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

How to Master the Five Secrets: If You Dare! In our recent podcast surveys, one of the highest rated show topics was learning therapy techniques, both for therapists and for the general public. That's why today we're going to take a deeper dive on some of the fine points of the Five Secrets of Effective Communication. We'll show you how to use them with individuals who are angry and hostile, including some patients with Borderline Personality Disorder as well as kids who may be ticked off at a parent. These topics were specifically requested by people who completed the podcast survey. Link to Five Secrets The Five Secrets are like a fantastic musical instrument, capable of working magic for troubled relationships. You can't just sit down at a fine grand piano and pound on the keys and expect great music to emerge. You'll just get cacophony. To learn the Five Secrets, you need: Great determination and desire The willingness to endure the "Great Death" of the "self," or pride. Tons of ongoing practice with immediate feedback and deliberate practice involving role reversals until you get it "right," or receive an "A." To get started, Rhonda and David made a list of a few of the most challenging criticisms a therapist might hear from a patient, or a parent might hear from a teenager. Criticisms from patients included: You don't care about me! I'm not getting better. You're not helping me! You charge too much! All you care about is your darn techniques. That's not my child's name! You're not listening to me! And this one, from a first time patient referred by the courts: I got anxious last night and masturbated to your image, which I found on the internet, and it really helped! These are some criticisms from kids: Stop nagging me! Stop giving me advice. I don't want any advice! We demonstrated the "Intimacy Exercise" I have created for our training programs. You can use this exercise to work on conflicts with patients and conflicts with loved ones. It works exactly the same way in both situations. You'll need someone to practice with. Step 1. One of you agrees to play the critic and the other plays the role of the person being attacked (therapist or parent, for example.) Step 2. The person playing the role of the critic verbalizes the hostile comment. Step 3. The person playing the role of the therapist / parent responds as effectively as you can, using the Five Secrets of Effective Communication. Now you must STOP. The exchange is done. No further interaction in the role playing format is permitted. Step 4. The person who played the role of the therapist / parent gives himself / herself a grade between A and F. Ask yourself, "How well did I do just now?" Step 5. The person who played the role of the critic gives the therapist / parent a letter grade, and then provides the following specific kinds of feedback using Five Secrets language. Positive Feedback: Here's what you said that worked pretty well. Your Thought Empathy was great, and your Disarming Technique was fairly good. Your Stroking was excellent, especially when you said X, Y, or Z. Negative Feedback: Here's what you said that needs a little fine tuning: Your Feeling Empathy was completely missing—you did not acknowledge how the other person was feeling. Your "I Feel" statements were also missing, and there was no Inquiry at the end. Then you can suggest ways to include the Five Secrets elements that were missing or "off," and demonstrate how you might improve the response to the criticism with a role reversal, followed by another round of grading and positive and negative feedback. Continue using role-reversals until both parties can get an A on the exercise, always using the same harsh criticism that you're trying to learn how to master. Don't try something new until you've mastered the thing you're working on. The practice is powerful but hard, and requires the philosophy of "joyous failure." This means welcoming the chance to get immediate feedback about your skills, or lack of skill, instead of getting blown away, defensive, or "yes-butting" the person who's trying to correct your technique. You will hear some pretty dramatic examples of this on today's podcast! The Five Secrets can be life-changing, but the price of learning is fairly stiff. If you want the rewards, the exercise we demonstrate in today's podcast can be incredibly helpful—but scary! Also, you can read my book, Feeling Good Together, and do the written exercises while reading if you're a therapist or a general citizen. This helps a lot. Dr. Jill Levitt said she kept Feeling Good Together on her nightstand for more than a year when she first joined by training group at Stanford. Her dedication and hard work have clearly paid off for her. If you're a therapist, you can also read the chapters on E = Empathy in my Tools, Not Schools, of Therapy book, and make sure you do the written exercises while reading! Thanks so much! And good luck if you're brave enough to try our "Intimacy Exerc

Check it Out! The September, 2022 Podcast Survey Dear Podcast fans. Thank you for your responses to our podcast survey yesterday, asking about your likes and dislikes, as well as your suggestions for the future of our podcast. The following report is based on 355 responses we received the first day of the survey. A link to the survey report will be included in spots so you can examine it for more information! LINK TO SURVEY RESULTS Thanks So much! Rhonda and David PS Rhonda is now our official Host and Producer! Demographics Gender: 58 / 42 = female / male Age: 21 to >70. None under 21. Education Grad school: 64% College: 29% High school, grammar school, other: the rest Comment: high average education level is likely due to high number of therapists Therapist No 56% Yes 33% TEAM certified therapist Yes 15% No 85% Podcast Interests Listen to improve your therapy skills? Yes 47% No 53% Listen for personal healing? Yes 90% No 10% How many episodes have you listened to? All 26% A lot 37% About half 16% Just a few 21% What elements do you value the most? Teaching Therapy Techniques 86% Live Work 72% Story Telling 58% Critical Thinking 57% Inspiration 54% Warmth 46% Laughter 42% Guest Interviews (36%) Under 30%: Tears (23%), Banter (29%), Controversy (17%), What types of podcasts appeal to you the most? Therapy Methods 194 Live work 184 Anxiety Help 168 Ask David 163 Self-Help 158 Depression Help 156 Relationship Problems 154 TEAM Training 126 Habits and Addictions 107 Procrastination 94 Guest Experts 88 Weight Loss 51 Other What do you think about paid ads? Hate it 28% Love it 20% Unsure 52% Would you recommend the podcast to a friend? Yes 96% No 4% What grade would you give the podcast? A 77% B 20% C 3% D 0% F 0% Written Responses Elements you like the best (selections 356 responses) Learning about techniques to help patients from experts in the field! Realistic and humorous portrayals and disclosure Always pick up a new concept Brilliant teaching and great techniques The idea that long- lasting change can happen quickly The use of Paradox There is done sort of therapy by proxy that seems to happen during live therapy work. Even when situations are different, amazingly meaningful. I enjoy the Q&A podcasts where you cover 4 to 5 great questions. Having Rhonda and Matt (and, of course, Dr. Burns!) give their viewpoints on topics that can be helpful to everyone is very useful. Learning how to retool my brain. I love the feeling of comfort I get from hearing your stories, both personal and from guests. I was particularly touched by Rhonda's openness when she first joined the podcast and worked through her feelings of inadequacy. I think about those episodes a lot because I relate to them. Feel less alone The live therapy sessions. Hearing Dr. Burns, Jill, Rhonda and others do externalization of voices, positive reframing, and other techniques is SO incredibly powerful. Hundreds more! (link) Elements you like the least (selections 356 responses) The long intros sometimes before the topic gets started Boasting, rambling on and on. Sometimes the attitude towards other practices and theories is condescending and fails to appreciate the contributions different approaches make to understand and alleviate suffering. endorsement emails Something I've noticed in live coaching is that there seems to be a strong focus on externalization of voices as a method. In Feeling Great, I love your 50 methods - but I wonder why it feels like 80% of the time you focus on externalization of voices vs other methods. Honestly, that's super nit-picky. But I felt like I had to include something in the "liked least" section. Otherwise, I think the Feeling Good podcast is A+++ Not a fan of the hokey -- the weird Hello Rhondas, etc. Ditto for the four letter words. IMO these detract from the content, dumb down/lessen the credibility of the presenters and content. Distracting and make me cringe. I won't quit listening... just unprofessional and low class. Hard to complain about something this good Hundreds more (link) What other topics might interest you? Trauma work. Meaning - I find that MANY people are talking about "Childhood Trauma" as if it's a separate thing. "Trauma-Informed Therapy" seems to be a new hot topic. Wondering what you feel about trauma and this seeming growth in trauma-focus. Use 5 secrets in relationship with someone with borderline personality disorder 5 secrets training How to make friends How TEAM principles can help you raise happy/healthy kids! Discussion of how to manage anxiety when it's hard to pinpoint the direct cause, making it hard to challenge our thoughts. Also topics on panic attacks. integrating the buddha dharma with cbt Definitely PTSD (I have PTSD from finding my partner dead after a suicide), body image, more about dating and relationships. How to treat low self esteem. How to increase happiness. How to make touch decisions about careers or other things that have pros and cons. For example, doing the dec

Smashing Shyness-- Shame-Attacking and Beyond Come to our Full-Day Workshop on Sunday, October 2, 2022 For therapists and lay people alike Click here for registration and more information Today we interview our beloved Jill Levitt, PhD who will be joining me in teaching the upcoming social anxiety workshop on October 2nd. Jill is the co-leader of my weekly psychotherapy training group at Stanford, and is the co-founder and Director of Training at the Feeling Good Institute in Mountain View, California. Social anxiety was one of the most frequent problems that patients sought help for when I was in private practice in Philadelphia. Because of my own severe and persistent social anxiety since childhood, it's my favorite problem, too. Whatever you've had, I can tell you that I've had the exact same thing, too, and know how sucky it can be. I can show you the path to freedom from that affliction, and what a joy that will be! According to the DSM5, there are at least five types of social anxiety: Shyness Public Speaking Anxiety Performance Anxiety. This a broad category that can include athletic or musical performance, or any time you have to demonstrate your skills in front of people who might judge you. For example, I had a severe camera phobia since I was a child, and only got over it a couple years ago! Test Anxiety Shy Bladder / Bowel Syndrome In addition, other negative feelings typically go hand-in-hand with social anxiety, such as shame and loneliness, as well as depression and feelings of inferiority and even hopelessness. This workshop will focus on therapists looking for training. However, the general public are also included, since you will get the chance to practice and work on your own fears during the workshop. I (David) have noticed that feelings of social anxiety, especially performance anxiety, are almost universal among therapists, at least judging from those who attend our weekly TEAM-CBT training group at Stanford. So, come to heal yourself AND to learn how to heal your patients and loved ones. We will be covering not one, but four treatment models for social anxiety in the workshop: 1. The motivational model: Nearly all anxious individuals resist exposure, which is a crucial part of the treatment. Most therapists also resist exposure for a variety of reasons, thinking the patient is too fragile, or the technique will be too dangerous or upsetting for their patients. This is unfortunate, since this pretty much dooms the treatment to failure, especially if you are aiming for a "cure" rather than endless talk and hand-holding. 2. The Cognitive Model. Although usually not completely curative, the Daily Mood Log is essential to treatment, so you can find out exactly what patient are thinking and feeling at one specific moment when they were feeling anxious. I present the case of Jason, a young man feeling shy and anxious while standing in line to check his groceries one Saturday morning at the local grocery store. Many cognitive techniques are incredibly important and useful in the treatment of social anxiety, including Explain the Distortions, the three types of Downward Arrow (uncovering) Techniques, the Double Standard Technique, Externalization of Voices, the Feared Fantasy, and more. Although these methods are helpful and illuminating, they will rarely or never be quite enough for a complete cure. For that you will need: 3. The Exposure Model. In the workshop, we will be teaching: Smile and Hello Practice: In today's podcast Jill discussed the purpose of this technique, how to introduce this technique to your patients, and how to implement it. This is an example of the many techniques we will teach on October 2. David provided a dramatic example of how this humble technique changed the life of a young man from India. Flirting Training Talk Show Host Rejection Practice Feared Fantasy: We role-played how I used this humor-based technique in my work with Jason Self-Disclosure Survey Technique Shame-Attacking Exercises. We will also explain how to use several techniques crucial to the reduction of the patient's resistance: Dangling the Carrot Gentle Ultimatum Sitting with Open Hands Fallback Position However, many therapists have intense resistance to making patient accountable with these techniques that are absolutely central to TEAM-CBT, thinking they are cruel or crude or narcissistic, or some such thing. In the podcast, Jill illustrates a beautiful and gentle but firm way of introducing these techniques to patients, and emphasizes that they are actually ethical, therapeutic, and necessary for a good outcome. She also emphasizes, and I totally agree, the importance of going with the patient into the real world to do the Exposure Techniques. I have used extreme exposure techniques on hundreds of occasions when treating anxious colleagues on Sunday hikes for example, urging them to stop hikers we meet and disclose their own shyness, for example. The advantages of doing this type of thing in th

Professor Mark Noble Shares his Thinking on the Uptick in Loneliness. Rhonda starts today's podcast with a beautiful podcast endorsement from Eduardo, a fan who loved our recent podcast 303, featuring the dramatic, humble, and inspiring Jason Meno, a data scientist and software engineer who is making superb contributions to the Feeling Good App. Eduardo was especially interested in how to bring non-verbal, difficult-to-access negative thoughts to conscious awareness with the Stick Figure Technique. Today we interview Professor Mark Noble on the topic of loneliness. Mark is best known for his pioneering research on stem cells, but he has become an active and beloved member of the TEAM-CBT community since joining one of my Sunday hikes back in (date?) Mark is currently an active member and small group leader in Rhonda's Wednesday TEAM training group. He generously wrote brilliant chapter for my most recent book, Feeling Great, and has also written the Brain Users Guide to TEAM CBT which you can download for free from https://www.feelinggreattherapycenter.com/resources Mark begins by dedicating today's podcast to listeners who may be struggling with feelings of loneliness, and explains that loneliness appears to be on the increase, along with virtually all types of negative feelings, especially since the onset of the pandemic. He emphasizes that there are many roads to loneliness, including: Loss of a loved one, including friends, family, colleagues, or even a beloved pet Betrayal by someone you trusted Being trapped in an abusive relationship Being abandoned or neglected as a child Not being accepted by your family due to sexual orientation, religious preference, choice of life partner, or other factors Feelings of isolation due to COVID A dead marriage Infidelity And more. Of course, Social anxiety is one of the most common causes of loneliness, and last week we interviewed two individual, Cai Chen, MD, and Chan Mary Soeur, RN, BSN, who have fallen in love. Both were lonely and struggled for years with social anxiety. Their work with TEAM-CBT has not only helped them greatly with their anxiety and loneliness, but has brought them intense romantic love! Not bad! People struggling with loneliness often think there's something "wrong" with them. For example, you may feel unlovable, and fear that you'll be alone forever. In addition, the belief that we "need" love to feel happy and fulfilled often leaves the lonely individual feeling like they're doomed to endless unhappiness and a lack of fulfillment if they're alone. Mark explains that the scientific definition of loneliness is the distress you feel when you think that your "needs" for connection and relationships differ from what you have. In addition, he believes that loneliness is not abnormal, but is rather an indication of healthy brain function that has been important to the survival of the human race. For example, feelings of loneliness motivate us to connect with others. In fact, feelings of loneliness prompt babies to cry for their mothers when they feel hungry, hurt, or alone, and this process begins within seconds of being born. We raised the question of whether the cure for loneliness is internal or external. The internal solution involves changing the way you think, and your relationship with yourself. The external solution involves trying to find a loving partner or becoming more involved in activities with others. Although this is the solution most people pursue, it often falls short. David emphasizes the important of the internal solution, and discovering that you can feel completely happy and fulfilled when you're alone. In fact, this is the first step in overcoming loneliness that he emphasizes in his book, Intimate Connections. Mark, Rhonda and David also discuss some of the paradoxes of TEAM-CBT, and how the "need" for love often drives others away, since you are asking people to give you something you can only give yourself. In contrast, when you feel happy within, and no longer "need" the love of others, love will often pursue you. We hope you enjoyed today's podcast, and want to thank our buddy, Professor Noble, who has made so many in our TEAM-CBT community feel less lonely and more connected! Warmly, Mark, Rhonda, and David

Swimming in the River of Love Rhonda starts today's podcast with a beautiful podcast endorsement from a fan named Vicky, from Australia, who was thrilled with the two recent live therapy podcasts with Nazli (podcasts 301 and 302). She wrote that she felt so lucky to hear someone with the exact same negative thoughts, and same feelings of depression and anxiety, that she's had since she was 10 years old. I have often said that when therapists have the courage to do their personal work in public, you not only heal yourself and learn cool techniques first-hand and experientially, but you also heal many others who are touched and inspired by you. Thanks to all of our fans for your frequent loving comments and cool questions for future Ask David podcasts. We then give a little promotion for several upcoming group events, involving: May 2, 2022. Dr. Jill Levitt and I will be teaching an exciting, full-day workshop on "Smashing Social Anxiety: Shame-Attacking and Beyond." It will be open to shrinks and the general public alike. The focus will be on learning to treat social anxiety, including your own! For registration and more information, please go to CBTforSocialAnxiety.com. September 13, 2022: Drs. Brandon Vance and Heather Clague start two new Feeling Great Book Clubs. For registration and more information, please go to www.feelinggreattherapycenter.com/book-club. September 14, 2022. Drs. Heather Clague and Brandon Vance will start their weekly "Deep Practice" group for training in the Five Secrets of Effective Communication. This type of practice is absolutely needed if you want to use these fantastic techniques to greatly boost your clinical effectiveness or enhance your relationships with the people you care about. For registration and more information, please go to www.feelinggreattherapycenter.com/5-Secrets. Date (to be announced). Zeina Halim soon begins the first-ever book club for When Panic Attacks. This terrific group could be helpful if you've ever struggled with phobias, social anxiety, chronic worrying, panic attacks, OCD, PTSD, and more. For registration and more information, please go to https://feelinggood.com/2022/08/08/anxiety-book-club/ Date (to be announced). Zeina Halim will collaborate with our Feeling Good App development team in an experiment to test a month's use of the Feeling Good app with or without a weekly practice group to supplement your work with the app. This exciting project is currently in the planning stage, but if you think you might be interested, please contact Zeina at Zeina Halim so she can contact you once we're ready to start. As an aside, the app will be free since we're still involved in beta tests, but the weekly practice groups will involve an additional charge. Today we feature a love story involving Dr. Cai Chen, a young psychiatrist who did his residency training in Texas and now has moved to California to be with his love, Chan Mary Soeur, RN, BSN. Both have been members of my TEAM-CBT training group at Stanford. Cai practices at the Feeling Good Institute in Mt. View, California, and Chan Mary who is pursuing a master's degree as a Psychiatric Nurse Practitioner. Cai explains that he'd felt socially anxious and lonely for used, and used the tools in my book, Intimate Connections, when he got tired of dating sites. One crucial thing he learned is that you have to stop "chasing" if you want to find love. Then he met Chan Mary in one of the breakout groups in our weekly training group. Chan Mary said, "I also used to struggle with social anxiety. Even now, on this podcast I have thoughts that I won't be as impressive as Cai. Cai is much better at expressing himself and being vulnerable in front of others. "I've been on a personal journey to get over my intense social anxiety. I've always held back in groups, and have never been the first one to reach out. "After listening to the Feeling Good Podcast's episode on how to overcome social anxiety, I decided to challenge my fears and reach out to Cai. I contacted him and told him I really admired the courage he was showing in his transparency about his feelings, and in his courage to challenge his fears with the many Interpersonal Exposure Techniques we were learning about in our training. "I also decided to try another technique, Flirting Training. I told him that I thought everything he was doing was inspirational, and that I felt close to him." Rhonda asked about the importance of taking risks if you struggle with social anxiety. Chan Mary explained it like this: "I was extremely anxious about reaching out to someone I didn't know. For me, a simple thank you email and introducing myself was anxiety provoking because I had never done that before. I was also worried about asking too many questions because I didn't want to come off as intrusive or even bothersome." Chan Mary continues: "After conquering my initial fears of reaching out, I went even further, I invited him to join me for a week in Hawaii as our first

TEAM-CBT Celebrates Diversity Today's featured image is Sean Williams, co-founder of the BAD Group Rhonda starts today's podcast with a terrific endorsement from Steve, from England. He really liked Feeling Great, and said he benefited from the personal work with Dr. Mark Taslimi that we published as the first live therapy on the Feeling Good Podcasts (see podcasts 29-25 and 141.) Steve wrote that the live work, and the teaching points that Dr. Jill Levitt and I made during the podcasts to explain our strategies, is the best learning by far. Rhonda and I strongly agree, and I feel fortunate to have been able to publish many additional live TEAM-CBT sessions since that time. It is my hope that some day these live therapy podcasts will be used in teaching graduate psychology classes so that future practitioners can pick up where we left off and benefit from the rapid treatment techniques we've developed. Today we interview Amber Warner, LCSW, Sean Williams, LCSW and Chelsea Dorcich, MFT. Amber is a Level 3 certified TEAM therapist, living and working in Lake County, where she provides mental health care in a rural community. She has a private practice that includes a virtual practice for anyone in the State of California. Amber has been a member of our Tuesday TEAM-CBT group for the past year. Chelsea is also a Level 3 Certified TEAM therapist with a private practice for anyone in the State of California. Both Chelsea and Amber work at the Feeling Good Institute in Mountain View, California. Sean is a Licensed Clinical Social Worker and also Level 3 TEAM-CBT therapist and co-founder of the TEAM CBT Clinicians of BAD, for Black African Descendants, along with Amber and Chelsea. He is a long-time and beloved member of the Tuesday training group at Stanford. He currently resides in Colorado and works for the Ohio State University where he works with active duty and retired soldiers regarding their PTSD suicidal ideation and trauma. He treats patients and also supports the Ohio State University's research. He also has a part-time private practice for people who live in Indiana. Amber got our podcast going by saying: "My introduction to TEAM-CBT was in 2017, while at a Sunday workshop about 1 1/2 years ago. I'd been struggling with grief after accidently finding out my employer had hired others at a higher salary, so I started a Daily Mood Log and did a downward arrow (this is an uncovering technique) using one of my negative thought. I discovered that my Self-Defeating Belief (SDB) was not included in David's list of 23 common SDBs. "I felt like all the weight of the world was on my shoulders because my employer had hired white people with less experience at higher salaries. I asked myself what I was going to do. "Do I care to stand up for myself? It felt like a heavy dilemma. I decided to face my fear and talk it over with my employer. It took some time, but things eventually turned out in my favor." Way to go, Amber! Amber mentioned that Philip Lolonis, LCSW, a member of our TEAM-CBT community, urged us to create and teach an introductory TEAM-CBT course for African-American clinicians in 2021. Amber reached out to Sean and Chelsea and asked if they'd be interested in creating a "Clinicians of Color" group on Facebook. And that got the ball rolling. Rhonda asked, "What kinds of challenges have you faced?" Sean said that one barrier was the whole process of getting licensed. It requires a lot of time and money, nearly always meaning large loans and years of training. One goal of their group is to assist interested people through from initial training through the licensing clinicians, as well as introduce TEAM therapy to the larger therapeutic community. There are very few Black mental health professionals within the TEAM community. Amber explained that one of their goals is to provide support and encouragement to young Black men and women who might want to enter the counseling profession by attending medical school, or a doctoral or graduate school in counseling or psychology, or obtaining a certified coaching diploma. Amber also stated that TEAM-CBT has made a powerful impact on her, Chelsea and Sean, so they formed an affinity group, TEAM CBT Clinicians of B.A.D. Their primary goal is to support and encourage clinicians of color to learn and practice TEAM-CBT and explore culturally responsive methods to enhance the therapeutic alliance and improve treatment outcomes. Sean explained that he was introduced to TEAM and David's work around the year 2000. He was looking at books in the self-help section of a Barnes and Nobles bookstore, but most of them were too expensive. He said, "Most of them were too expensive, but then I saw Feeling Good lying on a table, and it was only $8.95, so I purchased it and read about the list of cognitive distortions that David had created. That book changed my world view and changed me as a clinician. I realized that I really wanted to disseminate this information to clinicians of c

306: Ask David: Featuring Matt May, MD 1. Kevin asks: Hi David, Is it possible to have a healthy relationship with someone who can be classed as "Borderline Personality Disorder"? 2. Brittany asks: How do you deal with the injustice of people who rip you off without giving you credit? 3. Paul asks: Is there a way to know if I have done the Hidden Emotion Technique correctly? Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1. Kevin asks: Hi David, Is it possible to have a healthy relationship with someone who can be classed as "Borderline Personality Disorder"? Hi David, Is it possible to have a healthy relationship with someone who can be classed as "Borderline"? What are keys to being in a relationship with someone that exhibits some of these characteristics? Is it a lost cause? Is borderline personality disorder bullshit and simply a result of assumptions such as "I need love to be worthwhile" as indicated in your books? Best, Kevin David's reply Great question, here are a couple brief responses off the top of my head: "Healthy" exists on a continuum. In my experience, the therapeutic relationship with a patient diagnosed with BPD exists on a continuum, it is not all-or=nothing, and you can have excellent interactions, but this often requires great diligence and skill in the use of the five Secrets of Effective Communication. I have not observed any unique relationship between the Love Addiction and BPD. That's because the "need" for love is pervasive in our culture, and is, in fact, one of the most common Self-Defeating Beliefs. I do believe that Other-Blame (along with Self-Blame) is a common feature of BPD, along with the unwillingness to be accountable and to have tow work hard and consistently for recovery. I have had a number of patients with BPD threaten suicide if I asked them to do psychotherapy homework, for example. At my clinical in Philadelphia, we diagnosed the ten personality disorders prospectively, at the intake evaluation, and depressed patient with and without BPD improved at almost the same rate during the first 12 weeks when treated by the forerunner of TEAM-CBT, when controlling for severity of initial depression. I published this surprising finding in the top journal for clinical psychology research, the JCCP, but it got little attention for some reason, and some of the reviewers of the article were critical of this finding which they found difficult to believe or accept. DBT has been the "go-to" method for BPD, and BPD therapists may think that CBT / TEAM-CBT would or could not be helpful. Still, I am grateful for DBT welcoming such patients and helping them, when so many therapists avoid these patients! At my clinic in Philadelphia, something in the range of 28% of our patients were diagnosed with BPD at intake. david Matt's Reply: I'm really just guessing, but perhaps Kevin is feeling quite sad, worried and hopeless, about his relationship. Perhaps he's been treated badly and is also angry and scared that this will continue to happen in his current relationship. If so, he might be having thoughts like, 'This relationship will always be terrible' or 'They will continue to hurt me and disrespect me and treat me badly' of maybe, 'This is their fault, they have Borderline Personality!'. This is only a guess, but if it were the case, I would imagine Kevin could use a great deal of empathy and listening, right about now. It is possible he has been treated terribly or even abused. His partner may indeed meet the criteria for BPD, in which case they would be tremendously sensitive and frequently reactive and prone to unhealthy expressions of anger. Perhaps Kevin has displayed tremendous patience and tried very hard in the relationship, which would be admirable, but only amplify his disappointment when the same hurtful patterns continue. Kevin may even feel worthless, if he believes that the way he is being treated by others is an indicator of his worth as a person. I feel for you, Kevin, and hope you're getting the Empathy you need. I think there is a lot we could offer someone in this situation, in addition to Empathy, as well. We certainly have the technology, in TEAM, to alleviate the worthless feelings, the anxiety and worry, the feelings of anger and hopelessness, etc. and to replace these with a sense of confidence, joy and optimism. We could also offer skills that that one could use to substantially improve the quality of their relationship. Meanwhile, there are many reasons why someone would prefer to maintain very high levels of hopelessness, anger and worry and low self-esteem in this context. For example, as a protection against getting hurt again. Or they might not want to like and admire themselves if their partner is dissatisfied with them. We've also discussed, on the podcast, how tempting and seductive Blame can be. When we tell ourselves, 'It's their fault, they

Ask David: Featuring Matt May, MD 1. Nick asks: "What if you want a positive relationship with someone who does not want the same thing?" 2. Debbie asks: Hi David, I can't stop ruminating and obsessing about weird states of minds or when I was afraid of harming someone or remembering. Everyone says to let go but why do I hang on. Where in your book can you help me? 3. Dean asks: I'm having trouble sleeping. What should I do? 4. Kathy asks a question about social anxiety / panic and the hidden emotion technique. Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1. Nick asks many general relationship problems that all need specific examples. Dear David, Thank you for all the amazing work you do. Your books and podcasts have helped me to understand and start to transform a lot of negative and unwanted frames that I carry around. I'm also working with a Level 3 therapist who I found through the Feeling Good Institute. One area I'm working on is building my empathy skills using the Five Secrets model. I see how powerful it is in situations where both people are open to a positive relationship. But I struggle with the idea that each of us creates our own interpersonal reality, and can always create a positive outcome regardless of the other person. Can you help me understand how to apply the technique to some challenging situations? - What happens if you want a positive relationship with the other person, but they fundamentally do not? I find that this situation leads the other person to react to the Five Secrets with anger or indifference. Or they view you as weak for exposing your emotions and vulnerability, and try to exploit them for advantage over you. Is it even worth trying to have a positive relationship with such a person? David's reply I try not to impose on people who do not want a positive relationship with me. You could also provide a specific example, as I always insist on having! These vague questions to my ear are kind of useless. Matt's reply David, you've said that the cause of all relationship problems is Blame. I agree with this and sense that Nick's question is driving at that point, as well. If someone doesn't want to participate in our definition of a 'positive' relationship, the approach that is most in line with the 5-Secrets and Empathy is to let go and stop demanding the other person change. That's the cause of the problem: trying to force people to do things, our way, regardless of what they want. This will cause them to resist and will damage the relationship. David, you have also talked about the opposite mindset of blame, where we can wield 5-Secrets honestly and effectively, the concept of 'Open Hands'. When we have the attitude of 'Open Hands', we can welcome other people and receive them or gracefully let go. This mental state avoids conflict and the 'blame game' in a healthy, non-avoidant way. For example, if someone says, "I don't want to have a relationship with you". We might reply, using the 5-Secrets, 'You're right, I've been disrespectful and inappropriately pushing you too hard in the direction of having a relationship with me. I appreciate your letting me know, clearly, that this isn't something you want. While I can imagine you might be angry with me, I'm sure you don't want to talk about that, but prefer, instead, to end the relationship as quickly as possible. I'm feeling awkward and would like to get out of your hair as soon as possible, too. What can I do to facilitate ending this relationship in a way you would be satisfied with?" To put it another way, while you can maximize your chances of having a positive interpersonal experience with someone, using these communication skills, the 5-Secrets, they are not 'mind control' and trying to use them that way will only make matters worse, hence the importance of the internal mindset of 'open hands', accepting others' preferences and being willing to let go, perhaps grieve, refocus our attention elsewhere, if that's not what they want. Otherwise, we are in the 'chasing' and 'blaming' role, which is doomed to fail, as has been discussed on previous podcasts. It may also be useful to consider whether it's actually possible to 'not have a relationship' with someone. My sense is that there is, in fact, a relationship, even between total strangers and between people who have decided, mutually, to end their relationship. We could point out how those two types of relationships might differ, say, if you were to bump into each other in a grocery store. In the latter example, you might be expected to try a bit harder to avoid contact, with an agreed-upon, 'ex' than you would, with a stranger. There are rules and expectations and ways in which both people think about the other person and define their 'relationship', even if you are saying that it has 'ended'. The conflict comes when we don't have the same agenda and don't ag

304: TEAM-CBT, Spirituality, and Beyond: Featuring Angela Poch Rhonda begins today's podcast, as usual, by reading two touching emails from podcasts fans, including Coach Teddy, who said that Podcasts 295 and 296 featuring live work with Zeina were incredible, and Carol who was equally enthusiastic about Podcast 297 (on "Homework—Yuck!). Carol also strongly recommends David's book, Ten Days to Self-Esteem which is a simplified version of Cognitive Behavioral Therapy that can be used as a manual for therapy or self-help groups. https://www.amazon.com/Days-Self-Esteem-David-Burns-M-D/dp/0688094554 Today, we interview Angel Poch, a certified life coach, registered professional counselor, and certified Level 4 TEAM therapist and trainer. She lives two hours north of Glacier National Park in British Columbia, but teaches therapists and treats people virtually from around the world. Her new booklet, "The Truth Shall Set You Free," integrates TEAM-CBT with a Christian perspective and is available for free on her website. https://www.angelapoch.com/. She is a regular in David's weekly virtual psychotherapy training group at Stanford and assists in the teaching. She has also worked tirelessly and selflessly behind the scenes making David's work way more accessible to lay people as well as mental health professionals wanting to learn more about TEAM-CBT. For example, she adds links to every new Feeling Good Podcast on David's website, so you can easily find and link to more than 300 podcasts. Check it out! She has also transformed a massive amount of David's work into electronic tools for shrinks, accessible in David's online shop: Recently, she has created two amazing new documents you can link to. One is a spreadsheet that lists 138 of David's TEAM-CBT tools and techniques, like the "Anti-Procrastination Sheet" and many others, with page links to the descriptions of how to use each tool in David's books, like Feeling Good, Feeling Great, David's TEAM-CBT therapist eBook, and many others. Check it out! This data base will be invaluable to interested lay people, therapists, and teachers who want clear instructions on how to use the Daily Mood Log, Relationship Journal, and numerous additional tools and techniques. Derek Gurney and Angela are working on an equally awesome database for the Feeling Good Podcasts: Check it out as well! Angela begins her personal statement in today's podcast by describing her struggles with depression and irritability, including some very dark days in 2006. Her doctor recommended an SSRI antidepressant, and she went to integrative health program, "Depression: the Way Out" that required participants to read Feeling Good https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380810336 Although she didn't love the book, she resonated with the idea that all of our feelings, positive and negative, result from our thoughts, or perceptions, and her depression cleared up. She liked that when she read Feeling Good, she got many new tools she could use to change her negative thoughts and feelings. She also appreciated the ideas in the book didn't go against her belief system, which many fear about psychology. David pointed out his own father, a Lutheran minister, worried about this, and was very suspicious of psychiatrists. Angela's thinking, which resonates with David's, is that the core ideas of religion and psychotherapy are actually high compatible, and even synergistic. Angela explains that when she was a young child, she didn't fit in socially or even in her own skin. "I felt like I was a boy in a woman's body. I felt like I was in the wrong body, and prayed for help." She started to see in a very limited, childlike way, her thoughts were distorted, that a body was just a body and she could trust God wouldn't give her more than she could bear. These new realistic, counter thoughts relieved the negative body dysmorphia she'd been struggling with. She reports, "I decided it was okay to be flawed and not fit in." The rest of her young childhood was mostly joyful. In middle school she was the target of mean-spirited bullying because she was a tomboy. She developed intense social anxiety and was relieved when her mom took her out of school. She was homeschooled for a few years and studied Karate to exercise and develop some confidence. High school brought new challenges. She describes responding with her version of the Five Secrets of Effective Communication to an aggressive bully who threatened her with brass knuckles and challenged her to fight her. However, the girl backed off and started telling people that Angela was her friend! After a bad relationship, Angela started to struggle with depression and described her suicide attempt when she was 18 because "I wanted the pain to stop." She explains that: I met my husband, moved home, and started reading the Bible. I was impressed by the passage, "the truth shall set you free." I realized I had to control my own thoughts rather than look for the

The Dramatic Journey of Jason Meno In today's podcast, we interview the amazing but humble Jason Meno, who has been doing incredible programming for the Feeling Good App for the past year. Like everyone on our app development team, Jason was driven to TEAM-CBT and the Feeling Good App by his own personal struggles, and also by his training in Buddhism and his commitment to doing something to help relieve the enormous suffering endured by so many people in the United States and around the world who are struggling with depression and anxiety. The podcast notes will focus first on how he recently came to join our app team, and then on Jason's amazing early years in his search for meaning and a solution to his personal suffering and tragedies. Jason's journey to the Feeling Good App Jason began the podcast by describing how he became familiar with David's work. Then he described his own personal journey and search for enlightenment. I'll summarize some of both in these show notes. He said: I was struggling with severe depression in 2020. I felt like my body was falling apart because I've been afflicted with type 1 diabetes since I was five years old. I didn't have the resources to work with a therapist and felt hopeless, so I searched the internet, looking for a way of overcoming depression on my own. I first turned to apps for help, but my experience was not great. I eventually found David's book, Feeling Good: The New Mood Therapy. Through that book, I discovered that depression and anxiety are cons and that I was tricking myself. However, I didn't use the tools or do the written exercises in the book. I started listening to the Feeling Good Podcasts and waited for the new book, Feeling Great. Often, when listening to the podcasts I would start crying. I am not a crier, and this often happened in public, so it was pretty embarrassing! I was also practicing meditation every day, but that didn't provide much help. It does have its benefits and was a solace for me when I had nothing else, but after years of practicing, it still didn't give me the tools to combat the thoughts that trigger depression and suicidal urges. But then I had an "ah-ha" moment when David talked about resistance and the power of positive reframing. It was a tremendous relief to see that it was reasonable to feel the way I was feeling. I devoured the Feeling Great book but still wanted to die since I was still not doing the written exercises that David repeatedly urges the reader to do. Then, on one of the podcasts, someone said, "you can't challenge your negative thoughts in your head." I resisted that message and told myself that I had no negative thoughts. Many of my negative thoughts are quiet since you learn to empty your mind when you meditate. But then I realized that negative thoughts are just the top layer of your consciousness and that the concept of "cognitions" not only includes thoughts like "I'm a loser," but also your daydreams, beliefs, and perceptions. Then, once I sat down and wrote down my negative thoughts, identified their distortions, and challenged them with more realistic thoughts, I began to feel a lot better within five minutes! If you, the podcast listener, are feeling down, there's a step-by-step guide in Feeling Great that could be enormously helpful to you. I started following this guide, and then I really started to feel great. After using it a few times, I had the thought, "Wow, this could be a pretty amazing app!" One of the first questions you ask yourself, "do I really want to feel better?" had a massive impact on me and, of course, is one of the unique elements of TEAM-CBT. And although I made mistakes while using the tools on my own, they still helped more than anything else I've tried. Eventually, I saw a non-TEAM therapist who provided me with some great empathy and valuable perspectives while I used the TEAM-CBT process and daily mood log on my own. Then I suddenly realized that I had no more suicidal thoughts. TEAM-CBT is a way for you to rapidly train your mind and develop a new mindset that reduces suffering. This is an important ethical issue to me, given all the suffering that remains throughout the world, and it reminded me of my Buddhist vow to help others. So, I signed up to be a beta tester for David's Feeling Good App. However, I was disappointed in the early version I tested and created a 12-page document listing my complaints. Then I reached out to Jeremy Karmel, the CEO of the Feeling Good App, and he invited me to join the development team. I was so excited that I left my job as a data scientist working on an automated insulin device and joined the app development team. And although I was not familiar with the computer language Jeremy was using, I learned it quickly, and now I'm programming all kinds of cool things for the app! Jason's early years You may or may not be familiar with Herman Hesse's famous 1922 novel, "Siddhartha," which traced the journey of the young Buddha as he was sea

Today, you will hear the the second half of the live therapy session that Dr. Jill Levitt and I did with Nazli, a young woman from Turkey, at our recent "David Burns Live" workshop on May 22, 2022. Nazli has been struggling with intense performance anxiety and generalized anxiety, and generously who volunteered to be a "patient." Jill and I are very grateful for Nazli's courage in sharing herself so courageously with all of you, and hope you enjoy the session and learn from it. Last week, we played the first half of the therapy session, including the initial T =Testing and E = Empathy. Today, you will hear the exciting conclusion, including A = Assessment of Resistance and M = Methods, and final T = Testing. As a reminder, you can review the Daily Mood Log and Brief Mood Survey (BMS) that Nazli filled out at the start of the session. Part 2 of the Nazli Session: A = Assessment of Resistance and M = Methods After a period of empathizing, Nazli gave Jill and David an A in Empathy, so we moved on to the Assessment of Resistance portion of the session. This often involves the following steps: Invitation Step Miracle Cure Question Magic Button Positive Reframing Pivot Question Magic Dial Jill issued a Straightforward Invitation, asking Nazli if she was ready to get down to work, or if she needed more time to vent. She said she was ready to go to work, so Jill asked what changes she was hoping for during the session. This is the so-called "Miracle Cure Question." This helps to focus the session on something specific. Nazli said that her hope was to reduce or eliminate the negative thoughts and feelings that were making her clinical work so stressful. And like nearly everyone, she said she'd eagerly press the Magic Button. Then Jill and David pointed out that although we didn't have a Magic Button, we did have some powerful techniques that could help, but it might not be the best idea to use them. That's because there might be some positives hidden in her negative thoughts and feelings, and perhaps we should first take a look. David and Jill asked Nazli these three questions: 1. Given your circumstances, why might this negative thought or feeling be totally appropriate and understandable? 2. What are some benefits, or advantages of this negative thought or feeling? 3. What does this negative thought or feeling show about you and your core values that's positive, beautiful, or even awesome? This technique is called Positive Reframing. The goal of Positive Reframing is to reduce the patient's subconscious resistance to change, along with their feelings of shame about their symptoms.. Paradoxically, the moment patients see the beautiful and awesome things about their negative thoughts and feelings, their resistance to change typically disappears. Positive Reframing is one of the unique features of TEAM-CBT and it opens the door to the possibility of rapid change. As an exercise, see if you can find some positives in five of Nazli's feelings, Anxiety Ashamed, bad Inadequate Hopeless Angry Please do this on paper, and NOT in your head, using the blank Positive Reframing Tool you'll find at the end of the Daily Mood Log. Getting it "right" isn't important. What is important is trying. This will get your brain circuits firing in a new way. Then, when you see the work that we did with Nazli, you might have your own "ah-ha" moment, as well as a powerful new skill that may be helpful to you as well. Okay. Did you do that yet, or do you plan to look at the answer without doing the exercise? Oh! I see! You're planning to look at the answer. If you want to learn at a deep level, whether you're a therapist or lay person, do the exercise first! It may be challenging at first, but it will fire up your brain circuits, so when you look at the answer, you'll suddenly have a new and deeper understanding of Positive Reframing. When you're done, you can check this link to see the work that Jill and I did with Nazli. But either way, I'm grateful that you're listening to these podcasts and reading the show notes! If you click on this link, you can find the Emotions table from Nazli's Daily Mood Log showing her goals for each negative feeling after we use the Magic Dial. After we finished the Magic Dial, we went on to the M = Methods portion of the TEAM-CBT session, and helped Nazli challenge some of her negative thoughts using a variety of techniques including Explain the Distortions, the Externalization of Voices, Examine the Evidence, the Acceptance Paradox, and more. One of the thoughts she wanted to work on first was this one: "If I don't fix this patient or make him/her satisfied, then she/he will judge me and think poorly about me." Together with Nazli, we identified a number of distortions in this thought, including a couple more that popped into my mind while doing the show notes: Fortune-Telling: Making a negative prediction without good evidence. Mind-Reading: Assuming that I know how my patients are thinking. Hidden Should Sta

In the next two podcasts, you will hear the live therapy session that Dr. Jill Levitt and I did with Nazli, a young woman from Turkey, at our recent "David Burns Live" workshop on May 22, 2022. Nazli has been struggling with intense performance anxiety and generalized anxiety, and generously who volunteered to be a "patient." Jill and I are very grateful for Nazli's courage in sharing herself so courageously with all of you, and hope you enjoy the session and learn from it. Although the facts of your life are probably quite different from Nazli's, you may be able to identify with the almost universal theme of feeling like you are not "good enough." The ultimate antidote to this type of suffering is simple, but so basic that you may not "see it" at first, especially when it comes to your own negative thoughts and feelings. Although we all have many flaws and shortcomings, our inadequacies are rarely or never the cause of our emotional distress. Our emotional distress, in terms of anxiety, depression, inferiority, loneliness, hopelessness, and anger, nearly always results from our thoughts, and not so much from what's actually happening in our lives. In addition, the thoughts that trigger those kinds of feelings are almost never valid. Instead, they are loaded with cognitive distortions. As you probably know very well, I have often said that depression and anxiety are the world's oldest cons. And here's the really good news. The very moment you change the way you THINK, you can change the way you FEEL! Sounds wonderful. But isn't it just a little, or a lot, too good to be true? And can you really trigger real change at the gut level by changing the way you think? Let's find out! In today's podcast, you'll hear the first half of Nazli's session, including T = Testing and E = Empathy. Next week, you'll hear the exciting conclusion of her session, including the A = Assessment of Resistance and M = Methods, followed, of course by the final of T = Testing so we can see if Nazli really changed, and if so, by how much. We'll also see and how she rated Jill and David on Empathy, Helpfulness, and more. If you've followed the Feeling Good Podcasts, you know that doing live therapy to challenge your own demons is part of therapist training in TEAM-CBT This experience greatly deepens your understanding of team and allows you to give this message to your ow patients: "I know how you feel because I've been there myself. And it will give me great joy to show you how to CHANGE the way you FEEL, too!" I think of this personal step as the transition from technician to healer. But you cannot take this step with credibility if you haven't yet done your own "work." At the start of the session, Nazli explained that she's struggled with anxiety ever since she was a child, and that's what triggered her interest in a career as a clinical psychologist. In my experience, this is true of many if not most mental health professionals. Although the general public often have the impression that shrinks have it all together, nothing could be further from the truth. Most went into the field hoping to find a solution to their own suffering, and a great many—probably nearly all—are still searching and hoping to find a their "cure." After completing her master's degree in counseling 10 years ago, Nazli got a job at a counseling center, and in spite of the fact that she received consistently good feedback, she quit after 2 and 1/2 years and took a job in administration. This was because of the intense anxiety she experienced during sessions, resulting from the constant and relentless bombardment with negative thoughts that popped into her mind when treating patients. However, she still yearned to do clinical work, so she decide to go back to clinical work several years ago and has been doing therapy for patients being treated for cancer. But the negative thoughts and feelings still continued to haunt her. You can review them on the Daily Mood Log that Nazli showed us at the start of her session. As you can see, when she's treating patients, she feels severe depression, anxiety, shame and inadequacy. She also feels humiliated, hopeless, and discouraged, along with some moderate feelings of anger and resentment. Nazli explained that she has no fear of public speaking, but said that when she's working with a client, she constantly criticizes herself for fear of making a mistake and tell herself: I'm not doing a good job. This job is not for me. Should I just quit? My friends are at a better place in life. I'm 38 years old and missing out on a lot. Why am I like this? Recently, she went to visit one of her patients, a young woman struggling with lung cancer; but when Nazli entered the room, her patient said: "I don't want to talk to you!" Nazli said, "I was devastated and felt like crying." When you review Nazli's Brief Mood Survey (BMS) at the start of the session, you'll see that the only feeling that was elevated was anxiety, and that was minimal.

Podcast #300: Celebrating Five Million Plus In today's podcast, we celebrate, thanks to Rhonda and Fabrice, our 300th podcast, featuring some of our most beloved guests since our first podcast on October 27, 2016. We began with Fabrice Nye, who describes the birth of the Feeling Good Podcast, and two of our favorite and most popular guests, Drs. Matthew May and Jill Levitt. The schedule for all of the guests appears below. The featured guests include Fabrice Nye, Matthew May, Jill Levitt, Angela Krumm, Lorraine Wong, Kyle Jones, Brandon Vance, Heather Clague, Leigh Harrington, Sarah Hester, Brian Wright, Mark Noble, Thai-An Truong, Stirling Moorey, Rose Markotic, Mark Taslimi, Sunny Choi and Elizabeth Dandenell. Time Featured Guests 1:30-1:45 Fabrice Nye, The father of us all! #177, Research in Psychedelic-Assisted Therapy Matt May, co-therapist with David: live therapy with Marilyn & me, Many, many Ask David episodes, #265, Exposure to Leeches with Danielle Kamis Jill Levitt, David's co-therapist doing personal work with David, plus #146, When Helping Doesn't Help 1:45-2:00 Angela Krumm (#270-losing weight & flirting), Lorraine Wong (#155-treating emotional eating & #257 Intensives), Kyle Jones (Dating strategies, #151-Treating LGBTQ, #157-Psychotherapy Training, and #267-Talking to loved ones who criticize your sexual orientation 2:00-2:10 Brandon Vance- #160 Listening to the Music of TEAM #161, Music under what someone is saying #249, Report on Feeling Great Book Clubs #260, TEAM games (with Amy Spector) Heather Clague-(All of the above except #249) 2:10-2:20 Leigh Harrington, #279, Goal setting for Habits & Addictions Sarah Hester,#181, Live therapy, treatment of panic and insecurity, #193, Relapse 2:20-2:30 Brian Wright, #235, Anger in Marriage/5 Secrets Revisited 2:30-2:40 Mark Noble, #100, The New Micro-Neurosurgery, #167, TEAM and the Brain, #275, His latest thinking on how the molecular biology of stress & learning are consistent with TEAM, plus his chapbook on TEAM Thai-An Truong, #178, co-therapist with David at Atlanta Intensive Social Anxiety Be Gone, #218, Postpartum Depression, #264, How to get laid with help from the 5-Secrets #283, The "O" of OCD 2:40-2:50 Stirling Moorey, #280, A Beloved Voice from the past, #289 & 290, A case of social anxiety, personal work with Anita 2:50-3:00 Rose Markotic, #252 & 253, Sadness as Celebration Mark Taslimi, #29-35, Live sessions with Mark, "I'm a failure as a father." #141, 2-Year follow up "I've been a failure as a father." 3:00-3:10 Sunny Choi, #214 & 215, The Approval Addiction Elizabeth Dandenell, #240 & 241, struggling with anxiety and fear of poverty. Rhonda, Fabrice and I want to thank all of our guests who have contributed so generously to our efforts, and to all of you, who have supported us! Most of the guests today have done personal work with David, often with Jill, Matt, or Rhonda as co-therapists, and almost all had some version of "I'm not good enough" when they were upset, and all found solutions to this which expanded their humanness and deepened their skills as TEAM therapists. Our guests who did personal work were asked how things had been for them since doing that work, and they all reported that the results have been long-lasting, even permanent! In the following email I just received, Dr. Matthew May shared some feelings about today's show. Hi David, I like the show notes and approve of their humble nature. Brevity is the soul of wit! If I were to edit anything, and I'm not sure that I would, it would be to list all the names of all the excellent folks who participated, in the first paragraph. My sense is that it was their vulnerability, as well as their willingness to do challenging personal work, that led to enduring improvements in mood, relationships and lives. I thought it was the personal endorsements and descriptions of how TEAM has improved their lives, that were the most compelling themes of the podcast. Adding to this, it goes without saying, that none of this would have happened without you, David. You created this model of therapy for one thing. You also created this community of people. As you said before the podcast started, the most meaningful and important part of all of this has been the relationships and friendships that have developed as a result of this work. (I'm paraphrasing and not doing a very good job of it, sadly!). In any case, I caught myself wondering if this format of therapy, one that is public and open, might be the future. Meaning, instead of hiding our flaws and insecurities behind closed doors, if we might continue to attack the shame and stigma of "mental illness" by exposing it to the light of day, realizing that there was nothing to be ashamed of or afraid of, only opportunities to connect and be in the good company of other flawed, imperfect souls, just like us. -Matt Fabrice replied to Matt: Early Christians were doing their confessions in public—why not? ☺ Our numbers continue to grow each mo

299: Ask David: Retirement blues; patients who refuse homework (and the therapists who love them); ADHD; David's new pooping story; and more! We regret that our beloved Matt May, MD could not join us today due to an emergency involving his website. We look forward to him joining us next time for more exciting Ask David's that will include: Does the "self" exist? Does God exist? And MUCH more! We open with two announcements: 1. Return of the awesome Feeling Great Book Club, with Drs. Brandon Vance and Heather Clague, will meet weekly, starting on September 13th. This will be a terrific experience, and only costs $12 per week with a sliding fee scale if you cannot afford it. You will go through the Feel Great book, learn techniques, have fun, and practice in small groups. This is a fantastic opportunity for everyone. For more information, go to: https://www.feelinggreattherapycenter.com/book-club. 2. The TEAM-CBT World Congress, Warsaw Poland, August 18 - 21. This first of a kind event will take place live and virtually, and will be somewhat like David''s famous Intensives with teachers from around the world, many of whom have been featured on this podcast. The CONGRESS will feature interactive sessions which participants can learn and practice the elements of the powerful TEAM system while receiving expert coaching on TEAM techniques. This event is organized by Daniel Minte, Mariusz Wirga, and Yehuda Bar Shalom. For more information, please go to: https://teamcbt.eu Today's questions: Retirement depression / anxiety; patients who refuse to do exposure or psychotherapy homework; treating procrastination and ADHD; David's new pooping story, and more! 1. Paul asks: Are you planning on doing a podcast about people who are about to retire and are very anxious about the prospect and also depressed about closing that chapter in their lives? I'm in that boat. 2. M asks: My patient refuses homework and isn't getting better. I think I'm a victim of what you've referred to as "reverse hypnosis." What should I do? 3. Heather asks: Hello David! How would you treat ADHD with TEAM-CBT? 4. A asks: Hello sir, Is it okay if I do the written work by typing in my laptop on a word processor or is it must that I write on a paper? Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. In some cases, I did not have time to polish and edit my responses below. I've been super busy developing the Feeling Good App, which is coming along tremendously well. It has the potential to help millions around the world who are struggling with depression and anxiety, but I have to be super careful with my time these days. If interested in beta testing, you can sign up here. 1. Paul asks: Are you planning on doing a podcast about people who are about to retire and are very anxious about the prospect and also depressed about closing that chapter in their lives? I'm in that boat. David's reply Have you read the introduction to Feeling Great? Or done any of the written exercises in that book, or in any of my books? Of listened to my free Ted Talk on my website? We can provide more specific information in the live discussion on the podcast. 2. M asks: My patient refuses homework and isn't getting better. I think I'm a victim of what you've referred to as "reverse hypnosis." What should I do? Dear Dr Burns, Many thanks for your blogs, podcasts, books and TEAM CBT. I have experienced (and I am experiencing) being hypnotized with a Panic Attack patient with Border Line PD- . I know this after the sessions. During the sessions I feel I cannot even think well. I see this client through SKYPE, And cannot see her face to face due to distances. I have try to follow your approach, but she's resistant, I do include exposure exercises that she never completes. How to do a Shame Attacking Exercise when I cannot go with the patient to the places she needs to in order to do the exposure. I have even been in the phone and she driving, but 2 years later nothing works. Any thoughts will help! Many thanks in advance. M. David's reply Thanks, great question! Some training or individual case consultation or both, or workshops, would help a lot. We have two free weekly training groups for therapists in California and therapists around the world. For example, the last two weeks in our Tuesday group we have focused on the negative thoughts and feelings therapists have during sessions that interfere with their ability to do excellent work. So your question is very timely and relevant! Also, the www.feelinggoodinstitute.com has free and paid training. Two of the finest teachers are Mike Christensen and Dr. Jill Levitt, and there are many others as well. Jill has just released an introductory recorded class on TEAM-CBT that you can purchase and watch whenever you like. She is a brilliant teacher! And yes, you HAVE been hypnotized during sessions! David 3. Heather asks: Hello

Today we feature Professor Hitendra Wadhwa PhD who has been a fan of David's work for the past ten years. Hitendra has just published a new book, Inner Mastery, Outer Impact. Hitendra is a Professor of Practice at Columbia Business School and Founder of the Mentora Institute, and his class on Personal Leadership & Success is one of the most popular at Columbia Business School. He believes that the secret of leadership and success in business stems from inner mastery. He also has his own fascinating and skillfully produced podcast called Intersections where he interviews accomplished individuals from different spheres of human pursuit to draw out their insights and stories about the pursuit of success and happiness. One of Hitendra's aims has been to integrate current psychological trends with ancient wisdom in order to glean the most important ideas needed for happy and successful lives. He has backed this up with a daily meditation practice he began 20 years ago, seeking answers to the most basic questions about the meaning and purpose of our lives and a philosophy that leads to joy, connection, and productivity. Hitendra gives an example of how inner mastery can lead to outer impact. A colleague named Dan used to relentlessly find shortcomings and point to improved solutions every time Hitendra presented his work when he was first working as a business consultant. He said that he carried a grudge against Dan for several weeks because he was trying to impress his colleagues and felt put down by Dan. Of course, this type of attitude and defensiveness can easily trigger the very adversarial responses we fear. Then we tend to blame the "outer" and overlook how we might be inadvertently creating our own negative external reality. Fortunately, the opposite is equally true. When your attitude suddenly shifts, and your "inner" self changes, your outer reality will nearly always suddenly shift at the same time. One day, one of Hitendra' s supervisors said to him: You should be more like Dan. He's trying to help you take your game to the next level, but you don't take a similar interest in helping him find ways to improve his work!" Hitendra explained the impact of his supervisor's statement: "This comment suddenly turned on a light bulb in my head. I realized I was viewing Dan as an enemy, so if he criticized me, I thought he was against me, so I viewed him as the "enemy." Instead, I decided to find the truth in his criticisms and began to view him as an ally, as a teacher, as someone who wanted to help me. "At that point, our entire relationship changed dramatically, and I felt empowered!" Of course, podcast fans will realize this as the Disarming Techniques, one of the Five Secrets of Effective Communication that David has popularized. Hitendra also discussed other themes in his new book, like what it means to "be true to yourself," and how to discover the crown jewel within yourself, at your core. He also described how to tap into the five sources of core energy within yourself: Purpose, Wisdom, Growth, Love, and Self-Realization. He said that many people are afraid of Love, fearing that it is the same as weakness and will lead them to get taken advantage of. He suggested that in reality, love is a powerful force, and gave examples of the expression of love in a variety of successful business. He told many fun and inspiring stories, including his stuckness when trying to think of a way to honor his father's 80th birthday. He couldn't think of what he'd say at the celebration, because he'd always done the opposite of what his father had recommended. But then, while meditating, he saw that he'd been inspired all long by how his father had lived his life. He talked about the concept of transcendence as well as racism, and pointed out that we tend to label people based on some characteristic like skin color. But this can be very misleading, because two people who are Black, for example, will often have radically different backgrounds and life experiences. As an example, he described someone from the Caribbean who had no experience of racial discrimination when growing up. He emphasized that when we label people, we get lazy and do not respond to the reality and depth of who that person really is. Essentially, we are then putting people in "boxes" instead of seeing them for the full richness of who they are. He also said that our human identities are partly shared and partly unique. For example, Martin Luther King, Jr. learned a great deal from Mahatma Gandhi, who in turn was inspired by Leo Tolstoy—indicating a merger of three strikingly different cultures. Using story-telling, Hitendra addressed basic questions like: How do we integrate our (partially hidden) inner and outer selves? Who am I, really? What's my purpose in the universe? He said that what many psychologists believe they "discover" is actually not new, but based on ancient wisdom, like the practice of gratitude in meditation, and shifting your mindset

297: Yuck! Homework! In today's podcast, we discuss the important but dreaded topic of psychotherapy homework, and our featured guest is Alexis, whom some of you know from her fabulous work organizing beta tests for the Feeling Good App. Today, Alexis brings us a very special gift, by showing us how she "walks the walk."! At the beginning of the podcast, we discussed the two major reasons to do psychotherapy "homework:" First, the homework gives you the chance to practice and master the techniques you're learning, so you can keep growing and strengthening your skills. And second, because it's an expression of motivation; motivation alone can have powerful anti-depressive effects and lead to rapid recovery. I also talked a research study I did with a friend and colleague who got depressed following the breakup of his relationship with the woman he'd been dating for several years. Each night he would partially fill out a Daily Mood Log, including a brief description of the upsetting even or moment. Then he would circle and rate his negative feelings on a scale of 0 (for not at all) to 100 (the worst), for how he was feeling at that very moment. Then he recorded his Negative Thoughts and indicated how strongly he believed them on a scale from (not at all) to 100 (completely). He was telling himself that he'd never find anyone to love, that he'd never find work, and so forth. Then he'd flip a coin to decide on one of two courses of action. If heads, he would jog for 30 minutes or so at a fairly fast clip and then re-rate his belief in each negative thought as well as the intensity of each type of negative feeling on the same scales of 0 to 100. If tails, he would work on his Daily Mood Log for 30 minutes and then rerate his belief in each negative though and the intensity of each type of negative feeling. He did this for several weeks and I was thrilled to see that he recovered on his own from a pretty severe bought of depression without any psychotherapy or medications. However, I did give him a little coaching on how to challenge various kinds of distortions. Once he recovered, we analyzed the data using Structural Equation Modeling. We discovered that the jogging had no effects whatsoever in reducing his belief in his negative thoughts. This finding was not consistent with the popular idea that exercise boosts brain endorphins and causes a "high." I was not surprised, since jogging has never elevated my feelings, either, although some people do report this effect. In contrast, on the nights that he worked with his Daily Mood Log, there were massive reductions in his belief in his negative thoughts as well as his negative feelings. This finding was consistent with the idea that psychotherapy homework is very important, whether or not you are receiving treatment from a human shrink. The study also confirmed the idea that distorted negative thoughts do, in fact, cause depression and other negative feelings like anxiety, shame, inadequacy, and hopelessness, and that a reduction in your belief negative thoughts triggers recovery. Anecdotally, I would like to add that he maintained his positive mood and outlook following his recovery. His career flourished, and he got married. I showed him his negative thoughts years later, and he was shocked. He found it hard to believe that he was giving himself and believing such harsh and distorted messages at the time he was depressed. I've often said that there is a kind of hypnotic aspect to depression, anxiety, and even anger. You tell yourself, and believe, things that are simply not true! Recovery is a little (or a lot) like snapping out of a hypnotic trance! Here is another implication of the study of exercise vs the Daily Mood Log, as well as other studies that have confirmed the critical importance of psychotherapy homework in recovery from depression and anxiety. Because we know the importance of homework, if we are not asking our clients to do homework, then we may actually be impeding their progress rather than supporting them. That's why I let people know prior to the start of therapy that the prognosis for a full recovery is very positive, but homework will be required and is not optional. If they feel like they don't want to do the homework, I don't encourage them to work with me. This is called the Gentle Ultimatum and Sitting with Open Hands. Oddly, enough, this approach seems to enhance patient motivation as well as patient compliance with homework between therapy sessions. The homework, in turn, speeds recovery and reduces patient drop-out. When I'm doing research, I try to create mathematical models that reveal causal factors that affect all human beings, and not some finding that only applies to this or that school of therapy. Therefore, it would seem to follow, that doing "homework" is just as important if you are working on your own without a therapist. And it would seem like it should be important in our app, as well. These hypotheses have been confirme

Podcast 296: Forced Empathy: A Master Class--Part 2 of 2 Last week you heard part ! of our work witt Zeina, a young professional woman struggling with a conflict with her mom. Zeina feels like her mother is too critical of her, and she finds the criticisms devastating. In today's podcast, you will hear my co therapist, Dr. Jill Levitt, and I, doing Forced Empathy with Zeina, and you will hear the exciting conclusion of the session. I am including the entiere show notes from last week, in case you have not yet reviewed them. Show notes from last week commence here. Today Dr. Jill Levitt and I do live work with Zeina Halim who has been experiencing some intense negative feelings because of her mother's criticisms of her. Zeina is a member of my weekly training group at Stanford and has appeared on the podcast on several previous occasions (Please provide numbers plus link to podcast page on website.) Zeina is one of our small group leaders in our Tuesday training group. She works with teens and adults in-person in her office in Menlo Park and also provides tele-health sessions for clients living anywhere in California. Dr. Jill Levitt is the co-leader of my Tuesday training group at Stanford and will be my co-therapist today. We hope for some more of the "magic" that frequently appears when we do therapy together. Today's podcast will illustrate a number of teaching points, including these: Forced Empathy: We illustrate exactly how to use this powerful and sophisticated technique. When I first created this technique many years ago, I thought there would be little interest in it, so I rarely taught it in my workshops or training groups. In the past several years, an intense interest in this technique has emerged, so you will get to see exactly how it works. Five Secrets Resistance: There has been great interest in the Five Secrets of Effective Communication that are featured in my book, Feeling Good Together. When used skillfully, they can have a phenomenal effect on any troubled relationship. I am even aware of a case of a woman who was kidnapped at gunpoint by a violent serial rapist who planned to kill her. Out of desperation, she used the Five Secrets I had presented at a workshop he had just attended, and he let her go and turned himself in to the police. The Five Secrets literally saved her life. And yet, many of us stubbornly refuse to use the Five Secrets with family, friends and loved ones. Why do we fight against the very tools that would rapidly bring us peace, love and joy? And what can we do about our own internal "resistance"? The "inner" and "outer" solutions: Whenever you are involved in a conflict with someone, there are two battles raging at the same time. One is the "inner battle" with your own negative thoughts, telling you that you're no good, or that the other person is to blame, and the voice that powerfully urges you to do battle. We approach the "inner battle" with the familiar Daily Mood Log, that helps you pinpoint the distorted messages you are giving yourself. You will see that those messages—the way you talk to yourself when you're upset—are loaded with distortions; such as All-or-Nothing Thinking, Overgeneralizations, Mental Filtering, Discounting the Positive, Mind-Reading, Labeling, Should Statements and Hidden Should Statements, Emotional Reasoning, Other-Blame, and more.In today's session, we do battle with Zeina's distorted thoughts with the Externalization of Voices, arguably one of the most powerful psychotherapy tools ever created. The EAR Checklist / Relationship Journal. The "outer battle" involves the words you use when you respond to the other person's criticisms of you. Here we use the Relationship Journal, another super powerful tools that allows you to analyze your own statements with the EAR Checklist and see the shocking reality that you are creating the very conflict that you are complaining about so vigorously. This involves one of the "Great Death" of the self, which can be profoundly painful, but it also leads to liberation from your self-created misery and the chance for renewed love and connection with the person you feel so alienated from. Two-hour sessions. You can do far more in a single, two-hour session than in many 50 minute sessions scheduled at weekly intervals. I have often said that this is how I always do therapy, and if you have some therapy skills, this model is vastly more effective and cost-effective as well. It puts you under pressure to accomplish something today, right now, and not in the vague or distant future. Uncovering Techniques. You will see how you can use the Man from Mars Technique to uncover more of your patient's negative thoughts and core beliefs. This is just another way of doing the classical "Individual Downward Arrow Technique" that I developed way back in the 1970s. The Acceptance Paradoxes. There is a great deal of talk these days about Acceptance is being an important key in many schools of psychotherapy. But what is ac

Podcast 295: Forced Empathy: A Master Class--Part 1 of 2 Podcasts 294 (Part 1) and 295 (Part 2) Forced Empathy: A Master Class Today Dr. Jill Levitt and I do live work with Zeina Halim who has been experiencing some intense negative feelings because of her mother's criticisms of her. Zeina is a member of my weekly training group at Stanford and has appeared on the podcast on several previous occasions (Please provide numbers plus link to podcast page on website.) Zeina is one of our small group leaders in our Tuesday training group. She works with teens and adults in-person in her office in Menlo Park and also provides tele-health sessions for clients living anywhere in California. Dr. Jill Levitt is the co-leader of my Tuesday training group at Stanford and will be my co-therapist today. We hope for some more of the "magic" that frequently appears when we do therapy together. Today's podcast will illustrate a number of teaching points, including these: Forced Empathy: We illustrate exactly how to use this powerful and sophisticated technique. When I first created this technique many years ago, I thought there would be little interest in it, so I rarely taught it in my workshops or training groups. In the past several years, an intense interest in this technique has emerged, so you will get to see exactly how it works. Five Secrets Resistance: There has been great interest in the Five Secrets of Effective Communication that are featured in my book, Feeling Good Together. When used skillfully, they can have a phenomenal effect on any troubled relationship. I am even aware of a case of a woman who was kidnapped at gunpoint by a violent serial rapist who planned to kill her. Out of desperation, she used the Five Secrets I had presented at a workshop he had just attended, and he let her go and turned himself in to the police. The Five Secrets literally saved her life. And yet, many of us stubbornly refuse to use the Five Secrets with family, friends and loved ones. Why do we fight against the very tools that would rapidly bring us peace, love and joy? And what can we do about our own internal "resistance"? The "inner" and "outer" solutions: Whenever you are involved in a conflict with someone, there are two battles raging at the same time. One is the "inner battle" with your own negative thoughts, telling you that you're no good, or that the other person is to blame, and the voice that powerfully urges you to do battle. We approach the "inner battle" with the familiar Daily Mood Log, that helps you pinpoint the distorted messages you are giving yourself. You will see that those messages—the way you talk to yourself when you're upset—are loaded with distortions; such as All-or-Nothing Thinking, Overgeneralizations, Mental Filtering, Discounting the Positive, Mind-Reading, Labeling, Should Statements and Hidden Should Statements, Emotional Reasoning, Other-Blame, and more. In today's session, we do battle with Zeina's distorted thoughts with the Externalization of Voices, arguably one of the most powerful psychotherapy tools ever created. The EAR Checklist / Relationship Journal. The "outer battle" involves the words you use when you respond to the other person's criticisms of you. Here we use the Relationship Journal, another super powerful tools that allows you to analyze your own statements with the EAR Checklist and see the shocking reality that you are creating the very conflict that you are complaining about so vigorously. This involves one of the "Great Death" of the self, which can be profoundly painful, but it also leads to liberation from your self-created misery and the chance for renewed love and connection with the person you feel so alienated from. Two-hour sessions. You can do far more in a single, two-hour session than in many 50 minute sessions scheduled at weekly intervals. I have often said that this is how I always do therapy, and if you have some therapy skills, this model is vastly more effective and cost-effective as well. It puts you under pressure to accomplish something today, right now, and not in the vague or distant future. Uncovering Techniques. You will see how you can use the Man from Mars Technique to uncover more of your patient's negative thoughts and core beliefs. This is just another way of doing the classical "Individual Downward Arrow Technique" that I developed way back in the 1970s. The Acceptance Paradoxes. There is a great deal of talk these days about Acceptance is being an important key in many schools of psychotherapy. But what is acceptance, and how do we teach it to our patients and colleagues? Today's session with Zeina, who has a great interest in Buddhist philosophy and practices, illustrates one of more than 20 paths to acceptance, and this one in particular will teach you the steps in accepting others, especially when you are desperately trying to change them and you are insisting that they "shouldn't" be the way they are! Self-acceptance is always about graspi

May 30th, 2022 Our recent Ask David with Dr. Matthew May included a question on the Acceptance Paradox that triggered many enthusiastic email responses, and people were asking for more on this topic. Rhonda read several, including an email from Jeff who finally "got" the Acceptance Paradox and grasped the meaning of the "Great Death" of the Self. So, today, we're dedicating the entire hour to this topic. In addition, I'm including a link to a partial draft of a manuscript I'm working on entitled "25 Paths to Self-Acceptance." It's fragmentary and far from complete, but does include some potentially useful ideas and techniques, including a vignette with a quiz about a woman from South Los Angeles who experienced what I call "instantaneous enlightenment" during one of my 5-day psychotherapy intensives several years ago at the South San Francisco Conference Center near the San Francisco airport. (LINK TO MS) First, here's what a listener named Jeff wrote after the previous podcast. Ah! I F-I-N-A-L-L-Y get what you're saying. I've pondered this death of "self" for quite a while after reading Feeling Great and it finally sunk in. Saying "I want to improve myself" or "become a better person" is nonsensical. It's like there's an amorphous ghost "self" that I want to somehow "improve" or make "more worthwhile." But it's all made up. There is no actual "self." Meaning, I can improve skills I have - but my "self" won't be better. My skills might be - but there's no "self" to improve. I can improve my juggling skills but never my "self." Wow. Even when it comes to flaws, I can see that they're also very specific. I don't have a flawed "self" or a bad "self." I may have certain flaws but there's no "I" or "self" to be flawed or worthless. It took me a long time to see it - but now that I do, how awesome it is to stop having to IMPROVE myself. Instead, I can just let go of "my self." Thank you for the response and the additional information. That is so helpful! ! During today's show, a number of vignettes illustrating acceptance were shared, including a man from the CIA who was intensely ashamed because he didn't have a sense of humor, and all of the men he worked with loved to hang out during breaks at work telling jokes and laughing. He pretended to laugh, but inwardly felt ashamed and inadequate, and was telling himself that he was inferior, or defective because he didn't have a sense of humor. His enlightenment came during role-playing with a powerful technique called the Externalization of Voices. David played his Positive Self, and the patient, in the role of his Negative Self said this to David: Patient, in the role of his Negative Self: You know, you're really inferior because you don't have a sense of humor. You're not a real man! David in the role of the Positive Self, responded like thi:s.Well, you know, you're right. And in fact, I have tons of flaws. My lack of a sense of humor is just the tip of the iceberg! This struck the patient as incredibly funny, and he began laughing uncontrollably for several minutes and almost feel out of his chair. Then David said, "Not bad for someone with no sense of humor," and that triggered even more laughter. That's why it's called the Acceptance Paradox. The very moment when you accept yourself, exactly as you are, warts and all, everything—all your perceptions of yourself and the world—are suddenly transformed, and your freed from the prison you'd been in for many years, or possibly for your entire life. Let me spell out what happened. For many years, my patient had been struggling with his lack of a sense of humor, and the harder he fought, the tighter the trap become. He could not change, and his life had become grim, and he felt inadequate and ashamed, thinking he wasn't a "real man," which seemed awful! The very moment he "gave up" and accepted the fact that he had no sense of humor, he suddenly found his sense of humor, and laughed uncontrollably for several minutes. That's what I mean when I say that acceptance is the greatest CHANGE a human being can make--and that's a gigantic paradox. Can you see that now? One important focus of the show was debunking the many reasons people have for resisting Self-Acceptance, such as: If I accept myself, I'll just be ordinary, or below average, and I won't be special. Acceptance is a slippery slope. If I accept something bad about myself, or some awful thing I did, I might end up doing something immoral or wrong. If I did something immoral or wrong, or even if I screwed up and failed to achieve my goals, I deserve to suffer. If people see that I'm flawed or "less than," they'll judge me. If I accept myself, I'll lose my motivation to learn, to grow, and to improve myself. If I accept myself, I'll have to lower my standards. I may be unhappy, even miserable at times, but at least I have high standards! When I beat up on myself, it shows that I'm honest about my flaws. If I accept myself, I will end up accepting the fact that I mi

293: The Five Secrets with Violent and Angry Individuals, Featuring Heather Clague, MD Heather Clague MD is a Level 5 TEAM therapist and trainer with a practice in Oakland, California and consult-liaison psychiatrist at Highland Hospital in Oakland. In addition to running an online consultation group for TEAM therapists, she is faculty for All Things CBT, teaches for the Feeling Good Institute, and has taught the Five Secrets of Effective Communication to medical staff. Her writing can be found at psychotherapy.net. With Dr. Brandon Vance, Heather co-leads the Feeling Great Book Club, a book club for everyone, everywhere who wants to learn the magic of TEAM. In today's podcast, Rhonda and David speak with Dr. Heather Clague who describes her working in the psychiatric emergency room at Highland Hospital in Oakland, California, and other emergency facilities including Fairmont Hospital in San Leandro, California, interacting with hostile and psychotic individuals who often have to be held against their will because they are a danger to themselves or others, or unable to care for themselves. Although today's podcast will be of special interest to mental health professionals, it will also be of great interest to anyone having to interact with strangers, friends or family members who are angry and abusive. She explained that In these types of settings, we often have to give patients the opposite of what they want. For example, if they're involuntarily hospitalized for dangerous behavior, we have to restrain them, or keep them in the hospital, when they desperately want out. Or, if they want to stay in the hospital, we may have to discharge them. Many of these patients are psychotic and lack judgment, so they may shout and act out in anger and frustration. The Five Secrets (LINK) have been a godsend, and when it works, the results are amazing. For example, if a patient is screaming for us to release them, the natural instinct to get defensive just agitates them more and is rarely or never effective. If in contrast, you say, "You're right, we are holding you against your will and you have every right to be angry," they usually feel heard and calm right down. In one recent case, an agitated and confused homeless woman needing dialysis was near death because she was refusing treatment and refusing to take her medications. She was manic, agitated, and talking rapidly, non-stop. I said, "I think you're really upset because we're keeping you against your will." The patient shouted "Yes!" Then I said, "And you're telling us that you do have a place to go to if we let you out." The patient said, "yes," in a softer voice, and let the nurse come in and give her her medications, which she took. Heather described phrases she uses to get into each of the Five Secrets in high-secrets situations when you don't have much time to think and have to respond quickly, including these: For the Disarming Technique: "You're right," followed by a statement affirming the truth in what the patient just said. Thought Empathy: "What you're telling me is" followed by repeating what the patient just said. This is helped greatly by writing down what the patient said. Without writing things down, this technique tends to be impossible for mental health professionals OR the general public. In spite of this, most people refuse this advice! Feeling Empathy: "Given what you just told me, I can imagine you might be feeling X, Y, and Z" where X, Y and Z are feeling words, like "upset," "anxious," or "angry," and so forth. Inquiry: Heather emphasizes two productive lines of Inquiry: "Am I getting it right?" "Can you tell me more about how you're feeling?" "I Feel" Statements: "I'm feeling X, Y, and Z right now," where X, Y, and Z are feeling words like sad, concerned, awkward, and so forth. When done skillfully, this technique adds warmth and genuineness, and facilitates the human connection. Heather cautions against saying "I feel like you . . . " since this ends up not as a statement of your own feelings, but a criticism of the other person. "I feel that . . . " has the same problem. Stroking: This conveys caring, liking and respect, but cannot be done in a formulaic way. You might say things like "I care about you and I'm really concerned that you're struggling right now," or 'What you are saying is very important, and I want to understand more." For example, you might say this to an angry patient being held against his or her will: "You're right, I am holding you against your will, and insisting that you stay, and I don't like it either. But I'm very concerned that if I let you out now, you might get hurt, or do something to hurt yourself, and your life is precious. I don't think I could forgive myself if I did that." Of course, all of this has to come from the heart and has to be done skillfully, or it will not work. Heather described other inspiring stories of challenging patients she'd worked with, and we took turns modeling Five Secrets respons

David Meets the British TEAM Group, Part 2: Burns vs. Van de Kolk, Treating somatic symptoms, chronic doubters, GAD, and more! Last week, David answered four questions posed by the British TEAM-CBT group. Today, he answers five more questions, including one on controversies in the treatment of PTSD. Peter – Positive Reframing in TEAM—How much is "enough?" When you do Positive Reframing to reduce Outcome Resistance, how extensively do you have to do it? Do you have to include every emotion the patient has listed on their Dailly Mood Log? Do you also have to focus on most or all of their Negative Thoughts? What's the best approach? Tom – Burns vs. Van De Kolk After reading The Body Keeps the Score, by trauma specialist and psychiatrist, Dr Bessel Van De Kolk, it would appear that people with complex trauma require a high degree of stabilizing work, like deep-breathing, meditation, or yoga, before they can engage with effective therapy. Otherwise, they might not have the words to describe their emotions, or might have repressed memories. In addition, they might not engage or might become destabilized and highly emotional or destructive towards themselves and other people. I wonder if that's your experience with patients you have seen with severe complex trauma in your career? Do you think the TEAM-CBT model has limitations in this area and would you refer to a trauma specialist before embarking on TEAM therapy with such a patient? Sean – Treating Somatic Symptoms with TEAM I'm curious about dealing with the somatic experiences of patients struggling with anxiety, depression, insomnia, trauma, etc. Clients can often challenge their distorted Negative Thoughts but still struggle with the somatic symptoms. I'm curious to know David's thoughts. Hassam – Treating Chronic Doubters with TEAM I'm wondering if David has had experiences with chronic doubters - obsessive doubt in which a patient might say: "Yeah, all these cognitive techniques seem good and all, but what if really I am useless and worthless, and all of this has just been a gimmick? What if it is all a lie? What if we have missed something which really would show how worthless I am ?" Basically, this is closely related to the Pure O version of OCD. OCD is known as the doubting disease, and I really want to hear David's thoughts on how he operates with extremely sticky doubting thoughts. Jacky – Treating Generalized Anxiety Disorder (GAD) with TEAM I have a question about clients with Generalized Anxiety Disorder. When they present with multiple worries, do we need to cognitively restructure every worry? Clients with GAD often have multiple worries so we could be there for quite a while if we have to work on every single worry! End of the Part 1 Questions. David will return to the British group for Part 2 in the future, since they had many additional questions. Here is a note from Dr. Peter Spurrier to all who want more information about the UK TEAM-CBT training group: If you are interested in learning more about our group, or want to contact members, please visit us at: https://feelinggood.uk.com/ You will find contact details for many of us on the "Our TEAM CBT Practitioners" page. If you are interested in joining our TEAM-CBT training group, or want more information, you can email me (Dr. Peter Spurrier) at [email protected].

David Meets the British TEAM Group, Part 1: Treating adolescents, Intrusive thoughts, TEAM-CBT homework, Surprises from the beta tests, and more. Greg – What were the Surprising Results of the Feeling Good Beta Test? What were the surprising results you referred to in the beta testing the new TEAMCBT App? Were there some things that weren't effective or didn't work in the way you expected? Rima – Is Psychotherapy "Homework" required in TEAM-CBT? I have a question about rapid recovery with TEAM CBT. Traditional CBT usually takes quite a lot of sessions and requires homework between sessions. How does this fit with a recovery in a single (two-hour) session? Do the patients still have to do homework? Paul – Treating PTSD with Intrusive Thoughts How can TEAM help an individual who has intrusive thoughts about a traumatic event in their past? Jessica – Treating Adolescents with TEAM-CBT Do you need to vary the therapy techniques when working with adolescents, as opposed to adults? And if so, how? Peter – Positive Reframing in TEAM—How much is "enough?" When you do Positive Reframing to reduce Outcome Resistance, how extensively do you have to do it? Do you have to include every emotion the patient has listed on their Dailly Mood Log? Do you also have to focus on most or all of their Negative Thoughts? What's the best approach? The following questions will be answered next week in Part 2 of David's encounter with the British group. Tom – Burns vs. Van De Kolk After reading The Body Keeps the Score, by trauma specialist and psychiatrist, Dr Bessel Van De Kolk, it would appear that people with complex trauma require a high degree of stabilizing work, like deep-breathing, meditation, or yoga, before they can engage with effective therapy. Otherwise, they might not have the words to describe their emotions, or might have repressed memories. In addition, they might not engage or might become destabilized and highly emotional or destructive towards themselves and other people. I wonder if that's your experience with patients you have seen with severe complex trauma in your career? Do you think the TEAM-CBT model has limitations in this area and would you refer to a trauma specialist before embarking on TEAM therapy with such a patient? Sean – Treating Somatic Symptoms with TEAM I'm curious about dealing with the somatic experiences of patients struggling with anxiety, depression, insomnia, trauma, etc. Clients can often challenge their distorted Negative Thoughts but still struggle with the somatic symptoms. I'm curious to know David's thoughts. Hassam – Treating Chronic Doubters with TEAM I'm wondering if David has had experiences with chronic doubters - obsessive doubt in which a patient might say: "Yeah, all these cognitive techniques seem good and all, but what if really I am useless and worthless, and all of this has just been a gimmick? What if it is all a lie? What if we have missed something which really would show how worthless I am ?" Basically, this is closely related to the Pure O version of OCD. OCD is known as the doubting disease, and I really want to hear David's thoughts on how he operates with extremely sticky doubting thoughts. Jacky – Treating Generalized Anxiety Disorder (GAD) with TEAM I have a question about clients with Generalized Anxiety Disorder. When they present with multiple worries, do we need to cognitively restructure every worry? Clients with GAD often have multiple worries so we could be there for quite a while if we have to work on every single worry! End of the Part 1 Questions. David will return to the British group for Part 2 in the future, since they had many additional questions. Here is a note from Dr. Peter Spurrier to all who want more information about the British TEAM-CBT training group: If you are interested in learning more about our group, or want to contact members, please visit us at: https://feelinggood.uk.com/ You will find contact details for many of us on the "Our TEAM CBT Practitioners" page. If you are interested in joining our TEAM-CBT training group, or want more information, you can email me (Dr. Peter Spurrier) at [email protected].

Podcast 290: A Case of Social Anxiety: Featuring David with Dr. Stirling Moorey (Part 2 of 2) Last week, you heard the first part of this live therapy session with Anita, a woman struggling with severe social anxiety. David and Dr. Stirling Moorey, from London, are co-therapists. Last week included the T = Testing and E = Empathy portions of the session. Today you will hear the A = Assessment of Resistance, M = Methods, along with end of session Testing and follow-up. A = Assessment of Resistance David asked Anita if she was ready to roll up her sleeves and get to work, or if she needed more time to talk and be listened to and supported. Because she was eager to get to work, David asked the "Miracle Cure Question:" He said, "What would happen in today's session if it went really great and knocked your socks off? She said that her negative feelings and self-critical thoughts would be greatly diminished. David asked the Magic Button Question, and she said she'd press it for sure! David said he had no Magic Button, but did have some powerful techniques that could be super helpful, but was reluctant to use them. Anita was puzzled, and this led to Positive Reframing. He encouraged Anita to ask the three questions about each Negative Thought and feeling on her Daily Mood Logs: Why might this thought or feeling be perfectly appropriate, given your circumstances? What are some advantages, or benefits, of this negative thought or feeling? What does this negative thought or feeling show about your core values that's positive, beautiful, or even awesome? Although puzzling at first, Anita soon got into the swing of it and came up with the following list of Positives. If I tell myself "I have nothing to say" in a group, I'll listen more and learn more. I won't risk speaking and making a fool of myself. So my social anxiety is really a source of self-protection, or even a form of self-love. My self-criticisms show I have high standards. My high standards motivate me to work hard and do my best. My self-doubt shows that I'm humble. My concerns about being judged show that I care for the people in the group and want to have positive relationships with them. Shows I'm not pushy, dominating, or arrogant. When I tell myself that "They are all better than me," it shows that I have room to learn from all the people who are ahead of me. This shows I want to grow and do better. This shows I'm honest and realistic about my limits and flaws. This shows I'm accountable. This gives me "vicarious joy" in the accomplishments of others, a Buddhist concept. This thought shows that I can appreciate the gifts of others, which is a gift to them. When I tell myself, "I wasted a year," it shows that I value hard work, learning, and dong a good job. It shows that I value what other people think, and take their criticisms seriously. It shows that I want to be seen for who I am! David pointed out that there were many positives on the list, and if we had time many more could be added, but asked Anita if the positives were: Real? Important? Powerful? She gave enthusiastic "yes" answers to all three questions, and then david asked the Pivot Question: Why in the world would you want to press that Magic button, because if you do all these positives will go down the drain, right along with you negative thoughts and feelings Anita suddenly didn't want to press the Magic Button, but agree to use the Magic Dial and lower her goals for each negative feeling, which you can see if you click here. This concluded this part of the session, which brought us to the M of TEAM. M = Methods During the Methods portion of the session, David and Stirling used a number of techniques, including: Identify the Distortions Explain the Distortions Straightforward Technique Externalization of Voices with Self-Defense, the Acceptance Paradox, and the CAT (Counter-Attack Technique) And more, using frequent role reversal until she got to "huge" wins, which didn't take long. Stirling also asked gave Anita how she might test if her fears about the way others saw her were accurate, and they devised some homework to do in the Wednesday training group to find out if other group members had experienced similar doubts about their abilities as therapists. This would involve using: Self-Disclosure - Survey Technique "I stubbornly refused" Technique You can see her final Daily Mood Log if you click here (LINK). We also jumped in and tried to work with Anita's conflict with her supervisor, but ran out of time and might pick up that thread again in a future session if she is interested. I might add that both David and Stirling also used Self-Disclosure and Story-Telling during the session, as well as some spontaneous humor, which can also be viewed as a valuable treatment method, but one that is hard to explain or teach. You can see Anita's final Daily Mood Log with the outcomes of all of her negative feelings. As you can see, she exceeded her goals in every category, which is not unusual,

Podcast 289: A Case of Social Anxiety: Featuring David with Dr. Stirling Moorey (Part 1 of 2) Today, David is joined by one of his first students, Dr. Stirling Moorey, for co-therapy with Anita, a woman struggling with social anxiety. You may remember Stirling from Podcast 280. Stirling was one of David's first cognitive therapy students, and they spend a month doing cotherapy tether in 1979 and again in 1980. David described the magic of their work together in his first book, Feeling Good, and today they are reunited as a therapy team again for the first time in more than 40 years! I, David, am super excited about working with Stirling again, and hope you enjoy our work with Anita. Rhonda, Stirling, and I are very grateful for Anita's courage and generosity in letting us share this very personal and real session with you! Anita is a member of the Wednesday International TEAM Training group run by Rhonda and Richard Lam, LMFT. She lives in Nairobi, Kenya, and has a Master's Degree in Counseling. Here is how she introduces herself: I am Anita Awuor from Nairobi, Kenya. I have worked as a therapist for 20 years but only recently been introduced to the TEAM Model which has changed the way I work. I work with couples, individuals and families. And recently I worked with an NGO part time. It's an honor for me to be here to work with David, Rhonda and Stirling. Dr. Stirling Moorey had the good fortune to be trained by two founders of Cognitive Behavioral Therapy, Dr. Aaron Beck, and our own, Dr. David Burns. Stirling and David worked together in 1979, when Stirling was in medical school in London and came to Pennsylvania for an elective with Dr. Beck. Once he arrived, Dr. Beck asked David if he would work with Stirling, and then, history was made as David created the 5-Secrets of Effective Communication after watching Stirling provide deep empathy to the patients they worked with together. Stirling is currently a Consultant Psychiatrist in Cognitive Behavioral Therapy and was the Professional Head of Psychiatry for the So. London & Maudsley Trust from 2005-2013. He is currently the visiting senior lecturer at the Institute of Psychiatry, Psychology and Neuroscience in London. He is the co-author, with Steven Greer of The Oxford Guide to CBT for People with Cancer, and co-edited the book, The Therapeutic Relationship in CBT, published by Sage Publishing. T = Testing If you click here, you can take a look at Anita's initial Brief Mood Survey, which was completed just prior to her session with Stirling and David. As you can see, her depression and anxiety scores were in the moderate to severe range, but her anger score was minimal, only 1 on a scale from 0 to 20. Her Happiness score was extremely low, and here marital satisfaction score was fairly good, but with some room for improvement, especially in the category of "resolving conflicts. E = Empathy You can take a look at the first of two Daily Mood Logs that Anita sent to us just prior to the session. It describes her anxiety while driving to a support group. As you can see, her suffering was intense. She also brought in a second Daily Mood Log which described her feelings after receiving a poor evaluation from one of her supervisors at work. The supervision did not involve her clinical work but some management work she was doing. Stirling, with backup from David, did explored and summarized Anita's feelings. She explained that "Sadness has been a part of my life. I'm sad more often than I'm happy. Sometimes, the negative feelings are hard to live with. . . Problems in relationships often trigger my negative feelings, especially when others criticize me, and I've been down the last several days because of a poor evaluation I received from one of my supervisors at work. . . I don't like criticisms or conflicts, and sometimes I tell myself that I'll never be comfortable in groups." Stirling asked about Anita's negative thoughts when criticized: I'll never be good enough. What's wrong with me? It's all my fault. She described a sequence where her negative thoughts about the situation lead on to more general self critical thoughts like "I'll never be comfortable in groups" and she then ruminates about her perceived shortcomings. She said, "when I have these kinds of thoughts, the feelings of sadness, anxiety and worthlessness get very high." David read her two Daily Mood Logs (LINK) and she described the criticisms she received from her supervisor, who suggested that Anita's efforts had not been helpful. Anita felt hurt and angry, especially since this was the first time she'd received criticisms from her supervisor. Anita added that when she goes into a negative spiral, everything becomes 'huge," and she also tells herself, "I'm a bad mom." Stirling asked what she does to cope when she's in pain: "I cry a lot. I beat myself up. And sometimes I share my feelings with my husband, but sometimes I just hold it all inside. Sometimes sharing with my husband helps, but som

Podcast 288: TEAM-CBT for Video Game Addiction, Featuring Adam Holman, LCSW We are joined today by Adam Holman, who specializes in the treatment of teens and young adults with video game addictions. Adam was drawn to this field by his own 16 hour a day addiction to video games which caused him to fail his first two years of college. Following his recovery, he decided to become a therapist so he could specialize in the treatment of this problem, and the rest, as they say, is history. He was drawn to TEAM-CBT because of the emphasis on measuring outcomes with every patient at every session, using my Brief Mood Survey and Evaluation of Therapy Session. Prior to that, he said he felt like an "imposter," and had no evidence that he was actually helping his patients. He explained that his clinical supervisor wasn't much help, and simply said, "Well, Adam, your clients are coming back, aren't they?" implying that this meant they were improving and satisfied with the treatment. Adam explains how he created his own measures first, and then found an online therapist group at Reddit, and heard about the Burns measures, which, he says, "were a gift to me and my clients." By looking at his feedback, he learned he was "helping" too much and trying to solve problems prematurely, before really "listening" and empathizing with his patients. He had some tips for the parents of kids with gaming habits. The first is for them to recognize that the addiction is not the problem, but rather the child's solution to the problems in his or her life. In his own case, for example, he explained that he was struggling with enormous amounts of anxiety, but felt relief when playing video games. Nearly all the kids he's treated are struggling with depression, anxiety, and relationship problems, and often feel considerably better just by having the chance to talk and have someone show an interest in them. He said that most of his patients start out with a scowl, arms folded, defiant that someone is going to try to control them or tell them what to do, and they aren't looking for "help" because, in most cases, their parents bring them to treatment. They are surprised when Adam empathizes and tries to understand their thoughts and feelings. He said most do have issues they want to work on, although it's not usually their gaming habits. Initially, this can cause conflicts between Adam and the parents, because they think Adam is siding with their children instead of "fixing" them. He said the paradoxical techniques in TEAM are especially helpful, helping them identify all the really GOOD reasons for their addictions using tools like the Triple Paradox, although this is enormously confusing to the kids at first. They have to list all the positive advantages and benefits of their addictions, plus all really sucky things about quitting, as well as what the addiction / habit shows about them and their core values that's positive and awesome. They get excited and want to share their lists with their parents. He completes the Triple Paradox with the Acid Test question: "Why in the world would you want to change, given all of the positives?" So, Adam's second tip for parents is to focus on your relationship with your child and not on his or her gaming addiction. Adam teaches parents the Five Secrets of Effective Communication, and they find that the problem usually disappears on its own. However, he agreed that learning to use the Five Secrets skillfully requires a lot of commitment and hard work from the parents. Adam recommends reviewing podcast episodes 65-70 on The Five Secrets to learn more. Rhonda mentioned that in many cases, the kids are struggling with social anxiety, and Adam mentioned that when they are playing video games with others online, they usually do not feel anxious because they don't feel judged. Once again, the games are a solution to a problem, fulfilling the need for socialization and connection. Adam uses the concept of "Sitting with Open Hands" to find out what the kids want to work on, instead of imposing an agenda on them. He described one client who was socially anxious and thought people were "creeped out" by him. Adam asked if he wanted to get over that "right now" and persuaded the young man to go outside where there was a lot of foot traffic and start doing "Smile and hello" practice as well as "Self-Disclosure" to strangers. One of the first people he said this to said he was, in fact, shocked, but added, "You made my day!" This was a huge relief. The young man began feeling less anxious in social situations. He developed an interest in tennis and felt more comfortable playing with his peers, and his interest in computer games reduced significantly. Adam uses the full spectrum of TEAM-CBT techniques in his treatment, including the Devil's Advocate Technique, Stimulus Control, and more. Here are some of the tempting thoughts a video gamer might have: Common now, it's okay, everyone plays! It's going to be really fun! It

287: Ask David, Featuring Matt May, MD: Acceptance. Irritating Questions. And More! Today, Rhonda, Matt and David answer several challenging questions submitted by fans like you. William asks: How would the TEAM-CBT model look with an addiction or a habit like procrastination? Robin asks: What's the difference between a habit and an addiction? Edwin asks: What's the best treatment for internet surfing? It feels like my actions operate below the level of consciousness! Matt asks: What's the full list of questions that David finds irritating? Matt also asks: How do we help patients who don't "get" the Acceptance Paradox? Phil asks: Hey David, Rhonda and Mark, Can't thank you enough for all your hard work and effort! Where do you guys get all your energy?! Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1: William asks: "How would the T.E.A.M. model look with addiction and procrastination?" I have a question about your recent podcast on weight loss with Dr. Angela Krumm. She is doing a great job … but did not need any help from others. About the T = Testing part of TEAM, you could say that Angela had lost her kilo's. But I am not recognizing the testing in the form of a depression / anxiety test or something alike. With the E = Empathy part, it is even more strange. Where is the Empathy section? How would the T.E.A.M. model look with addiction and procrastination? Anyway, I assume you can't expect that addiction and procrastination issues will be solved in a single therapy session? I realize that Dr. Burns empathized in the podcast, but then the 'work' already was done. Thanks a lot, William David's reply Thanks, William, for your thoughtful questions. I will probably make this an Ask David, but here's the short answer. Yes, empathy must always come first. As you point out, Angela was simply discussing the methods she used for weight loss. This was not a live therapy session. And yes, in therapy sessions I always start with T = Testing, but often add the Temptations Scale as well. And yes, procrastination can usually be cured in a single (two-hour for me) session, and sometimes addictions too, but severe addictions might need ongoing support, as with AA for example. Rhonda and I did a free two-hour workshop on Habits and Addictions on January 26th, 2022, sponsored by PESI. To view it, you can click on the link and download the entire video. Then you can watch it locally on your devise. On the bottom of my homepage on www.feelinggood.com, you'll find an offer for two free unpublished chapters on habits and addictions. D 2: Robin asks: What's the difference between a habit and an addiction? No email, just the question. David's reply You could check with a dictionary. I think Shakespeare said that a rose by any other name is still a rose! Technically, an addiction is associated with physiologic dependence and withdrawal symptoms during discontinuation. But once again, if "yearning" is a withdrawal symptoms, then habits, too, could be seen as addictions of sorts. You might also think of habits and addictions as two points on a continuum, with addictions being on the more severe side of the bell-shaped normal distribution curve. But all these definitions are, to some extent, arbitrary. Does "alcoholism" exist? Or just people who are drinking excessively? 3: Edwin asks: What's the best treatment for internet surfing? It feels like my actions operate below the level of consciousness! Dr. Burns, I am a huge fan of your books and podcast, and I enjoyed your talk today on Habits and Addictions as well as your "Feeling Great" bonus chapter on the same. I struggle with a habit of internet surfing (news, social media, etc.) when I'm avoiding boring or unpleasant tasks at work. Do you feel that motivational and cognitive techniques are sufficient for addressing this habit when it often feels like my actions operate below the level of consciousness? For example, I often start surfing the internet before I even consciously realize what I'm doing! Additionally, I've found stimulus control to be difficult for this habit given that I work on the computer all day. Any advice on addressing this particular habit, or similar ones, would be much appreciated. Thank you for all of your work helping people! Edwin David's reply Check out the free chapter(s) offer at bottom of my homepage. Read, do then exercises, then you can ask your question. Also, it depends on how far "below consciousness" your habit is. If it is only a couple inches below, you should be fine! D 4: Matt asks: What is the full list of questions that David finds irritating? David's reply Good question. Most of the time, I really appreciate the comments and questions from our many fans around the world, but there are, in fact, some questions that I find irritating. This may not be the "full list," but these are some questions that could use, perhaps, a bit of f

Helping the Poor in Heart, featuring Victoria Chicurel and Silvina Carla Bucci One of my favorite New Testament quotations comes from the "Sermon on the Mount" by Jesus: "Blessed are the poor in heart, for they shall see God." Matthew 5:8. I'm not 100% sure what this means, exactly, but it seems to me to suggest the values of compassion and humility, as opposed to self-aggrandizement. I once had the chance to speak to a Catholic priest with a PhD in philosophy who had just returned from several years working with the indigenous people in Paraguay. He said that although the people were poor, and sometimes experiencing the effects of repression from the government, he said they were mostly happy and supported one another. He also said that when he flew into Miami and walked through the airport, he was shocked to see so many overweight and visually unappealing people, after living for many years in Paraguay among the "poor." Who, really, is "poor," and who, in contrast, is "wealthy?" That's kind of the meaning I attribute to the Biblical quotation from the book of Matthew. I looked him up on Google, and apparently he worked as a tax collector in Copernicium prior to becoming a preacher in Judea. At any rate, today's podcast features two women who are working with the poor in Mexico and in the Pomona Valley in Southern California. Victoria Chicurel and Silvina Carla Bucci and working to promote TEAM-CBT in Mexico and Victoria is working with a group of Mexican women immigrants, some un-documented, most with limited English-language skills in the Pomona Valley teaching them a simplified version of TEAM-CBT. Victoria calls these women, Promotoras. In a pilot study sponsored by an organization called Common Good, Victoria has trained a group of approximately ten women in the ten cognitive distortions as well as the Five Secrets of Effective Communication and other simple cognitive therapy techniques, so they can teach these skills, called "psychological first-aid," as coaches, to women without access to mental health care. These lay coaches trained are paid $15 per hour by Common Good, and the clients are treated for free. They were very enthusiastic about the results of their informal study. (The director of Common Good is Nancy Minte, the sister of one of our esteemed colleagues, Daniel Minte, LCSW.) Victoria described a shame attacking contest organized by Daniel Minte, a Level 5 TEAM therapist. Shame-Attacking Exercises were developed by the late Dr. Albert Ellis from New York City, one of the founders of cognitive therapy,. Shame-Attacking Exercises are designed to help people with social anxiety get over their fears of looking foolish in front of others. You intentionally do something bizarre in public so you can discover that the world doesn't come to an end when you make a fool of yourself. . The goal of the contest was to do the most weird and courageous Shame Attacking Exercise. The winner was a woman who was one of the promotoras working with Victoria who suffered from severe social anxiety and who was greatly helped by a "Shame Attacking Exercise." In one of her English classes, she stood and announced she was going to do something ridiculous to overcome her fear of making a fool of herself in public, and warned them that she had a terribly singing voice. She then burst into song, singing the national anthem of Mexico, and received enthusiastic cheers from her classmates at the end. This experience changed her life! Prior to her experience, she had been so shy that she was afraid to express her opinions in public. After the exercise, her shyness instantly become a memory and she won first place in the competition! Many others have been helped, too. I mentioned the experience of Sunny Choi who worked for years with Asian immigrants in the SF Bay area. He said that these patients did not expect long term treatment, and often responded in just four or five sessions, even if they were struggling with very severe problems. Victoria said they were seeing the same thing, and described a woman struggling with perfectionism who recovered in just five sessions. The coaches in the program use my Brief Mood Survey, translated into Spanish, to track progress, and have access to the Spanish version of my first book, Feeling Good. Silvina is working to promote TEAM-CBT in Mexico and other Spanish speaking countries like Ecuador, Peru, Spain, and Columbia. She has even created a TEAM-CBT licensing program for Spanish-speaking mental health professionals. She says that her biggest challenge is one I have run into in my efforts to teach in the United States as well: The therapists are skeptical and have an attitude of "prove it to me." In addition, they have difficulties learning to use the Five Secrets in their clinical work and personal lives, especially "I Feel" Statements and the Disarming Technique, as well as the paradoxical techniques of TEAM-CBT. For me (David) personally, I welcome skepticism, but find the arro

Podcast 285: TEAM-CBT for Chronic Pain. Featuring Derek Reilly-- with the Exciting Findings from a New British Outcome Study Rhonda begins the podcast with two inspiring emails about our recent podcast on "The Unexpected Results of the Latest Beta Test id the Feeling Good App, Part 1 of 2, published on2-28-2022. One is from Vivek Kishore, who used to come to all of my Sunday hikes prior to the pandemic, and Rizwan Syed, from Pakistan, who is an enthusiastic member of my Tuesday training group at Stanford as well as Rhonda's Wednesday training group. Here's what Vivek wrote Dear David and Jeremy, This is so amazing and has the potential to change the world. I am sure millions across the globe will benefit from this app. Can't wait for its launch. Thank you! Vivek Here's what Rizwan wrote: Dear David: Reading your books changed my life completely. I am so much happy and optimistic about life compared to highly critical of myself and others and had been so much bitter. I am sure your team therapy app would be as mind boggling and revolutionary as had been your bibliotherapy. I am no God. Had I been one, I definitely would have chosen you as my prophet to spread my message. Rizwan Today, we interview Derek Reilly, a Cognitive Behavioral Psychotherapist, and Registered Mental Health Nurse with 20 years of clinical practice specializing in the treatment in chronic pain. He is an Accredited CBT therapist with the British Association for Behavioral and Cognitive Psychotherapies in the United Kingdom, and a TEAM certified Level 3 TEAM-CBT therapist. Derek is also a founding member of the new TEAM-CBT UK group. He has published papers on panic, OCD, and pain. He lives in Darfield, a small village in South Yorkshire, which is a mining area in England. Derek, like a previous guest, Dr. Peter Spurrier, attended a two-day workshop I conducted on TEAM-CBT in the treatment of anxiety disorders in London in 2015. Although I felt quite discouraged during and after the workshop, thinking I'd done a poor job, and since the crowd size was modest at best, a number of those who attended apparently got the message and became excited about TEAM. Derek said that the emphasis on T = Testing and on A = Assessment of Resistance made the biggest impact on him. He explained it like this: David described the four forms of Outcome Resistance and the four forms of Process Resistance. I suddenly realized that resistance was huge in the population I was treating, and that my biggest error had been trying to "help," which usually just triggered more resistance and yes-butting by my patients, who would complain that no one was helping them with their pain. Dropout rates were high, and I also felt frustrated with the lack of progress I was seeing in my patients. Both Derek and Peter then attended my four-day intensive at the South SF Conference Center in 2017 and got hooked. Derek said: I thought about testing, and where it could be improved, and developed my own Pain Problem Survey (PPS) of the most common kinds of negative thoughts I was seeing in my patients, as well as the negative feelings these thoughts were triggering, like frustration, anger, anxiety, and more. I asked them to rate three emotions on a scale of 0 to 10, as well as their cognitions and behaviors, and tried to figure out what the resistance was all about. I also discovered that the simple step of T = Testing helped greatly with the E = Empathy, because my patients began to feel understood. This was different from the way I'd been trained which was to push this or that technique to "help" with their pain. He said that the concept of "acceptance" is a popular and common buzzword these days among mental health professionals, but there's a huge difference between intellectual "acceptance" and acceptance at the gut level. He liked the fact that TEAM offered specific tools to bring resistance to conscious awareness and to quickly reduce the resistance as well, as the paradoxical techniques that David has developed. Some of the common Negative Thoughts he heard from his patients included: I should bed doing things quicker. I should be responding faster. The doctor should fix me. Why is this happening to me? This is unfair! Many had been feeling demoralized that there was no medical solution, and ashamed of the fact that the could no longer work and do things that had once been automatic, like housework, or picking up and hugging the grandchildren, or going to work and earning money. Their disabilities seem to contradict their personal values, and they felt like they were letting people down. He said: Many of my patients had 10 or even 20 years of suffering and failed treatments, including multiple surgeries in some cases for back pain, for example, and often complained that nobody had been listening to them. That's why the E of TEAM was so important, and I practiced using the Five Secrets of Effective Communication to respond to their complaints. I worked especially hard on Feelin

284: Ask David, Featuring Matt May, MD Defeating your Self-Defeating Beliefs. Help with fear. Dealing with people who gossip. Today, Rhonda, Matt and David answer three challenging questions submitted by fans like you. Caroline asks: I've done Cost Benefit Analyses (CBAs) for many of my SDBs (Self-Defeating Beliefs), and the disadvantages greatly outweigh the advantages? What's the next step? Al asks: Can you help me with fear? Khoi asks: How do you deal with colleagues who gossip about your boss? Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1: Caroline asks: I've done Cost Benefit Analyses (CBAs) for many of my SDBs (Self-Defeating Beliefs), and the disadvantages greatly outweigh the advantages? What's the next step? Hi David I finally got all the CBAs from my Self-Defeating Beliefs done. I have a ton of them. I also did a CBA on Self-acceptance and a CBA on Self-Criticism. I found out, that the disadvantages of my Self-Defeating Beliefs are massively higher than the advantages. Only with Self-Acceptance the Advantages were much higher than the Disadvantages. Now that I have got all these CBAs done, what do I do with my findings? Do I rewrite my Self-Defeating Belief into something more realistic or lets say, into something with acceptance? Thanks for your help! Many greetings Caroline David's reply Great work. Yes, you can, as a first step, or next step, rewrite each belief so the disadvantages disappear, and you get to keep the advantages. This will be different for each person, and it is called the Semantic Technique, but here is an example: SDB: Achievement Addiction: My worthwhileness depends on my productivity and achievements. Revised version: I can enjoy working hard and being productive, but my "worthwhileness" as a human being does not depend on my successes, failures, or hard work. There are many things in life I can love and enjoy. It isn't just all about achievement and productivity. I can learn from failures and mistakes. They make me more "human," and not "worthless" or even "less worthwhile." In fact, I have no desire or need to be "worthwhile." It's a nonsensical, meaningless concept. People don't much care about how "worthwhile" I am. They care about how I treat them! That's just an example of how I deal with this particular belief. Giving up the "Achievement Addiction" actually helps me achieve more, because the pressure and the anxiety is gone. But I still enjoy working and creating stuff! Another dimension has to do with giving up the habit of beating up on yourself. We are talking about depression and inadequacy here. It touches also on anxiety, but anxiety can have other SDBs as well. d 2: Al asks: Can you help me with fear? Dr Burns, I need help with fear. Can you send me podcasts dealing with that subject? Thank you very much. David's reply Tell me which of the many already published, and available via search function on my website, you have already listened to? And how much of my book, When Panic Attacks, have you read? May make this an Ask David, since it seems lots of folks are not using the massive free resources I've already developed. Have you take the free anxiety test and course on my website, feelinggood.com? The free anxiety course is, in fact, a compilation of some of the best podcasts on fear. david 3: Khoi asks: How do you deal with people who gossip about your boss? Hello Dr Burns, Thanks for your time to write so many great books and creating this podcast. I am from Vietnam and know about you and your book thanks to the publisher to translate into Vietnamese. When I read your book, it is very simple fact but very true at the same time. I wonder how can I not know about your book earlier? Actually, I read a lot of self-help books but I find most would say about what should I become or be, but don't really show me how to do it. As you said, the idea I feel because I thought is not new, but I don't know how to change my thought and beliefs after reading these books. Your books show me simple techniques but very useful and effective. And I really like your 5 Secrets of Effective Communication, especially these podcasts, because it helps me understand more clearly. One difficult situation that I don't know how to apply, is when somebody attacks somebody else, not me. For example, my colleague criticizes my boss (behind his back) via email message or face to face with me. I am afraid if I agree with her, my boss might think I talked behind his back too. So, should I just keep silent for this case because she does not attack me? Another situation is when 2 people attack each other, like 2 of my staff argue with each other, and I cannot agree with one side because it will make the others get mad with me. Do you have any advice on this? Thanks Dr Burns. David's reply Good question, and I will include in an Ask David, if that is okay. My short answer is that in mos

Podcast 283: The O of OCD: Featuring Thai-An Truong, LPC, LADC Overview: The "O" of OCD (obsessions) is treated differently from the "C" (compulsions.) Thai-An Truong teaches us what really works! Compulsions can be treated with Response Prevention. The techniques for treating the Obsessions include Flooding, Cognitive Techniques, Motivational Techniques for Outcome and Process Resistance, the Hidden Emotion Technique, and more. OCD (Obsessive Compulsive Disorder) consists of frightening thoughts, or obsessions, plus rituals people do in an attempt to prevent or undo the danger. So, for example, if you go to bed and have the thought, "what if I left the burners on the stove turned on," you might get up and check the burners. Doing this once could be considered normal. But if you do this repeatedly, you definitely have the symptoms of OCD. Rhonda wanted me to share how I treat the obsessions in OCD (Obsessive Compulsive Disorder), also known as "pure O." I often say I wasn't looking to treat OCD, but OCD found me, since I do a lot of work with postpartum women struggling with feelings of depression and anxiety, they are actually about 2.5 times more likely than the general population to develop OCD. We're not sure why, but my theory is OCD attaches to the things we value the most (e.g., health, children's well-being), and not much is valued more greatly than our baby. "Pure O" is actually a misnomer. We think that some people with OCD only have obsessions, without the rituals, because they have lots of mental rituals that people can't see. So therapists wrongly conclude that they just have a "pure O" variety of OCD. We usually think of compulsions in OCD as mainly behavioral (e.g., handwashing too prevent contamination or checking the mail box repeatedly when you put your letter in to make sure it didn't get "stuck"), but mental compulsions (rituals) are also very common. Obsessions are the thoughts or images that cause distress; compulsions, in contrast, are the behavioral or mental acts people engage in to try to decrease the distress. Mental acts, compulsions, and rituals can include: Praying Counting Repeating words silently Recalling events in detail Repeating a mental list to ensure safety Mentally reviewing the past like a video Self-assurance: "I'm okay, nothing bad will happen." Saying the number 4 to reduce the distress of seeing 6, associated with the devil Thinking of a positive image to replace the disturbing obsession/thought Those are just common examples, but there are many more. Dr. Edna Foa, who has done a lot of research on OCD and the effectiveness of Exposure and Response Prevention (ERP) for the treatment of OCD states that patients who have ONLY obsessions or ONLY compulsions are unlikely to have OCD. Over 90% of people with OCD reported having both obsessions and behavioral compulsions/rituals. When mental rituals were included, just 2% reported "pure O". Foa, E., et al (2012). Treatment That Works: Exposure and Response Prevention for OCD, Second Edition, p. 12 She states we need to assess patients carefully to weed out other disorders: Only O may be depression or GAD. Only C may be trichotillomania, Tourette's syndrome, autism, schizophrenia – all can display repetitive and ritualistic actions. Trauma can look like OCD. For example, a woman who was raped obsessed about harm coming her way and compulsively checked the doors and windows in her apartment. She may need trauma treatment instead of OCD treatment. Specific Phobias: fear of animals (dogs, snakes, etc), heights, needles, storms, flying, driving, etc. Paraphilia: pedophilia, voyeurism, exhibitionism, etc. Dr. Burns' EASY Diagnostic System can be a great tool for pinpointing these and many other diagnoses. How I've helped clients: A step-by-step approach: Disclaimer: This is not meant to be a substitute for therapy. It is frequently most helpful to have a therapist work with you through this process. Initial Assessment: Dr. Burns EASY Diagnostic System Y-BOCs – Yale-Brown Obsessive Compulsive Scale - not diagnosti. This tool is great for identifying types of obsessions, compulsions, and avoidance behaviors. T = Testing – Brief Mood Survey E = Empathy Psychoeducation about OCD and nature of obsessions The more we engage with them, try to suppress them/control them, the stickier they become Share with them about exposure and response prevention and TEAM-CBT approach to treatment Ultimate goal is to eliminate all compulsions – since they the OCD and are the food that feeds the OCD monster Normal for obsessions content to shift from one subtype to another Let them know I will not provide reassurance. Anything expressed/done once is educational, more than once becomes reassurance Include the family in this process A = Assessment of Resistance DML of most disturbing obsession Identify the feelings and thoughts to increase your understanding of the content and level of disturbance Can use the What-If Technique to identify the patient

The Feeling Good App: Part 2 of 2-- The Surprising Basic Science Findings-- How Does Psychotherapy REALLY Work? And Why Did Everything Change So Fast? Feeling Good Podcast Special Edition #2: March 07, 2022 Today's special podcast features the second part of the recording with David and Jeremy Karmel, David's founding partner of the Feeling Good App. Jeremy and David discuss the exciting results of the basic science findings most recent beta test, which included 140 participants. David uses an advanced form of statistics, called Structural Equation Modeling (SEM) to identify causal effects and to learn more about how the app actually works. This information has immense practical and theoretical implications. Here's a portion of what we've discovered so far. All seven negative feelings are high correlated because they all share an unknown Common Cause (CC) predicted by David in one of the top psychology research journals in the late 1990's. Here's the reference2 Burns, D. D., & Eidelson, R. (1998). Why are measures of depression and anxiety correlated? -- A test of the tripartite theory. Journal of Consulting and Clinical Psychology, 66(3): 461 - 473. The CC accounts for most of the variance in all seven negative feelings, with R-square values ranging from 66% for anger, and 98% for Anxiety. Since there has to be some error variance in the estimates of the negative feelings, there is practically no room left for any significant additional causes. If you would like to see the standardized output of the SEM model, click here. The CC also has causal effects on Happiness, but these effects are much smaller, with an R-square of only 30%. This proves that Happiness has its own causes that are completely different from the factors that trigger depression. Happiness, in other words, is NOT just the absence of depression. The radical reductions in all seven negative feelings were mediated by the reduction in the user's belief in their negative thoughts, as predicted by cognitive therapists, like Albert Ellis and Aaron Beck, as well as the Greek Stoic philosopher, Epictetus, nearly 2,000 years ago. This is the first proof of that theory! At least three components of the app have been isolated which appear to have substantial causal effects in the Common Cause, which in turn triggers simultaneous changes all negative feelings as well as happiness. Those three components include: A cognitive variable: the user's belief in his or her negative thoughts. A motivational variable: measured with extremely precise and sensitive instruments. the user's liking of the app. The magnitude of all three causal effects was large. However, the motivational variables and user's liking did not have direct effects on changes in depression and other negative feelings. The changes were ALL mediated via reductions in the user's belief in his or her negative thoughts. This finding is consistent with the hypothesis that it is impossible to reduce negative feelings without change the belief in the negative thoughts that trigger those feelings. The SEM models were replicated in two independent groups, including 60 participants with moderate to extremely severe depression at the start of the day, and 73 participants with no or only mild feelings of depression. The fit of the model was outstanding in both groups, and there were few or no significant differences in the parameter estimates. This indicates that the findings are valid and do not represent capitalization on chance. David has reported extremely rapid changes in all negative feelings in his single-session treatment of individuals using TEAM-CBT. Some people have suggested that this is because he often treats mental health professionals as well as individuals who are very acquainted with his work. CLICK HERE FOR THE FULLL REPORT However, data from the beta test indicates this is not likely to be true. Mental health professionals did not respond any differently from non-professionals. In addition, the Familiarity with David or with TEAM variables did have modest effects on the degree of liking of the app, but no direct causal effects on changes in depression or the Common Cause. The basic research is just beginning and ongoing. David believes that the research potential of the Feeling Good App may be as significant as the healing effects documented in the outcome findings with the app in the previous podcast. If you are interested in participating in our upcoming beta test, you can sign up at www.feelinggood.com/app. We will be testing a radically revised version of the basic training module, plus some powerful new modules, and we will also be looking at relapse and relapse prevention techniques for the first time to find out if the improvements last. Research on more than 10,000 sessions by human therapists using TEAM indicates that a portion of the gains patients make during individual sessions dissipates between sessions, but the "staying power" of the gains is facilitated by the patien

The Unexpected Results of the Latest (and Largest) Beta Test Feeling Good Podcast Special Edition #1: February 28, 2022 Today's special podcast features Jeremy Karmel, David's founding partner of the Feeling Good App. Jeremy and David discuss the exciting results of the most recent beta test which included 140 participants with depression ranging from no depression at all to the most severe depression that one can possibly experience. David explains that in the middle- to-late 1970's he first conceptualized the possibility of creating an electronic version of himself that could treat people without any assistance from an actual shrink. He explains that My first fantasy was a small booth you could go into, like the ones for taking photos, where you would be presented with a hologram of a shrink who would talk with you in just the same way that a human therapist does. I also imagined creating kiosks that could be placed in groceries stores or places like Epcot Center in Disney World. where people could insert 25 cents and have their emotional or marital problems analyzed, or their depression treated, and so forth. I imagined that the kiosk would be loaded with powerful statistical software that could analyze data on the fly, and create huge data bases, and do research on the causes and cures for emotional and relationship problems. Once the internet evolved, my fantasy change slightly, and I imagined creating an electronic version of myself that would be available to anyone in the world as an app. In addition, because of some promising published research on the antidepressant effects of my first book, Feeling Good, I had a hunch that I could create an app that might be as effective, or even more effective, than human therapists. Two years ago, Jeremy and David teamed up to see if this dream was possible. Today, they present the incredible results of the latest beta test of the Feeling Good App. They measured changes in seven negative feelings as well as happiness in 140 individuals who had access to one portion of the app—the Basic Training—for one day only. The seven negative feelings were depression, anxiety, guilt and shame, inadequacy, loneliness, hopelessness, and anger. All feelings were measured on the same scale from 0 (for not at all) to 100 (for completely). The reliabilities of the negative feelings scale were .91 at the initial evaluation and .93 at the end of the day. David divided the participants into two groups, including 60 participants with moderate to extremely severe depression at the start of the day, and 73 participants with no or only mild feelings of depression. The results indicated, unexpectedly, that they may have already achieved their goal. Here's what they found: The reductions in depression in both groups, as well as the additional six negative feelings, were substantially greater than the reductions reported in large numbers of published outcome studies with cognitive therapy, other schools of therapy, and antidepressants. All seven types of feelings were dramatically reduced in both groups. For example, the depression reduction was 62%and 51% in the severe and mild groups, respectively, and the anger reduction was 70% and 81%, respectively. (Click here for the complete report). Individuals in both groups also reported boosts in happiness, with a 33% increase in the mild group and a mind-boggling 80% increase in the severe group. The lower (but significant) boost in happiness in the mild group was because many of these individuals were already pretty happy at the start of the app, so there wasn't a lot of room for improvement. CLICK HERE FOR THE FULL REPORT One of the most exciting features of the Feeling Good App is that it does research on itself in real time and shows us which parts are the most and least effective. In fact, one part of the app in this beta test was not helpful, and actually made depression somewhat worse, on average. In spite of that, the changes in all the negative feelings were spectacular by the end of the day. We have already modified the parts that were not effective, and anticipate the app will become more and more powerful over time. This is just the beginning, and the sky's the limit! The feedback we received on the app has been largely totally unexpected. Some things that we thought were blow-away were criticized, and some parts that we thought were weak were strongly celebrated. This experience has been much like using David's feedback scales in therapy. Therapists learn that their perceptions of how their patient feel are often not off-base, and that many of your favorite techniques and strategies are not effective. This information, if processed with respect and humility, can transform your clinical practice. And of course, similar information is rapidly and radically transforming our app! Once again, our "patients," or more accurately "app users," have become our best teachers. In the next podcast a week from today, we will discuss the basic sc

Podcast #282: Mike Christensen on Deliberate Practice: Was David Right All Along? Rhonda and I are thrilled to welcome Mike Christiansen, head of TEAM-CBT in Canada. Mike is a fantastic clinician and teacher, and an old beloved friend. Today he talks about the impact of David's work that is finally being felt and appreciated by innovators in the field of psychiatry and psychology. Rhonda begins the broadcast by reading a really touching endorsement from a young man in Turkey whose life was changed by David's work after he came close to suicide. One of the key's was David's statement that we are disturbed, not by events, but by our thoughts about them." Of course, that incredible idea goes back all the way to the Greek philosopher, Epictetus, nearly 2,000 years ago. It is so basic that most people don't "get it," but once you do, it can be mind-blowing. The young man ended his note to David by saying that, "Life is beautiful now. Thank you!" Mike described a similar enlightenment experience when he was doing counseling, and first attended one of David's intensive workshops in Canada. He knew that his training did not provide him with the tools to make much of an impact on his patients. He was excited by what he learned, and subsequently attended many of David's workshops, and became certified in TEAM-CBT. Mike now teaches from around the world at the Feeling Good institute in Mt. View, California. He teaches a highly acclaimed 12 week introductory course in TEAM. If you are looking for some in depth training, Rhonda and I would STRONGLY recommend this class. Mike described a vitally important new direction in psychotherapy called "Deliberate Practice," and is co-authoring a book on this topic with Maor Katz, MD, head of the Feeling Good Institute, and two pioneers in deliberate practice, Tony Rousmaniere & Alex Vaz. Essentially, Deliberate Practice refers to two things. First, therapists must use rating scales, like the ones David has created, to assess patients progress in multiple dimensions, as well as their perceptions of therapist empathy and helpfulness, at every single session. This keep therapists on their toes, and gives them a crystal clear picture of their effectiveness or lack of effectiveness with every patient at every session. Although this can often be painful for the therapist, it can transform the therapist's clinical skills and turn every patient into the finest teacher the clinician has ever had! Second, deliberate practice refers to refined training tools for therapists to practice on an ongoing basis, not only when learning therapy for the first time, but throughout your entire career. The key is doing short, role plan exercises that focus on specific tools, like the Five Secrets of Effective Communication during the E = Empathy step of TEAAM, or the "Invitation Step" at the start of A = Assessment of Resistance, or the Externalization of Voices during M = Methods. And here's the most important part. After the role play, the student is given a letter grade plus specific feedback on what she or he did right and what needs improvement. Then you do repeat role reversals until the student gets an A. David compares this to the type of training a professional athlete might receive to improve his or her skills at basketball or any sport. However, this also requires great motivation and courage on the part of those who are learning and teaching, because every error is highlighted—there's no hiding! That's why the philosophy of learning in the spirit of "joyous failure" is crucial to survival and success! Rhonda, Mike, and David demonstrated this strategy several times, focusing on the Invitation Step of the Assessment of Resistance with an "easy" as well as a more "challenging patient. Sure enough, grades below an A WERE received, and errors WERE pointed out. And, in addition, grades of A were fairly readily achieved, showing that this type of "deliberate practice" definitely DOES work. During the podcast I took the opportunity to vent some of my frustrations with the field, and Mike and Rhonda kindly didn't point out that I probably sounded like a half-demented loony. But I do feel strongly about this topic, and extremely proud of the amazing work that Mike is doing on so many levels. Most therapists resist rating scales. One of my students did a survey for his PhD research, and it seemed like only a small percent (less than 5%) of the psychologists he polled who advertise in the Psychology Today website are using ratings scales to track patient progress. To me, this is both unethical, anti-scientific, and totally unacceptable. Therapists have endless excuses for resisting, and all of the excuses are spurious. For example, they think patients won't be honest, but the big problem is that the overwhelming majority of patients ARE honest, and therapists don't want to hear the truth bout their errors and ineptitude. I do not support, but rather condemn, therapists who refuse to use rating instrume

Sanjay asks: How can we convert our "needs" into "wants?" Vanessa asks: How can we think upon the threat of a nuclear war, or the thought of America becoming a totalitarian state, or the loss of voting rights, without becoming anxious or depressed? Cliff asks: I have pure obsessive OCD and get stuck on intrusive thoughts. What should I do? Upcoming Questions in Ask David podcasts William asks: How would the T.E.A.M. model look with addiction and procrastination? Caroline asks: I've done Cost Benefit Analyses (CBAs) for many of my SDBs (Self-Defeating Beliefs), and the disadvantages greatly outweigh the advantages? What's the next step? Al asks: Can you help me with fear? Khoi asks: How do you deal with colleagues who gossip about your boss? Matt asks: How do we help patients who don't "get" the Acceptance Paradox? Edwin asks: What's the best treatment for internet surfing? It feels like my actions operate below the level of consciousness! Al asks: Can you help me with worrying and fear of symptoms? Paul asks: Are you planning on doing a podcast about people who are about to retire and are very anxious about the prospect and also depressed about closing that chapter in their lives? I'm in that boat Sanjay asks: How can we convert our "needs" into "wants?" Dear Dr. Burns I thank you for pointing out "dramatic shift" in the foot notes and it has given me immense satisfaction . So my learning from this is that 'Low Level Solution' remains just a "first aid" only because it is still in the category of "NEED" has not yet moved into the category of "WANT". A further question comes to mind So what is the process / formula to keep the deepest desires of ours from not entering into NEEDs and remain in the WANT zone. and yet we can work with highest passion and love to achieve them . OR in other words , how do you keep your biggest desire of your APP in the WANT zone and still maintains the highest level passion to achieve it . what is he process to reach that stage? You have already given us the answer to this and shown us the way towards Enlightenment via FOUR GREAT DEATHS of the "self." Still if you would like to say something more that will help us to grasp the process of keeping the desires in WANT only. warm regards Sanjay David's reply In reply to Sanjay Gulati. You can also do two Cost-Benefit Analyses CBA. For example, the first might be a CBA on the Adv and Disadv of Needing love, achievement, or approval, for example, and the second would be a CBA on the Adv and Dis of Wanting the same. You could also use the semantic Technique. What could you tell yourself instead of "I NEED great achievement (or love or approval or whatever) to feel happy and fulfilled." A third could be to do an experiment and see if it is really true that happiness always or only comes from achievement, love, approval, etc. A fourth strategy would be to do a Feared Fantasy and have a conversation, in imagination or in role play with a therapist, with someone who has achieved tremendously. That person would have to explain that she or he looks down on most other people because they haven't achieved as much, so s/he feels they are less worthwhile. You might suddenly discover that such a person doesn't actually seem especially "worthwhile," but more of an egotistical type. With regard to the app, I'm just having fun with it, and making all kinds of amazing discoveries. Parts of it are really effective. Other parts are ineffective and need to be changed. But it is all an adventure. I can't control the outcome—will it be popular? Will we develop a business model that allows us to pay our bills? Maybe yes, maybe no, maybe partially. But to be honest, I don't really care! And not "caring" or "needing" frees me up to care way more effectively, and more creatively, and more lovingly. And with inner peace along the way. Here is something else. You begin to realize that there is no such thing as "failure," only information. For example, if people don't like some lesson, or some word I have used, I just change it and make it better. Most of the negative and positive feedback is totally unexpected and surprising, which is really fun! I feel privileged, not pressured. These feelings are quite rewarding and addictive. I realize, too, that most people don't really care how "successful" I am, including you. Most people do appreciate it when I treat them well, however. Same with our cat that we adopted at the local humane society after her owner died. Might make this an Ask David if it is okay! Thanks, david By the way, you subsequently emailed me and asked me to comment on "intense wants" vs. "needs," so here's a little more. When I was a young man, I used to collect antique paper money from around the world as a hobby. I can vividly recall seeing a rare uncut sheet of banknotes at a trade show that I feel in love with instantly. It was from the US Virgin Islands from the 1850s, if I recall correctly, and it consisted of a one thousand dollar bill and t

The Feeling Good App: Part 2 of 2-- The Surprising Basic Science Findings-- How Does Psychotherapy REALLY Work? And Why Did Everything Change So Fast? Feeling Good Podcast Special Edition #2: March 07, 2022 Today's special podcast features the second part of the recording with David and Jeremy Karmel, David's founding partner of the Feeling Good App. Jeremy and David discuss the exciting results of the basic science findings most recent beta test, which included 140 participants. David uses an advanced form of statistics, called Structural Equation Modeling (SEM) to identify causal effects and to learn more about how the app actually works. This information has immense practical and theoretical implications. Here's a portion of what we've discovered so far. All seven negative feelings are high correlated because they all share an unknown Common Cause (CC) predicted by David in one of the top psychology research journals in the late 1990's. Here's the reference2 Burns, D. D., & Eidelson, R. (1998). Why are measures of depression and anxiety correlated? -- A test of the tripartite theory. Journal of Consulting and Clinical Psychology, 66(3): 461 - 473. The CC accounts for most of the variance in all seven negative feelings, with R-square values ranging from 66% for anger, and 98% for Anxiety. Since there has to be some error variance in the estimates of the negative feelings, there is practically no room left for any significant additional causes. If you would like to see the standardized output of the SEM model, click here. The CC also has causal effects on Happiness, but these effects are much smaller, with an R-square of only 30%. This proves that Happiness has its own causes that are completely different from the factors that trigger depression. Happiness, in other words, is NOT just the absence of depression. The radical reductions in all seven negative feelings were mediated by the reduction in the user's belief in their negative thoughts, as predicted by cognitive therapists, like Albert Ellis and Aaron Beck, as well as the Greek Stoic philosopher, Epictetus, nearly 2,000 years ago. This is the first proof of that theory! At least three components of the app have been isolated which appear to have substantial causal effects in the Common Cause, which in turn triggers simultaneous changes all negative feelings as well as happiness. Those three components include: A cognitive variable: the user's belief in his or her negative thoughts. A motivational variable: measured with extremely precise and sensitive instruments. the user's liking of the app. The magnitude of all three causal effects was large. However, the motivational variables and user's liking did not have direct effects on changes in depression and other negative feelings. The changes were ALL mediated via reductions in the user's belief in his or her negative thoughts. This finding is consistent with the hypothesis that it is impossible to reduce negative feelings without change the belief in the negative thoughts that trigger those feelings. The SEM models were replicated in two independent groups, including 60 participants with moderate to extremely severe depression at the start of the day, and 73 participants with no or only mild feelings of depression. The fit of the model was outstanding in both groups, and there were few or no significant differences in the parameter estimates. This indicates that the findings are valid and do not represent capitalization on chance. David has reported extremely rapid changes in all negative feelings in his single-session treatment of individuals using TEAM-CBT. Some people have suggested that this is because he often treats mental health professionals as well as individuals who are very acquainted with his work. CLICK HERE FOR THE FULLL REPORT However, data from the beta test indicates this is not likely to be true. Mental health professionals did not respond any differently from non-professionals. In addition, the Familiarity with David or with TEAM variables did have modest effects on the degree of liking of the app, but no direct causal effects on changes in depression or the Common Cause. The basic research is just beginning and ongoing. David believes that the research potential of the Feeling Good App may be as significant as the healing effects documented in the outcome findings with the app in the previous podcast. If you are interested in participating in our upcoming beta test, you can sign up at www.feelinggood.com/app. We will be testing a radically revised version of the basic training module, plus some powerful new modules, and we will also be looking at relapse and relapse prevention techniques for the first time to find out if the improvements last. Research on more than 10,000 sessions by human therapists using TEAM indicates that a portion of the gains patients make during individual sessions dissipates between sessions, but the "staying power" of the gains is facilitated by the patien

Podcast #280: A Beloved and Brilliant Voice from the Past: Dr. Stirling Moorey! Rhonda and I are thrilled to welcome Dr. Stirling Moorey, from London, England, to today's podcast. Stirling was one of my first students, and he sat in with me my on all my sessions as a co-therapist for a month for two summers in the late 1970s. I wrote about Stirling in my first book, Feeling Good: The New Mood Therapy, which was published in 1980. One of the miracles of the internet, and zoom, is the chance to reunite with friends and colleagues from the past. Needless to say, Rhonda and I were SO EXCITED when Stirling accepted the invitation to join us! Rhonda starts the podcast by saying that "Dr. Stirling Moorey had the good fortune to be trained and supervised by two pioneers in the field of cognitive therapy, Drs. Aaron Beck and David Burns. In 1979, when Stirling was still in medical school in London, he did an elective with Dr. Aaron Beck at the Centre for Cognitive Therapy in Philadelphia." I (David) might put it a bit differently. I would say that during the early days of cognitive therapy, I had the fantastic opportunity to do co-therapy together with Stirling with many patients. I learned a tremendous amount from Stirling, even though I was, in theory, the "expert" and he, in theory, was a totally untrained and green novice. But he was phenomenal right out of the gates, and those months were among the happiest of my life. What I learned by observing Stirling's superb interactions with my patients eventually morphed into my Five Secrets of Effective Communication and my first book, Feeling Good Together! Rhonda continues: "Stirling was one of the first British therapists to study CBT when that discipline was in its infancy. David described their fantastic collaborative work with Stirling in Feeling Good, and has described Stirling's brilliant empathy skills in dozens of workshops. Stirling is currently a Consultant Psychiatrist in Cognitive Behaviour Therapy, and was the Professional Head of Psychotherapy for the South London and Maudsley Trust from 2005-2013. He has been a Visiting Senior Lecturer at the Institute of Psychiatry, Psychology & Neuroscience in London." Stirling is a highly regarded therapist, trainer / supervisor / teacher and workshop leader. His main research interest is in the application of CBT to life threatening illness and adversity. He was one of the first therapists to develop CBT for people with cancer and has contributed to five randomized controlled trials in both early and late stage cancer. Stirling is also co-author with Steven Greer of The Oxford Guide to CBT for People with Cancer, and has co-edited a book entitled The Therapeutic Relationship in Cognitive Behavioural Therapy, published by SAGE (Moorey & Lavender, eds.) During today's podcast, Stirling reminds us that one of the aims of cognitive therapy is encouraging patients to examine their distorted negative thoughts and self-defeating beliefs in a way that is not threatening. If patients don't feel validated, they may feel attacked and become defensive, which, of course, can undermine the therapist's effectiveness. He also reminded us that the grandfather of cognitive therapy, the late Dr. Albert Ellis from New York, often attacked the beliefs of his patients in a somewhat aggressive manner, and that this can frequently trigger therapeutic resistance. In fact, an overly aggressive therapeutic style can split patients and colleagues into two camps: those who love you, and those who may stubbornly resist and oppose you. During the podcast, we reminisced a bit on shared memories, and Stirling said that "David took me under his wing with such willingness to share his knowledge and experience . . . and I was just an ordinary medical student. We had many great moments!" Although Stirling was tempted to relocate to America, he decided to remain in England, and has never regretted that decision. For one thing, he met and married his beloved Magda. My own wife, Melanie, and I were honored to take our two kids to England to attend their marriage. We all loved England and had a ball! Magda, Stirling's wife We discussed some of Stirling's amazing work with the patients we saw together in Philadelphia, as well as his visit one summer when we were in California visiting with Melanie's parents in Los Altos, where we now live. Stirling recalled that when we were out shopping one day, my wife and I tried to persuade him to purchase a large Stetson hat, but he resisted! Stirling described the three ways in which he encourages people to change their negative thoughts using the Socratic Technique of gentle questioning: he asks if the negative thoughts are realistic, if they are helpful, and if an alternative perspective can be taken. The reality testing approach focuses on the important differences between healthy negative feelings, like healthy sadness or grief, which don't usually need any treatment, and unhealthy negative feelings like depressi

Podcast 279: Dr. Leigh Harrington on Goal Setting for Habits and Addictions or Using Habits to Feel Better Today, we are joined by a very special member of the TEAM-CBT family, psychiatrist Leigh Harrington, MD, who will teach us how to set goals that work when battling habits and addictions. Leigh Harrington, MD, MPH, MHSA, is a psychiatrist, TEAM-CBT Therapist and Trainer. Originally from Michigan, where she completed medical school and graduate school, she had the good fortune to meet Dr. David Burns in 2004 during her psychiatry residency at Stanford University when she joined his original group of Tuesday night students. She specializes is helping therapists and individuals reach their goals especially in the areas of Interpersonal Exposure, Relationships, and Habits. She lives in Davis, California with her two beloved daughters. Leigh begins by saying that there are many parts of the TEAM-CBT model than help when battling unwanted habits and addictions. Our habits definitely result from how we think, and the stories we tell ourselves, and treatment can sometimes be more than just treatment, but a transformational experience. She explains that "I gained 20 pounds following my last pregnancy, so I began to set three kinds of goals: Mental goals Physical goals Relationship goals" Mental goals She continues: "I focused on reducing the many Should Statements I was battering myself with, like "I should have done this or that," or "I should do this or that." These kinds of statements sounded demanding and triggered feelings of guilt and frustration that actually made it harder to achieve my goals. "So, I decided, instead, to notice my thoughts, and focus instead on appreciating things. This was just one of many approaches to rewiring my brain. "For example, I realized I had been letting my brain run itself each morning. When I woke up my mind would start to tell me all the things I needed to (should) do that day. . . Sometimes I would wake up feeling "okay," but I was definitely not in a state of bliss, gratitude or joy. "Sometimes it seemed as if my mind would look to find reasons I might not be feeling top-of-the-world: 'Well there is this issue… or this… and also this…' "Which told me a story of my unhappiness, or simply a lack of joy. Of course, my mind was well-intentioned, trying to help me out, but it didn't end in greater joy, but in the weight of 'shoulds' and reasons to feel crummy. It had become a habit--a thinking habit. "I was struck by the idea that I didn't have to let my mind think whatever it wanted and wondered if I could break this thinking habit. In habit work, we determine the new habit we want, check our motivation, plan solutions to any problems, and commit to the new habit. "I thought I would keep my new habit simple, believable, and incorporate gratitude, as that can sometimes be helpful, too. "My new habit was to catch myself while I was still in bed, as soon as I recognized I was having thoughts, and say to myself something I believed that, was non-controversial. When I caught myself thinking any shoulds or telling myself any unhappy stories, I said to myself, 'I love my bed. I love my house. I love my lamp.' "This might seem simple, trivial, or silly. But the point of the new habit was not to be profound and brilliant. The point was to change my thinking in the smallest of ways and to prove to myself I could create a new thinking habit. "This simple thought habit has allowed me to start my day on a better note and has allowed me to prove to myself I can change my thinking habits." Physical goals Leigh explains: "Here's how I lost the 20 pounds I had gained. Instead of focusing on one strategy – like, "I will only eat vegetables," or "I will exercise 2 hours per day," I focused on achieving the goal by any means. I used the experimental technique and went through a series of habit experiments. "First I tried just thinking I'd like to lose the weight. I. This may seem crazy, but there have been times in my life when I've seemed to effortlessly loose weigh, so that seemed like an easy first go. "As you might imagine, it didn't work as well in my 40's as it did in my 20's. As long as I kept giving in to my urges to have a sugary treat in the afternoon as a pick-me-up, and refusing to be in deprivation, nothing at all happened with my weight. "I also allowed myself to eat as much as I wanted to, just as I had when I was pregnant and nursing my daughter. "Since that didn't work,. I experimented with some green juice in place of sugary snacks. I felt healthier, but there was no change in my weight. "Then I decided on a multi-pronged approach. I would keep drinking my fruit-smoothies in the morning, along with a protein shake mid-morning, and a normal lunch, plus a normal dinner – just one serving at lunch and dinner, and no more than one dessert per week, Whenever else I was hungry I would drink a protein drink and lots of water. I also committed to walking every day for 30-60 minutes an

#278: Buddhist Strategies for Financial Abundance, Featuring Zeina Halim Jan 24, 2022 Today, we feature the work of Zeina Halim, a beloved member and small group leader in our Tuesday training group at Stanford, who specializes in the treatment of anxiety. This is Zeina's third appearance on our podcast. Previously she helped us with a fabulous program on family conflicts at the start of the pandemic (Corona Cast 3, 4-06-2020) and later did live some personal work on one of the Self-Defeating Beliefs, the Achievement Addiction (Podcasts 211, 10-12-2020, and 212, 10-19-2020). Today Zeina brings us something radically different: Buddhist Strategies for Financial Abundance. What in the world does that mean, and why should you care? She starts by describing her study of Buddhist practices, and cites some books that have inspired her, including The Diamond Cutter: The Buddha on Managing Your Business and Your Life, by Geshe Michael Roach. Zeina explains the quasi-mystical concept of "Karma," which is the idea that you get what you give. In other words, the energy and spirit you convey to others, and to the universe, will come back to you. For example, when clients who are not a good fit for her practice contact her, Zeina goes out of her way to help those clients find a great fit with another therapist. This "Karmic practice," she explains, has paradoxically caused many patients to suddenly seem to show up, asking for treatment. In other words, when she meets the needs of others, the universe meets her needs. She says that she doesn't need to do very much at all of the kinds of traditional marketing that most other therapists do in an attempt to build their practices. This "karmic practice" has been mostly sufficient and far more effective than traditional marketing methods. This is a theme that I (David) resonated with, since I also give away almost everything for free, and have received an abundance of positive and loving gifts from the universe in return. Zeina cautions that this, and all Buddhist practices, must be done with balance and thoughtfulness: "When I started, I gave too much, and this can actually cause self-harm." She said that some people have raised the question: "But isn't this an inherently selfish practice, since you are hoping for abundance for yourself?" Her response to this is that when you receive financial abundance, you can give even more to others for free. She also described another book of Geshe Michael Roach's, The Karma of Love, where you try to give to the other person and meet their needs instead of worrying about whether they're loving you enough or meeting your needs. In a previous relationship, this led to inner peace and, paradoxically, she felt much more loved, although nothing observable had changed in the way her partner treated her. The change in her feeling loved all came from changes SHE made, not her partner. This aligns very closely with the TEAM-CBT approach to relationships, as well as the teachings of most religions. We also discussed group TEAM-CBT vs. individual therapy. I described my phenomenal experiences in Philadelphia creating a large intensive group therapy program at my hospital, which was in a rough, inner city neighborhood. Most of our patients had few resources, and many could not read or write. Some were homeless. The program was more or less free to all of them, and our patients and their families gave us so much in return. I was absolutely thrilled that Zeina also loves doing therapy in groups. Many patients and therapists alike think of group therapy as a kind of inferior approach, but my experience has been the opposite. If given the choice, I'd treat everyone in groups. Zeina will be starting a TEAM-CBT anxiety group within a week of this podcast. The group will focus on all the anxiety disorders, such as chronic worrying, shyness, phobias, OCD, PTSD, and more. There will be one group for adults and one for young adults, aged 18-24. If you're interested, feel free to text Zeina at 1-408-412-5678, email her at [email protected] or visit her website at ZeinaHalimTherapy.com As an aside, we'll find out if Zeina's Buddhist Karmic Marketing works. She did not ask me to promote her group. I just decided to promote it a little bit because I'm so excited about what she's doing, and I hope her practice grows and prospers to the max! Thanks for joining us today! If you like what we're doing, tell your friends about the podcasts. Your word of mouth is our main and only source of marketing. This year, we'll see the five millionth download of our podcasts. Thanks so much for your support and for making it all happen! Rhonda, Zeina and David

Rejection Practice: A Love Story, Featuring Dr. Cai Chen Jan 17, 2022 Rhonda starts today's podcast by reading two wonderful recent endorsements from listeners. A therapist from San Jose, Ca was moved and inspired by the two podcasts (Episodes 268 & 269, published 11-15-2021 and 11-22-2021) with Dr. Carly on the tragic loss of her baby via ectopic pregnancy, and another listener described TEAM-CBT as "revolutionary" due to the emphasis on reducing resistance. She compared the approach to the indirect hypnotic approach developed by the late Milton Erikson. Dr. Cai Chen recently completed his psychiatric residency in Texas, and then moved to California to join the TEAM-CBT community and unite with the love of his life, who happens to be a member of our Tuesday group. Cai attributes much of his dating success to one of the techniques he read about in my book, Intimate Connections, called "Rejection Practice," because he practiced that technique to successfully defeat his negative thoughts about all the awful things that might happen if he tried to talk or flirt with an attractive woman. He would tell himself things like: She'll think I'm being too forward. She'll be offended and might call the police. People who see me trying to flirt will be offended. I'll be rejected. He described what happened when he forced himself to get 20 rejections in a mall in order to overcome his fears. His stories about what happened are both funny and inspiring. Cai also describes his initial intense resistance to using this technique, giving himself messages like, "I shouldn't have to learn to flirt because it's beneath me!" I heard excuses like that all the time when I was in clinical practice, working with shy, lonely men! Rejection Practice is a powerful and potentially super-effective technique you might want to try if you're also struggling with social anxiety or if you treat patients with this problem. We also illustrated the hilarious Feared Fantasy Technique on the podcast, where Cai enters an Alice-in-Wonderland Nightmare World, and meets the "woman from hell" who represents all of his worst fears, and verbalizes things like this to him: You're assaulting me and I'm going to call the police. You're the last person I'd ever date! You're forgettable! you You're too forward. I can see that you're very insecure! In addition, he meets the "observer from hell" who verbalizes things like this to Cai: I'm terribly offended that you tried to talk to that woman. It's highly inappropriate to flirt like that in broad daylight. You shouldn't be doing that. I condemn and reject you! Cai was surprised to discover that the monster has no teeth and experienced some enlightenment and freedom from his fears. Rhonda, Cai, and I had a lot of fun with these techniques, and hope you enjoy them, too. Again, if you're a therapist, you might consider including these techniques if you work with shy individuals. We also discuss the idea of "Physician, heal thyself," a quotation from the New Testament (Luke 4:23). We are all convinced that doing your own personal work can vastly increase your skills and depth as a clinician, because you can tell your patients, "I know what you're going through, because I've been there myself. And what a joy it's going to be to show you how to overcome your shyness and develop greater confidence, and more loving relationships with others." And that's exactly what happened to Cai. He found the love of his life. You'll hear all about it if you listen to this heart-warming podcast! Dr. Cai is just starting his TEAM-CBT practice at the Feeling Good Institute in Mountain View, California. However, since he is a trained physician and psychiatrist, he can also prescribe medications if patients need them in addition to the therapy. Dr. Cai Chen is a warm and brilliant young psychiatrist. If you would like to contact him, you can contact him at [email protected], or call him directly at 1-916-877-4749. Thanks for joining us today! If you like what we're doing, tell your friends about the podcasts. Your word of mouth is our main and only source of marketing, since I have refused to monetize the podcasts. So our budget is meager at best. Still, this year, we'll see the five millionth download of our podcasts. Thanks so much for your support and for making it all happen! Warmly, Rhonda, Cai and David

Here are the questions for today's Ask David, featuring special guest, back by popular demand, the extraordinary Dr. Matt May, and of course, our super-special hostess, Dr. Rhonda Barovsky! Why is my dad the way he is? Why are people the way they are? What can you do about positive distortions? More Should Statements! How can you talk to someone who refuses to talk to you? Why is my dad the way he is? Why are people the way they are? Hi Dr. Burns and Dr. Barovsky! I love your show. Keep up the good work! I'd deeply appreciate your time and insight. My dad is 70, my mom is 67, and I'm 38. Throughout my life my dad has done things like he did earlier tonight. I was at my parent's house and my mom was telling me how Thanksgiving was going to be at my parent's cabin with the whole family like we have in years past at which my point my dad firmly said "No." My mom asked "Why?" and he just shook his head and shortly after walked out of the room to go to the bathroom, shut the door, and said "no" angrily three times in the other room to himself but loud enough for she could hear. He'll seemingly randomly act extremely possessive by angrily forbidding family get togethers, or my mom from doing things, or family to borrow things. He'll just say "No" without further explanation. Always, always, upon asking "Why?" to his "no." He'll either say angrily, "Because I said so!", say nothing, or just repeat "No" further. My mom says sometimes "Can you just gave me a reason?" and it's the same "No", silence, or "because I said so." I don't jump into the aforementioned back and fourth communication because I know such a person can't be changed and don't want to make an argumentative mess. He's never displayed any comfort with expressing the slightest vulnerability. He's very, very silent. All of my life he has displayed bullying type tendencies. Whenever I visit my parents he always shows tremendous eagerness to want to scowl and berate people for the tiniest mistakes (even people he doesn't know in public, like cashiers.) I think even the most skilled of five secrets practitioners might be outmatched. My mom tonight, and all my life, has asked me why is he like this? I've been haunted to try understand this question all my whole life too. So, I'm putting the question to you Dr. Burns and Dr. Barovsky: Why is someone like this? You must've heard of similar situations and have insight? I want to feel compassion and understanding for him. I don't want to live with baggage. And mainly, mainly I just want to relieve myself from anger thinking should, labeling, and overgeneralizing thoughts like "He shouldn't act like this", "He shouldn't be such a bully", "He's being a jerk." Thank you, Mark David's Reply Thanks, Mark, I can certainly understand your sadness, frustration, and anger, as well as your love and concern for your mom. Scientists don't yet know why people are the way they are. My focus is on helping people at specific moments of interaction when they want help. You have not asked for help in this email. I do make this type of statement in practically every Ask David episode, but have not had much luck in getting people to listen, because the general questions that have no answers keep rolling in. You say that your dad cannot change. To my ear, this statement is both blaming and untrue. People change at every moment of every day. The real question I always have is this, and it might not interest you. Do YOU want to change the way you interact with him? You and your mom probably both do things that trigger him, like silence, or asking WHY when it is abundantly clear that this response has a 100% guarantee of triggering him. I apologize if this is not the answer you were looking for! David What can you do about positive distortions? How much information is there in the book (or a particular podcast) on how we address positive distortions most effectively? It is mentioned briefly that these can be more difficult to overcome, because of the more positively perceived "benefits", which may also be re-enforced externally (such as "yes, he is such a nice person, nobody wants him to express any frustration or anger occasionally - not even he himself want to do this!"). It affects motivation to any change, or, at least, creates ambivalence. Some more on this would be great, please. Thanks, Tillerich David's Reply Hi Tillerich, Good question, and I will schedule it for an Ask David. As you point out, there usually isn't much motivation for change when it comes to positive distortions. Positive distortions trigger habits and addictions, violence, mania, marital conflicts, and narcissism, to name just a few areas. Each is handled differently, but dealing with motivation / resistance is key in every area. David More Should Statements Johnny asks: Can you help me disprove my negative thoughts? I manage to disprove them, but they return after a few hours. "A loser is someone who lives at home with his parents after he turns 18." "I shou

Hi everyone! This special podcast features one of our favorite people, Professor Mark Noble from the University of Rochester in New York. Professor Noble is a world-renowned neuroscientist and cancer researcher, one of the pioneers in stem cell research, and all-around good guy. He contributed a brilliant chapter on how TEAM-CBT interacts with the brain for my book, Feeling Great. For the past two years he has been a very beloved member of the Wednesday TEAM-CBT Training group, adding his wisdom and clarity to the teachings. Rhonda and my co-teachers, Leigh Harrington and Richard Lam, and all of our students feel very honored to have him in our midst. This is our third podcast with Dr. Noble, and the first podcast to usher in the new year. We're excited to speak with him again today. He will update us on his latest thinking on how the molecular biology of stress and learning are totally consistent with the rapid mood changes we see in TEAM-CBT. He also describes his latest writing project, tentatively entitled, The Brain User's Guide to TEAM-CBT, and you can download it for FREE if you click here! (LINK) In this booklet Professor Noble presents the "brainological perspective" on TEAM-CBT. He emphasizes that this booklet is written at the 9th grade level so as not to intimidate anyone. If you're curious, take a look, and feel free to share it with others who might be interested. Professor Noble explains that his new booklet was inspired by patients who ask how TEAM differs from traditional (aka "normal") talk therapy. Of course, the differences are many and profound, but one of the questions new patients and therapists ask is whether the rapid recoveries we observe during TEAM-CBT treatment are just superficial and temporary, or even fake. Mark asserts that nothing could be further from the truth, and that the thing that makes TEAM-CBT so special is how closely it is aligned with how the human brain actually works. He explains that there are ten essential steps in TEAM, starting with Empathy. He defines Empathy as "being in a safe place, where you can share feelings without being judged." Empathy allows the patient to access the networks in the brain where the patient's pain may be stored as memories. The spoken and written language exercises used in TEAM actively and rapidly modify the networks that generate the feelings of depression, anxiety, shame, inadequacy and hopelessness. Dr. Noble places a great importance on the written Daily Mood Log, which he describes as arguably the "greatest development in the history of psychology." He says that when you describe the horrible and traumatic things that happened to you, and you record your Negative Thoughts on paper in a systematic, step-by-step way, you can look at your thoughts, feelings, and painful memories as separate from your "self" and gain some distance from them. Then, when you pinpoint the many cognitive distortions in your negative thoughts, and substitute more realistic interpretations, you gain freedom and relief because you are actually re-wiring your brain. He said that most of our human thinking is called Fast Thinking. This is the automatic thinking that we do 98% of the time as we go through our daily lives. Fast thinking is great, but growth, learning and change can only result from Slow Thinking, where we reflect and analyze things. Slow thinking takes concentration and effort because you are changing actual networks in your brain when you challenge and crush your negative thoughts with powerful techniques like the Externalization of Voices. He says that we are not just telling people to "Stop it!" or "Get over it!" Quite to the contrary, we are teaching specific, powerful techniques that give you the chance to pinpoint and modify the exact brain networks that cause your negative feelings. He explains that "language is a powerful tool for figuring out exactly how we see the world when we're feeling down, and TEAM gives us many tools in TEAM to modify the errors in our perceptions that cause so much suffering. Mark laments on the excessive misuse of medications for individuals, including children, who are struggling with behavioral and emotional problems. He wishes more people would simply sit down with the person who is upset and ask, "What's going on? How are you feeling? What are you thinking and telling yourself?" I have had the same thought when thinking about how therapists not familiar with TEAM or Cognitive Therapy use and promote dozens of presumably therapeutic approaches without simply asking patients, "What thoughts go through your mind when you are feeling depressed, anxious, ashamed, inadequate, or hopeless?" The answers to this question provide direct and immediate access to the brain networks that need re-wiring! Mark concludes today's podcast by saying, "I went into medical research on cancer and other serious problems because I wanted to help people who are suffering. I'm convinced that TEAM-CBT, and the powerful Daily Moo

The Sara Session—Total Blow Away! (Part 2 of 2) Last week, you heard the first part of the session with Sara, a woman haunted by feelings of anxiety and inferiority from the time she grew up in a village in Mexico. Because she received a great deal of mean-spirited put-downs, she same to see herself as an "outsider" who wasn't good enough. She has finally decided to challenge this crippling and disturbing mind-set, and in today's podcast you will witness her metamorphosis. She will also join us for the fascinating follow-up to her amazing treatment session. If you click here, you can see Sara's Brief Mood Survey at the end of the session, along with her Evaluation of Therapy Session. As you can see, the changes in her mood scores were profound, and her ratings of Jill and David on "Empathy" and "Helpfulness" were excellent. If you click here, you can see Sara's Daily Mood Log at the end of the session. By the end of the session, all of Sara's negative emotions had gone down dramatically, to zero or near zero levels. However, one negative feeling, jealousy, only went down to 30%, and this feeling was still nagging at her. She said she still felt inadequate and jealous of people who had accomplished more, since she'd been procrastinating for years at promoting and developing her private practice. I don't like to leave people with loose ends, if at all possible, and Sara clearly wanted to zap the feelings of jealousy if we could, since we hadn't focused on this emotion at all during the session. You may be fascinated by the surprise ending to the session, and the method that allowed Sara not only to blow away her feelings of jealousy, but a discovery of how she could use those feelings to connect more deeply with her childhood friends, including those who had accomplished a lot! There were quite a few teaching points, including but not limited to these: Rapid, profound, and lasting change is possible, even when people have been struggling for years or decades, or even since childhood, with feelings of depression and inadequacy. The goal of therapy is not just a reduction in depression, but a total elimination of depression along with being catapulted into a state of enlightenment, joy or even ecstasy. Sometimes Positive Reframing can blow away a negative thought, as you'll discover in the surprise ending to her session. Sara totally threw herself, body, heart and mind into this work. That commitment is a vital ingredient of success. Several days after the session, Sara sent this beautiful note to the Tuesday group. Hello, Tuesday Group! I apologize for just now sending this email. I had told David I would email the group this past weekend with an update, but I have been TOO busy dancing away (more about this in a second). 😝 Anyway, I will try to make this email short because I tend to go overboard and write too much, and I know everyone is busy. I will just share a few things that have happened since my personal work two weeks ago. I am also forwarding the email I sent David and Jill Tuesday evening after the magical evening. First of all, THANK YOU all for your awesome support and empathy during that beautiful evening. At that time, I did not realize how much this is the story of many of us in the group (the learning disability and being bullied, humiliated and teased because of it.) I felt very connected to you and felt your love and deep compassion and understanding. Thank you! So, I was not kidding when I wrote that I am dancing away. You see, during the last two weeks when I have been at a grocery or department store, I have been dancing away to the music playing in the store. For some reason my body just gets moving and doesn't want to stop no matter what song is playing. As you can imaging, this is not typical of me. As a matter of fact, I am not a music person let alone a dancer. I prefer to listen to NPR or a Feeling Good podcast when I'm in the car and don't play any music at home. Anyway, when I have been at a store these last few days, I have let loose. It was really funny when a lady at the end of the aisle noticed me dancing, and said to me, 'You go girl!" We both giggled and I kept dancing even after the song was over. I am NO longer inhibited and have allowed my body to do what it needs to do, and I really don't care what anyone thinks or says. What a liberating feeling this is! My husband also thought it was funny that I have made silly sounds, especially during meals, and we would just burst into laughter. Needless to say, a lot has gone on since my personal work. I am definitely more relaxed, and therefore, less serious and more playful. Enjoying life!!! The main shift has been my thought that has been ingrained in me my whole life: "Que van a pensar?" which translates to "What are they going to think?" I used to care and believe this !00% but now I don't believe it (0%) and it does not matter to me what people think. My new thought now is more powerful and I believe it 100%: "I don't care

The Sara Session—Total Blow Away! (Part 1 of 2) In one of my recent Tuesday psychotherapy training groups at Stanford, we reviewed the Interpersonal Downward Arrow Technique. This is a high-speed technique I created that allows you to rapidly identify the roles that you play in your relationships with others so you can pinpoint the patterns that create tension and unhappiness for yourself as well as the people you care about. The Interpersonal Downward Arrow Technique is similar to what psychoanalysts try to do with free association on the couch, except it only takes five to ten minutes, as opposed to five to ten years. In addition, I have also developed fairly rapid ways to change and modify those dysfunctional patterns—IF this is what you want to do. Some of the psychoanalysts call these hidden patterns "core conflicts." The late Dr. Lester Luborsky (https://en.wikipedia.org/wiki/Lester_Luborsky), a prominent psychotherapy researcher at the University of Pennsylvania School of Medicine, has written about core conflicts extensively. He gave as an example of a core conflict, a person who might have the belief that "my needs will never be met in my personal relationships." Beliefs like this not only create unhappiness, but they can also function as self-fulfilling prophecies. In addition, most people re not aware of these "core conflicts," and do not realize they are just beliefs. Most people just believe that "this is just the way the world is," and think they have a profound insight into the reality of human nature. But we actually create our own interpersonal realities at every moment of every day. Since we usually cannot "see" what we're doing, we may wrongly conclude that we're victims of the "badness" of others. And, of course, there is always a grain of truth in that belief as well! During the training group, we had group members identify some of their own "core conflicts," using the Interpersonal Downward Arrow Technique, and this hit one of our members, Sara Shane, like a ton of bricks. She discovered that she sees herself as "an outsider" and has always believed she is stupid and inferior to others. And this intense belief has caused tremendous suffering for Sara for decades, including her participation in the Tuesday training group, where she is usually totally silent. Sara traced this pattern to her childhood, growing up in a village in Mexico, where she was bullied and put down because she was short and overweight, and had the darkest skin of any of her many siblings. In addition, she struggled with a learning problem and was frequently put down and labeled as stupid. Sara's sudden decent into emotional hell was fueled by the fact that she was planning the wedding of her niece at a town in Mexico which was only two hours from the town where she grew up. And the thought of showing her daughter that town filled her with feelings of shame and terror, fearing she would run into the people she grew up with, including the people who cruelly put her down. Here's what she wrote prior to doing personal work on this problem in a subsequent Tuesday group: Hello Jill and David, Where to begin…all day yesterday it was very painful as I thought about emailing you... As I'm writing this, I am in tears and I know it is going to take me a while to write everything I want to say. But first let me say that it has taken me a long time to even sit in front of the computer because this has been very difficult for me. I had earlier said I would email you yesterday morning but I know now why I could not. I procrastinating mainly because this hurts a lot, beyond what I had earlier experienced. Right now, I am not even paying any attention to proper writing because I just want to write this without worry about correctness and just express my feelings. Let me describe what I have been feeling physically all week long since Tuesday. I have been feeling sick to my stomach especially when I was working on the DML. I felt a hole in the pit of my stomach. I felt anxiety all over my body and felt overwhelmed. At times I could not even go one. I had to push myself to complete the Cognitive Distortions on the DML. I just wanted to run away from it all. It was that painful. But I also knew this was a good thing because I was getting down to something very important that I wanted and needed to face. So the Interpersonal Downward Arrow has been very enlightening, but also, extremely painful. And David, you are absolutely right, there is no doubt in my mind (not that there ever was), that all of our problems are encapsulated in one brief moment in time and that we create our own interpersonal reality at every minute of every day. Let me explain what transpired on Tuesday that motivated me to be a volunteer during small group practice. After postponing it for more than a year due to COVID, my niece is having her destination wedding in Mexico in November. My husband and I along with our daughter are attending the wedding. While there,

272 Ask David, with Special Guest, Dr. Matthew May: Shoulds, Free Treatment, Blame, and More! Here are the questions for today's Ask David, featuring special guest, Dr. Matt May, and, of course, Dr. Rhonda Barovsky! How can I turn off my Shoulds!? Is there a downside to treating people for free? What's the difference between Feeling Great vs Feeling Good? Isn't it important to blame the other person when that person really IS to blame? How can I turn off my Shoulds!? Nice podcast! (Maurice is referring to Part 2 of "I want to be a mother.") It's refreshing to see that we sometimes mix our needs with wants. I also have a huge problem with regret and shame, saying to myself "I should be far more ahead in life." "I should have dated more." "I should have used my energy to create art and being productive." I pinpointed the moment in my daily mood log, and it occurs usually when I compare myself with people online or with people in my friend group who seem to be far more ahead in life than me in terms of career and achievements or that they used their energy of their younger years more constructive than me because they didn't deal with depression. I tried the semantic method to soften my thoughts regarding my should statements but telling myself "I wish I did xyz," is carrying the same weight of regret as when I "should" myself. These thoughts also seem very realistic to me and pinpointing the distortions in them is not helping me much because there is so much resistance and weight to the thought, plus the positive thought that I subsequently come up with does not crush the negative thought. I often ask myself: "Am I really a failure?" Maurice David's Reply Thanks, Maurice You are struggling with resistance, which is the cause of virtually all therapeutic failure. You can use Search on my website to look up podcasts on Positive Reframing, Assessment of Resistance, and Paradoxical Agenda Setting. I usually select ten to fifteen or more methods to crush any Negative Thought, but would only use them after the resistance issue has been successfully addressed. For example, we could use "Let's Define Terms," as one of 15 or 20 potentially helpful techniques. It might go like this: Is "a failure" someone who fails all the time, or someone who fails some of the time. If you say, "some the time," then we're all "failures," so we don't need to worry about it. If you say, "all the time," then no one is a "failure," so we don't need to worry about it. If that technique is not effective, we'd have tons more to try. You can read one of my books, like Feeling Good or Feeling Great, to learn more about the Assessment of Resistance and the use of various techniques to crush distorted thoughts. Might also use this on an Ask David. Can use a fake first name, too, if you like. Please advise. david Is there a downside to treating people for free? Dear David and Rhonda, I live in England, and I'm close friends with a team CBT therapist in Bristol (Andy Perrson), and I've been listening to your podcasts for the last year. I have found them to be stimulating, thought-provoking, often really humorous but above all enormously helpful in helping me journey with other people. I have just embarked on counselling training and would love to steer myself down the same avenues as my friend Andy. I'd also like to use your methodology at a later date. In the meantime, I have a question for you. I am conscious that almost all of your work now is done on a free, pro bono basis. I think that would be my preference as well especially as I have managed to cover the economics of life from other things and it would remove any feeling of conflict, or ambiguity around my motivations in helping people. But, I am also aware that there are so many advantages in there being a financial commitment from clients. Sadly, things that are free and that spring from generosity are not always valued by the recipient, things like commitment and timekeeping become relaxed. It can be awfully irritating for the therapist (a bit like making someone a cup of tea and them not drinking it), and probably a waste of time for the client. A bit like the example you often give around the outcomes for clients who don't do homework. I would be very interested in your view on this and on balance whether it is better to charge or not charge for treatment, in the scenario where a therapist does not have a desire to charge. David comment: I think the word "therapist" in the line above was supposed to be "patient." I hope that makes sense. Thank you again to you and Rhonda for all your hard work. Kind regards Brad Askew (Bristol, England) David's Reply We can reply live on the podcast. The thrust might be that you can make patients accountable even if you treat them for free. What's the difference between Feeling Great vs Feeling Good? Dear Dr Burns, First of all, thanks for the great work that you do and also all the podcasts you did, I am planning to order a copy of Feeling Great, your

Today's podcast features Dr. Peter Spurrier, a British physician who has founded TEAM-UK. Peter describes how he spent most of his career as a physician in general practice, but was forced to see patients for only ten minutes due to the British health system. He didn't like the "quick fix" approach to patients with emotional struggles, and at the age of 55, five years before he retired from General Practice, he decided that he wanted to do something more meaningful, so he began to get training in CBT which "helped me listen better." However, CBT seemed stilted, and the outcomes weren't very good, either. Then he attended a two-day "Scared Stiff" workshop I presented in London several years ago. The workshop was sponsored by my friend and colleague, Jack Hirose, from Vancouver, Canada. I was not aware that Peter was in the audience, but was really happy to hear that he like the workshop. I had been pretty disappointed in it, since the attendance was light and I ran into quite a bit of resistance from the audience. This was a huge surprise, since I thought they'd be eager to hear about all the improvements we'd made in traditional "Beckian" CBT. At the workshop, Peter purchased my Therapist's Toolkit, but said "it just laid on my shelf for two or three years. Then, he began using it and decided to focus on TEAM-CBT full time. He began listening to the Feeling Good Podcasts, starting from #1 and eventually caught up. He says that "along the way, I learned by practicing the techniques I was hearing about." He says he has always been a critical thinker, and initially was dubious about the T = Testing part of the TEAM treatment model. As a GP, he was required to use questionnaires for patients with anxiety and depression, but for some time he thought it wasn't very accurate data. When he started using the Brief Mood Survey, he was shocked as he began to realize that this WAS good data, and that his reading of how his patients felt was frequently off-base. This, of course, is the foundation of the TEAM-CBT model, which is entirely and intensely data-driven. Then he attended one of my four-day summer intensives at the South San Francisco Conference Center, and loved the warm and encouraging atmosphere, commenting on the friendliness and encouragement of Rhonda, whom he met, and Dr. Angela Krumm, from the Feeling Good Institute in Mountain View, California. They both reached out to him. He said it was actually great to get the chance to work with people, and he was delighted by a demonstration I did on public speaking anxiety and social anxiety, which captivated the audience. After the intensive, Peter returned to London and founded TEAM-UK. He also looked up Dr. Stirling Moorey, who I'd mentioned in my first book, Feeling Good. I have also mentioned Stirling in numerous workshops, especially when teaching therapeutic empathy. Although Stirling was my student, I learned a great deal from him, especially in the area of empathy. Peter described an outstanding chapter on empathy, written by Stirling in a book he has co-edited with Anna Lavender entitled The Therapeutic Relationship in Cognitive Behavior Therapy. I got excited to hear this and hope we can feature Stirling on a podcast one day soon! I would love to hear about his journey since we first worked together more than forty years ago, when he was just a medical student. His particular interest has been the application of CBT to life threatening illness and adversity. He was one of the first therapists to develop CBT for people with cancer and is co-author, with Steven Greer, of The Oxford Guide to CBT for People with Cancer. I got excited to hear this and hope we can feature Stirling on a podcast one day soon! I would love to hear about his journey since we first worked together more than forty years ago, when he was just a medical student. Peter wrote an article on TEAM-CBT for the newsletter of the British CBT group entitled "CBT Today." He got zero response for several months, and then heard from Derek Reilly who uses TEAM-CBT in the treatment of pain patients. And, slowly, others began to join Peter's TEAM.CBT.UK group, and now there are 25 to 30 members. Click here if you'd like to see the current edition of the Feeling Good UK newsletter! Peter also talked about the visit that Rhonda recently paid to the UK and TEAM UK's first in-person meeting, at Oxford University. "It was such a great pleasure to meet and spend time with Rhonda. She formed strong connections with the group, which we hope will endure for years to come". Rhonda on her visit to the UK TEAM group at Oxford University. We discussed the resistance to change that we sometimes run into among mental health practitioners. Peter said, "It's often quite hard to get people to change their ways, and organizations are not always that flexible, either." One of the things that drew Peter to TEAM-CBT was the fact that it offered a way to embrace the best from various approaches to CBT. This is a phenome

Today's podcast features an esteemed colleague and beloved friend, Dr. Angela Krumm, who will describe her personal victory over a recent weight gain. We will illuminate the TEAM-CBT techniques she used so that you can use them yourself if you'd like to lose some weight. But I have to warn you that you have to do these techniques using paper and pencil. If you try to learn and use them just from listening, they will not be effective. As an aside, if you go to my website, www.feelinggood.com, you'll find a free chapter offer at the very bottom of my home page. If you click on it, you'll receive two unpublished chapters from my most recent book, Feeling Great, with crystal clear instructions on the methods you'll learn about in today's podcast. Angela's biosketch goes next, including how she joined David's Tuesday training group when she was a post-doctoral fellow in clinical psychology and how she ultimately developed the TEAM-CBT certification program at the FeelingGoodInstitute.com. Hopefully Angela can help with this paragraph! As the podcast begins, Angela explains how she's always viewed herself as a very fit, health-conscious woman who actually completed some marathons in the past. But during 2021, her life has been complicated by a number of tragedies and traumas, including: Angela's father was sadly diagnosed with terminal cancer and died within four months. Angela had many personal injuries that impacted her capacity to exercise, including a laceration of her retina and a fractured toe. In addition, she fell backwards over a ledge in her backyard and plunged eight feet. She sustained a concussion and experienced many lingering symptoms for 6 to 8 weeks including dizziness, brain fog, and sensitivity to light. She described what happened next like this: All this time my weight kept creeping up. I stopped caring about exercise, and during the COVID crisis, food become a joy and an escape. Then, I had a wake-up call, an ah-ha moment when everything suddenly changed. Angela described attending a wedding, and her husband was the photographer. When she saw herself in the photos, she was shocked that she no longer recognized herself because of the weight she'd gained. She also noticed that the day of the wedding, she'd eaten six huge but delicious chocolate chip cookies that her niece had baked. She says, It hit me, and I didn't have to think twice. There's a history of diabetes in my family, and I didn't want to keep gaining weight and struggle with all the medical complications of type 2 diabetes. I want to be healthy and fit so I can live to an old age and enjoy my children and grandchildren! She used behavioral and TEAM-CBT skills to tackle the problem, starting with setting specific goals for herself. She said that lots of her patients who are overweight have vague goals, like "I want to lose some weight" or "I want to get in shape," but general goals won't be effective. In TEAM, you always focus on something specific. Angela explained the critical difference between Outcome Goals and Process Goals. An example of an Outcome Goal would be telling yourself that you want to lose ten pounds or whatever your goal might be. There's a big problem with Outcome Goals. You might go on an extreme, like fasting or eating very little, so you can lose weight fairly quickly. Then you will feel happy and tell yourself that you're done when you've achieved your goal. The big problem is that you haven't modified your eating habits, and that's exactly why you will quickly gain back all that weight you temporarily lost. Process Goals are different. Instead, you focus on the number of calories you can eat each day in order to lose weight, and then you make wise food choices within your calorie limit. In addition, you start out with a gentle but consistent exercise regimen, and then you slowly build up to more exercise. Angela started with two workouts per week and built up to four weekly workouts over time. She also set modest and realistic goals for weight loss, setting a calorie limit that would allow her two lose weight slowly, at the rate of just ½ pound per week. This plan has allowed her to lose 21 pounds, and she was looking terrific today! She has been using a free app called Lose It which provides her with all the information she needs for tracking calories bd weight, along with her BMI (Body Mass Index). She's now on a maintenance diet of 1800 calories per day and she's really pleased with it. We also illustrated several powerful motivational TEAM-CBT techniques, including: The Triple Paradox. You divide a piece of paper into three vertical columns where you list Advantages of your habit / addiction: First, you list all the GOOD reasons to continue with the status quo of unlimited eating and little or no exercise. Disadvantages off change: Next, you list all the negatives and hassles associated with dieting and exercise. Core values: Finally, you list what your overeating and slacking on exercise shows about you

The featured photo shows Dr. Carly Zankman at the Big Sur with her 8 month old nephew, Micah October was Pregnancy & Infant Loss Awareness Month. We are dedicating this and last week's podcast to all the mothers and fathers who have lost infants or struggled with pregnancy complications and tragedies. This will be the second of two podcasts featuring a live therapy session with Dr. Carly Zankman, a courageous young psychologist. Dr. Zankman has been struggling with the aftermath of a traumatic ectopic pregnancy and some intense fears that she may never get the chance to be a mother. In addition, she is 100% convinced that she can never feel happy or fulfilled in life unless she becomes a mother. Last week, we featured the first half of her session with Dr. Jill Levitt and me at one of our Tuesday Stanford training groups. If you have not yet heard part one, you can link to it (podcast #268) at the list of Feeling Good Podcasts on my website. In this podcast, you will hear the conclusion of our work with Carly. We are also delighted that Carly could join us in person today to tell us what has transpired since the end of her session some months ago. You can see Carly's Daily Mood Log (DML) and Brief Mood Survey (BMS) at the start of the session as well as her Brief Mood Survey and Evaluation of Therapy Session at the end of her session. You can also review her completed Daily Mood Log so you can see her final mood ratings along with how she challenged each Negative Thought. There were a number of teaching points in Carly's session: Depression nearly always results from telling yourself, and believing, that you have lost, or don't have, something you believe you "need" in order to feel happy and fulfilled. It could be something internal, like greater intelligence or talent, or something external, like a baby, or a family, or greater wealth or status. There is a difference between a high-level and a low-level solution to most depression. In a low-level solution, you find happiness by getting what you want. For example, you learn that you are pregnant, or that you got an important promotion at work, or that someone you're attracted to has accepted a date with you. In a high level solution, you discover that you can feel happy and fulfilled without the thing you were so certain that you "needed." Although therapeutic empathy alone has limited healing powers, it can be absolutely precious and essential. Sometimes, people have a desperate need to be heard and given the space to express their feelings and to be accepted. In addition, people who have experienced a traumatic event or series of events often need the time to describe their experiences in detail. This can function like exposure, allowing the anxiety to diminish. Therapy without a meaningful agenda is highly likely to fail. And sometimes, a therapist has to "sit with open hands," even when the patient's agenda may be a bit different, or even radically different, from you own. Our task is not to force the patient to conform to our standards and expectations, but to help the patient find happiness on their own terms, pursuing their own goals. The Downward Arrow Technique was helpful and revealing during the Empathy phase of the session. This technique allowed us to pinpoint Carly's core belief, which was also a Negative Thought on her DML: "I'm never going to feel fulfilled in life without children." It is okay for therapists to struggle with, and discuss, moments of confusion or uncertainty during a session. This type of dialogue can involve the patient and can often help you find your path forward. There were some additional steps that could have been taken but we were limited by time. For example, we could have explored the interpersonal dimension of how to enhance the communication of feelings between Carly and her husband, as well as between Carly and other family members. She sometimes feels ignored and hurt. This problem is exceptionally common and can be addressed with tools like the Relationship Journal, the Interpersonal Downward Arrow, and the Five Secrets of Effective Communication. However, this can take some time, and also requires an agenda for the patient to be willing to examine his / her role in the problem and practice some new communication skills. Our negative feelings always result from our thoughts and beliefs, and not from the actual events in our lives. However, sometimes patients can be extremely fixated on certain beliefs that trigger their pain and may even put up a powerful wall to protect those beliefs. This is human nature, and part of what makes the job of therapy incredibly challenging, fascinating, and rewarding. We are all extremely grateful to Carly for her courage in sharing this intensely personal part of her life with us. She received, as you might imagine, incredibly support from all the members of the training group during and after her session, as others had struggled with similar fears as well. You can find her Bri

The featured photo shows Dr. Carly Zankman at the Big Sur with her 8 month old nephew, Micah Podcast #268 : An Ectopic Pregnancy (Part 1 of 2) October was Pregnancy & Infant Loss Awareness Month. We are dedicating this and next week's podcast to all the mothers and fathers who have lost infants or struggled with pregnancy complications and tragedies. This will be the first of two podcasts featuring a live therapy session with Dr. Carly Zankman. Dr. Zankman, a 27 year-old clinical psychologist in our Tuesday training group at Stanford, is facing a serious crisis involving motherhood. She is struggling with the aftermath of a traumatic ectopic pregnancy and some intense fears that she may never get the chance to be a mother. In addition, she is 100% convinced that she can never feel happy or fulfilled in life unless she becomes a mother. The featured photo for this podcast is Dr. Zankman at the Big Sur with her 8 month old nephew, Micah. You can see the love and joy in her face, and her intense desire to become a mother herself. The session took place at my Tuesday training group at Stanford, and my co-therapist was Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California. You can see Carly's Daily Mood Log (DML) and Brief Mood Survey (BMS) at the start of the session The DML reflected her feelings several weeks before, when she felt that her chances for pregnancy were greatly diminished, and the BMS reflects how she was feeling at the beginning of our session. As you can see, she was still moderately depressed and anxious, and her happiness and marital satisfaction scores were quite low, indicating that she was unhappy and somewhat dissatisfied with her relationship with her husband. Carly was also anxious about being on the podcast, due to these additional negative thoughts: I'm not going to be able to describe what I've been through. She believed this 70%. There's a potential to be judged by people. She believed this 100%. In today's podcast, you will hear the T = Testing and E = Empathy portions of the session, and in next week's podcast you will hear the A = Assessment of Resistance and M = Methods portion of the session, and hopefully Carly will be able to join us for a follow-up to see how she's been doing since the session. The show notes for next week's podcast will include eight teaching points. Rhonda Jill and I are all extremely grateful to Carly for her courage in sharing this intensely personal part of her life with us. She received, as you might imagine, incredibly support from all the members of the training group during and after her session, as others had struggled with similar fears as well. Thank you for listening, David, Rhonda, Jill & Carly

Hi everyone! This podcast offers specific help to LGBTQ individuals who are under attack from loved ones who might judge them and criticize their sexual orientation or gender identity. Plus, we all get slammed at times by people who judge us for all sorts of reasons, which can be immensely painful, so most of today's discussion will apply to people more broadly. I recently received a great email from Heather Donnenwirth, a therapist in Ohio who works with LGBTQ individuals. She mentioned that some of her patients struggle with how to respond to critical or judgmental statements from loved ones, including parents, and provided several examples: "Being Gay is wrong/a sin" "If someone doesn't know if they are a man or woman, then something is messed up in their head." "We are worried that you are going to go to Hell for your lifestyle." "We don't want your partner at our house, and we don't want to see any displays of affection." Heather wanted to know how one might use the Five Secrets of Effective Communication to respond to these kinds of criticisms. I invited her to join us in the podcast, and she wrote: I was excited about this topic. Thanks so much for including me. David's work has improved my life in so many ways and Rhonda's Wednesday TEAM training group has been a wonderful way to practice my TEAM skills and improve the kind of care I can offer patients. I appreciate and admire you both so much!! Also, I can't wait to meet Kyle!! I also invited the brilliant and wonderful Kyle Jones to join us. Kyle is a TEAM therapist who joined my training group in 2016 before ever seeing a patient! He is completing his PhD in clinical psychology at Palo Alto University and his dissertation research focuses on psychologists who provide mental health treatment to LGBTQ people. Kyle joined us in 2018 for a FB Live TV program on dating and flirting strategies (https://feelinggood.com/2018/06/17/dating-strategies-today-on-fb-live-sunday-june-17-2018-at-3-pm-pst/) and in 2019 for Podcast 151 on treating LBBTQ individuals with TEAM (https://feelinggood.com/2019/07/29/151-working-with-lgbtq-patients-whats-the-team-cbt-approach/). During today's podcast, we used the excellent statements that Heather provided in role-playing exercises with the Five Secrets of Effective Communication. We used the Intimacy Drill that I developed, which is by far the best way to master the Five Secrets. We also discussed the issue of the inner dialogue that always accompanies the outer dialogue with the person you're in conflict with. If you get anxious, depressed, and angry when criticized, it will be much more difficult to use the Five Secrets skillfully, because you may feel defensive and resentful and inadequate. So some work with the Daily Mood Log may also be invaluable before trying to use the Five Secrets. Finally, we discussed the question of "Outcome Resistance." This means asking yourself if you WANT to develop a more loving relationship with a loved one who is being highly critical of you because of your sexual orientation, or for any other reason. We decided it is perfectly acceptable to decide NOT to try to develop a more loving relationship, if that feels better to you. It may even be in your best interest or help keep you safe from harm if you're an LGBTQ person facing discrimination and persecution because of your sexual orientation or gender identity. I explained my own anger toward my father who was a successful Lutheran minister. However, when he retired from his ministry at the Shepherd of the Valley Lutheran Church in Phoenix, Arizona, he began working with gay individuals at the Arizona State University, trying to convert them to a heterosexual orientation. This was profoundly disturbing to me, I felt a great deal of shame and anger, and it ultimately led to a sad rupture of our relationship. Rhonda, Heather, Kyle and David

266: Ask Matt, Rhonda, and David: Can we solve the pain in the world? How can we deal with someone who might weaponize our vulnerability? What can I do about my emotional eating? And more! Today's podcast features awesome questions from viewers like you, with answers from Rhonda, David, and our brilliant guest expert, Dr. Matthew May. Here's the list of questions, followed by partial answers (prepared prior to the podcast) from David. Ezgi Asks: Is there any way to solve pain in the world? Some people are committing suicide because they don't wanna suffer anymore. Is there any way to "finish" the suffering while we are still living in this world? Megan asks: Hi David, I was wondering what your thoughts are about using the five secrets when in communication with someone who may not be coming from a place of love or respect, or someone who might weaponize your vulnerability, such as someone with narcissistic tendencies? Telia asks: Could you please do another episode on compulsive emotional eating? I have suffered with this my whole life. Daniele asks: What "upsetting event" should I put at the top of my Daily Mood Log? Does it have to be the event that triggered your depression? Anca asks: Should I work on a different upsetting event every day and do a Daily Mood Log? What about the days when I don't have any distorted negative thoughts? Oliver asks: Dear Dr. Burns, How much time do you require your patients to spend on their daily psychotherapy homework (Daily Mood Journal)? What is overkill when doing Positive Reframing? Sarah asks: Hi Doctor Burns! Your podcasts have been so helpful! I want to know what you would have said to the husband, in this episode, if he were the one that came to you, first, about the marriage.(By way of explanation, Sarah is referring to an episode on the Five Secrets where the wife was blaming her husband for saying, "You never listen" for 25 years, and was shocked to discover that she was causing the very problem she was complaining about.) * * * Ezgi Asks: Is there any way to solve pain in the world? Some people are committing suicide because they don't wanna suffer anymore. Is there any way to "finish" the suffering while we are still living in this world? Thanks, Ezgi, I will read and answer this on an upcoming Ask David. I have committed my life to helping people who ask for help with depression, anxiety, and other problems. I do not evangelize or reach out, trying to convert people to some new way of thinking and feeling. Also, I only work with people one to one, (or in groups), and I think healing must begin with yourself. There are tons of free resources on my website, plus my books, like Feeling Good, and others, can be invaluable, including on the topic of suicide. You can get used copies inexpensively on Amazon, too! All the best, david * * * After Hearing Podcast 14 on the Five Secrets Megan asks: Hi David, I was wondering what your thoughts are about using the five secrets when in communication with someone who may not be coming from a place of love or respect, or someone who might weaponize your vulnerability, such as someone with narcissistic tendencies? Thank you, I appreciate you and all you do to make the world a kinder and gentler place. David's Response Hi Megan, Please provide a specific example. What did the other person say, and what, exactly, did you say next. One exchange is enough. Then we can do something amazing, and not just BS on an abstract level that will be useless. You see yourself, based on your note, as the sweet innocent victim of the other person's "badness." Once we have a specific example of an interaction that did not go well, and you focus on your own role, things will suddenly fall into a shockingly different perspective. david Will include this in an Ask David. * * * Telia asks: Hi David, Thank you so much for your free information and podcast #155 on emotional eating. Could you please do another episode on compulsive emotional eating? I have suffered with this my whole life. I listened to episode 155 but I need more help like actual questions to ask myself or tools to use in the moment. I have suffered with this my entire life, and I know with your help I can be free from it. Thank you Telia from Australia David's Response Hi Telia, Check out the free chapter(s) offer on bottom of my website home page. Full instructions are right there. Feel free to contact me if any questions after following the guidelines there, and doing the exercises on paper. d * * * Daniele asks: What "upsetting event" should I put at the top of my Daily Mood Log? Does it have to be the event that triggered your depression? Hello Dr. Burns, i am reading your second book, Feeling Great. The first one, the new mood couldn't help me or i couldn't get it done right. And now i am trying Feeling Great. I like the book and your thoughts. I have struggled with anxiety and depression since 2014 - on and off. Lately more on.... My biggest problem with the exercise is that