do the A = Paradoxical Agenda Setting or Assessment of Resistance. If you're a general citizen, you can do Positive Reframing. In other words, instead of trying to make your negative thoughts and feeling disappear entirely by pushing the Magic Button, you can ask two questions about each negative thought (NT) or feeling: How might this NT or feeling be helping me? What does this NT or feeling show about me and my core values that's positive and awesome? Example. In the current example you are 95% anxious and panicky about your report for work as well as the fact that you can't relax and fall asleep. Could there be some positives in your anxiety and panic? For example, these feelings might show Your intense commitment to your work. They may be a reflection of your high standards. Your anxiety, while uncomfortable, has probably motivated you to work hard and achieve a great deal. Your anxiety may protect you from danger and keep you focused on what you have to do to succeed and survive. Your anxiety could be an expression of your respect for your boss and for the company you're working for. Your desire to do a good job is probably a reflection of one of your core values as a human being. You could make similar lists for other feelings as well, like feeling down, guilty, discouraged, angry, and so forth. At that point, you can set your goals for every negative feeling. For example, you might decide that 15% or 20% might be enough anxiety and panic, and that 15% shame would be enough, and so forth. You can record your goals for each negative feeling in the goal column of your Daily Mood Log. This is much easier than if you try to reduce them all to zero by pressing the Magic Button. And even if you could, then all of the positives you listed would go down the drain, right along with your negative thoughts and feelings. Instead, you can aim to reduce them to some lower level that would allow you to relax while still maintaining your core personal values. Now we're ready for the M = Methods portion of the TEAM session. You will enjoy this portion of the podcast. Marina led Rhonda in three classic TEAM methods: The Paradoxical Double Standard Technique, the Externalization of Voices, and something Marina calls Distraction Training, which is actually a mix of Image Substitution, self-hypnosis, and relaxation training. Essentially, you focus on something positive and relaxing, as opposed to ruminating about all you have to do. This approach will come to life when you listen to the podcast, and I think you will agree that it IS innovative and significantly different and from 99% of what is currently sold as "insomnia treatment!" Marina emphasizes that you, the client, will have to agree to spend 15 to 20 minutes per day doing written work with the Daily Mood Log, or all bets are off. In addition, I would like to add that you and your shrink (or you and your patient) will have to find effective ways

392 The Empty Nest Cure Featuring Jill Levitt, PhD Plus BIG NEWS! The Magical Annual Intensive Returns this Summer at the South San Francisco Conference Center August 9 -13, 2024 You can Review the Exciting Details Below Or click this link! Today we are proud to feature our beloved Dr. Jill Levitt. Jill is the Director of Clinical Training at the Feeling Good Institute in Mountain View, California, and co-leader of my Tuesday evening psychotherapy training group at Stanford. She is a dear friend, and one of the world's top psychotherapists and psychotherapy teachers. Today, Jill joins us to discuss the so-called "Empty Nest" syndrome. According to Wikipedia, this is the "feeling of grief and loneliness parents may feel when their children move out of the family home, such as to live on their own or to pursue a higher education." Jill emailed Rhonda and me to explain why she thought a podcast on this topic might be of some value. She wrote, Recently, I was working with two different women around the same age who were having similar feelings of guilt and shame about the choices they made around parenting versus working. Jane is a 60 year old high level executive with two boys who was super successful and is now retired. She is telling herself, " I did not do enough for my boys. I should have worked less. I should have spent more time with them. I was selfish, and worked because I enjoyed it. I should have done more for them. I'm a terrible mother. Stephanie, in contrast, is a 60 year old stay-at-home mom of four adult kids, and now that her last kid has left for college, she is telling herself: I should have had a career. I have done nothing with my life. I am a smart woman so I should have done more. I am inferior compared to other women who have contributed to society in some way. Jane and Stephanie both struggled with feelings of guilt, shame, sadness and inferiority, and they were both telling themselves that they should have made different choices. I'm sure your life is very different from their lives, but you may have also looked in to the past and beaten up on yourself for what you should or shouldn't have done. Or, you may be beating up on yourself right now with shoulds, telling yourself that you should be better, or smarter or more successful or popular than you are. In fact, according to the late Dr. Albert Ellis, these "Should Statements" are responsible for most of the suffering in the world, and there are several different types, including: Self-Directed Shoulds, like "I shouldn't be so klutzy and shy in social situations. These self-directed shoulds trigger feelings of depression, anxiety, inadequacy, inferiority, guilt, shame and loneliness, to name just a few. Other-Directed Shoulds, like "So and so shouldn't be such a jerk!" Or, "You have no right to feel the way you do!" These other-directed shoulds trigger feelings of anger, blame, resentment, irritation, and rage, and can easily escalate into violence, and even war. I'm sure you can see that both women were struggling with Self-Directed Shoulds. What can you do about these shoulds and the unhappiness they trigger? Jill explains how both women experienced rapid recovery when she used simple TEAM methods systematically, including empathy and Positive Reframing as well as other basic techniques like the Double Standard Technique and the Externalization of Voices, and more. I, David, then described a woman he treated who fell into a depression when her two daughters went off to college. And she was perplexed, because she'd always had a super loving relationship with them, just as she'd had with her own mother when she was growing up. When I explored this with her, a Hidden Emotion suddenly emerged, as you'll hear on the podcast, and that also led to a complete recovery in just two sessions. Then Jill had a sudden "eureka" moment and realized that the Hidden emotion phenomenon was also central to the anxiety that one of her two patients was experiencing. One of the neat things I (David) really like about TEAM is that we don't treat people with formulas for "disorders" or "syndromes." These three woman all had the same "Empty Nest Syndrome," but the causes and the cures for all of them were unique, as you'll understand when you listen to this podcast. Our 400th podcast is coming up soon, and we want to thank all of you in advance for your support and encouragement over the past several years, which we all DEEPLY appreciate! We'll be joined by a number of our podcast stars from the past 100 shows, as well as our beloved founder, Dr. Fabrice Nye! And we have one VERY special event coming up this summer that might interest you if you're a shrink. I (David) have done very few workshops over the past five years because of the pandemic as well as the intensive demands of developing our Feeling Great App which will be available soon. The most fantastic work of the year was always the summer intensive at the South San Francisco Conference Center. Well,

Evolution of TEAM from CBT Porn Compulsive Liars Angry Patients Who Resist Where's the App? and More! Note: The answers below were written by David prior to the podcast, just to give some structure to the discussion. Keep in mind that the actual live discussion by Rhonda, Matt and David will often go in different directions with different information and opinions. So, please listen to the podcast for the more complete answers! Today's live discussion was especially fun and lively, so make sure you listen to the actual live podcast. Questions for this Ask David Podcast Stan asks if any of my early methods have been abandoned by newer and more effective methods as CBT evolved into TEAM. Stan asks if mild porn is harmful or helpful. Rima ask how you can deal with compulsive liars. Pretika asks what to do with patients who angrily resist positive reframing. Anonymous asks several questions about the Feeling Great App. 1. Stan asks about new approaches in TEAM for habits and addictions, as well the evolution of TEAM, as compared with the much earlier classical CBT. 2. Stan also asks if mild porno is helpful or harmful. Hi David. I read in the eBook (I think it was) that you have radically changed your approach and have many new methods for Habits and Addictions. I actually have many of your books such as: Feeling Good Feeling Good Handbook When Panic Attacks Intimate Connections Feeling Good together Feeling Great eBook I wonder if you could please tell us in one of your Ask David podcasts which methods described in your earlier books you no longer recommend, because they have been superseded by more effective ones described in Feeling Great for example. I am sure there must be a lot of material that is still valid in those earlier books and which is not mentioned in Feeling Great. It would be great to know which ones you no longer recommend for the general public. I also want to ask you about Porn Addiction. Do you think occasional mild porn use is harmful or beneficial? I read in a BBC article that porn probably isn't harmful for most men, and can even be positive for couples. For example, some couples start to engage in oral sex after seeing it on the internet. Porn seems a bit like alcohol, if you abuse it it will be bad for your health but if you don't go for the strong stuff and don't over use it, it could be OK. I think some people might misinterpret your references to porn addiction as being any kind and intensity of porn use. Maybe these people feel anxious and shameful for using it as a result. I would welcome your clarification on this issue. Finally, even though I know you have heard it thousands, or hundreds of thousands of times, your work is having a really positive effect on my life. I am truly grateful for all that you do. Thank you, David. Warm regards Stan David's Reply Hi Stan, I can turn this into a couple Ask David questions for the podcast if you like. There have been many upgrades of the therapy ideas and techniques over the years, as we develop greater understanding of how people change, and what works and what tends not to work. In addition, I would say that we develop new methods and ideas on a weekly basis. The TEAM models lends itself very nicely to evolution, perhaps one of the strong points. I can speak in more detail on the podcast, but here are two ideas. First, I have come to appreciate more and more that all change in emotions comes from a reduction in belief in the negative thoughts that trigger negative feelings with few, if any, exceptions. In addition, any reduction in belief in negative thoughts will case an immediate reduction in the negative feelings that thought causes. This insight angers many people who don't really "get" it, so I don't push it. I find that people sometimes do not take kindly to statements that challenge their sacred beliefs. A simple example would be jogging, or aerobic exercise. Some people believe on faith or personal experience that exercise has a mood elevating effect due to release of endogenous "endorphins" in the brain, and many even claim that exercise is the most effective antidepressant known. While some people do experience a mood lift after strenuous exercise, I believe this is due to the change in their thoughts, telling themselves and believing that this is going to be good for the health and outlook. So that thought can have potent effects on mood. I can describe some experiments on exercise and mood. Second, I have tilted much further in the direction of appreciating the existence and power of resistance in all emotional and behavioral problems, and the often magical power of the new resistance-melting techniques I've developed in opening the door to the possibility of rapid and dramatic change. I'm also very aware of the therapy wars, predicated on the belief that our group as THE answer and your group consists of fools! And typically, one or both of those who are arguing have never measured anything in their patients on a session by

Self-Acceptance, People who Resist, Secrets of Dynamic Job Interviews, Five Secrets with your Boss, Do Cognitive Distortions Cause Transgenderism? Note: The answers below were written by David prior to the podcast, just to give some structure to the discussion. Keep in mind that the actual live discussion by Rhonda and David will often go in different directions with different information and opinions. So, please listen to the podcast for the more complete answers! Questions for the this Ask David Podcast Rizwan suggests a new method for self-acceptance. Anonymous asks how to convince someone that depression is NOT due to a chemical imbalance in the brain. My father does not believe that you can change the way you FEEL by changing the way you THINK! Marc asks about tips for job interviews, as well as how to respond during periodic performance reviews at work. Brian asks if transgenderism could be the result of distorted thoughts. 1. Rizwan asks I have a question about the Acceptance Paradox that came to my mind during our Tuesday training group on 19 Dec, 23. As homework, will it be useful to ask clients to make a list of things which they have already accepted in life and made peace with? At the next stage, in the session, would it be useful if the therapist asks them, "why did you accept and make peace with those things? "Can you use the same criteria to accept other things in your lives which you are not accepting now?" Sincerely, Rizwan David's take Yes, you can certainly try that and let us know how it works out? I do lots of spontaneous and "new" things in almost every therapy session. Some things work out, and others do not. That way, I learn from my clinical work. One thing to be aware of is that your proposed approach might overlap with "helping," when a paradoxical approach might have more "punch" / impact, After all, the Acceptance Paradox is arguably more of a decision, than a skill. But try, even with yourself if you like, and let us know what you discover. TEAM constantly evolves, and you can be an important part of that process! Best, david 2. Anonymous asks how to convince someone that depression is not due to a chemical imbalance in the brain and that you can change the way you FEEL by changing the way you THINK? Hi David I love listening to your podcasts. And now I am seeing differences in my life but not my father who has been depressed for around 40 years. He is on medicines and has an extreme belief that it's on the basis of chemical imbalance. He is a pharmacist by profession, and loves to learn about how chemical changes mood swings. I am not able to convince him to read your books. He just take sleeping pills every single and sleeps all day. He is learning something about neuroplasticity which is actually the case that happens in cbt. But he think it's some kind of thought changing therapy which cannot change the chemical in our brain. Please help David. I would love you to answer this. Regards, Anonymous David's Response Hi, I once gave the keynote address at a research conference at the Harvard Medical School. When the department chairman introduced me, he something like, "Dr. David Burns is going to show us how you can change brain chemistry with CBT, and without drugs!" It was pretty cool! That's one dimension. And we could add more evidence and research findings to support our side of the argument. But on another level, we see the underlying issue of trying to convince someone who is taking an adversarial position and content with their own thinking and beliefs, and determined to argue no matter what evidence you present. In my experience, spending time trying to convince them is almost always a losing cause. All you do is engage in a frustrating philosophical debate, at least that's my thinking! The podcasts on the theme of "How to Help and How NOT to Help" might be useful, in case you are looking for help with your relationship with your father. Your love and concern for him is huge and very touching! Okay to use in an Ask David? I will not use your first name! Best, david 3. Marc asks for tips on job interviewing. Hi David, I hope you are keeping well. I am wondering if you have any tips / strategies/resources that you recommend for an upcoming job interview? Also, you once told a story of someone who worked in the tech industry that you counselled, and you recommended some questions for him to ask in periodic performance reviews. Does this ring a bell at all? I've had trouble remembering/locating this Podcast. Stay well, Marc David replies Hi Marc, Yes, we can discuss the secrets of successful job interview on a podcast. I have LOTS of tips, actually, and we can perhaps do a podcast on this. We could also focus on how to respond to your supervisor during performance reviews, and I DO have an amazing story about that as well; it was the fellow who had been fired six times in two years. Thanks for reminding me. I might have given him the name of Rameesh, but not sure! Best, Da

Featured Photo is Dr. Amy Huberman The Amy Story, Part 2: The Joys of Doing the Laundry! Amy and her exuberant son, Sasha, and wife, Alena Last week you heard Part 1 of the Amy session, which included T = Testing, E = Empathy, and A = Assessment of Resistance. Today, you will hear Part 2 of Amy's exciting journey from perfectionism to JOY. M = Methods We used a variety of Methods to help Amy challenge her negative thoughts, starting with the first, "I'm failing my patients." We started with Identify and Explain the Distortions, then went to the Double Standard Technique, and ended up with the Externalization of Voices. As a reminder, you can see Amy's Daily Mood Log at the start of her session here.. As an exercise, see how many distortions, or thinking errors, you can find in her first Negative Thought, "I'm failing my patients," using the list of cognitive distortions on the bottom of her Daily Mood Log. You'll find the list of the ten cognitive distortions if you click here. After you've identified each distortion, see if you can explain two things about it: Why is this distortion in Amy's thought unrealistic and misleading? Why might it be incredibly unfair and hurtful? You'll find my list of the distortions in this thought at the end of the show notes. But don't look until you've made your list! These techniques we used were effective , as you'll hear on the podcast, especially the Externalization of Voices. You'll hear us doing role-reversals with Amy, and the method that "won the day" was the CAT, or Counter-Attack Technique, combined with the Acceptance Paradox. The Acceptance Paradox involves finding truth in a negative thought with a sense of peace or even humor. The CAT involves confronting the hostile voice in your head and tell it to go fly a kite, or other gentle but firm message You'll enjoy seeing some striking changes in Amy, as her tears and feelings of intense self-doubt are suddenly transformed into joy and laughter. Those changes created strong feelings of joy for Jill and me as well. We both have incredibly fondness and admiration for Amy, and feel great joy as well when she feels joy. Here are Amy's final scores at the end of the session. Emotions % Now % Goal % After Sad, blue, depressed, down, unhappy 80 25 0 Anxious, worried, panicky, nervous, frightened 80 20 0 Guilty, remorseful, bad, ashamed 90 5 0 Worthless, inadequate, defective, incompetent 100 15 5 Lonely, unloved, unwanted, rejected, alone Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing 90 5 0 Frustrated, stuck, thwarted, defeated 80 5 5 Angry, mad, resentful, annoyed, irritated, upset, furious Other The Joyous Dr. Amy! Sudden and dramatic change is pretty trippy, but it isn't much good if it doesn't last. And it won't! Negative thoughts and feelings will always return, because no one can be happy all the time. That's why some relapse prevention training and ongoing practice and refinement of what you've learned can be vitally important. In our follow-up session with Amy one week later she said she'd felt way better during the week, but did, in fact, have some relapses and had to challenge her negative thoughts again. She'd been helped a lot by the idea that it was okay to fail, to seek consultation, and learn, and that failing with patients gave us endless opportunities to learn and grow as therapists. And it was also okay not to have to listen so intently to the attempts of the negative self to put her down. In fact, our misery almost never results from our failures, but from telling ourselves that we "shouldn't" ever fail, and from punishing ourselves mercilessly when we do. One of her most exciting statements in our follow-up session was that she discovered that even something as humble as putting the dirty clothes into the washing machine could be a joyous experience without that negative voice in her brain constantly hollering at her that she wasn't good enough! Teaching points It was hard, at first, for Amy to "see" how distorted and unfair her negative thoughts were. She is an extremely intelligent, accomplished, and beloved colleague, and yet most of us cannot "see" or really "grasp" that we can be pretty mean to when we're feeling down and anxious. I have often said that feeling anxious and depressed is a lot like being in a deep hypnotic trance, telling yourself and believing things that just aren't true. For example, Amy is doing beautiful work with the great majority of her patients, and is doing the exact same thing with the patients who are responding beautifully as she is with the two who are stuck. So, when she tells herself she's a failure, she's clearly involved in All-or-Nothing Thinking. In other words, she's thinking that if she's not perfect, she's a complete failure and a fraud. She also seems to have many Hidden Shoulds (e.g. I SHOULD be able to help every single patient quickly) and Mental Filtering (focusing only on the negatives) and Discounting the

Featured Photo is Dr. Amy Huberman The Amy Story Part 1: True Confessions of a "Fraud" and a "Failure" Part 2: The Joys of Doing the Laundry Amy and her exuberant son, Sasha, and husband, Poppy Today's podcast, and next week's podcast, include a single, two-hour session with Amy Huberman, MD. Amy is a psychiatrist in private practice in Baltimore, MD. She also serves on the volunteer faculty at the Johns Hopkins University School of Medicine. Amy specializes in brief, intensive psychotherapy to help people overcome struggles with anxiety, OCD, and trauma, but today comes to us to get some help with her own anxiety. Often doing our own work can be a vitally important part of our training and growth as mental health professionals. Amy has been upset because she is stuck with two of her patients, and she's telling herself that she's a "fraud" and a "failure." Although her life is undoubtedly very different from yours, the root cause of her problem might be very similar to the source of your unhappiness, especially if you sometimes get down in the dumps and tell yourself that you're just not good enough. My co-therapist for this session is Jill Levitt, Ph.D. co-founder and Director of Clinical Training at the Feeling Good Institute in Mt. View California. Jill also serves on the Adjunct Faculty at the Stanford Medical School and is co-leader of my weekly TEAM Therapy training group at Stanford, Tuesdays from 5-7:00 pm pst. If you are interested in joining David and Jill's Tuesday group, please contact Ed Walton, [email protected]. That group is now virtual and therapists from the Bay Area and around the world are welcome to attend. It is free of charge. Rhonda Barovsky also runs a free weekly training group with Richard Lam, on Wednesdays, from 9-11:00 am pst, which is also free of charge. If you are interested in joining the Wednesday group, please contact Ana Teresa Silva, [email protected]. Because the groups are virtual, they are open to therapists from around the world. Amy has been a member of our Tuesday training group, and is a highly skilled, certified TEAM therapist. Like nearly all the mental health professionals who come for training every Tuesday, Amy has incredibly high standards and is sometimes harshly self-critical when she feels she is not living up to them. At the same time, those high standards can be strongly motivating, and this can create strong feelings of ambivalence when it's time to change. Sound familiar? If you're struggling with perfectionism, you might want to check out these two podcasts! Part 1. The True Confessions of a "Fraud" and a "Failure" Amy opened by saying she was anxious and telling herself: I'm about to reveal my weaknesses and my inner self—This is something I've never done before in such a public setting. . . I also have to confess that I'm struggling with social anxiety right now. I'm afraid that my patients might see this and think, "I don't want to work with her! I want to work with a competent psychiatrist." I Included that because I am hoping you will appreciate Amy's incredible courage and gift of sharing her true inner self today! Amy described the problem that's been bothering her for several weeks. Although she specializes in the short-term treatment of anxiety, she has been struggling with two patients with OCD symptoms who have been stuck and not making significant progress for a long time. This has triggered feelings of shame and intense anxiety which have invaded Amy's every moment when she's NOT seeing patients, and has even prevented her from getting restful sleep at night. She keeps ruminating and beating up on herself. You can see Amy's Daily Mood Log Amy here.. As you can see, she was feeling intensely sad, panicky and ashamed, and rated these three feelings as 80% on a scale from 0 (not at all) to 100 (the most severe). She was also feeling worthless and defective which she rated at 100%, as well as hopeless (90%) and stuck (80%). As you know, feelings do not result from the events in our lives (in Amy's case, the fact that two of her patients were stuck), but rather from her thoughts, or interpretations, of those events. You can see on her Daily Mood Log that she was being intensely self-critical, telling herself that she was failing her patients, that she should refund their money, that she was not competent to practice psychotherapy and should find a new career, that she "should" know how to get them unstuck, and more, and finally that she was a fraud and a failure. Her belief in all of these thoughts was super high, ranging from 80% to 100%. And if you've ever felt down or inadequate, I'm sure you recognize the same types of thoughts in your own thinking, telling yourself that you're a failure, or not good enough, and so forth. During the session, Jill and David went through the TEAM acronym: T = Testing We measured her negative feelings at the start of the session so we could measure them again at the end to see how we did. E = Empa

Why Do We Resist Accepting Ourselves Other People, and the World? The Five Most Common Reasons! Rhonda and David are joined in today's podcast by Dr. Matt May, a super popular and loved guest on our show, to discuss the resistance findings in David's recent survey on acceptance and resistance. The following is a summary of some of the statistical findings, but the actual podcast dialogue was wide ranging and tremendously engaging, and won't require a lot of statistical smarts! We also discussed the vitally important difference between healthy and unhealthy acceptance. Healthy acceptance is accompanied by feelings of joy, lightness, and liberation. Unhealth acceptance is accompanied by feelings of unhappiness and despair. Unhealthy acceptance is characterized by Should Statements and self-punishment for your failures and shortcomings. Healthy acceptance is an expression of self-love. The group brought the five most common reasons to life with engaging stories. Why should you accept yourself? We are not saying that you "should," and it's really a decision. However, the statistical models the I (David) developed indicated that healthy acceptance can trigger a 49% reduction in negative feelings and a 39% boost in positive feelings, which is tremendous. Matt told an inspiring story about two strategy for training the dolphins at SeaWorld. One strategy involved trying to shape the behavior of the dolphins with little shocks, in much the same way that some people train horses. Sadly, the dolphins went to the bottom of the pool and appeared depressed, not moving much. It was a complete failure. Then they tried a radically different strategy--they gave a new group of dolphins fish to reward them for doing the things the trainers wanted them to do. This strategy was tremendously successful. So, the question is whether you want to shape your own life with frequent shoulds and self-criticisms, which can have the effect of electric shocks every time you fail or screw up or fall short of your goals, or whether you want to shape your life with love and rewards. Some of us have discovered that acceptance is way more fun and vastly more effective! Quick Bottom Line The typical survey respondent endorsed 1/3 of the 12 Resistance Scale items, and seemed to believed that Acceptance would be foolish and lead to a life of misery and mediocrity. The actual causal impact of the Non-Acceptance and Resistance scales on positive and negative feelings was massive and appeared to be in the exact opposite direction. Findings The respondents in the Resistance survey endorsed an average of 33.8%. (+/- 0.1%) of the items, ranging from 0 to all 12. The most commonly endorsed was, "Acceptance is easy for rich and famous, but hard if you're struggling just to pay the bills." 47% (+/- 2%) endorsed this item. The least endorsed was, "If I beat up on myself, people will love me more," although 25% (+/- 1%) of the people endorsed this item, so it was fairly popular. The high scores on the resistance scale items is also pretty consistent with my experiences over the years—the people in the study, and the people I've worked with, have expressed MANY reasons to beat up on themselves. You can see the list of the 12 Resistance Scale items below. I have bolded the five most often endorsed. As you can see, many people surveyed believed that acceptance is fine for people who are rich and famous, but terribly painful and foolish for people who struggle with real problems. Many respondents were convinced that acceptance leads to pain, robs you of motivation and does not make sense in a the world that's falling apart. If I accept my flaws and shortcomings, I'll end up with a second-rate life. If I accept my flaws and shortcomings, I'll lose all my motivation to learn If I beat up on myself and work my ass off, people will love and admire me. It would be tremendously painful to accept my flaws and shortcomings. That would be like giving up and having to live with a heavy load of inadequacies. Life has many real disappointments and losses. I don't want to feel happy and chipper by "accepting" all those negatives when the world is falling apart all around me. That just doesn't make sense! I haven't achieved many of my goals in life. I think it would be kind of pathetic to suddenly accept myself and feel enormous joy that I haven't really earned or deserved. I've often fallen short, and I've made a lot of mistakes in my life. Are you saying that I should be happy about that? Hell NO! I am never going to accept myself as just another average or below-average person. That would be awful! If I accept my flaws, failures, and shortcomings, I'll just be like everyone else. I won't be special, and I won't have the chance to become special. If I admit that I often fail and screw up, people will think less of me. If I've done things that have hurt others or if I've violated my moral values, then I deserve to suffer. Acceptance is fine and easy for people who've enjoyed

Accept this Sh__? Hell No! Rhonda and David are joined in today's podcast by two dear friends, Dr. Matt May, a popular regular on our show, and Matt Pierce, a co-founder of the soon-to-be-released Feeling Great App Brief bio sketch of Matt Pierce goes here, should you wish to include it in the show notes. Matt,. A pic would also be great, but not required. People get tired of the same pics each week, so a fresh face to illustrate this episode would be cool! You've probably heard about acceptance. It's a popular buzzword in the mental health space these days. In fact, some experts claim that it's THE key to happiness and enlightenment. It's NOT, but it can be incredibly helpful. I wanted to learn more about Acceptance and put some numbers on it's effectiveness, or lack of effectiveness, so I recently sent an invitation to the 45,000 people on my mailing lists to complete a new survey on acceptance and resistance. More than 1,000 quickly responded, which was great. I hoped the data could provide some answers questions like these: What is acceptance? How interested are we in accepting themselves, other people, and the world? Many people, and perhaps most of us, strenuously resist acceptance. Why? What are the things that we have the most trouble accepting about ourselves and others? Is all the hype about acceptance justified? Does it actually have meaningful effects on how we feel? Can money buy happiness? And if so, how much, exactly, does it cost? Why are single people more depressed and unhappy than people with partners? And if so, is it because of the lack of a loving partner? Or was there some other reason? Thanks for listening, David, Rhonda and Matt

Do we have a "Self"? Or "Personality"? What's the best way to combat Should Statements? Is TEAM effective without a therapist? What's the Difference between Positive Reframing and Positive Thoughts? Note: The answers below were written by David prior to the podcast, just to give some structure to the discussion. Keep in mind that the actual live discussion by Rhonda, Matt and David will often go in different directions with different information and opinions. So, please listen to the podcast for the more complete answers! Questions for today's Ask David Podcast: Stefan asks if we have a "self" or a "personality." Slash wants to know how to combat a "Should Statement." Magellan asks about the effectiveness of TEAM without the guidance of a therapist. Werner asks about the differences between Positive Reframing and the Positive Thoughts you record on the Daily Mood Log. 1. Stefan asks if we have a "self" or a "personality." What is the so-called "Great Death" of the "self," referred to in Buddhism? Hi David, I really love your work, both the books and the podcast you've created. Lots of great tools there. I think your down-to-earth approach is effective and great in de-mythologizing mental health care. Still, one thing has been bugging me about your approach: the fact that you quite casually seem to discount the existence of the self. As a theologian I understand this position. In discounting the self as a construct, you'll open the way to less resistance and more acceptance. I studied both Christianity and some Buddhism, and in that tradition the self is essentially something to let go of as an illusion. I think you called this the death of the ego, and it's common in many mystical currents both within and without the major religious traditions. However, by embracing this tradition in a therapeutic setting, I think there's a great risk to gloss over long-held implicit beliefs or patterns in the construction of a personality that might hold people back from reaching their full potential. More specifically, I'm talking about schemas or Lifetraps (in the terminology of Jeffrey E. Young and Janet S. Klosko). I know Aaron Beck supports their work to address these "chronic self-defeating personality patterns" that are usually considered the be part of the self. What's your take on their work? Kind regards, Stefan David's reply Hi Stefan, Personality, like "self" is not a "thing," but just the observations that different people have different behavioral patterns. So, some are more outgoing, for example, while others are more introverted and shy and insecure. The only meaning of "self" is the context in which the word appears. So, "behave yourself" simply means that you are misbehaving and need to stop! Can you come to the Sunday hike is a question. It does not need the add on, "and do you plan to bring you 'self.'" The only meaning of any word is the context, and many uses in the English language, or any language. Nouns do not always refer to "things." Words are just sounds that come out of our mouths. I don't go into this much because few people "get it." Thanks so much, Stefan. Warmly, david PS The above is my take on Wittgenstein's Philosophical investigations, published after he died in 1950. . Second PS I had a random and fairly weak thought, but here it is. When doing my daily "slogging" a while back, I was going through a pleasant and familiar path and noticing how beautiful everything was, and had the thought, "This land is so valuable and expensive, and I'm SO GLAD I don't have to own it. It would involve a nightmare of paper work, taxes and all kinds of worries. But I can just enjoy it without any of those burdens of ownership. Then I thought of the "self," and what a heavy burden it is to "have one," and worry about whether or not it is "good enough," or "inferior," and so forth. Selves tend to be a bit overweight, and heavy to carry around. And how much more fun, beautiful, and rewarding life is without having to have a "self" to worry about. Rhonda found this helpful after a time feeling confused about the "self," and Matt added this: "Right, and if we own the 'land' one day, and it changes, the next moment, is it the same 'land'? Do we still own it?" Matt's "Self" Thoughts Wittgenstein is one of my favorite philosophers due to the elegance of his solution to philosophical problems, which is to recognize that they are not, in fact, 'problems'. Instead of trying to answer the question, 'is there a self', 'do I have a self', he would point out that these questions are meaningless and can't be answered. One way to bring these questions into a form that could be useful and answerable, is to define the terms. What is the 'self', and what can it do? How would I know, if I had a 'self'? If the definition was in the form of a testable hypothesis, we'd be a step closer to arriving at a meaningful answer. In some cases, this answer is incredibly meaningful, in terms of our mental state and relationships. Let's t

Can You Treat ADHD with TEAM? Does Humor Play a Role in Therapy? What's the Difference between Rejection Practice and Shame-Attacking Exercises? Featuring Dr. Matthew May Note: Not all of the information covered here is in the podcast, and much of what we discuss in the podcast is not covered here. Questions for the next two Ask David Podcasts: Rich asks how you treat ADHD in TEAM. Hwa-Chi Qiu Alvarez asks about the use of humor in therapy. Rima asks about the differences between Rejection Practice and Shame-Attacking Exercises. Rich asks: How do you treat ADHD? From Richard: How about a podcast concerning ADHD? I feel that applying TEAM would work. No? I mean "disorders" arise from distortions…so what does a distraction "disorder" arise from? Thanks for all you do David, Rich David's reply: Hi Rich, I don't treat "disorders," I treat individuals at specific moments when they're struggling and wanting help! Hope that helps. As an aside, if you or a friend, colleague, or patient have ADHD and you can describe a specific moment when that person was struggling, I would love to hear about it! Then you'll see how TEAM works it's magic by focusing on individuals, and not "problems" or "disorders," etc. TEAM is a "fractal psychotherapy." I will explain! Warmly, david Matt's Take: Thanks for the question, Rich! I love what David is saying, about treating the individual, not the diagnosis. There are a lot of things that can interfere with focus and attention, such as. medical problems, sleep difficulties, toxin exposure, substance misuse, and relationship problems. In addition, depression and anxiety can interfere with concentration and contribute to ADHD symptoms. Below, I've listed many of the distracting thoughts that my clients have had. Along with a list of some good things about being Distracted. Hope you enjoy! Matt's A – Z List of Distracting Thoughts: I don't feel like doing this This is boring and no fun I never get to do what I want It's not fair I'll do it later There's plenty of time Best not to rush things I might be missing out on something interesting or important I'll check my phone one more time, real quick, and then get right back to work This time will be different. Seriously. I mean it. Actually, I'm feeling too tired to concentrate I'll just take a quick, 5-minute nap I'll get to work when I feel more rested and motivated I've had a hard day and deserve a little break and some fun Tomorrow's going to be really hard, so I need to rest up I just *can't* concentrate, at all There's something seriously wrong with me I lack willpower / I have no ambition I shouldn't have to do this There's no point doing this I'll never be able to do this I need to be doing important, interesting things It would be really exciting and fun to … x, y, z, instead I need to tidy up a bit before starting this big project I don't know where to get started / don't want to mess up I'll be too distracted if I don't take care of this one thing, first Matt's A – Z List of GOOD Reasons to be Distracted I can be spontaneous, have fun and be present, in-the-moment I won't miss out on something interesting and important I won't waste my life doing boring stuff that leads nowhere I'll focus on what makes me happy I won't let other people control me or make my decisions for me I like to feel powerful and in-charge; I call the shots This is my time, nobody controls me It's calming to know that I'm in-control I want to treat myself with respect I want to be free, not shackled It's important to take breaks I want to maintain a good work-life balance It's fun and exciting to be a bit of a 'rebel' I'm my own unique person, doing things my way I just want to 'go with the flow', it's easier I want to be safe, protected me from failure. I can't really fail if I don't give it my all I can get instant relief from the pressure anxiety when I outsource this task to 'future me' I deserve to do what I want, when I want to; I'm sticking up for me I can reject others' advice and feel superior I don't know where to start I can have more time to plan I'll be less likely to mess up if I consider my approach carefully I don't want to do an average job, this needs to be amazing I can prepare, talk, plan and complain; that's more interesting and fun than doing I don't have to face how dull and boring some parts of life can be I can daydream about a better life On the live podcast, Matt and Rhonda gave examples of individuals diagnosed with "ADHD" who all needed completely different and highly individualized treatment, which is what TEAM is all about. Matt described treating a boy with ADHD who would get anxious in class when he was called on to read out loud. He was afraid he'd get nervous and make mistakes, and the other students would judge him. The technique that helped him was the Feared Fantasy. Matt also described a fellow with ADHD who had trouble keeping appointments and getting places on time. He was helped by the technique I have called "Little

Transgender Issues Featuring Dr. Robin Mathy Emily Dickinson, from Amherst, Massachusetts, was one of the greatest American 19th century poets, and after hearing one of our Amherst professors explain her life and work, I fell in love with her incredible poetry. When she attended Mt. Holyoke College as a freshman, she was obligated to sign up as a "Christian," a "Non-Christian with hope," or a "Non-Christian without hope." She was the only student who had ever signed up as a "Non-Christian without hope," and she was given one semester to change her registration category. When she refused, she was asked to leave, and spent the rest of her life living in Amherst, baking cookies for children and writing her fabulous poems, which were sometimes included in her cookie packages. Her poetry was all about loss, which was much the story of her life. However, she was not self-pitying, which is part of what makes her poetry so sad and magical. Emily Dickinson always dreamed of visiting the west, but never got the chance to travel much beyond the outskirts of Amherst. She once wrote, To make a prairie, It takes one clover, and a bee. One clover and a bee. And reverie. The reverie alone will do, if bees are few. Tears come to my eyes every time I think about that poem! When I was a student at Amherst, we used to visit her grave, and I once actually knocked on the door of the house where she once lived. I explained I was a huge fan and actually got the chance to look around. I actually found a poem scribbled on a scrap of paper on a window ledge. Today we interview Dr. Robin Mathy, who describes herself as "A human who hopes." Robin is a well-published expert on LGBTQ issues, with a specialization in transgender research and political activism based on science to debunk hateful myths about sexuality. She is also a new member of our Tuesday training group at Stanford! In addition to studying to become a TEAM therapist, Robin is a Doctor of Social Work student at Tulane University. She is a researcher and activist who has published four books and more than 50 peer-reviewed articles or book chapters. She is a beloved member of David and Jill's Tuesday TEAM CBT group. Rhonda kicked off today's podcast by reading two very moving endorsements from people who heard part 1 of the live work with Jessica, "Living with Regrets," which we had published just prior to our interview with Robin. Then Rhonda kicked off our dialogue with Robin by asking if there are any special treatment considerations when you are working with trans individuals. Robin said that there really aren't—TEAM-CBT is already highly personalized and individualized, so we let the patient set the agenda. Robin emphasized the importance, of course, of being warm, affirming, and supportive. In addition, do not assume that the patient is there because of gender identity issues, or automatically refer them to a support group on that topic, because the patient's issue may be radically different, and that would amount to stereotyping your patient. I asked Robin for a simplified introduction to LGBTQ, including what these terms actually mean. That's because I have to admit I never had any good sexual diversity training during my medical school or psychiatry residency, and I suspect that some of our podcast fans, perhaps many, would also appreciate a little enlightenment based on science. Robin pointed out that transgender has to do with identity issues: what is your sense of self? Do you see yourself more as a woman or a man? And sometimes, this will be quite different from the gender you were assigned at birth. So, for example, you may be assigned as a boy at birth, but your sense of who you are may be a girl, when you are young, and a woman as you develop during puberty. In this case, you would be a trans-gender woman. To be respectful, you should refer to a transgender woman as she or her. And, of course, if you were assigned as a girl at birth, but your sense of who you are is a boy/man, you would be a transgender man, referred to as he / him. Some transgender people are nonbinary, meaning they do not want to be referred to as either a man or a woman, and they do not want to be referred to with either binary pronoun. To be respectful and sensitive, you should always ask someone what pronouns they prefer. In contrast, the terms, LGBQ, do not refer to gender identity, but rather to sexual attraction. So, a lesbian is a woman who is sexually or romantically attracted to women, and a gay man is attracted to men, and so forth. The term, "cis," refers to your gender that was assigned at birth. According to the National Center for Transgender Equality, When a person begins to live according to their gender identity, rather than the gender they were thought to be when they were born, this time period is called gender transition. Deciding to transition can take a lot of reflection. . . . Possible steps in a gender transition may or may not include changing your clothing, appear

Overcoming Loneliness Part 2-- A Master Class on the Feared Fantasy Technique Featuring Dr. Orly Marmur This is the second of a two-part series on loneliness, featuring the courageous personal work of Dr. Orly Marmur with Drs. David Burns and Jill Levitt as co-therapists. After Orly shared her story, we worked on helping her learn to use the Five Secrets, especially the Disarming Technique and Inquiry, to develop closer relationships with others. Jill described the philosophy of this approach as learning to be "interested" in others—encouraging them to talk about themselves—rather than trying to be "interesting" or "impressive," which is usually a losing battle. We also worked with the Feared Fantasy technique to help Orly deal with her fear of rejection. Essentially, we explained that we would enter an Alice-in-Wonderland Nightmare World where there were two weird rules:. If you think people are judging you or looking down on you, they really are! In this Nightmare World, people are not polite but get right in your face and tell you all the negative thoughts they're having about you. We asked Orly to describe the worst criticisms she thought her friends might have about her. Here's the list: We're not really interested in you. You don't really say or create anything interesting. You are by yourself. We have families. You're not funny enough. You're not fun enough. You're too intellectual. You're too political. You're a liability. Orly bravely took the role of herself to kick things off, and Jill and David played the role of the "friends from hell," and verbalized these criticisms to Orly. At first Orly struggled to respond effectively to the critical statements. She got stuck defending herself at times, and forgot to express interest in the critic and the specific criticisms. David and Jill modeled more effective responses, using the Five Secrets of Effective Communication, including The Disarming Technique (finding truth in the criticisms), Inquiry (ask for more information with a spirit of curiosity) Thought and Feeling Empathy (acknowledging how the critic was thinking and feeling) "I Feel" Statements (sharing feelings like sadness, shame, and loneliness in an open, respectful way) and Stroking (expressing positive regard for the critic, even in the heat of battle). Orly did a fantastic job, as you'll hear on the podcast, and we did some role reversals to refine certain responses. The goal of the Feared Fantasy is not so much to prepare for rejection in the real world, since very few people would ever say these things in such a harsh and open way. The Feared Fantasy "Monster" actually exists primarily in your own mind. But since most of us never think about the thing we fear, we don't realize or discover that the monster has no teeth. That is to say that by engaging with your greatest interpersonal fears, you discover that if someone were to attack you with over the top vague criticisms, you would survive, and it would reveal something terrible about the other person, not about you! The Feared Fantasy Technique brings this to life in a dramatic, emotional, and vivid way. At the end of the session there was a dramatic reduction in all of Orly's scores on the Emotions Table of her Dailly Mood log. Her Unhappiness dropped from 40 to 0 Anxiety dropped from 100 to 5 Shame went from 85 to 0 Worthlessness dropped from 95 to 0 Loneliness fell from 100 to 10 Self-consciousness fell from 8 to 5 Hopelessness fell from 100 to 5 Stuck and defeated fell from 100 to 0 Resentment fell from 90 to 0 Disappointed in myself fell from 100 to 0 As you can see, there was a dramatic reduction in all of her scores. We asked Orly what the most important healing elements during the session were. What techniques were that were most helpful. Orly said that the empathy from Jill and David was really important as she felt heard and accepted. The Feared Fantasy Technique also made a huge difference, as it taught her what she wanted, which was to feel intense feelings without doing anything about them. Orly felt that this is the continuation of earlier work that made her realize that she struggles with Emotophobia (which means "the fear of feeling your emotions), and she wanted to increase her capacity to simply feel. Rhonda, Jill, and David want to give a shout out and virtual hug to Orly for a most fantastic session and learning opportunity for all of us. Teaching Points Here are a few teaching points for therapists as well as the general public. The secret of meaningful relationships is to be interested in others instead of trying to be "interesting" or impressive. You do not need to add more accomplishments to the list in order to feel close and loved by others. The Disarming and Inquiry Techniques (which are parts of the Five Secrets of Effective Communication) are extremely important in calming troubled relationships, if used skillfully, because they open the door for the other person to be heard and validated, and hopefully inte

Overcoming Loneliness Part 1-- How to Develop Loving Relationships Featuring Dr. Orly Marmur This is the first of a two-part series on loneliness, featuring the courageous personal work of Dr. Orly Marmur with Drs. David Burns and Jill Levitt as co-therapists. Orly is a clinical psychologist from Southern California and member of our Tuesday TEAM-CBT training group at Stanford. She loves to hike, and recently went on a 25 mile solo hike from the North to the South Rim of the Grand Canyon, an arduous hike that she planned for a long time She happened to be hiking on October 7, 2023, the day of the Hamas invasion of Israel. The hike was a huge victory for Orly, but when she arrived at the top of the South Rim, her cell phone was instantly bombarded with news and emails about the Hamas invasion and brutal murder, beheading, and rape of many innocent Israeli citizens. For the next several days, Orly's mind was flooded with flashbacks of her life, growing up in Israel when the country was still young, and living through four wars. Her father and brothers were in one war together, and her brother was wounded, but survived and recovered. Orly felt guilt and shame because she was not there to help. She said that she wanted to go to Israel to help her brother with his farm, but was conflicted because she did not want to abandon her clinical practice in Southern California. She explained: I grew up with the people who started the State of Israel. Those were idealistic, heroic times. My grandmother left Europe when she was 17 and settled in Israel. The focus was on building. We learned to be heroic. A few days later, in the Tuesday group, David noticed that I was feeling down and lonely unable to focus and "checked out." I had a hard time feeling my feelings. I had shut down. I began being flooded with memories of sexual molestation at my grandparents' house when I was a girl in Israel. I remember standing next to a tree, and feeling like I was "different" from the other kids, I started feeling sad and guilty about losing so many relationships over the years. I've alienated so many people, and now I want to accept responsibility for that. When my daughter was 1 year old, I became friends with other parents at the day care center. We became like an extended family as our kids grew up, getting together on Fridays for dinner, celebrating holidays together and being there for each other. However, during the pandemic, I began to feel rejected by them. And sometimes there were individual rejections. We had often camped out together over the years, but all of a sudden, I was not invited. I was the only single person. The rest of the group are couples. Over the years, I was told a few times that, at times, my presence makes things difficult. Since then, I've been invited to some but not other functions of our group. I haven't felt like people are interested in me, or like me. I also want to feel my feelings and develop a sense of empathy for others and greater pride in myself—after all, I DID survive. I became very politically active with others interested in supporting Israel after the October 7th invasion. I was hoping to feel close to people, but it didn't work because I still felt alone. I had hoped they'd be impressed with my political activism, but it didn't help. My problem was not the war, but me. I'm hoping today you can help me to feel my feelings again! I realize that I tend to jump to action rather than feel my feelings. I think that it has to do with my upbringing and the circumstances and culture that I came from. Next week you will hear the exciting conclusion to the work with Orly, and a follow-up several weeks later. Orly's Daily Mood Log. End of Part 1 Thanks for listening today! Rhonda, Jill, Orly, and David

The Anxious Child— Three Common Errors Parents Make, and How to Avoid Them! Featuring Dr. Taylor Chesney Today we interview Dr. Taylor Chesney who is the Director of the New York office of the Feeling Good Institute. She specializes in the treatment of children and teens, and today will tell us about the three biggest errors parents make in dealing with anxious kids. Dr. Chesney has been a guest on several of our podcasts in the past (episodes 107 and 263, and Corona Casts 4 and 6) and is a terrific teacher and therapist. She recently taught a 12 week course for therapists working with teens and children (ages 6 to 18) and their parents and brings us some of the highlights today. She always begins treatment by interviewing the child and the parents and pinpoints what they want help with. Then she assesses how hard they are willing to work to bring about that change. The goals may be quite different for the child and the parents. It's crucial to develop a meaningful therapeutic contract with the children, as well as the parents, as opposed to thinking your role is to "fix" the child for the parents. If the child is less than 11 years old, she meets with the parents first. If the child is 12 and up, she meets with the child first. Either way, she empathizes with the child and encourage them to tell their side of the problem. During or after empathizing, she does Positive Reframing, to show the child what their negative feelings, like depression and anxiety, show about them that's positive and awesome. For example, if you're sad about not being invited to a birthday party, it shows that you value friendships, and that you care a lot about other people. If the child is anxious, she will teach them how their anxiety can be helpful. For example, if the child is a good athlete or student, anxiety can be an important motivating force in their success. But sometimes we might get too anxious and feel intensely anxious about something that is not actually dangerous. Then you might experience your anxiety as trouble eating, a belly ache, trouble sleeping, or some other symptom that gets in the way of your optimal functioning. The most important question with parents and children is usually: "Do you want to learn some tools and skills to help you change the way you feel?" She also teaches children and teens what different kinds of emotions are, and the kinds of thoughts that trigger them. For example, if you feel anxious, you're probably telling yourself that you're in danger and that something bad is about to happen. If you feel guilty, you're probably telling yourself that you've done something bad, or that you hurt someone you love; and if you're feeling angry you may be telling yourself that someone is trying to hurt you or take advantage of you. Taylor brings the core cognitive therapy ideas to life with examples that children can understand. Here's how she explains the idea, taught by Epictetus nearly 2,000 years ago, that our feelings do not result from what happens to us, but from our thoughts about what's happening. Let's say that you got a 90 on a test. How would you feel? You might feel overjoyed if you studied hard and felt like you did a good job and got a wonderful grade. However, if you felt like you had to get a 95 to raise your semester grade in the class to an A, and you even skipped going to the prom to study extra hard, you might feel sad, ashamed, frustrated, angry, and disappointed, telling yourself that you "failed." Same grade, but two radically different emotional reactions, depending on how you think about your grade. Conclusion: it's not what happens, but what you tell yourself, that triggers all of your positive and negative feelings. Taylor said that anxiety is incredibly common in her clinic population and that surveys indicate that a whopping 25% of children have an anxiety disorder. She teaches her patients that anxiety in children, teens, and adults results from giving in to the urge to escape from a frightening or uncomfortable situation instead of facing your fears and discovering that the monster has no teeth. For example, Taylor was in the ocean with her 9 year old son, and there were jellyfish in the ocean. Her son was terrified and wanted to get out of the water and back to the shore. Taylor asked him what he was telling himself, and he said he was thinking that the jellyfish were bad. She also told him, "It's okay to be afraid and to be careful and avoid the jelly fish, but you can also choose to stay in the ocean. Then we can have some fun together playing in the water." He decided to stay and have fun and felt proud of himself! She described Three Common Mistakes parents make in dealing with an anxious child. Error #1: The Quiet Out Trap She explained that we love our children, and don't want them to suffer, so we may give them an easy way out. For example, if your child is afraid to go to the party when you are dropping them off, you might say, "If you don't want to go to the p

Personal Work with Dr. Tom Gedman-- Overcoming Performance Anxiety The Triumphant Conclusion Last week you heard Part 2 of our personal work with Dr. Tom Gedman, which included T = Testing and E = Empathy. This week you will hear the dramatic and inspiring conclusion of the session, including A = Assessment of Resistance and M = Methods. Dr. Tom's beloved pal Start of Part 2 A = Assessment of Resistance We began with the Invitation Step, asking Dr. Gedman what he hoped to accomplish in today's session. His list included: Develop some clarity on the direction of my business. Become more authentic in my video recordings promoting my clinical work. Increase in self-confidence. Feel accepted by David and Rhonda. My ability to push ahead during recordings instead of stopping and backing down because it isn't "good enough." Dr. Gedman said that he'd gladly push the Magic Button to make his negative thoughts and feelings instantly disappear, but agreed to look at some of the positives in them first by asking these types of questions of each negative thought or feeling. Is there some truth in this negative thought? Could this negative thought or feeling be appropriate or even healthy, given my circumstances? How might this negative thought or feeling be helping me? What does this negative thought or feeling show about me and my core values that's positive and awesome? Could there be some negative consequences of giving up this negative thought or feeling? The Positives in My Negatives Negative thought: "I can't be authentic on videos. I look like such s smug phony." I want to be other-centered, and focused on how I might be able to relieve the emotional struggles and health problems of my patients. I value being authentic and genuine. I want to help people who resonate with my message. I don't want to hide. I want to be open with my flaws. I value honesty and integrity. I value humility. I value compassion. Negative feeling: sadness I care a great deal about my dream. I don't want to fail and let my family down. Negative feeling: shame Motivates me to work harder Shows my love for my family. I'm aware that I'm letting down the very people I want to help. Negative feeling: inferior, inadequate Show that I respect and admire the many people who have superior skills at talking live in front of a camera. Shows that I'm aware of what others have accomplished. Shows I don't feel superior to others. The idea behind the Positive Reframing is to help the patients see that their negative thoughts and feelings are not the expression of what's "wrong" with them, but what's right with them. This paradoxically reduces the resistance to change and opens the door to the possibility of rapid recovery. You can see Dr. Gedman's goals for each of the negative feelings on his Daily Mood Log if you click here. As you can see, instead of trying to eliminate his negative thoughts and feelings by pushing the Magic Button, he has decided to dial them down to lower levels with the Magic Dial. Of course, these are only goals. We will need methods to challenge and smash his negative thoughts so we can reduce his negative feelings. M = Methods Rhonda, Tom, and David used a variety of methods to work on several negative thoughts Tom wanted to work on first, including numbers 1, 2, and 4 from Tom's Daily Mood Log.. I can't be authentic. I look like a smug phony. 100% I waste so much time on my videos. I should be quicker. This should be easier. 100% David and Rhonda will judge me for what I'm doing. 80% We used several methods including Explain the Distortions, Survey Technique, Externalization of Voices (with Self-Defense, Acceptance Paradox, Counter-Attack Technique,) and more You can see Dr. Gedman's end-of-session scores on his nine negative feelings on his Daily Mood Log if you click here. As you can see, eight of the feelings fell all the way to zero, and his feelings of inadequacy fell from 100 all the way to 5. Toward the end of the session, we discussed Tom's medical and psychological philosophy, which might appeal to some of our podcast fans, especially if you live in England. First, he uses TEAM-CBT in individual two-hour sessions to help help people who are struggling with feelings of depression and anxiety. He finds this work thrilling because you can often see amazing changes within a single session, just like we saw in Tom's work today. Dr. Gedman also hopes to develop TEAM-CBT groups as well. This can be difficult because you need many referrals, but in my experience, TEAM groups can be incredibly effective, and cost-effective as well. In addition, Tom also has a Functional Medical Practice which focuses on developing healthy nutritional and eating habits, consistent exercise, limiting the intake of toxins, developing loving relationships via the Five Secrets of Effective Communication, and enhancing spirituality. If you would like to contact Dr. Gedman and learn more about his clinical practice, he can be reached at www.DrTomGedm

Personal Work with Dr. Tom Gedman-- Overcoming Performance Anxiety Have you ever struggled with Performance Anxiety? That can include public speaking anxiety, as well as anxiety when having to perform in an athletic or musical event, or speak on the radio, TV, or internet , etc. This is one of the most common forms of anxiety that we see in mental health professionals, as well, of course, in general citizens, including children, teens and adults. Today you will hear Part 1 of the live work with Dr. Tom Gedman, a British physician struggling with intense performance anxiety, including the initial T = Testing and E = Empathy. Next week, you'll hear Part 2 of the session as David and Rhonda do the A = Assessment of Resistance and M = Methods portions of the work with Dr. Gedman. You may recall Dr. Gedman from our previous podcast (# 348). Recently, Dr. Gedman has wanted to promote his new programs on health and mental health in brief videos he plans to publish on social media sites, but finds himself crippled by negative thoughts that make him freeze up in front of the camera, like these: I'm not good at this. 100% I can't be authentic. 100$ I'll look like a robot! 100% Tom practices in England as a family practice doctor, but has decided to work part time for the national health service while he establishes his clinical practice because he is only permitted to spend 10 minutes with each patient. He has developed a love affair and expertise with TEAM-CBT, and wants the freedom to practices in the way he wants, offering two-hour individual and group sessions, where he emphasizes the integration of physical with mental health. But this means having to advertise his clinical practice to solicit patients, and this is a bit of a treadmill because of the rapid changes he sees in so many of his patients. Hence, his urgent need to overcome his public speaking / performance anxiety. I have a soft spot in my heart for anyone who's struggle with these types of anxious thoughts and feelings, because I have encountered them on many occasions in my professional career when I had to present my work in conferences, or even when attending receptions that included other mental health professionals. In fact, I am the "voice" on the Feeling Great App that I've been developing over the past several years, and it took me some time to get comfortable with the recordings, since I told myself that I "had to sound natural, spontaneous, and inspiring." Of course those internal and external demands caused the exact opposite—feelings of tension, insecurity, pressure, and intense self-doubt, resulting in "robotness" as opposed to spontaneity! Yikes! It was a dreadful battle for a while! So, I KNOW how Tom has been feeling. And our beloved Rhonda has been there, too, especially when she took over from Dr. Fabrice Nye as host of the Feeling Good Podcast that you're listening to right now. If you recall, she was feeling pretty darn insecure! (See Podcasts # 142 and 143.) Perhaps you've also struggled with social or public speaking anxiety, and felt insecure, panicky, frustrated, or ashamed? Have you? Even in our weekly training group at Stanford for mental health professionals, these feelings are rampant and nearly universal. Part 1 of the work with Tom T = Testing Tom brought a partially completed Daily Mood Log to today's session. You can review it if you CLICK HERE. As you can see, he was feeling nine different categories of negative feelings, all intensely, with estimates ranging from 70 to 100. This is why T = Testing is necessary for all mental health professionals, regardless of your so-called "school" of therapy. People, like Tom, may look attractive and filled with enthusiasm and joy on the outside, and still be experiencing EXTREME levels of distress inside. The T = Testing vasty improves your accuracy in understanding how your patients are feeling. It also makes you accountable, which can be sobering, because we will again ask Tom how he's feeling at the end of the session. The improvement, or lack of improvement, will tell us EXACTLY how effective, or ineffective, we were today in our work with Tom. This is a great bonus for therapists who are courageous enough to use my Brief Mood Survey at the stat and end of every session, with every patient, because your patients become your best teachers, by far. But it's also a threat, because the numbers don't lie, and you'll also be confronted by your ineffectiveness with many of your patients / clients. Sadly, a great many therapists would prefer not knowing the truth! E = Empathy Although Tom had previously defeated these anxiety-provoking thoughts and reached a state of relative enlightenment and joy, the thoughts have come creeping back into his psyche. That's one of the things about anxiety. Once you've beaten it, you have to keep up the assault with frequent, ongoing exposure, or the anxiety will once again invade your brain and body. But the good news is that the methods that helped

Rhonda Describes the GRIP Program and Interviews GRIP Graduate, Shakur Ross The Guiding Rage Into Power (GRIP) Training Institute serves incarcerated men and women in California. Their mission is to create personal and systemic change to turn violence and suffering into opportunities for learning and healing. I (Rhonda) was introduced to the GRIP program when two of my dearest friends, Steve Zimmerman and Vicki Peet, invited me to a yearly celebration of the GRIP Training institute. I was blown away by who I met and what I learned that I wanted to share it with the Feeling Good Podcast listeners. Thank you, David, for letting me deviate from our typical subjects. The GRIP program is a different subject for the Feeling Good Podcast, because it is not about TEAM-CBT. What the GRIP Program and TEAM-CBT have in common is that they are both evidence-based programs that incorporate CBT theory and methods into their treatment methodology. But the main thing they have in common is that people who engage in these two therapies experience profound, enlightening changes in their lives. From their program: "The GRIP program is an evidence-based methodology developed over 25 years of work with 1000's of incarcerated people and many victim/survivors. Rooted in Restorative Justice principles, the program's trauma informed model integrates cutting-edge neuroscience research. Students engage in a yearlong, in-depth journey to comprehend the origins of their violence and develop skills to track and manage strong impulses rather than acting out in harmful ways. They transform destructive beliefs and behaviors into an attitude of emotional intelligence that prevents revictimization." The GRIP Training Institute was started in 2011. As of October 2020, nine years after running its first group, 915 students have graduated. Of the 915 graduates, 369 were released from prison. Only 1 graduate in nine years returned to prison, which is a recidivism rate of 0.3%, which is very impressive considering the recidivism rate for California is between 44-46%. Many, if not all of the graduates, say that GRIP saved their lives. Something many people who have benefitted from TEAM-CBT echo. At the GRIP celebration, I was standing in line waiting for the buffet. A man got in line behind me. It was confusing where the line ended, which was not directly behind me. In another circumstance I might have mentioned to him that the line ended somewhere else, but he was kind of scary looking, big, buff with obvious prison tattoos on his neck so I didn't say anything. But the line moved slowly and I was curious so I asked him what his connection to GRIP was. He told me he was a graduate of the program and then politely asked me the same question. It has been my experience that often people love to talk about themselves more than they are interested in other people so I was immediately impressed that he was as interested in me as I was in him. When I told him I was a therapist, he asked me what kind of therapy I practiced. I explained TEAM-CBT, and he was super interested! He told me he loved CBT, and had learned a lot about himself through that kind of therapy because GRIP incorporated it in their program. I asked him about his experience in GRIP and his tough exterior transformed right in front of me as he talked about how GRIP saved his life. I talked to several other men (so far only men have graduated from the GRIP program because the services have only recently been brought to a women's prison), and had the same experience. I met our guest on this podcast, Shakur Ross, who kindly agreed to share his journey of transformation with us. GRIP graduates continue to do the work and live as Peacemakers. Shakur works for GRIP and returns to San Quentin and other prisons to provide the same lessons that he received. The podcast starts with an interview with Kim Moore, the Executive Director of the GRIP Training Institute, who explains some of the key concepts of the program. Thanks for listening today! Rhonda