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

238: Feeling Great Book Club Featuring Drs. Sharon Batista and Robert Schacter In today's podcast, Drs. Sharon Batista and Robert Schacter describe their visionary 16-week Feeling Great Book Club for mental health professionals that we mentioned in a podcast several months ago. The group was a great success, and I am super thankful to them for creating it! Sharon described how the group came into being. She'd been looking forward to Feeling Great and ordered the hardbound and the audio version as well. But she found, like so many mental health professionals, that it is difficult to keep up with career and family, and sent out a post to colleagues suggesting a possible book group to make the process of learning easier. Bob wrote back and said, "What a brilliant idea! Let's do it!" Sharon and Bob reported that the more than 40 therapists signed up for the Book Club, which consisted of 90-minute sessions every other week. The participants ranged in experience from Level 1 to Level 4 certification in TEAM-CBT. Sharon explained that "People liked learning the parts of TEAM piece by piece. Being assigned to read 1 chapter per week gave them enough time to read and digest the material in small chunks. And people had a myriad of questions at every group." Sharon and Bob graciously said that "a highlight for the group was the time David attended and generously gave us over two hours for Q and A." For me (David) it was also a peak experience. Due, in part, to my narcissism, I just love answering questions, and they asked tons of really good ones! The other phenomenon they described was that "we became a group. It was comforting to see each other every two weeks with a common purpose and sense of community. People felt the group was relaxed and said they gained more understanding than from the training groups they'd been in. People were relieved to discover that they weren't the only ones who thought TEAM-CBT was very complex." Sharon added; "As therapists, we face lots of challenges and sometimes make mistakes. The participants got a lot of support and engaged in a process that involved learning and personal growth." The questions from book club members began with clarifying the descriptions of the ten Cognitive Distortions. People asked questions like these: What is the difference between Overgeneralization and Mental Filtering? Why is a Should Statement a cognitive distortion? Why do some methods work better than others for various distortions? How do we know which ones to use? What is Unconscious Resistance? Why does the therapist need to become the voice of that resistance? What do you do when nothing seems to be working? Can you explain how the Magic Button leads to the "Switch" that makes someone decide to get better. How do you show empathy to someone who is suicidal? Can you explain the Death of the Ego? (This was a big question) When you are dealing with the spiritual side, how do you take the path of acceptance? What is the path of acceptance? What is the difference between a low-level and high-level solution? How can you be happy if the negative thoughts are true? How can you do TEAM-CBT when only 50-minute sessions are possible? Tell us what Enlightenment is! A major question was: Why do some people seem to not want to get better? How do you figure out what the resistance is, and how do you work through it? We shot the breeze about some of these questions in today's podcast. If you would like to start your own Feeling Great Book Club for therapists or for lay people, and need more information, feel free to contact Sharon or Bob. Sharon M. Batista, M.D., FAPA, FACLP, FAMWA Medical Director, Balanced Psychiatry of New York (212) 869-0515 [email protected] Rhonda and I want to thank both of them and send them a big virtual hug!

Podcast 237: The Gentle Ultimatum: Can We Make Our Patients Accountable? April 12, 2021 At the top of the podcast, Rhonda reads several beautiful and thoughtful comments from listeners like you. One was an enthusiastic listener who found us on YouTube and wondered why we don't have vastly larger audiences, since the quality of what we offer is not only free, but it beats out all the other "self-help gurus" by a large margin. Thanks for that. We are not experts in market and could use all the help we can get. So if you can spread the word for us, we'd appreciate it! David announced that his next workshop with Dr. jill Levitt will be on May 16, 2021, featuring David and Dr. Jill Levitt working with two audience volunteers who are struggling with depression and anxiety. Link to Registration Information It should be dramatic, inspiring, and profoundly educational, so you can see how TEAM-CBT really works in a live and spontaneous setting with no role-playing. This will be the real thing! One of the unique features of TEAM Therapy is the Gentle Ultimatum. At the beginning of therapy, we tell patients what will be required of them, and how the therapy works, if we accept them as patients. That way, they can make an informed decision about whether or not they want to work with us. This table illustrates what they'll be asked to do. Problem What the "Gentle Ultimatum" involves Rationale Depression Psychotherapy homework David's published research indicates that psychotherapy compliance has massive causal effects on recovery from depression. Anxiety Exposure Extensive research shows that Exposure is effective in the treatment of all forms of anxiety. Clinical experience indicates that full recovery from depression is difficult, if not impossible, without exposure. A Relationship Problem Giving up blame and focusing on your own role in the problem Research and clinical experience indicate that blame is probably the main cause of troubled relationships. In the podcast, David and Rhonda discuss the rationale for the Gentle Ultimatum, as well as how to do it skillfully, and when. David describes his own reluctance to make patients accountable during the first seven or eight years of his practice, and what happened to change his mind, and how that led to the emergence of TEAM-CBT. David also describes the correct and incorrect way of presenting this to patients at the initial evaluation in a kindly, collaborative way. This requires therapist integrity, skill, and compassion. You cannot simply issue a crude "my way or the highway" demand. David also describes the Concept of Self-Help Memo that he created and began sending to patients prior to their first visit. The memo explains the rationale for requiring psychotherapy homework, briefly describes the ten most common forms of homework, and asks patients if they are willing to do homework if accepted into the clinical. The memo also asks how many days per week they'll agree to, how many minutes per day, and how many weeks she or he will keep it up. The memo concludes with a list of "35 GOOD Reasons NOT to do Psychotherapy Homework," and patients indicate how strongly they agree with each one. David illustrates how he discusses the memo, and the topic of homework, with new patients. David compares the Gentle Ultimatum with what happens when you go to the doctor with a broken leg. He or she might say you have to get an X-ray, and then we'll give you a cast. If they patient protests and says that she or he is against X-rays and casts, and wants to be treated with "talk therapy," the doctor would politely decline and explain that s/he is using a medical model of treatment, and that "talk therapy" is not offered for broken limbs. David and Rhonda explore the fairly intense resistance of many, and perhaps most therapists to making patients accountable. Rhonda describes her own inner fight about this, and how she had to terminate a patient recently because s/he refused to do homework, and opted for pure "talk therapy" from another therapist instead. The table above indicates that if the patient is struggling with anxiety, Exposure is the focus of the Gentle Ultimatum. If the patient wants effective treatment, Exposure will be required, and not an option. If, in contrast, you want help with a relationship problem, like a troubled marriage, you will have to agree to stop blaming the other person, and focus on pinpointing your own role in the problem, which can be immensely painful and humiliating. But it's also liberating, because when you change yourself, instead of blaming the other person, you can transform trouble relationships into loving ones. Rhonda points out a potential conflict of interest with TEAM-CBT and the Gentle Ultimatum. It can lead to such rapid recovery that therapists need a large flow of patients. David mentions that one of the therapists in Rhonda's FeelingGreatTherapyCenter.com, Sunny Choi, has this exact problem. His patients are getting better so fast he c

Upcoming Workshops The Cognitive Distortion Starter Kit With David Burns, MD A One-Day Workshop on May 5, 2021 Click here for more information including registration! 8:30 AM to 5:00 PM West Coast Time: 7 CE Credits Bringing TEAM-CBT to Life in Real Time Two Live Therapy Demonstrations with Drs. David Burns and Jill Levitt REGISTRATION CLOSES AT 5:30 PM PACIFIC TIME ON SATURDAY 5/15/21. NO EXCEPTIONS. Live Online Workshop with David Burns, MD and Jill Levitt, Ph.D. Click here for more information including registration! May 16, 2021 | 7 CE hours. $135 8:30 AM to 4:30 PM West Coast Time Binoy asks: How does one know that a thought is a good one or a bad one? Or put in another way, how do I know if my fortune telling thought is really a fortune telling one? What is the basis? Binoy also asks: Is there something called "objective truth" that we can all agree on? Kristina asks: I have been labeled codependent in therapy. Is it a true label? . . . Do you believe in highly sensitive or empathetic people that can feel others energy? Fabrice asks: What do you think about this definition of the "self?" Don asks: Is TEAM as effective as you say? Binoy asks: I live in an Arab country and some of the things on your list of Shame-Attacking Exercises could get me arrested. Is there a better way to overcoming anxiety? * * * Binoy asks: Hi David, I just listened to podcast 079: "What's the Secret of a "Meaningful" Life? Live Therapy with Daisy." One of the questions that came across my mind is, how does one know if a negative thought is a good one or a bad one? Or put in another way, how do I know if my fortune telling thought is really a fortune telling distortion? What is the basis? Hi Binoy, thanks! Excellent question I might address on a future Ask David podcast. However, I would need you to give me a specific example of a thought you want help with. Specifics typically lead to illumination, whereas abstract thoughts sometimes lead to endless pontification. Binoy also asks: "Hi David, I did listen to the podcast #20 on "The Truth About Antidepressants." I wish everyone agreed that there is something called objective truth. This is a question about truth or the existence of objective truth. Is the popular ideology that there is nothing called objective truth (everything is relative) correct? How can we talk about truth in a way that will help us be on the same page? So, I hope to hear from you again! Hi Binoy, this is also an abstract question, best answered through specific examples. For example, I can explain the concept of controlled outcome studies to test a drug against placebo, but even there you can find lots of ways to challenge any scientific study. We can also talk about distorted negative thoughts that trigger negative feelings like depression and anxiety. These thoughts are not really true. but we always focus on one specific thought at a time, and only from someone asking for help. I do not pontificate about "truth" in some abstract sense! All the best, david * * * Kristina asks: I have been labeled as codependent in therapy. Is it a true label? Hi Dr. Burns, Thank you so much for all your services and help that you offer Dr. Burns. It has been life changing and I'm just starting to help myself out of this anxiety and depression. I wanted to ask how you feel about the terms, codependency and boundaries. I have been labeled codependent in therapy and is it a true label? Do you believe in highly sensitive or empathetic people who can feel others' energy? Thanks again for all you do! Thank you, Kristina Hi Kristina, I had to look up the term. According to dictionary.com, someone who is codependent "is in a relationship in which one person is physically or psychologically addicted, as to alcohol or gambling, and the other person is psychologically dependent on the first in an unhealthy way." David and Rhonda can mention: the "codependency" and compulsion to "help" or "rescue" that often gets therapists into trouble with patients. This is a kind of addiction that therapists have, and is the main cause of therapeutic failure. that I work with specifics more than labels. For example, if a patient wanted help with "codependency," I would ask him or her to describe a specific time on a specific day when this seemed to be a problem. Then I'd figure out what was going on, and find out if it was an individual mood problem or a relationship problem. After empathizing, I would find out what, if anything, the patient wanted help with, and then I'd bring the resistance to change to conscious awareness. My research on empathy indicates that even therapists are not accurate in sensing how their patients feel. The same is true, I believe, of the general public. People vastly overestimate their capacities to understand how others are thinking and feeling, and this is super easy to demonstrate with simple experiments using rudimentary statistical analyses. David * * * Fabrice asks. What do you think about this definition of the

235: Anger in Marriage Several months ago. a professional dancer named Brian emailed me with an Ask David question on how to deal with anger in marriage using the Five Secrets of Effective Communication. I was pretty excited because anger in marriage is a problem nearly everyone can identify with, and something we all need some help with! Brian and his family Brian said that he and his wife, Michelle, have been married since 2009, and while he loves Michelle a great deal, their relationship runs hot and cold, with frequent angry clashes. I asked Brian for a specific example, including a partially filled out Relationship Journal (RJ), so I could get some details on what his wife said to him, and what, exactly, he said next, during one of their conflicts. Brian and his wife, Michelle The analysis of this exchange will provide us with a crystal clear example of the type of problem they are struggling with, along with the opportunity to pinpoint the specific errors Brian is making in responding to his wife's criticisms. In the example he sent, she said that he wasn't doing enough to help put the kids to bed one night, and he responded by saying nothing. He analyzed his response with the EAR technique from my book, Feeling Good Together. By ignoring her, it was obvious that failed on E = Empathy (he did not acknowledge how she felt), and A = Assertiveness (he did not share his feelings), and on R = Respect (he did not express any warmth, respect, or love for her.) He was able to see that this response will make the problem worse and force her to keep criticizing him. When he ignores her, she feels even more hurt, ignored, abandoned, and unloved. As a result, she'll keep criticizing him since he hasn't yet listened or "gotten it." So although he feels like an innocent victim, he's actually the secret creator of his own interpersonal reality. In other words, he forces her to do the very thing he's complaining about. That's the purpose of the Relationship Journal (RJ) —to help you see your own role in a conflict. It's an amazing but pretty painful tool that's potentially liberating. At my urging over the past several months, Brian worked really hard studying the Five Secrets of Effective Communication (LINK) and doing the written exercises in Feeling Good Together. After a rocky start, with some notable failures in his attempt to improve his interactions with his wife, he slowly began to "get it," and their relationship began to improve a lot. Brian joins us today to describe his journey, and share his excitement about my first book, Feeling Good, as well as Feeling Good Together. I am really proud of what Brian has accomplished through commitment, practice, and hard work, as well as his courageous willingness to look at his own role in the problem. This is nearly always painful, and requires the "great death" of the "self," or "ego." During today's podcast, we practiced with the "Intimacy Exercise." This exercise can help you improve your skills with the Five Secrets. Here's the way it works. To get things started, either Rhonda or David will play the role of Brian's wife, and Brian will play the role of himself. We will criticize Brian in the way his wife sometimes criticizes him, and then he will respond, using the Five Secrets. For example, she recently said: "When I was on the phone with my best friend, you were rude and selfish, and making too much noise with the video you were creating." Then he responded and we gave him a grade, and pointed out what he was doing right and what he was doing wrong that needed improvement. If you check your ego at the door, this can be a great, but challenging, way to learn! Brian gave himself a C on his response, which you'll hear in the podcast, and Rhonda agreed. She also gave him a C. I gave him a B, as I thought he did some pretty cool things while making several errors. Here's where he needed improvement. His use of the Disarming Technique needed upgrading. He didn't strongly and directly endorse the truth in his wife's criticism. For example, he might say something like this: "You're right, I was being insensitive and selfish, and I've done that to you so often over the years." His response would benefit from the inclusion of some "I Feel" Statements," since it sounded a bit mechanical. For example, he might say, "I feel really sad and ashamed to hear you say that I was selfish and insensitive, because you're absolutely right, and I love you so much." There was no Stroking, and I included one way to do this in the "I Feel" response I just described. His Thought Empathy was good, but there was no Feeling Empathy. In other words, he did not mention how sad, hurt and angry his wife might be feeling. He did not finish with a sound use of Inquiry that would invite his wife to open up even more. For example, he could end by asking her to tell him more about how she feels when he's being insensitive and selfish, and how hurt, angry, and lonely she might feel. Brian was non-def

Announcements / Upcoming Workshops March 24, 2021 Feeling Great: A New, High-Speed Treatment for Depression and Anxiety. A One-Day Workshop by David Burns, MD. sponsored by Jack Hirose & Associates, Vancouver Click here for more information including registration! April 7, 2021 Bringing TEAM-CBT to Life in Real Time, by David D. Burns, MD. A Half-Day Live Therapy Demonstration Sponsored by Jack Hirose & Associates, Vancouver Click here for more information including registration! * * * Podcast 234: How To Deal with Whiners and Complainers In today's podcast, we bring to life two of the earliest CBT techniques I developed way back before I wrote Feeling Good: The New Mood Therapy. The are: The Anti-Whiner Technique The Anti-Heckler Technique they are both based in two of the Five Secrets of Effective Communication: The Disarming Technique: You find truth in what the other person is saying Stroking: You find something positive to say to the person In addition, if appropriate you can include Feeling Empathy, especially in the Anti-Whiner Technique. This means that you acknowledge how the other person is feeling The Anti-Whiner Technique Most of us know someone who tends to whine and complain a great deal, and you might have noticed that when you try to help them, cheer them up, or give them some advice, their whining and complaining just escalates, so you end up secretly frustrated and annoyed. If you're tired of this pattern, you might want to try the Anti-Whiner Technique, which can be incredibly effective, but it's anti-intuitive. You simply agree with the person who's complaining, and give them a compliment. Rhonda and David will illustrate this with complaints like these: Nobody cares about me! I never get to do what I want to do. Nobody likes me. I never get invited anywhere. I never get to do anything fun. I've tried everything and nothing seems to help. All the doctors just seem to care about themselves. Nobody listens to me! Life is unfair. People only care about themselves I have to do everything for myself. Nobody helps. I can't hear very well, my sight is deteriorating, and I've got hemorrhoids! What can I do? Preparation H doesn't help at all! My students just don't listen. This younger generation is totally screwed up! Nothing helps! I'm depressed all the time. I've tried everything. No one every said one kind thing to me! I've got so much to do, but I just can't get started, and everything just keeps piling up! The Anti-Heckler Technique I love treating public speaking anxiety because I used to struggle with this problem myself, but now I totally love public speaking. One of the many reasons that people fear public speaking is because they're afraid someone in the audience will become critical or hostile, or ask them something they can't answer. The Anti-Heckler Technique is fairly easy to use, and works like a charm if done skillfully. It's similar to the Anti-Whiner Technique we just illustrated. Just make a list of hostile things that the audience member from hell might say during your talk, or during the Q and A period, and then respond with the Disarming Technique plus Stroking. Rhonda and I will illustrate this with these kinds of critical comments. You're full of shit and you know it! What you're saying isn't true and doesn't make sense. You're a total fraud and a fake. You're not supposed to say that. You talk too fast. You are confusing. You don't know what you're talking about. You are not following the outline you gave us. It's too cold, too hot. You're wrong about that. You are quoting outdated research that's been debunked already. I didn't like it when you made jokes. You don't know enough to teach this class. You're disorganized, incomprehensible, and boring. You always call on the same people in the audience, you play favorites. Rhonda and David also explore why it is so hard to use these techniques in our personal and professional relationships, and why we lapse into adversarial defenses when we could collaborate with others in the spirit of mutual exploration and learning. Most of it has to do with the idea that we have a "self," or "ego" to defend! As the Buddha so often said, "Selves are cheap. Selflessness is dear!"

Phillip with his brother, (Paul), his mother (Maureen) and Ladybug (Labrador). Phillip Lolonis joins us again with vital information we forgot to explore in his first podcast two weeks ago. Phillip's interest in the treatment of schizophrenia stemmed from his relationship with his brother, who suddenly and unexpectedly developed schizophrenia when he was 19 years old. and Phillip was 26, One of his motivations to become a therapist was his anger and disillusionment with the treatment his brother received that was medication focused and somewhat formulaic. Phillip thought the impact was somewhat detrimental. In today's podcast, we explore how to use the Five Secrets of Effective Communication, and especially the Disarming Technique, in interactions with individuals with schizophrenia. This can be difficult and challenging, because many of the things the patient says are delusional and can't possibly be true, like "I know you're plotting against me!" And yet, as David points out, if you listen to the "music" behind the words, you will see that the individual is saying something that's absolutely true. He or she is just expressing feelings in a symbolic manner. And if you find the truth in what the person is saying, he or she will nearly always calm down and feel heard and respected. Rhonda, Phillip and David demonstrate this in role-playing, using statements like "You're against me!" David recalls his treatment of an angry young university student with severe paranoid schizophrenia who responded beautifully to Dr. Stirling Moorey, a (then) visiting medical student from London who was doing cotherapy with David so he could learn the then-new cognitive therapy. Stirling used the Disarming Technique when the young man insisted that the police were trying to prevent him from seeing John the Baptist who had secrets about the spiritual human of the human race. When Stirling expressed interest and found truth in what the young man was saying, there were immediate and dramatic results. David described this interaction in his first book, Feeling Good. Phillip said he's experienced similar things with his brother, and that this new way of communicating has been helpful. Rhonda commented that we've had many podcasts recently on the Five Secrets of Effective Communication. These techniques are very challenging to learn, for technical and human reasons, but incredibly rewarding if you're willing to learn them and let your "ego," or "self," die. Phillip asked us to add these comments to the show notes: I'd like to add that the place that has been a godsend for my brother and our family is called the Putnam Clubhouse he regularly attends but not during covid, it's tough on everyone especially the severely mentally ill, in terms of isolation. They do have zoom meetings and come by members' homes to deliver food and goodies during covid. It's a place that provides socialization, work, gatherings with music/poetry and outings like going to a baseball game. They are part of a larger organization world wide. This is the link to the Clubhouse in Contra Costa County. and this is the link to the international Clubhouse for the severely mentally ill Rhonda asked me the question if have I ever been afraid of my brother. That was a good question, Rhonda and I didn't answer very well. Only once in the 20 years of my brother's disease have I been afraid of him. People judge my brother as potentially violent when in fact he's terrified daily because of the violent voices towards him he hears. My brother is stigmatized by the world as dangerous when the facts state that most people with schizophrenia are preyed upon, like my brother has been over the years---people taking his money, people crossing the street to avoid him, people calling the police on him, etc. When he is upset or angry, and I respond with 5-Secrets, especially a strong "I Feel" Statement, his rage softens immediately. Your question itself, "was I ever afraid?" is a misnomer. Here's a better question: Is my brother afraid? Yes, every day he's afraid of being misunderstood, stigmatized, hospitalized by the police (5150) but mostly he is afraid of the voices hurting him. And my mother and I are afraid someone will eventually hurt him, or he will take his own life because he has stated that he has done enough over the years to defeat the voices but they won't go away. So at times he feels hopeless.

Announcements: Feeling Great Book Club We're excited to announce a Feeling Great Book Club for anyone in the world, supporting people in reading and learning from David Burns' powerful and healing TEAM-CBT book Feeling Great with questions and answers, exercises and discussions in large and small groups. It will meet online for an hour at a time for 16 weeks on Wednesdays starting March 17 at 9am and 5pm Pacific Time - which should allow for fairly reasonable hours from anywhere in the world. Note that the group is intended to provide education but NOT therapy or treatment. Cost is 8$ per session paid in advance, but people will be able to pay whatever they can comfortably afford and no one will be turned away for lack of finances. The group will be primarily led by Brandon Vance, a psychiatrist who is a level 4 TEAM therapy trainer who has studied with David Burns since 2011. Please go to https://www.feelinggreattherapycenter.com/book-club to find out more and to register. Your Book Club Teacher: Brandon Vance, MD Upcoming Virtual Workshops February 28, Self-Defeating Beliefs: How to Identify and Modify Them, a one day workshop for mental health professionals. 7 CE credits. Featuring Drs. David Burns and Jill Levitt, sponsored by FGI, Mt. View Click here for more information including registration! March 24, 2021, Feeling Great: A New, High-Speed Treatment for Depression and Anxiety. A One-Day Workshop by David Burns, MD. sponsored by Jack Hirose & Associates, Vancouver Click here for more information including registration! April 7, 2021, Bringing TEAM-CBT to Life in Real Time, by David D. Burns, MD. A Half-Day Live Therapy Demonstration Sponsored by Jack Hirose & Associates, Vancouver Click here for more information including registration! Today's Questions Brian asks: Can negative thoughts lead to high blood pressure? Thank you Jim asks: I'm having panic attacks! What should I do? Adam asks: Shouldn't we get rid of the terms, "Positive Thoughts" and "Self-Defeating Beliefs?" Phil asks: Hi David and Rhonda! Is it necessary to write out the distortions in your DML or would you get the same benefit by just plowing through with positive thoughts, realizing that your negative thoughts contain loads of distortions? Nandini asks: How do I get your Decision-Making Tool for help with habits and addictions? A man from France asks: After listening to Podcast 003: E = Empathy — Does It Really Make a Difference?: "How do we do when the person, we are having a conversation with does not feel comfortable in sharing his/her feelings and thoughts, or does not know how to deal with feelings and thoughts when hearing them? Thomas asks: What would you say to a person who wants more ego strength.? * * * Brian asks: Can negative thoughts lead to high blood pressure? Thank you Thanks Brian. I don't know the answer to your excellent question. One big problem is that much, if not all, of this type of research is of pretty poor quality. When I review research articles, my focus is not on "what are the implications of these findings," but rather on "what are the flaws in this research study?" Usually, the flaws are so severe, at least to my way of thinking, that the findings are not worth interpreting. I apologize for this answer, as it is way less exciting than speculation! On minor point would be that if you believe negative thoughts, you will experience feelings like depression, anxiety, anger, and so forth. So the real question would focus on whether elevations in negative feelings are associated with increases in blood pressure. One common phenomenon is that some people get very anxious when their blood pressure is measured, and this, it appears, can lead to temporary blood pressure elevations. So, sometimes the doctor or nurse will ask the patient to sit quietly for a little while, and will then repeat the blood pressure measurement. So, it might be the case that people who are more prone to feelings of anxiety would have more fluctuations in blood pressure. But the question then might be—are these temporary fluctuations associated with generally elevated blood pressure? I don't think they are, but I'm not up on the latest thinking on this topic. david Brian adds: David Burns Last night, I was having stressful thoughts about family and I checked my blood pressure and it was way up, so I think it does. 🙂 Cool, nice research! You can also see if changing those thoughts and feelings leads to a reduction in BP! d Dr. Burns i did and my stress lowered and so did my blood pressure Way to go, Brian! Kudos! david * * * Jim asks I'm having panic attacks! What should I do? Dear Dr. Burns, I recently bought copies of Feeling Good, Feeling Great, and The Feeling Good Handbook, and studying them has been remarkably helpful so far. Thank you for writing them! I hope this is not too forward, but I am struggling with one immediate difficulty: within the past two weeks, I have had two panic attacks that brought on heart palpitations, and i

This is the first of two podcasts featuring Phillip Lolonis, LCSW, who works with Rhonda at her new FeelingGreatTherapyCenter.com. Some of you may remember my descriptions and photos of my Sunday hikes for people in our training groups for the past ten years. Here's a photo from one my last hikes before the pandemic. Phillip is the one in red in the back row. I hope to resume the Sunday hikes as soon as people are vaccinated! In today's podcast, you'll meet Phillip Lolonis who has transformed TEAM-CBT hiking therapy into a high and exciting art form on the California trails near Mt. Diablo. Phillip is a licensed clinical social worker and Level 3 TEAM therapists who is a member of Rhonda's new Feeling Great Therapy Center in the East Bay. He describes his love for "nature therapy" and pointed out that the Buddha experienced enlightenment when meditating under a tree. Phillip describes growing up on a farm and feeling at peace and profound connection with nature as he watched his father working in the fields. He said that his ancestors were all farmers in Greece for hundreds of years. Phillip first started "hiking therapy" when he was working with groups of individuals suffering from schizophrenia. One day, he decided to take his group out for a hike in the hills behind the hospital, and noticed the peacefulness and relaxation the patients experienced while hiking, and see the views of the San Francisco Bay from (describe the location at the top of the hike.) He said the patients seemed to experience much less of the internal, distracting stimuli that interfered so greatly with their attempts to connect with others. All of his patients complete David's Evaluation of Therapy Session after each session. This tools encourages patients to rate the therapist's empathy and helpfulness and describe what they liked and disliked about the session. Phillip works with a wide range of individuals, and says that whether they are 10 years old suffering from shyness, or executives from a tech companies who are facing burnout, they often say that they feel more open, honest and willing to go deeper when hiking in nature, than when they are being treated back in his office or on zoom. He pointed out that these days, a great many individuals coping with mental illness end up being "treated" in jails, which are frightening and actually intensify the symptoms of schizophrenia. Phillip has a special tenderness and compassion for individuals with schizophrenia because his younger brother struggles with this affliction. However, his "hiking" therapy is not limited to individuals with schizophrenia, but adults and families with the full range of emotional challenges, such as depression and anxiety. He explained how he integrates the four elements of TEAM: T = Testing, E = Empathy, A = Assessment of Resistance, and M = Methods while hiking with his patients / clients. He also discussed some of the ethical considerations, and how to gently create boundaries so that his patients will understand that this is a professional relationship in a natural setting. Phillip is convinced, and probably right, that a beautiful and peaceful outdoor environment actually facilitates treatment and speeds recovery. Here are some photos from his hikes. just to give you an idea of what his special "office" looks like. It's a bit different from the analyst's couch! Take a look at this incredibly cute video of "talking turkey" on one of his hikes! [videopress McaWCx7u]

Ask David: Questions on self-esteem, recovery from PTSD, dating people with Borderline Personality Disorder, recovery on your own, and more! Jay asks: Is psychotherapy homework still required if you've recovered completely from depression in a single, extended therapy session? Is Ten Days to Self-Esteem better than the single chapter on this topic in Feeling Good? Are people who were abused emotionally when growing up more likely to get involved with narcissistic or borderline individuals later in life because the relationship is "familiar?" Many patients can read your books and do the exercises and recover on their own. Is a teacher or coach sometimes needed to speed things up? Is it possible for a person to become happy WITHOUT needing anyone else if they have had depression in past and/or PTSD? Also, how would Team-CBT address treating PTSD? PTSD can involve a person having multiple traumas. * * * Is psychotherapy homework still required if you've recovered completely from depression in a single, extended therapy session? Thanks, Jay, I will make this an Ask david, if that is okay, but here is my quick response. Although many folks now show dramatic changes in a single, two-hour therapy session, they will still have to do homework to cement those gains, including: Listening to or watching the recording of the session Finish on paper any Daily Mood Log that was done primarily in role-playing during the session. In other words, write the Positive thoughts, rate the belief, and re-rate the belief in the corresponding negative thought. Use the Daily Mood Log in the future whenever you get upset and start to have negative thoughts again. I also do Relapse Prevention Training following the initial dramatic recovery, and this takes about 30 minutes. I advise the patient that relapse, which I define as one minute or more of feeling crappy, is 100% certain, and that no human being can be happy all the time. We all hit bumps in the road from time to time. When they do relapse, their original negative thoughts will return, and they will need to use the same technique again that worked for them the first time they recovered. In addition, they will have certain predictable thoughts when they relapse, like "this proves that the therapy didn't rally work," or "this shows that I really am a hopeless case," or worthless, etc. I have them record a role-play challenging these thoughts with the Externalization of Voices, and do not discharge them until they can knock all these thoughts out of the park. I tell them to save the recording, and play it if they need it when they relapse. I also tell them that if they can't handle the relapse, I'll be glad to give them a tune up any time they need it. I rarely hear from them again, which is sad, actually, since I have developed a fondness for nearly all the patients I've ever treated. But I'd rather lose them quickly to recovery, than work with them endlessly because they're not making progress! People with Relationship Problems recover more slowly than individuals with depression or anxiety for at least three reasons, and can rarely or never be treated effectively in a single two-hour session: The outcome and process resistance to change in people with troubled relationships is typically way more intense. It takes tremendous commitment and practice to get good at the five secrets of effective communication, in the same way that learning to play piano beautifully takes much commitment and practice. Resolving relationship conflicts usually requires the death of the "self" or "ego," and that can be painful. That's why the Disarming Technique can be so hard for most people to learn, and many don't even want to learn it, thinking that self-defense and arguing and fighting back is the best road to travel! * * * Is Ten Days to Self-Esteem better than the single chapter on this topic in Feeling Good? Yes, Ten Days to Self-Esteem would likely be a deeper dive into the topic of Self-Esteem. It is a ten-step program that can be used in groups or individually in therapy, or as a self-help tool. There is a Leader's Manual, too, for those who want to develop groups based on it. * * * Are people who were abused emotionally when growing up more likely to get involved with narcissistic or borderline individuals later in life because the relationship is "familiar?" I was involved with a woman with Borderline Personality Disorder, and it was exhausting! Why was I attracted to her? Thank you for the question, Jay. Most claims about parents and childhood experiences, in my opinion, are just something somebody claimed and highly unlikely to be true if one had a really great data base to test the theory. We don't really know why people are attracted to each other. Many men do seem attracted to women with Borderline Personality Disorder. Perhaps it's exciting and dramatic dynamic that they're attracted to, and perhaps it's appealing to try to "help" someone who seems wounded. Good research on topics li

Today's emotional and inspiring podcast features Mary Stockton, an Level 3 certified TEAM therapist living in Ohio and her daughter, Elizabeth Stockton Perkins, who is 19 years old and a sophomore at Vassar College. They give testament to how the Five Secrets of Effective Communication have transformed their relationship as mother and daughter, as well as their relationships with others. Mary said that the Five Secrets changed her life personally and professionally, and that the tools have been "life-changing." Mary was first introduced to the Five Secrets of Effective Communication when she attended one of David's training workshops in 2002 entitled, "And It's All Your Fault!" However, she did not really dive in and use the techniques until 2017 when she received additional TEAM-CBT training from Rhonda, Jill Levitt, Daniel Mintie, Matt May, and Thai-An Truong. Mary introduced Elizabeth to the Five Secrets when Elizabeth was a junior in high school, and Elizabeth began to use these tools with friends and also in her baby sitting. Mary said it has transformed their relationship, because previously she had been addicted to "helping," rescuing, advising and problem solving, habits which often prevent closeness in relationships. David pointed out that many if not most mental health professionals, including many reading this at this moment, have been trained in these misguided "helping" methods, and are not even aware of it, or how unhelpful that "helping" can be. The relationship between Mary and Elizabeth is wonderful testament to the power of the Five Secrets. Mary said that using the Five Secrets in their relationship provides them with a wonderful framework that they share and enjoy. Elizabeth said they have zero other-blame or self-blame in their relationship, and that they routinely get a fun, positive charge from the Five Secrets. Elizabeth discussed a distressful situation when Mary responded to her using the Five Secrets and she felt supported, comforted and empowered. She was struggling with negative thoughts and feelings about her body image, telling herself on the one hand that "I should be bird boned and be a size 2 and be super skinny," while at the same time telling herself, "I should be a strong feminist and not give in to these societal messages about what a woman should be like." Because her mom relied on the Five Secrets of Effective Communication and other TEAM skills, Elizabeth suddenly found that she could open up about feelings she'd been hiding, and their relationship changed dramatically. Elizabeth suddenly found that she could open up about feelings she'd been hiding out of a sense of shame, and felt love and accepted. She said that "mom was the first person I'd been able to open up with. I felt relief that I didn't have to defend myself." Elizabeth cried when she described the gratitude she felt when she had the chance to be open and accepted, especially when she described her concern about being a good role model for two younger friends. They also described how Mary used the TEAM process of Empathy, Positive Reframing, and Methods like the Externalization of Voices and Survey Technique to help Elizabeth escape from the self-critical thoughts that had trapped her. It was a beautiful experience just to witness the joy and love in their relationship. They also described a program on the Five Secrets that they presented for other teens and families. We explored how one might use the Five Secrets when interacting with someone on the other side of the political divide who is angrily proclaiming political views that are sharply different from, and opposed to, your own. This is a huge problem in our country right now, with so much focus on blame, labeling others, and wanting to proclaim and insist on your own "truths." I have not done this podcast justice in my show notes. You'll have to listen to "get it." Mary, her elegant daughter Elizabeth, and the always wonderful and delightful Rhonda really hit it out of the park today. I deeply appreciated being included in this terrific experience, and hope you also enjoyed it! David

In today's podcast, we focus on a request by Tommy, a podcast fan who asked for a podcast on how TEAM evolved from traditional CBT. So here it is! Hi Dr. Burns, I hope you're doing well! I just recently completed Feeling Great and found it incredibly helpful. I found the technique chart that offered specific techniques for each distortion to be incredibly valuable and I've incorporated it into all my Daily Mood Logs. I've also listened to every podcast and have been already exposed to nearly all of the content within the book, but the book did such an elegant job of simplifying everything and putting it into context. I've already gifted it to several family members and am eagerly awaiting the audio version so I can gift it to my grandfather, a psychodynamic therapist of 30 some odd years who's vision impaired. I think he'll really get a lot out of it! Beyond the well-deserved praise, I'm emailing because I just listened to your post recent podcast episode (222) with Dr. Barovsky and you asked for any suggestions the audience might have concerning future episodes. There were two things that you mentioned that made me think an episode on the evolution of TEAM might be really cool and insightful. You mentioned that TEAM was specifically developed to deal with borderline personality patients that you saw at PENN and you also described an interaction with a stranger in California who approached you that inspired the concept of fractal therapy (at least that's how I understood that interaction). I think it would be incredibly interesting if you gave a sort of chronology of TEAM and what problems some of the core components were intended to solve. Obviously, I wouldn't expect you to go through every technique. But some insight into how you came up with positive reframing, the magic dial, perhaps uncovering techniques, and whatever else you'd be willing to share. Besides being interesting, I think it would be valuable because it would provide greater insight into the TEAM processes through demonstrating how it's overcome some of the obstacles that traditional CBT was unable to overcome. Dr. Mark Noble's chapter in Feeling Great led me to think quite a bit about this, particularly where he described how TEAM is really the ideal therapeutic structure from a neurological standpoint. Certainly you didn't just stumble into TEAM and I for one would find anything you'd be willing to discuss on this topic really interesting! Thank you again for everything you do. Best, Tommy Hi Tommy Here are some historical highlights in my thinking. In the podcast I will describe them and dialogue with Rhonda, but in no particular order. Thanks for the great suggestion, and hope you enjoy the podcast. Rhonda also mentioned how the empathy piece evolved, and we discussed that! Psychotherapy homework: Early research and clinical observations on psychotherapy homework and recovery from depression; how I published research on this topic and decided to make patients accountable. Helping: The man who I called at home twice every time he called me with some emergency one weekend, and my conversation with Dr. Wendy Dryden from England. The beauty of depression: The businessman who thought he was responsible for the death of his stepson. The universal importance of Positive Reframing: The time jill said she wished we'd done positive reframing during her session. Fears of therapists that keep them stuck: My observation through supervising psychology and psychiatry graduate students, as well as teaching workshops, how really hard it is for the vast majority of therapists to give up because of their addiction to helping and their intense fears of making patients accountable. Suddenly understanding "resistance." The meeting of the Stanford voluntary faculty on teaching, and I mentioned making the concept of "resistance" more understandable for the psychiatric residents. They didn't seem interested, and then I found the answer in a dream. Creating techniques with more "oomph:" The first method I created, Externalization of Voices, how this was inspired by my experiences in psychodrama marathons when I was a medical student. Giving up on "non-specific" techniques: The elderly depressed man who ran up to 12 miles a day. Therapeutic Empathy: What I learned from Stirling Moorey, and how I set up an empathy training program along with a scale to assess empathy after every therapy session. Rhonda and David

Many of you will recall one of our most popular and amazing podcasts of all, the recording of the live therapy with Michael at the Atlanta intensive last year. In today's recording, which was recorded for a different purpose, Dr. Michael recalls his entire experience that day, with many teaching points. Although I was AT the Atlanta intensive doing the therapy, with the help of my co-therapist, Thai-An Truong, I was fascinated and enlightened by this interviews because: Michael was incredibly warm, genuine and openness. The summary shows clearly and exactly how TEAM therapy works. He recounts not only his recovery, but also how was unexpectedly catapulted into what, by my understanding, is best described as "enlightenment." Or something awfully darn close to it! He reminds us that even after one has recovered and experienced "enlightenment," we are still human and never immune to the occasional return of negative thoughts and feelings of insecurity and self-doubt, which are now, for Michael, short-lived! I just got Rhonda's response after she listened to this recording for the first time. Here's what she said: I forgot to tell you that I listened to the 30-minute recording of Michael's reflections and I loved it. I think it would be a great podcast. He did a wonderful job summarizing the work, and how it impacted him at various stages. I liked how he included his skepticism and his awe in recovery. Warmly, Rhonda and David PS Rhonda and I are convinced that successful personal work is a necessary part of therapist training. When you've done your own work, you are no longer just a "technician," but a healer, because you can tell your patients, "I know you feel because I've been there myself, and I know how painful and lonely that can be. And I'm really excited to show you the way out of the woods, too, so you can get back to feelings of joy and self-esteem, so you can wake up in the morning and say that's it's GREAT to be alive!"

We have not had the chance to do a really good podcast on the Five Secrets of Effective Communication recently, so Rhonda and I jumped at the chance to do a podcast with a local executive we will call "Valentina" who is facing a severe challenge. How can she respond effectively to a ton of her colleagues who responded critically and angrily to one her first emails since being place in a top leadership role at work? They said that her email was harsh and accusatory, and sounded adversarial and provocative, and didn't give a feeling of partnership or appreciation for all the hard work they were doing. Yikes! That's pretty tough. And yet, my philosophy—in therapy, in family conflicts, and in work settings as well—is that your worst failure can often be your greatest opportunity in disguise. Is this true? Or just pie in the sky? Rhonda and I do a lot of role-playing and role reversals to (hopefully) show Valentina how to transform a humiliating professional failure into an enormous success. We'll let you know how it works after we get some feedback from Valentina. We are both deeply indebted to Valentina for her courage in allowing us to talk about a problem that most of us encounter from time to time. I often receive harsh criticism, so I know how anxiety provoking it can be, especially when the criticisms come from authority figures! Valentina was wonderful to work with, and said she felt happiness and a sense of peace at the end of the podcast. It was great to see that! Let us know what you think about today's podcast, and your own philosophy of how to respond to criticism skillfully and effectively. We alluded to, but did not delve deeply, into the opposite philosophy of arguing, defending yourself, and never apologizing. We've seen a lot of that in the past year on the evening news every day. Did the approach we modeled on today's show seem inspiring and awesome? Or foolish and self-defeating? Thanks for listening! We hope you enjoyed today's podcast and maybe learned something useful. For more information on the Five Secrets of Effective Communication, you can check out my book, Feeling Good Together, available in paperback on Amazon. Warmly, David and Rhonda

At the start of today's podcast, we got an update on the Feeling Great app from Jeremy Karmel. We are looking for one or more programmers who might like to join our project. Our goal is to create the first electronic tool that can outperform human therapists, and some super promising preliminary data suggests we may be on the right path to make this happen. We are looking for talented engineers and designers who would share our passion for this incredible dream. If you are interested, contact [email protected] Today we are joined by our beloved and brilliant colleague, Dr. Jill Levitt to ask two questions: Can the "self" be judged? Does the "self" exist? We got quite a bit of positive feedback to a recent Ask David Podcast that included a question about Buddhism, but people said they wanted more on the topic of the "great death" of the self. Bottom line was this: You can judge your own or someone else's specific thoughts and actions, but you cannot judge your (or somebody else's) "self." The question, "does the 'self' exist," is meaningless. The goal of therapy is not to get promoted from the "worthless" to the "worthwhile" category, but to reject these categories as having no meaning. David argues that it is impossible to feel depressed without the distortions of Overgeneralization and Labeling—that where you jump from a specific flaw or problem, like getting rejected by your boyfriend to some abstract label or judgment, like thinking you are "unloveable." We also used the real-life example of David responding to criticisms that he was too harsh with Steven Hayes on Episode 220. We show how TEAM therapy works, and illustrate several techniques for crushing the Negative Thoughts that lead to the painful negative thoughts that including Overgeneralization and Labeling, including: Empathy Positive Reframing Externalization of Voices Be Specific Acceptance Paradox Feared Fantasy We also focused on the concept of "laughing enlightenment," a key Buddhist concept, along with the "great death" of the self. When you lose your "self," you actually lose nothing, because there was nothing there in the first place. This is a kind of cosmic joke. But you inherit the world and gain liberation from your suffering, along with great joy, and of course, sadness as well. We also summarized the thinking of Ludwig Wittgenstein, arguably the greatest philosopher of all time, and how his sudden insight when a soccer ball hit him in the head transformed the history of philosophy. He was an extremely lonely man who had numerous episodes of depression, and never attempted to publish anything when he was alive, because only a handful of students and colleagues could understand what he was trying to say. This was intensely frustrating to him, because his message was so simple, clear, and basic—and yet the great philosophers could not grasp it. The Buddha had the same problem. The book, Philosophical Investigations was published in 1950, right after his death. It is just a series of numbered paragraphs, or brief comments, on different everyday themes, like bricklayers, string, games, and so forth. It is was based on a metal box they found under his bed, which contained notes from his weekly seminars at Cambridge. Many people, including myself, consider it as the greatest book in the history of philosophy, and think of Wittgenstein as the man who killed, or ended, philosophy. According to Wikipedia, the famed British philosopher, Bertrand Russell, described Wittgenstein as "perhaps the most perfect example I have ever known of genius as traditionally conceived; passionate, profound, intense, and dominating." Although Wittgenstein did not focus emotional problems, his solution to all the problems of philosophy is very similar to cognitive therapy. Here is the parallel: You don't try to solve the classic "free will" problem. Instead, you see through it and give it up as nonsensical, as language that's "out of gear," so to speak. Once you "see this," and understand why it is true, it is incredibly liberating. But it can be a lonely experience, because you suddenly "see" something super-obvious that seems to be invisible to 99.9% of humans. It's as if you had a "third eye," and could see something incredible that people with only two eyes cannot see. By the same token, when you suddenly "see" that the idea that you have a "self" which could be "superior" or "inferior" is nonsensical, it is also incredibly liberating. This, in fact, is the cognitive therapy version of spiritual "enlightenment." And that's also one of the goals of the TEAM-CBT that my collegues and I have created. Jill, Rhonda, and David

Podcast 224 Ask David January 11, 2021 Ask David featuring more challenging and interesting questions. Josh asks: What are the most effective types of psychotherapy homework assignments? Hassam asks: How would you treat my severe OCD? Exposure doesn't seem to be working! And Joe asks: Would you say that the secret to overcoming OCD is willpower? Ted asks: Does any psychiatric disorder result from a chemical imbalance in the brain? Brian W. asks: Burns, could you do a video on how to use CBT for stress? Thanks. Clarity asks: Is it too late to be a beta tester for your app? Simon asks: Is there a podcast that you can recommend for general depression, and how to find out what is wrong? Stephanie asks: My patients don't recover as rapidly as your patients. Am I doing something wrong? I'm feeling a lot of anxiety and self-doubt! * * * Josh asks: What are the most effective types of psychotherapy homework assignments? Hi David, thanks for all your work. It has been very helpful. You mention That doing homework is essential to recovery from anxiety and depression. Any homework you recommend? I am going to buy a few of your books and have the worksheets from the Neil Sattin podcast. Anything else that will benefit? Josh Hi Josh, It depends on the type of problem you are working on. I can work up an answer, perhaps, if you want to tell me! I did not hear from Josh, but Rhonda and I summarize the best kids of psychotherapy homework for: depression anxiety relationship problems * * * Hassam asks: How would you treat my severe OCD? Exposure doesn't seem to be working! Hi David, I love your work on the podcast. I have not yet found a copy of any of your books in Lahore (where I live), but I have grown to understand your philosophy through your podcasts. Episode 162 disturbed me a little. I suffer from severe OCD and its cousin, depression. And the "high-speed cure" in the title really attracted me. But I had buyer's remorse. Why? Because it does not work like that for most people. The guest on your show, had a few exposures, and BAM, cured. I have tried exposure many many times, and it very minimally helps in lowering the threat of the obsessions. I feel that this was a Magic Pill kind of account, and at the risk of judging a person's pain, I think your guest had a relatively mild (as compared to me) OCD. I would really love it if you could talk about Pure OCD (the type I have), and how it can be resistant to exposure. The intrusive thoughts/obsessions continue to be extremely, EXTREMELY, painful. This "high speed cure" idea seems dismissive of the seriousness of my condition. Please keep up the great work. And I hope to read your books one day. Thanks Hassam (Therapist in training) Thanks Hassam, sometimes, therapy is much harder, as you say! Good point. I often get slammed when I present patients who recover rapidly, especially patients who have had incapacitating symptoms for years or even decades of failed therapy. This is disappointing to me, as my goal is to bring hope to people that rapid and meaningful change IS possible. To be honest, I don't like it when I get slammed for presenting cases of rapid recovery. Some people think I am a con artist! Yikes! Of course, everyone is different, and some people will be more challenging to treat. One thing I learned when I was in private practice is that you can never tell ahead of time who will recover rapidly and who will take much more time. I've had patients I thought would be super easy to treat who responded much slowly than I predicted, and many who I thought would be nearly impossible to treat who responded almost overnight. You've mentioned that exposure has been of limited value for you. I totally agree and saw that early in my treatment of anxiety that exposure alone is often quite ineffective. That's why I argue so strongly that exposure is not a treatment for OCD or for any form of anxiety. It is just one tool among many I use in the treatment of anxiety. I use four very different treatment models with every anxious patient: The Cognitive Model The Motivational Model The Hidden Emotion Model The Behavioral (Exposure) Model Unless you understand and use all four models, the prognosis might be somewhat guarded, as you've discovered. In contrast, when you use all four strategies, your chances for success increase tremendously. For example, prior to using Exposure in the episode you listened to, I spent about 25 minutes with Sara using the motivational and cognitive models, which really helped. Focusing on one method alone will often not be terribly effective, especially if you're looking rapid, complete, and lasting recovery. However, occasionally one method will work, so therapists and patients alike get focused on some single approach they've learned, thinking they've found "the answer." There's a great deal of information on the treatment of anxiety disorders using these four models on my website, www.feelinggood.com. I often urge listeners to use the search f

The Jealousy Addiction! What Can You Do When Good Things Happen to Bad People? Hi podcast fans! Thanks for your wonderful support in 2020. You helped us hit our three millionth download. I wanted to give a shout out to my fantastic hostess, Dr. Rhonda Barovsky, who has brought magic to the Feeling Good Podcast! This is our first podcast of 2021. It is a really good one, I think. A tremendous amount of work has gone into it, both in the weeks prior to the podcast, as well as in the creation of the detailed show notes for those who want to study and understand exactly how TEAM therapy works for the thorny and almost universal problems of jealousy and anger. Much violence in the world, especially in couples, results from these feelings. I want to thank Bridget for her tremendous courage in giving us all this wonderful gift to kick off the new year! For therapists and therapy students, this show, with the show notes, should be a rich source of learning. David And, I, Rhonda wants to thank Dr. Burns for the incredible contribution he has made to the field of mental health treatment and for the honor of being part of the Feeling Good Podcast! Rhonda Bridget asks: Can you help me with my feelings of intense jealousy? Hello David & Rhonda, I've had this issue for a while now, and I'm wondering if others deal with it as well. If I find out that someone I dislike has something good happen in their life, I get extremely upset, frustrated, angry, jealous, & resentful. It will eat away at me, sometimes for weeks. The thing is I'm happy with my life & wouldn't actually want to trade places with these other people, but it's like just the fact that they get to be happy when they are a "bad person" & don't deserve it upsets me. By "bad person" I mean people who are manipulative, liars, cheaters, etc. I've always been a person who is big on justice. I don't want to focus on these other people anymore. I don't want to care. Any help would be greatly appreciated. Thank you, Bridget David's Comment I was pleased to receive this email, as jealousy IS a big problem, and one I have not focused on specifically in my books or podcasts. I exchanged several emails with Bridget who graciously gave me permission to feature her work in today's podcast. When people share their vulnerabilities openly, it is a gift to the rest of us, since the teaching and learning potential is great. In addition, most of us feel close to people who open up and share the inner feelings and insecurities that most of us hide. This is an action that requires great courage, and often results in even greater rewards. Bridget is also interesting because some fans have criticized me for featuring mental health professionals when I'm doing personal work. I do that because I'm no longer in private practice, and do not carry liability insurance. When I do personal work with therapists, it is in the context of their training, and is not considered an ongoing therapeutic relationship. But today, I have decided to bring you some really challenging work with someone who is not a therapist, but a married woman who works as a product manager for a high-tech company. Of course, I have disguised her identity. The emotions she is asking for help with, jealousy and anger, are the toughest emotions to challenge, far harder than depression or anxiety. That's because the thoughts that trigger depression and anxiety involve Self-Blame and self-criticism, so you tend to feel worthless or inferior. Crushing self-critical thoughts leads to relief and joy. But the thoughts that trigger jealousy and anger typically involve Other-Blame and other-criticism, which is far tougher to defeat, because blaming others can be associated with exciting feelings of moral superiority. (You will notice below that I am embedding the PDFs of Bridget's work in the show notes, as opposed to linking to them as I usually do. Let me know which format you prefer. Thanks! david) STEP 1: Record your negative thoughts and feelings at a specific moment Here was my response to Bridget: Thanks, Bridget! On the attached DML, fill out the event, circle and rate emotions, and record and rate belief in negative thoughts. Scan back to me, and then I'll have further instructions. d Hi Dr. Burns, Here is my DML. Thanks! Bridget's DML at the beginning of the intervention. Notice that the belief in the NTs are all high, and the negative feelings are intense. STEP 2: Positive Reframing Hi Bridget, You're moving fast! Way to go! Great example! Now list answers to these two questions about every category of negative feeling. What does this negative feeling show about you and your core values that's' positive and awesome? What are some benefits, or advantages, of this negative feeling? You can also do this with a couple of your negative thoughts. david Hi Dr. Burns, Some of these were difficult to find positives, but I do truly believe everything I wrote. This is Bridget's Positive Reframing Table. The items in caps were sugge

Podcast 222 Ask David December 28, 2020 Ask David featuring five challenging questions. Jay asks: How do you treat individuals with personality disorders using TEAM-CBT? Jeff asks: Can you talk more about the "great death" of the therapist's "helping" or "rescuing" self? This was really helpful to me! Darkmana asks: Hey David, are there any books about Buddhism you would recommend? I can see you're a fan of it from Feeling Great! Angela asks: What's a perfect score on your empathy test? Margaret asks: What can you say to a patient who doesn't want to push the Magic Button? * * * Jay asks: How do you treat individuals with personality disorders using TEAM-CBT? Dr. Burns Have you considered doing a podcast on using TEAM-CBT or CBT for Borderline, Narcissistic and Histrionic Personality Disorders? The interesting thing is those with personality Disorders seem to blame everyone and everything for their problems but themselves Also, what if anything could individuals do to not get attracted or quickly eject when they encounter these folks. One theory is that folks with abusive or neglectful parents are vulnerable. Because the chaos and drama is familiar. I think many therapists avoid folks with pd no? Particularly patients with Borderline PD. It's interesting in that kids have years of relating to parents with personality disorders. So how would TEAM-CBT help? Just curious what your experience and Rhonda too Jay Rhonda and David talk about how TEAM-CBT developed out of David's treatment of large numbers of individuals with Borderline Personality Disorder, and what some of the treatment strategies are. * * * Jeff asks: Can you talk more about the "great death" of the therapist's "helping" or "rescuing" self? This was really helpful to me! Hi Dr. Burns, I loved what you've taught on the death of the selves - and recently read the Four Great Deaths of the Therapists Ego in your new book, Feeling Great. One part that I found so helpful was the death of "The Helping, Rescuing Self." I think I've believed that's my purpose. That's why I'm there. I'm there to "help" the client feel better and live a full, rich, meaningful life. That's something I've struggled with - because if I'm not there to help, what am I there for? And if I don't FEEL like I've helped, then I've failed the client. I'd love to hear this concept expanded on. I think many therapists, coaches, etc. would benefit from seeing how they can work with clients without thinking they have to help or rescue them. Thank you, Dr. Burns. P.S. Your new book is a goldmine. Enjoying it immensely. * * * Darkmana asks: Hey David, are there any books about Buddhism you would recommend? I can see you're a fan of it from Feeling Great? Hi Darkmana, Thank you for your question. I'm sure there are many great books out there, but I have never studied Buddhism or read anything about it. I just sort of make things up! David will tell his Buddhism story when eating in a noodle house with his son Erik. Rhonda has invited the Dalai Lama to appear on a Feeling Good Podcast. It seems like a long shot, but it would be delightful to have the chance to chat with him, as there is so much overlap between Buddhism and TEAM-CBT! I would guess that he likely has a good sense of humor, since humor and laughter can be such great ways of grasping certain ideas and achieving enlightenment. I have heard that the Buddha talked about the "Great Death" of the self. In Feeling Great, I talk about four "great deaths" that correspond to recovery from depression, anxiety, relationship problems, and habits and addictions. I'd love to hear the Dalai Lama's thoughts about this. There may be large numbers of "Great Deaths," I suspect. To me, "reincarnation" is something that happens when we are alive, and not something that happens after our bodies die! However, I think most Buddhists might fiercely oppose my thinking in this regard. I think that "literalism" is one of the problems with most organized religions. Stories that are intended to convey wisdom and insight are taken as literally true. * * * Angela asks: What's a perfect score on your empathy test? Hello David, In the weekly practice group that I host, the question came up today "what does Dr. Burns mean by no less than 20? Is it the first section titled "Therapeutic Empathy" which is 20 points total, or the entire survey which is 20 questions? Warmest blessings, Angela Poch, RPC-C Hi Angela, Thanks, yes that is correct. 20 on the empathy scale is the lowest passing grade. A score of 19 and below indicate some significant failure in the therapeutic relationship / empathy. Since we are hoping for failure, I try to make failure as easy as possible! That's part of my "anti-perfectionism" philosophy. I encourage the four "great deaths" of the therapist's ego, and this is the first of the four deaths. * * * Margaret asks: What can you say to a patient who doesn't want to push the Magic Button? Hi Dr. Burns, I attended your intensive in Atlanta and am

Podcast 221 Ask David December 21, 2020 Today's Ask David features five challenging questions submitted by listeners like you! Sumaya asks: I recently bought Feeling Great and can't find the chapters on Habits and Addictions in the book. Could you please clarify? Jay asks: Can you provide more specific information on the contrasts between Feeling Good, The Feeling Good Handbook, and Feeling Great? Rizwan asks: How would you use the Five Secrets to respond to a truly irate patient? Casey asks: How do you treat resistant autism patients with All-or-Nothing Thinking? Debby asks: What's your definition of a violent person? Today's podcast begins with season greetings for people of all (or no) religious faiths. Rhonda reads a moving email submitted by a listener who was helped by the recent two-part Sunny series on the Approval Addiction. David gives a plug for his upcoming workshop with Dr. Jill Levitt on "Defeating the Beliefs that Defeat You and Your Patients" on February 28. 2021 (include link.) We also give a shout for Sunny's recently opened private practice, which offers super rapid treatment and a user-friendly fee schedule. Sunny can be reached at: Sunny Choi, LCSW [email protected] Better Mood Therapy rhonda's exciting new Feeling Great Treatment Center is now open for business as well. She can be reached at [email protected]. And now—your cool questions! * * * Sumaya asks: I recently bought Feeling Great and can't find the chapters on Habits and Addictions in the book. Could you please clarify? David explains that the two "lost" chapters on habits and addictions are available for free on the homepage of www.feelinggood.com. I had to cut about ten chapters from Feeling Great due to length, but put them on the homepage since the techniques for treating habits and addictions are new, innovative and powerful, and may help some folks. * * * Jay asks: Can you provide more specific information on the contrasts between Feeling Good, The Feeling Good Handbook, and Feeling Great? Dr Burns Is it possible for you and Rhonda to do a podcast about Feeling Great book and Feeling Good and Feeling Good Handbook? I sat down to hear the similarities and differences and target audiences etc. Very in depth etc but podcast 213 seemed to me to get derailed into the four ego deaths of the therapist and the four ego deaths of the patient. I am not minimizing the value of discussing Ego deaths. But it seems like you never really addressed the similarities and differences in the three books. One thing I have not heard you discuss is that powerful section in Feeling Good on preventing setbacks. Love addiction etc. Addressing the core beliefs that trigger recurrent depression in some people. Also the expectations of doing a two-hour session vs doing the daily mood log for 15-20 minutes per day over a few months ( in the Self Esteem section of Feeling Good.) I thank you Sincerely Jay Thanks, I DO meander! Both a curse and a blessing, as my mind works like that, with new ideas popping in all the time. First, here are the differences between the three books: Feeling Good is a beautiful presentation of the basics of cognitive therapy, including how to crush distorted thoughts and modify self-defeating beliefs like the Achievement, Love, and Approval Addictions, as well as Perfectionism and Perceived Perfectionism. The books focuses on depression, including suicidal urges. This book was published in 1980 and has sold more than 4 million copies worldwide. It has received a number of awards and has been named the top depression self-help book, from a list of 1,000 books, by American and Canadian mental health professionals. The Feeing Good Handbook has more exercises and a broader range of topics, including depression, anxiety, and relationship problems, as well as a special section for therapists on how to help challenging, difficult patients. This book was published in 1988 and has sold roughly two million copies. Feeling Great was published in September of 2020. It updates all the tools and techniques in the prior two books, but also includes powerful new techniques to overcome therapeutic resistance. It also includes a section on more spiritual (but still practical) techniques, including the four "Great Deaths" of the self. Feeling Great has a special section on how to crush each of the ten cognitive distortions, plus many real case examples with links to the actual therapy that you can hear online in my Feeling Good Podcasts. This is important because some readers may not believe that people with chronic and severe depression and anxiety can recover more or less completely in a single, two-hour therapy session. Toward the end there of Feeling Great there is a special chapter by the famed neuroscientist, Professor Mark Noble from the University of Rochester, on how TEAM quickly modifies specific circuits in the brain to achieve ultra-rapid recovery. The stance of the therapist has changed significantly i

Today's podcast features Dr. Steven C. Hayes, the founder of ACT (Acceptance and Commitment Therapy), and author of 46 books, including his most recent book, The Liberated Mind, which is available on Amazon. We are joined by Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California. Dr. Hayes began by describing ACT, a form of psychotherapy aimed at increasing something he calls "psychological flexibility." He defines psychological flexibility as the ability to stay consciously in contact with the present moment, including the difficult thoughts, feelings, memories, and bodily sensations you may be experiencing. At the same time, you direct your attention toward actions and behaviors based on your personal values. I think it is fair to say that Rhonda, Jill and I had a more than a little difficulty understanding what Dr. Hayes was saying at times throughout the interview, particularly when he was describing the six dimensions of his concept of psychological flexibility. This is unfortunate, because Dr. Hayes has a great personal story to tell, and he has done a tremendous amount of interesting and important research as well. Dr. Levitt did a tremendous job in tracing some overlap between ACT and TEAM in several areas. One is the idea that feelings like depression, anxiety, shame, and even anger are not bad but are actually good. These feelings can be telling us things that are tremendously valid and important about our core values as human beings. In TEAM, we call this Positive Reframing. Another overlap between ACT and TEAM-CBT has to do with what Dr. Hayes calls "cognitive defusion," a concept that has to do with the capacity to realize that your negative thoughts, like "I'm a loser," or your anxious thoughts, like "I'm about to go crazy," are simply thoughts, and not statements that are literally true. This is consistent with one of the goals of TEAM-CBT, which is to recognize that these kinds of thoughts are nearly always distorted, and the moment you stop believing them your negative feelings will diminish or disappear. ACT suggests that you need to simply "defuse" from your thoughts, while TEAM-CBT utilizes many techniques to help you crush the distorted thoughts that trigger negative feelings, since everyone is different, and you can rarely predict which approach will be effective for a particular individual. I sadly have to confess that after this face-to-face interview with Dr. Hayes, I still have extremely limited understanding of ACT, and apologize that I can't be a more effective translator of his many excellent ideas and methods! A touching moment came at the end of the interview when Dr. Hayes spoke about his own journey into a dark place in 1981, and why the ineffective therapy that he received at that time inspired him to create ACT. We all felt really close to him at that very human and vulnerable moment. If you would like to contact Dr. Hayes, you can reach him at [email protected] or visit his website at www.stevenchayes.com. You can also link to his new book A Liberated Mind. Thanks for joining us today! Rhonda, Jill, and David

Today's podcast features a most unusual and incredibly inspiring guest, Dr. Cai Chen. Cai is a fourth-year general psychiatric resident at the University of Texas Health Science Center in Tyler, Texas. He's also currently enrolled with Mike Christensen's "Live Online CBT Training Courses for Therapists." Cai has told me that Mike Christensen is a "friggin' amazing teacher" and that everyone who is interested in starting their journey in TEAM owes it to themselves to take his class. My first contact with Cai was an email he sent me after listening to Podcast #187 on the live work I did with Dr. Michael Greenwald and Thai-An Truong at the Atlanta intensive about a year ago. Cai wrote: Hi David, Michael, and Thai-An, This podcast episode helped me truly change my life. I thought I had things figured out before, but man! The work you three did that day crystallized my own social anxiety issues and gave me the courage to finally do some very hefty self-disclosure. I was in tears throughout the podcast and well after even waking up in the middle of the night crying, knowing that I had to do the exact same thing that Michael had done. So I finally told all the people I knew on social media that I struggled with social anxiety and that my deepest fear was my negative feelings inconveniencing people, hurting them, and showing how I was being selfish by taking the spotlight. I also told everyone how all of these fears led to a lifetime of loneliness, rejection, and helplessness. I cried writing it all out because it finally felt like I was letting all of that go for the first time in my life. The response I received from so many on social media, including people I hadn't heard from in years, was astonishing and so supportive! My social anxiety was completely shattered! Now I see the truth: that our feelings are an expression of our humanity and the most honest, loving thing to do is to share them with people! I'd be damned if I'm going to tell myself anymore that my negative feelings "inconvenience" or "hurt" people. Screw whether I'm being "selfish"! I finally understand what you mean, David, that the problem was NEVER that I have been inconveniencing, hurtful, or selfish. It's that I'm telling myself that these things about me are WRONG and that I SHOULDN'T be that way. I share my feelings all the time now! The constant feelings of nervousness/unease, OCD, and panic attacks I had before are gone 99% of my days! I feel more human and myself than I've ever felt for the last 20 years. You should call it "re-learning how to be human" therapy! God bless you David, Thai-An, and of course yourself Michael! I'm truly in your debt, Michael. You're my own personal hero and I wish I was there at the intensive to give you a big hug! I'm grateful, honored, overjoyed, and just so happy for the help you've all brought me it's making me tearful again. I love the work you've done and I love you all! I'll remember this for the rest of my life. Regards, Cai Today, Rhonda and I were thrilled to meet with Cai face to face for the first time to get an update on what's happened since that time. Cai emphasized that his intense feelings of depression, anxiety, crippling shyness and loneliness have vanished because of the intense effort he put in learning and using TEAM-CBT entirely on his own. He described how he first became acquainted with the podcasts. He felt a lack of clinical training in his residency program on how to do psychotherapy, so did a google search for therapy training, and came up with two podcasts, one of which was ours. So, he flipped a coin and the Feeling Good Podcasts won. He listened to the first podcast on measurement and testing, and said he was immediately excited about testing the idea that you could see exactly how effective or ineffective you were in every session with every patient. He was also excited by the idea that rapid changes in depression and anxiety really are possible, and that long term treatment is often not necessary. He describes his determination to use TEAM-CBT in his clinical work, after a tremendous amount of practice based on what he's been learning in the Feeling Good Podcasts. He stressed: The importance of T = Testing, and how helpful and challenging it was at first because, as I had predicted, he initially got failing scores on the Empathy and Helpfulness scales from nearly all of his patients. But this led to opportunities to deepen his relationships with them while processing their feedback from the previous session. He said that he was initially embarrassed about handing his patients the Brief Mood Survey and asking them to fill it out before and after each session. This was helpful, but very challenging, both from a technical and emotional perspective, since it was painful to have to view his failures. I mentioned that it has been the same for me, and described a recent extreme failure with a patient who was livid with me after a session I had thought was great. But talking it over

Do Negative Thoughts or Hormones Cause Postpartum Depression and Anxiety? And What's the Best Treatment? TEAM-CBT or Pills? We begin today's podcast with a lovely endorsement, and an announcement that Rhonda's new free Wednesday TEAM therapy training group will be open to therapists from around the world and will start on December 2, 2020 at 9 to 11 AM west coast (pacific) time. Rhonda will have many fine trainers working with her, including the incredible Richard Lam, and the magnificent Leigh Harrington, to make your training experience stellar. If you are interested, contact Rhonda right away, as slots will be strictly limited. You can also fill out this form to confirm your interest! Today, Rhonda and I are proud and excited to interview our brilliant and delightful guest, Thai-An Truong, from Oklahoma. Thai-An is an accomplished TEAM Therapist (the first in Oklahoma) and popular TEAM trainer for therapists who want to learn about these new techniques. Thai-An, her husband, and two children on Halloween, the day after this podcast was recorded. Her daughter was born earlier this year. Thai-An's niche is unusual and extremely interesting—she specializes in the treatment of women with post-partum depression with TEAM therapy, and usually without medications. This is extremely interesting since the world is currently focused on the belief that post-partum depression is a 100% biological disorder that results from hormonal changes, needs treatment with medications, and typically requires a year or more of treatment before improvement can be expected. Of course, this message can unfortunately function as a self-fulfilling prophecy. And is it even valid? No, says Thai-An. Although she sees a role for medications in some women with severe post-partum depression and anxiety, she says that the vast majority of the women she treats recover quickly without drugs. I was so happy to hear this, since my experience has been the same. In fact, Chapter 2 of my new book, Feeling Great, features my treatment of a woman struggling with severe post-partum depression who recovered in a single TEAM therapy session. Thai-An begins by describing her own horrifying and totally unexpected battle with post-partum depression after her first child was born 4 ½ years ago. She had a wonderful pregnancy and was excited about the prospect of giving birth to her daughter, but immediately after delivery, "it suddenly felt like the rug was pulled out from under me." She went into a state of self-loathing and struggled with extreme depression and anxiety. She says, "I could barely sleep, woke up in a state of panic, and wondered 'can I feed my baby?'" It got so bad that Thai-An began to think that her family and daughter would be better off without her. She said, "I even asked my mother if she'd be willing to raise her." I felt incredibly sad to hear that, and I could barely even grasp the intensity of her suffering. The suffering of extreme depression is almost beyond human understanding, especially if you've never been there yourself. Thai-An was treated with medications, including antidepressants, but they didn't help and made her more anxious. Then was told that these side effects are "expected" and advised to "wait it out." She said, "I saw how devastating post-partum depression is—it robs you of joy." They told me it was biological. One theme of Thai-An's depression was her belief that moms are supposed to bonded to their children and loving at every moment, so "I asked myself, 'did I make a mistake? Am I a monster? Why don't I feel that way?'" Fortunately, Thai-An recovered after 3 months, and decided she wanted to work with other mothers with similar problems. She now has a thriving practice in Oklahoma. Rhonda asked how other doctors view her work, since Thai-An's treatment approach—TEAM—is so radically different from current treatments that emphasize biology. Thai-An said the doctors have become extremely supportive when they see fabulous results in the patients they refer to her. Thai-An emphasized several components of TEAM-CBT that have been especially helpful to the women she treats. Positive Reframing. She says that this method is super powerful. Traditionally, woman are told (and think) that they need to "calm down," but this makes the symptoms worse, especially the anxiety. Positive Reframing, in radical contrast, honors their negative feelings, and the effect is often "mind-blowing." She says, "It heals a lot of the symptoms" Anxiety is even more common in post-partum depression than depression, including OCD symptoms. For example, many women have horrific intrusive thoughts that their child may suffocate, or that they'll throw their child down the stairs, or other gruesome scenarios that they try to control and suppress. Of course, that never works and always makes the symptoms worse. Exposure, techniques like Cognitive Flooding—leaning into the fantasies and surrendering to them—can often be rapidly curative, but require

Today's Ask David features four terrific questions. Kevin asks: Why is the concept of worthwhileness and worthlessness so important to people and their emotional health? Vallejo asks: Does the statement, "WHY AM I ALWAYS THE LAST ONE TO FIND OUT ABOUT ANYTHING?" correspond to overgeneralization, or self-blame? I've been listening to the early podcasts on the ten positive and negative cognitive distortions. David P asks: Do you think there is anything to be gained from a daily gratitude log, to go along with the daily mood log? Harvey asks: I don't see how Positive Reframing actually contributes to the therapy. Kevin asks: Why are the concepts of worthwhileness and worthlessness so important to people and their emotional health? Hi David, I have a quick question about the concept of being a worthwhile human being. Suppose a person believes they are unconditionally worthwhile, what are the implications of this? Why are the concepts of worthwhileness and worthlessness so important to people and their emotional health? Best Regards, Kevin Hi Kevin, Thanks! That's a very important question. However, it is abstract and philosophical. I have found that philosophical discussions tend to go on endlessly with resolve. In contrast, when someone asks for help with a specific moment when she or he was upset, then I can usually show that person how to change the way she or he is feeling. And when that happens, the person generally suddenly "sees" the solution to some very profound philosophical or spiritual questions. All that being said, I'll take a crack at it. The goal of TEAM therapy is not to go from thinking that you're a worthless human being to thinking that you're a worthwhile human being, but to give up these concepts as nonsensical. Specific activities, talents or thoughts can be more or less worthwhile, but a human being cannot be more or less worthwhile. We can judge specific events, actions, and so forth, but not humans. At least I am not aware of how to validly judge a human being, or a group of humans. We can only judge their actions, attitudes, thoughts, and so forth. Unconditional self-esteem is definitely better than conditional self-esteem, since you don't have to be perfect or a great achiever or a great anything to be "worthwhile," but you are still focused on being "worthwhile." I'm not sure what that means, but there is a downside, to my way of thinking. If you think you are worthwhile because you are a human being, does that mean that you are more worthwhile than animals? Lots of people abuse animals, hunt animals, and so forth, which many people find immensely disturbing. These are some of the consequences of thinking that animals are less worthwhile, for example. Not sure that helps, but like your line of questioning! David Kevin follows up: What is the implication then of giving up these concepts at all? I assume that thinking that you have unconditional worthwhileness because you are alive or to drop these concepts entirely have the same emotional implications for people. What are these implications? For example, if I think that worthwhileness and worthlessness are meaningless concepts, so what? What's the point? What do I gain? Hi Kevin, Let me start by saying, once again, that I am not an evangelist spreading the "gospel," so to speak. My goal is simply to help people who are struggling with feelings of depression, anxiety, and self-doubt. So, if your way of thinking about things is working for you, there's no reason to change. But my focus is always on someone who is suffering, and that's where these concepts can sometimes be important. I can tell you what I gained by giving up the idea that I could be, or needed to be "worthwhile" or "special." I gained a great deal of joy. It was a lot like escaping from a mental prison. It freed me to find incredible joy in the "ordinary" events of my daily life. It also freed me from fears of "failure" or not being "good enough." Depression always results from Overgeneralization--you generalize from failing at something specific to thinking you are a failure as a human being. Without Overgeneralization, I think it is safe to say that it is impossible to be depressed. For example, if you measure your worthwhileness based on your achievements and success, you may feel excited when you succeed and devastated or anxious when you fail, or when you are in danger of failing. I'm not sure if this addresses your excellent question! A young woman told herself that she was "unloveable" when she and her boyfriend broke up after two years of going together. Can you see that she thinks she has a "self" that can be "loveable" or "unloveable?" This thought was very disturbing to her, as you might imagine. Relationships do not break up because someone is "unloveable," but because of specific factors or events that drive people apart. Once you zero in on why the relationship failed, or more correctly, why the two of you broke up, then you can pinpoint the causes and lea

Ask David featuring four terrific Should questions, and more questions about "asinine, stupid, narcissistic, self-serving humans! " Oliver asks: Can a thought be thought as moral or immoral? Vincent asks: I have suffered from depression for about 3 years and say to myself, "I should have gotten better sooner." Isn't this "should" appropriate? Charles says: Your concept of "no self" shot my anxiety way up and made me feel hopeless. . . . It makes me feel worse than before! Michelle asks: How is your requirement that new patients must agree to not make any suicide attempts for the rest of their lives any different to a "suicide contract" which you mention are not effective? Brian asks: I've done a few things that made me feel intensely guilty. . . . The knowledge that I didn't do what I should have done led to a lot of guilt and shame, and eventually depression. Just wondering your thoughts on this Carrel asks: I'm a Democrat in Texas. How can we use disarming to heal the political rifts in our country? Natasha asks: How do I stop the dark thoughts of wishing harm to come to stupid humans who do asinine, narcissistic, self serving, irresponsible things—like driving massive, loud pickup trucks around the neighborhood, honking incessantly as they wave their 20 ft political flags; or bringing the family for a paddle boat ride in the local pond, taking delight in teaching their human offspring to paddle the boat as quickly as they can to chase after the beautiful, innocent geese and ducks trying earnestly and fearfully to swim to safety. and more. Dear Dr. Burns, Can a thought be thought as moral or immoral? In many podcasts and articles, you use "Thou Shalt Not Kill" to demonstrate morally should statement, which is one of the 3 valid should statements in English. I'm still somewhat confused about this concept. To tell you where I get stuck, I come up with three thought experiments. Imagine the following situations in which a should statement may come to mind: Situation 1 Lisa stole some money from a grocery store. When arrested by police, Lisa said with tears, "I shouldn't have stolen money. I feel ashamed for what I have done." In this case, it is obvious that "I shouldn't have stolen money" is a morally should statement, and also a legally should statement, because Lisa did something that violates the law and her moral principle. DAVID'S COMMENT: YES, YOU ARE CORRECT. LISA'S STATEMENT CAN BE CLASSIFIED AS A LEGAL SHOULD AND A MORAL SHOULD. Situation 2 One day, Bob went to Walmart to buy a suit. When he was passing by a shelf, a thought appeared in her mind. "What would happen if I steal this suit? I really want it, but I have very little money." When he came back home, he talked to himself," I shouldn't have felt the urges to steal things. And I shouldn't have thought about stealing the suit." DAVID'S COMMENT: THESE WOULD NOT BE CONSIDERED VALID SHOULD STATEMENTS BY MOST PEOPLE, SINCE WE HAVE FREEDOM OF THOUGHT. HUMAN BEINGS HAVE ALL KINDS OF FANTASIES AND URGES ALL THE TIME—AT LEAST I KNOW THAT I DO! AN URGE ONLY BECOMES IMMORAL OR ILLEGAL WHEN YOU ACT ON IT. HOWEVER, ALTHOUGH I DO NOT THINK THESE ARE VALID SHOULDS, BUT I TRY NOT TO IMPOSE MY VALUES ON OTHERS FOR THE MOST PART. I AM A SHRINK, SO I WORK WITH PEOPLE WHO ARE ASKING FOR HELP. FOR EXAMPLE, PEOPLE WITH OCD OFTEN PUNISH THEMSELVES JUST FOR HAVING "FORBIDDEN" THOUGHTS, FEELINGS, OR URGES. THE FIGHT TO CONTROL THEM IS THE ACTUAL CAUSE OF THE OCD. THE SHOULDS TYPICALLY MAKE THE PROBLEM WORSE, NOT BETTER. SELF-ACCEPTANCE CAN BE ONE OF MANY HELPFUL TREATMENT STRATEGIES. RELIGION CAN SOMETIMES BE A SOURCE OF OPPRESSIVE SHOULDS, ESPECIALLLY THE MORE FUNDAMENTALIST TYPES OF RELIGION. RIGIDITY MAY BE A PARTIALLY INHERITED TRAIT. FOR EXAMPLE, MANY RELIGIONS AROUND THE WORLD PROMOTE THE IDEA THAT HOMOSEXUALITY IS "WRONG" AND THAT PEOPLE "SHOULDN'T" HAVE URGES AND ATTRACTIONS TOWARD PEOPLE OF THE SAME GENDER. THIS IS AN AREA WHERE "SHOULD STATEMENTS" BECOME HIGHLY CONTROVERSIAL, AND ARE OFTEN A SOURCE OF HORRIFIC HATRED AND VIOLENCE, SOMETIMES IN THE NAME OF SOME "HIGHER POWER." Situation 3 Lucy was buying fruits in a grocery store when she found that a man was taking an apple off the shelf and hiding it in his clothe! Obviously, the man was stealing an apple. Lucy was very angry and said, "the man shouldn't steal things from the store. It's not right!" In this case, Lucy didn't steal apples, the man did. But Lucy made a moral judgement about the man's behavior, not Lucy's behavior. Then is this should statement valid for Lucy? DAVID'S THINKING. TO MY WAY OF THINKING, YES THESE ARE VALID LEGAL SHOULDS AND MORAL SHOULDS, SINCE OUR CIVILIZATION (AND ALL CIVILIZATIONS) HAVE DECIDED THAT STEALING IS ILLEGAL, AND IS ALSO CONSIDERED MORALLY WRONG IN MOST RELIGIONS: "THOU SHALT NOT STEAL" IS, I THINK, ONE OF THE TEN COMMANDMENTS. THE GOAL IS NOT TO CLEAN UP YOUR SPEECH SO THAT YOU NEVER USE SHOULD STATEMENTS THAT DO NOT FIT INTO ONE OF THE THREE VALID CATEGORIES OF L

Last week, you heard part 1 of the live work with Sunny. Today, you will hear the dramatic conclusion of that session. My wonderful co-therapist is Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California. Jill also co-leads our Tuesday training group at Stanford. This session took place between 5 and 7 PM at a recent Tuesday group because we feel that personal healing is a critical part of psychotherapy training. We will begin with a summary of A = Assessment of Resistance. David will summarize Sunny's Positive Reframing list, as well as the "turning point" when David challenged Sunny's first negative thought, telling himself that he shouldn't be getting anxious again. Once again, the moment he saw that he actually should be getting anxious, and that this was a good thing, and not a bad thing, the dam kind of broke open, and Sunny suddenly saw everything in a radically different perspective. This is one of the core principles and goals of TEAM—helping the patient suddenly see that his or her suffering is not the expression of what's wrong with you, like a "chemical imbalance" in your brain, but what's most beautiful and awesome about you, and your core values as a human being. During this phase of the session, Sunny expressed anger about parents who tell their children they SHOULD do X, Y, and Z, and thus sowing the seeds of low self-esteem and the need for approval. We continue and conclude the M = Methods, using: Identify the Distortions The Enhanced Cost-Benefit Analysis (Enhanced CoBA) The Externalization of Voices, with Self-Defense and the Acceptance Paradox The Hidden Emotion Technique The Five Secrets of Effective Communication Final T = Testing. You can see Sunny's end of session mood ratings on his completed Daily Mood Log, as well as his end of session scores on the Brief Mood Survey and Evaluation of Therapy Session. Here is Sunny's follow-up email to the Tuesday group: Hi folks. Just want to give you an update of what happened after our group meeting. I was exhausted after our session. But I felt very good - even different than other times when I did self disclosure and deep-down part of me was looking for some validations from others. This time, I came out feeling very confident about myself and my ability to swim without the floating bubbles (approval from others). Most importantly enjoy life now. In fact I didn't think talking with my mom was necessary because I was not angry with her the next day. Somehow I wasn't blaming her anymore because I know she changed since then. And I was thankful because I wouldn't be where I am without that push. But I did chat with her tonight. I told her how I was hurt when I felt a lot of pressure from her when I was young. And that I love her very much and now am happy that I am confident about my own life decision without needing approval from others. And she told me that she is happy that I am happy. And when we were young, she And she will always love me and support me. And she is happy that I am doing whatever I love so I don't regret in life. And on and on... lots of loving languages that we don't use together usually :) Net net: it was an awesome chat and we are closer. But as importantly, I wasn't looking for any validation from her - more like giving her some good news about my personal growth. And I felt more confident and equal but loving when I talked with her. So it's all good :) I do have an insight on self disclosure. From my experiences, there is a fine line between self disclosure vs approval seeking type of sharing. Both can have similar Immediate results - feeling good and emotional. So make sure our clients are clear of the objective of the self disclosure. And that there is no approval seeking hidden inside - if that's not the objective. See you all next Tuesday Sunny And here is some of the feedback from members of the Tuesday group: What did you like the least about today's Tuesday group? Nothing comes to mind Sunny was fabulous! This isn't something I disliked, but a question... I'm trying to figure out how David and Jill are able to get through the process so quickly and yet have it not feel rushed.. I suppose a lot of practice! Also curious about how Sunny will talk to his mom- thinking about doing this with my mother, I'd be worried that she'd feel like I was blaming her for something and become defensive and close down (which she typically does when anyone tries to bring up their feelings or even when they ask about hers), so I'd be curious about the specific details of the 5-secrets approach here Nothing — I loved everything about our session tonight Please describe what you specifically liked about the training? What was the most helpful? Agree with David that the learning which takes place via live personal work may be the most powerful of all. Helpful to review the various steps and methods while also watching the masters weave the art and science of It all together. Thank you to the

In today's podcast, we will work on another common Self-Defeating Belief, the Approval Addiction. Here are two definitions: My worthwhileness as human being depends on getting approval. I need approval to feel happy and fulfilled. I thought of calling this podcast "Curing a Case of Siliconitis" because here in Silicon Valley, there is a pronounced tendency for people to measure their self-esteem based on their accomplishments, so today's program also has some overlap with the Achievement Addiction we featured recently. Of course, you don't have to live in Silicon Valley to struggle with the Approval and Achievement Addictions. These problems are almost universal throughout the United States as well as the entire world. In fact, for today's special guest, Sunny Choi, the problem originated in Hong Kong when he was growing up. And although your life may be very different from Sunny's, you may discover that you, too, sometimes struggle with the need for approval, and the tendency to base your self-esteem on your achievements. So I'm hoping that the healing Sunny experienced might be contagious and end up helping you! I want to thank Sunny for allowing his personal work to be broadcast, raw and unedited, on the podcast. Personal work is absolutely essential to becoming a world-class therapist, because you can't really heal others until you've healed yourself. But sharing your inner struggles, your tears, and your shame, can be extremely frightening, making you totally vulnerable, so Sunny has given all of us an incredible gift! I also want to thank my amazing co-therapist, Dr. Jill Levitt, who helps lead the Tuesday group. She is also the Director of Training at the Feeling Good Institute in Mt. View, California. I love teaching and doing co-therapy with Jill. TEAM therapy does NOT require two therapist, but I love to work with a co-therapist whenever I do live therapy in a teaching situation, as it often makes for a richer and more dynamic session. The session will be broken into two consecutive segments. Today, you will hear the T = Testing and E = Empathy parts at the start of the session. Next week, you will hear the A = Assessment of Resistance and M = Methods parts. At the end of next week's podcast, Sunny will join us for a follow-up so we can see how he's been doing since the end of this session. At the beginning of the session, we reviewed Sunny's scores on the Brief Mood Survey, which indicated minimal feelings of depression, mild anxiety, and just a touch of anger. However, his happiness score was only 22 out of 40, indicating significant unhappiness, and his Relationship Satisfaction score, thinking of his mother, was only 16 out of 30, which is also not very good. However, he said that this score is higher than it's been, indicating longstanding dissatisfaction with his relationship with his mother. Sunny explained that he's been seeking and getting approval since he was a small boy. He was the "good golden boy" who always wanted what his mother wanted, and he always got rewarded. In addition, since he was a boy, he always got the best food, and his sister always got the less desirable dinner. In addition, she was a rebel, and often punished and beaten by their mom, which made Sunny feel guilty. At the same time, he was good at getting approval from just about everybody, so lots of people like him. His first frightening step toward independence was coming out as a gay man in his 20s. This was an intensely anxious time in his life. After his family migrated to California, he pursued a career in high tech, which was what his mother wanted, and he was very successful and earned a high salary. But he was unhappy, because it wasn't what he really wanted to do with his life. He wanted to help people, but because of a lisp in his speech, his mother urged him to pursue engineering, which, of course, he did, and he also graduate from Stanford University, which gave him even more approval and "success." His second frightening step toward independence was six years ago when he decided to leave high tech to pursue a master's degree in clinical social work. This was a bit anxiety provoking because he did his master's work at a program that was adequate, but not at all prestigious. That was about the time he joined my weekly training group at Stanford. Sunny took the TEAM model very seriously, and mastered it, developing superb therapy skills. Following his licensure, he took a job at a local mental health clinic and worked with many immigrants struggling with depression, anxiety, and somatic complaints, and experienced tremendous success, since most of us patients recovered in just a handful of sessions. However, he was anxious and ashamed of his success, since TEAM is so radically different from the more conventional forms of therapy his colleagues at the clinic were using. He feared their disapproval, and always tried to hide or downplay his success. Recently, Sunny took a third frightening step toward indepe

In today's podcast, we discuss a few of the many differences between Feeling Good, my first book, and my new book, Feeling Great, which was just released. We also discuss some of the differences between the cognitive therapy that I launched in Feeling Good, and the powerful new TEAM therapy that I feature in Feeling Great. I wrote Feeling Great because there's been a radical and enormous evolution of the treatment methods and theories in the 40 years that have elapsed since I first published Feeling Good in 1980. I now have many more techniques than I had then, and there's been with a radical development in my understanding of the causes of depression. I also have new ideas about the most effective treatment techniques, based on my clinical experience since I wrote Feeling Good (more than 40,000 hours treating individuals with severe depression and anxiety), as well as fresh insights about what's important, and what's not, based on four decades of my research on how psychotherapy really works. Rhonda asks many questions about the unique features of TEAM including the new T = Testing techniques, the new E = Empathy techniques, the A = Assessment of Resistance techniques, as well as the M = Methods. Rhonda is particularly curious about the four "Great Deaths" of the therapist's ego in TEAM therapy, which correspond to the four TEAM components of TEAM, as well as the four "Great Deaths" of the patient's ego, which correspond to recovery from depression, anxiety, relationship problems, and habits and addictions. One of the goals of TEAM is not simply the complete and rapid elimination of the symptoms of depression and anxiety, but the development of personal enlightenment and the experience of great joy and a deeper appreciation of life. Toward the end of the podcast, David tearfully talks about the life of his hero, Ludwig Wittgenstein, who is viewed by many as the greatest philosopher of all time, and David, a philosophy major when he was a student at Amherst College, would definitely agree with this assessment. But Wittgenstein was very lonely, and prone to depression, because very few people understood his ground-breaking contributions when he was still alive. In fact, it was thought that only five or six people in the world "got it." Part of the problem is that what he was saying was so basic and obvious that most people just could grasp it, or the extraordinarily profound implications of his work. His depression and loneliness, sadly, perhaps also resulted from the fact that he was gay, and living at a time when this was far less acceptable than it is today. He never published anything when he was alive, because when he was depressed, he thought he'd made no meaningful or enduring contributions. However, his remarkable book, Philosophical Investigations was published in 1950, following his death, and was soon regarded as the greatest book in the history of philosophy. Because of that book, David gave up his goal of a career in philosophy, since Wittgenstein wanted all of his students to give up philosophy and do something practical instead. So that's what I did! My only regret is never having the chance to meet Wittgenstein and tell him, "I got it!" and thank him for his incredible contributions. If you want to learn more, check out the short read by his favorite student, Norman Malcolm, who wrote "Ludwig Wittgenstein: A Memoir." I cry like a baby every time I read the book, and tears come to my eyes when I even look at the book, which is proudly displayed in my office. If you ever visit me at home, make sure you check out the book. I feel so fortunate to be able to work with Rhonda and bring my message to so many of you every week. Thank you for your support! [Note from Rhonda: I feel extremely honored to work with David and be a part of bringing David's message, and the TEAM therapy model to our listeners!] David and Rhonda

How to Change a Self-Defeating Belief (SDB) (cont'd) Last week, you had the chance to listen to our Tuesday training group at Stanford as we worked on the "Achievement Addiction," Part 1 (Podcast 211). Although we were working with a therapist named Zeina Halim, it turned out that just about everybody in the group had this belief, and perhaps you do, too--thinking that your worthwhileness as a human being depends on your achievements, hard work, and productivity. This belief, which is also known as the Calvinist work ethic (e.g. you are what you do) is actually at the heart of Western Civilization. And while it can trigger intense achievement, it can sometimes also trigger angst, including feelings of depression, anxiety, and endless self-doubt, wondering if you and your achievements are "good enough." In last week's podcast, we played the first half of the Tuesday group's session, featuring the Cost-Benefit Analysis. In today's group, we play the the recording of the last half of the group, featuring these three additional techniques. At the end of today's recording, Zeina joins us and talks about the session, and the techniques that were the most meaningful for her. The Semantic Technique. This involves change at the intellectual level. If you decide that a SDB is not working to your advantage when you do a CBA, you can you modify it so you can keep all the advantages you listed while getting rid of most if not all of the disadvantages. This is a bit of practical personal philosophy exercise with significant emotional implications. The group members came up with a wide variety of alternate beliefs, and I critiqued several of them, pointing out the benefits and pitfalls of each new version. The Feared Fantasy. Here's where change at the gut level begins, and you also can begin to challenge the idea that high achievers really are more worthwhile. We did a version of this technique that I've often demonstrated in my workshops called the "High School Reunion." It is a humor-based technique, but the goal is to make a powerful point at the gut level, so you can (hopefully) suddenly "see" that it is simply not true that people who achieve a great deal really are more worthwhile human beings. The Double Standard Technique. Here's where change at the gut level continues, and you will hear a beautiful example in Zeina's dramatic interaction with Dr. Levitt. Dr. Levitt plays the role of someone trying to figure out if she really is less worthwhile than people who achieve a great deal more. Rhonda and I hope you enjoyed our podcasts on the Achievement Addiction. We'd also like to thank our courageous Zeina for sharing her very personal work with all of us. Live work--and showing how a technique works--is generally far more inspiring and illuminating than simply teaching how a technique works. Please let us know if you'd like more Feeling Good Podcasts like this in the future, with recordings from our weekly training group, and also if there are additional Self-Defeating Beliefs you'd like us to feature. My new book Feeling Great, is now available on Amazon (see the link below) as a hardbound volume or as an eBook. It features all the new TEAM therapy techniques, and is geared for therapists as well as the general public. Rhonda and David

How to Change a Self-Defeating Belief (SDB) Many of you have expressed an interest in my free Tuesday training group for mental health professionals. Today, you can attend, thanks to the generosity of our group in allowing the group to be recorded on Zoom, and thanks Zeina, the group member who courageously volunteered to have us work on her "Achievement Addiction." I also want to thank my beloved and brilliant co-teacher, Dr. Jill Levitt, who always adds tremendously to our group, on so many different levels. Last week, we taught the group members how to pinpoint Self-Defeating Beliefs that trigger depression and anxiety, and we promised to show them how to challenge and modify a Self-Defeating Belief in the group you're about to "attend." We decided to focus on the Achievement Addiction, which is the belief that your worthwhileness as a human being depends on your achievements and productivity. Perhaps you share this belief! Most people do. Here's how a Self-Defeating Belief works. Let's say that you base your self-esteem on your achievements. As long as you think you're achieving and being successful, we would predict that you'll feel happy and contented. But we would also predict that you may experience episodes of depression, anxiety, and self-doubt when you fail or fall short of your goals and expectations. That's when you'll be most likely to start beating up on yourself with distorted negative thoughts, like "I'm a loser," or "I shouldn't have screwed up," or "I'm not good enough." So, in short, the combination of an SDB ("My worthwhileness is based on my achievements") plus a negative event, like a perceived failure, triggers distorted thoughts (like "I'm a failure" or "loser") which trigger negative feelings, like depression, anxiety, shame, inferiority, or even suicidal thoughts. In addition, cognitive therapists believe that if you modify the SDB, it will not only help you in the here-and-now, but it can also make you less vulnerable to painful mood swings in the future. But how in the world can you do that? If you like, take a look at the list of 23 common Self-Defeating Beliefs and see if you can find any of yours! Zeina said she wanted help with her tendency to base her feelings of happiness and self-esteem on her accomplishments. In the group, we demonstrated four techniques for changing this or any SDB, including: The Cost-Benefit Analysis. You list the advantages and disadvantages of the belief you want to change. You can find the one we worked on with Zeina during the group if you click this link. If you want a blank one you can work with, you can find one on page 2 of this link. The Semantic Technique. This involves change at the intellectual level. if the SDB is not working to your advantage, could you modify it so you can keep all the advantages you listed while getting rid of most if not all of the disadvantages. This is a bit of practical personal philosophy exercise with significant emotional implications. The Feared Fantasy. Here's where change at the gut level begins, and you also can begin to challenge the idea that high achievers really are more worthwhile. The Double Standard Technique. Here's where change at the gut level continues, and you can hear a beautiful example in Zeina's dramatic interaction with Dr. Levitt. In today's part 1 podcast, we completed the Cost-Benefit Analysis. I would urge you to do your own CBA while you're listening. When you're done, balance the advantages against the disadvantages on a 100 point scale. Put two numbers in the circles at the bottom to show whether the advantages or disadvantages are greater. For example, if the advantages of this belief greatly outweigh the disadvantages, you might put 80 - 20 in the two circles. If the advantages and disadvantages of this belief are about equal, you can put 50 - 50 in the two circles. And if the disadvantages are somewhat greater, you might put 45 - 55 in the two circles. When you do your own weightings, please note that the number advantages or disadvantages is not important--that's because one advantages could outweigh several disadvantages, and vice versa. Instead, look at the lists as a whole and ask yourself how they feel, and how this belief is working for you. In addition--and this is super important--remember that you are NOT evaluation the advantages and disadvantages of achievement. There probably aren't any disadvantages of achievement! Instead, you are evaluating the advantages and disadvantages of basing your self-esteem and feelings of worthwhileness on your achievements and productivity. At the end of the group work with the CBA, I emphasize that the goal of the CBA is simply to find out if you (or in this case Zeina) want to change your SDB. This is a motivational question. If the advantages and disadvantages are about equal (50 - 50), or if the advantages out weight the disadvantages (eg 60 - 40), then there may be no reason to change the belief. But when the disadvantages outweigh th

Corona Cast 8: Live Therapy with Dan. How Could You Treat an "Existential Depression" in the Midst of a Pandemic? Today David and Dr. Jill Levitt feature live work with Dan, a licensed clinical social worker who's been struggling with an "existential depression" for 15 years, but it has been recently exacerbated by the COVID-19 pandemic. The session took place in one hour and forty minutes on a Tuesday evening on July 23rd, 2020, in David's and Jill's Tuesday training group at Stanford. Live personal work is one form of training that is vital to professional growth and learning, so it is extremely beneficial for the person who volunteers for the role of "patient." At the same time, the live work also provides superb learning for those observing the process, since you can see what is really happening during a T.E.A.M. therapy session. Hopefully, you will learn a great deal as you listen to Dan's live and uncensored therapy session. Jill and I feel very grateful to Dan for allowing us to publish such an intensely painful and personal experience. You will likely feel grateful to Dan as well! All live therapy sessions tend to be dramatic and illuminating from a variety of perspectives. Today's session is unique in that the A = Assessment of Resistance was outstanding and unique. The remarkable changes that occurred would not have been possible without outstanding E = Empathy and A = Assessment of Resistance, which were stellar. However, the M = Methods portion of the session was also strong, especially in the use of humor and role-reversals during the Externalization of Voices to blast Dan's Negative Thoughts out of the water. That portion of the session confirmed by the three basic tenants of cognitive therapy: You FEEL the way you THINK. All of your negative feelings are caused by your thoughts in the here-and-now, and not by the actual events in your life. In other words, the COVID-19 pandemic cannot "cause" anyone to feel depressed or anxious. Depression and anxiety are the world's oldest cons. When you're depressed, anxious, or angry, the Negative Thoughts that upset you will not be valid. They'll be distorted and illogical. Depression and anxiety are the world's oldest cons. You can see the ten cognitive distortions I first published in my book, Feeling Good, at the bottom of Dan's Daily Mood Log (link). You can CHANGE the way you FEEL. The very instant you stop believing your distorted thoughts, your feelings will change. Recovery is not a long, drawn-out process that requires weeks, months, years or decades, as so many people believe, including the majority of mental health professionals. Recovery happens in a flash, an unexpected "ah-ha" moment when your perceptions of the world are suddenly transformed. You will witness such an event in today's session. Now let's see what actually happened! T = Testing Take a look at Dan's Brief Mood Survey (BMS) at the start of the session. He was feeling moderate to severe depression, no suicidal impulses, and just a little anxiety and anger. His Happiness score was quite low, only 7 out of 20, paralleling his depression score of 12, and his satisfaction with his relationship with his wife was a perfect 30 out of 30. He indicated he'd been doing a lot of psychotherapy homework. This, by the way, is the latest version of the BMS. We'll ask him to complete it again at the end of the session to see what changes occurred during the session. Because the BMS asks how Dan is feeling "right now," it's like an emotional x-ray machine, allowing therapists to see exactly how much, or how little, a patient is changing at every therapy session. The patient's scores at the start of the next session also allow the therapist to see exactly what happens between sessions in multiple dimensions. At the end of today's session, Dan will also fill out the Evaluation of Therapy Session (ETS), and rate Jill and David on Empathy, Helpfulness, and Session Satisfaction, and indicate how willing he is to do psychotherapy homework, whether he had unexpressed negative feelings during the session, and whether he had difficulty filling out any of the survey questions honestly. The BMS and ETS are invaluable tools that have been game-changers in psychotherapy. To my way of thinking, it is difficult, if not impossible, to do good therapy, much less outstanding therapy, without these powerful and extremely accurate tools. They have the potential to radically transform clinical work and have been an important key in the evolution of TEAM. E = Empathy After briefly reviewing Dan's starting scores on the BMS, Jill and David empathized while reviewing the Daily Mood Log that Dan filled out prior to the start of the session. The upsetting event was sitting at home on a Friday night with nothing to do, since his wife was studying for an upcoming exam. He points out that when he's busy doing therapy, he generally feels fine, but sometimes when he has nothing specific to do, intense negative feelings suddenl

Social anxiety has been one of our most popular topics. It seems like lots of people get anxious in social situations. and a great many have even greater difficulties talking to strangers and people they might be interested in dating. When I was in private practice, social anxiety, and "singleness," were exceptionally common. In fact, 60% of my patients were single—they'd been divorced and didn't know how to get back into the dating scene, or, they'd never developed romantic relationships in the first place. So today, we offer more tips and help for people who are afflicted with social anxiety. Rhonda and I are very proud and excited to be joined today by a brilliant colleague and expert on social anxiety, Dr. Jacob Towery. Dr. Towery is a Stanford-trained pediatric psychiatrist, and was a student of mine when he was a psychiatric resident, He practices in Palo Alto and helps teach our weekly Tuesday TEAM therapy training group at Stanford. Today (the day we recorded this podcast) was Jacob's 41st birthday, so Rhonda and I sang a rousing Happy Birthday for Jacob at the start of the podcast! He kindly tolerated our fairly awful but heartfelt rendition of that classic song. Perhaps you could think of it as our own (fairly mild) Shame-Attacking Exercise. As we begin today's podcast, Rhonda reads a sad but moving email from Davide, who desperately wants to open up and connect with people on a deeper level, but says "these things scare me like hell." In his email below, he describes his struggles and lists his negative thoughts about talking to people he doesn't know. He is especially afraid of Self-Disclosure—telling people that he struggles with social anxiety. To his credit, Davide has made significant progress, has worked hard on challenging many of his negative thoughts and self-defeating beliefs, and already has a girlfriend! But he wants to take his progress and growth to a new level. Here's the email I received from Davide: Hi David! There is no month that I don't listen to your podcast and take some notes. Yes, you can read my email and use my real name as you like! I really think that your methodology is a breakthrough in self-help and coping with emotions. Also, the new technique of positive reframing is very helpful. When I started using it for myself at the beginning of every daily mood log I really noticed a faster improvement. I completely agree with your vision that it would be better if there weren't schools of psychotherapy but tools that work. Your books and works have really changed my life for better and I'm looking forward your next book Feeling Great! In these two years I have done many Daily Mood Log, I have also done every day for a month the Smile and Hello Practice and I got a girlfriend for the first time in my life! I'm still not very good at breaking my negative thoughts though. I often end up with a lengthy, verbose and not so effective positive thought. Sometimes it seems that I understand rationally that a negative thought isn't true, but I don't feel better. Also, my social anxiety is reduced, but not gone. I still have a lot of social anxiety when I'm around people. I understand the Spotlight Fallacy and Brushfire Fallacy at the intellectual level and I'm definitely improved a little, but still today I can't remember a single good conversation with a person that I don't know and I'm not very comfortable with. I tried to use the Five Secrets but I can't think of anything good to say in real conversations. I want to do some shame-attacking exercises and also disclosure to random people on the street about my social anxiety, but these things scare me like hell and I don't have the courage to do these exercises. I know that these will help, but I feel really really scared and so far, I haven't mustered up enough courage. I want to leave home (I'm in Italy) for work in another country in Europe next year, but for me social anxiety is a really huge obstacle. This makes me feel a little sad because I see my social anxiety like a prison. These are some of my anxiety thoughts at the idea of disclosure to random people on the street that I want to go to work abroad but I'm too shy and suffer from social anxiety: I will not be able to say what I want to say because of anxiety. I will stumble in words and an inconclusive thing will come out. The other person will think that I'm completely crazy and I will frighten him/her with my behavior. I should never scare other people with my behavior. In the future I will remember all the things that I said wrong and I will beat myself up over and over again. I will waste the other person's time when I try to talk to them. I should never waste anyone's time. If I stop a woman, she will think I'm crazy creepy guy who wants to sexually assault her and I will scare her. The other person won't stop to talk to me and will just go their way, pretending I didn't exist. Sorry for this lengthy email. When I read your response I exploded with joy and I decided

Last week you heard Part 1 of David's TEAM Therapy session with Neil Sattin, who became pretty despondent and discouraged right after the first shut down because of the covid-19 pandemic in March of 2020. David and Neil went through the T = Testing and E = Empathy parts of TEAM, and David helped Neil develop a Daily Mood Log so he could record his negative thoughts and feelings at one specific moment at the end of a day when he was feeling like he hadn't gotten enough work done. Perhaps you've had the same problem at times! Today you'll hear the A = Assessment of Resistance and M = Methods parts of the session. As they begin, David asks Neil the Magic Button and Miracle Cure questions, and Neil says that he definitely does want help and would push the Magic Button to make all of his negative thoughts and feelings on his Daily Mood Log disappear. David cautions against that and suggests Positive Reframing, asking two questions about each negative thought and feeling. What does this thought or feeling show about you that's positive and awesome? What are some potential benefits, or advantages, of this thought or feeling? Here's Neil's list of Positives: My sadness: Shows that I'm ambitious Motivates me to achieve a lot Shows that I have high standards My anxiety: Shows that I'm responsible Keeps me vigilant Fuels me to take action Reminds me that I'm doing important things My guilt: Shows that I have a moral compass My feelings of defectiveness and inadequacy: Show that I want to be a good role model Show that I'm willing to be honest about my flaws Show that I hold myself accountable Show that I'm humble My feelings of being alone show that: I value connections with others Allow me to feel close to people My feelings of embarrassment and humiliation show that: I have high standards and goals I want my life to mean something I value acceptance My discouragement shows that: I have a vision I'm realistic about the many challenges I face and the sheer volume of work I have to do I'm willing to face the truth My frustration shows that: I'll persevere. I won't stop and give up. Feeling annoyed and irritated: Shows that I won't tolerate things that get in my way Gives me energy and determination Feeling overwhelmed: Reminds me that I might be taking on too much Protects me from trying and failing Shows that I'm looking for ways to take care of myself. After listing these positives, Neil used the Magic Dial and indicated that he'd like to dial down his negative feelings to lower levels, rather than getting rid of them entirely, as you can see in the "% Goal" column of his Daily Mood Log. Then they moved on to M = Methods, focusing first on Neil's Negative Thought (NT): "I'm not capable of getting organized. After identifying a number of distortions in the thought, Neil was able to generate a positive thought that fulfilled the necessary and sufficient conditions for emotional change: The Positive Thought (PT) has to be 100% true. The PT has to drastically lower your belief in the Negative Thought. You can see this on his DML. David and Neil used a variety of techniques, including Externalization of Voices, to challenge the rest of his NTs. Neil re-rated his negative feelings at the end of the session. They all feel to zero except feeling alone, which went from 80 to 5, which was his goal. Rhonda and David

Rhonda begins with a plug for David's new book, Feeling Great, which will be released on Amazon, on September 15, the day after after this podcast will be published. You can check it out at the link at the bottom of today's show notes. Today and next week you will hear parts 1 and 2 of a live therapy session I (David) did with Neil Sattin, host of his own terrific "Relationship Alive" podcast, which has received 5 million downloads. But as you know, we all sometimes need a little mental tune-up, including therapists. The session you are about to hear occurred on March 23, 2020, when the pandemic shut-down first occurred. Rhonda begins today's podcast with a moving email from a fan who heard Neil's live therapy session with David on Neil's Relationship Alive podcast. Then Neil explains how his work on troubled relationships were born out of his work as a dog trainer, and he saw many similarities with relationship issues! In addition to hosting his popular podcast, Nel does coaching for individuals and troubled couples. Neil explains that, "I've always been a person who people have turned to for relationship help. I saw the struggles my parents experienced, and I have experienced my own struggles, and I wanted to figure out how we might use struggles to deepen and improve relationships, so people can thrive and get past those challenging moments. Prior to his personal work with David, Neil sought help from a cognitive therapist, but it wasn't helpful thought. Neil thought it was too formulaic, a sentiment that David agrees with. Neil prefers working "in the moment," the way David does therapy. Today, you will hear the T = Testing and E = Empathy portions of Neil's TEAM therapy session with David, and next week you will hear the A = Assessment of Resistance and M = Methods portions. You can check out the Daily Mood Log that David and Neil filled out at the beginning of session. As you can see, the upsetting event was simply feeling like he hadn't gotten enough done when evening approached. Perhaps you've sometimes felt like that, too! You can also see that Neil had many negative feelings. Most were intense and Neil felt overwhelmed. He was telling himself there was way too much to do, that he was incapable of getting organized, and that he was going to end up unhealthy, weak and broke. These were messages he'd heard from his dad when he was growing up: "You've gotta clean your room. . . You'll never succeed." Tearfully, Neil says, "I've always wanted his blessing. . . but I've never gotten it. I wish he could see my role in the world, the impact I've been making, and I wish he would admire it! . . . I love him dearly, but there are things I just don't understand, things that have been the sources of my sadness and anger " Tune in next week for the exciting conclusion of the session! Rhonda and David

Ask David What do you do when someone won't stop asking questions? Hello David, It's been a while since I've emailed you, but that's because I've been doing really well thanks to you! I started a new job 3-1/2 months ago, & this woman seemed to take to me right from the start. It was nice at first having someone to talk to etc, but it has quickly turned bad. She sits in the cubicle right next to me. All day long she talks to me asking me questions. What did I do after work? Who was I with? How long was I gone? What did my husband do? And on & on. It feels like she's interrogating me because the questions never stop. I'm trying to get more vague with my answers hoping if will deter the conversation, but no luck. It really becomes distracting at times & then other times it just feels like she's being nosy & freaks me out. I just want her to leave me alone! I think this would be a good opportunity to use the 5 secrets of effective communication, but I'm struggling. Could you help? Thank you, Brittany Hi Brittany, Will send to Rhonda for an Ask David. But a simple approach would be to tell her that you admire her and appreciate her interest, but that you sometimes find the questions distracting from doing your work. Perhaps you could sit down with her for lunch or something, and then use your five secrets skills. Using the relationship journal, you could write down one thing she said to you, and exactly what you said next. Then we can see exactly what you are doing that is fueling the problem! I've attached one, and you could send it to us after you have completed Steps 1 and 2. David Thank you for the reply! It really made my day. I attached the relationship journal. It was actually more helpful than I thought it would be for this situation. Once I was able to think of a good example, I realized that maybe my lack of inquiry or showing interest in her is causing her to ask me all these questions. Although if I ask her more about herself, I don't know if it would result in her talking even more? Hard to say. Thanks for your help, and I appreciate your thoughts on my relationship journal. -Brittany Hello, Wanted to give you an update on how it went using the five secrets. First thing Monday morning my coworker started right up with the questions. I used the five secrets & said something similar to what I wrote to you. She apologized for bothering me, & things have been great all week! She actually brought in headphones & has been listening to music now. And there's no tension or animosity between us which was my fear initially. We still chat here & there & are friendly. Thanks again! -Brittany How can a pastoral counselor get training in TEAM-CBT? Dear Doctor David, I am a pastor from South Africa, married to an Australian, living in Dubai :) I was struggling with mild depression & came across your book "feeling good" and read it & applied all your techniques & it has been life-changing - THANK YOU! What surprised me most was the simplicity and effectiveness of the exercises. I believe that much of what you teach is life skills everyone should have! I wish I was taught these things when I was younger! Over the years I have helped people, from all walks of life - inmates, students, business people, etc., but primarily from a spiritual perspective. I believe I can be more effective and help so many more out there if I learn how to apply your exercises to others. I would love to train in TEAM and learn how to apply these techniques with the people I minister to, but I am not a psychologist or certified as per your requirements. I realize practice and critical feedback is paramount in order to get really good in TEAM. Please advise me on an alternative route. Any help with this regard would be highly appreciated! Thanking you in advance. Yours sincerely, Gareth Noble Hi Pastor Noble, Sure there is a certification program at the Feeling Good Institute. I believe pastoral counselors would be very welcome. They offer many online introductory classes in TEAM-CBT. Check our my free weekly Feeling Good Podcasts, too. I will include your question, with your permission, on an Ask David Podcast. I also offer a free depression class on my website, and about to post an anxiety class too, also free. There are tons of resources, almost all free, on my website, www.feelinggood.com. You can check out my website page from time to time for online workshops. Dr. Angela Krumm [email protected] is head of the certification program at FGI, which is www.feelinggoodinstitute.com. Angela and I are both PKs (Pastor's kids)! All the best, David Is love an adult human need? Rhonda said that people in the TEAM certification listserve thought they heard David say that love is not an adult human need. Is this true? David comments on hearing Dr. Beck say that decades ago, in one of Dr. Beck's weekly training groups at U. Penn, and what he (David) discovered. What's the best training program to learn TEAM-CBT? David and Rhonda, I hop

Today, the Cognitive Distortion Starter Kit Focuses on Blame This is the final podcast on the Cognitive Distortion Starter Kit. Today, we focus on techniques to combat Blame. There are two common forms of Blame, and both can be deadly. Self-Blame: You beat up on yourself and blame yourself for things. Self-Blame is nearly always accompanied with self-directed Should Statements: "I really screwed up. I shouldn't have done that!" Self-Blame triggers depression, worthlessness, and guilt, and sometimes triggers feelings of hopelessness and suicidal urges. Other-Blame: You beat up on others and blame them for the problems in your relationships. Other-Blame is nearly always accompanied with other-directed Should Statements: "He's such a loser. He shouldn't have such ridiculous beliefs!" Other-Blame triggers anger and conflict in relationships, and can sometimes trigger rage, violence, and even murder. Rhonda describes going on a bicycle trip with her husband. But when they got to the trailhead, they realized that her husband had put the wrong bicycle for Rhonda on their car. Sadly, the much-anticipated bicycle ride was ruined, and Rhonda began fuming and blaming her husband for having made this mistake. but then she decided to back off and think about her own role in the problem, and soon they were bake in a loving mood again. Unfortunately, for many people, the outcome is different, with escalating arguments and lasting feelings of resentment and indignance. David describes his work with a married woman who blamed herself for sexual difficulties and a history of sexual abuse as a child, who stood in front of a mirror with a razor blade to her neck the night before her first session with David. She was debating, "Should I just slit my throat and get it over with, or should I show up for my session in the morning?" Rhonda presses David for details about the treatment, which had a glorious outcome. David also gives a dramatic example of Other-Blame—a man who shot two obnoxious and aggressive teenage boys with his crossbow during a road rage incident. He shot one of the boys through the heart, and he fell and bled to death. Then he shot the other boy through the spinal column, and that boy survived but ended up paralyzed for life. The man was arrested and given a life sentence in prison. When interviewed by a television reporter and asked if he had any remorse or regrets, the man said, "Regrets! Hell no! That was the greatest accomplishment of my life! I think about constantly and it makes me euphoric. If I had the chance, I'd do the exact same thing again!" And that the huge problem with Other-Blame. Although negative thoughts containing Other-Blame are nearly always extremely distorted, just like the thoughts that cause depression, thoughts with Other-Blame trigger feelings of moral superiority and anger that can be extremely addictive. That's why anger and relationship conflicts can be way harder to treat than depression and self-blame. One potentially helpful technique is a Blame Cost-Benefit Analysis, listing all the many advantages and benefits of blaming others for your problems and relationship conflicts. Once you've seen all the benefits, you can list the disadvantages, and then balance them against each other on a 100-point scale. if the advantages of blame are greater, there's no reason to change. If you're interested, you can check out this link to a Blame CBA that my daughter and I prepared. Check it out! David explains how he used this technique to help a physician with chronic, refractory depression and episodic rage attacks in a single therapy session! It's a great technique to try if you're feeling unhappy and blaming others for the problems in your relationships with them. Rhonda and I have enjoyed creating this series for you. If there are other series you'd like to hear, let us know. For example, we could have a series of podcasts on all the different kinds of anxiety, illustrating the most helpful techniques for each one. We could also have a series on all of the different kinds of Self-Defeating Beliefs, like the Spotlight Fallacy, and how to defeat them. Or, if there are techniques you want us to highlight, we'd be more than happy to do that, too! Rhonda and David

Today, the Cognitive Distortion Starter Kit Continues with Should Statements Rhonda begins by reading a beautiful email from one of our listeners, and I give a brief shout out for my new book, Feeling Great, which can be pre-ordered on Amazon now (see below for the link). Thanks to your support, as of today (July 2) it is already the #1 best seller in the Amazon depression AND anxiety categories for impending new books! David and Rhonda briefly summarize the history of Should Statements, starting with the Buddha 2500 years ago, and culminating in the work of Karen Horney and Albert Ellis in the 20th century. They both emphasized that nearly all emotional suffering as well as relationship conflict results from "Shoulds." David and Rhonda describe the four categories of Should Statements: Shoulds directed against yourself cause depression, anxiety, guilt, and shame. and even lead to suicidal urges. Should directed against others cause anger, and can even lead to violence. Shoulds directed against the world cause frustration. Hidden Shoulds. They also describe the three valid types of Should Statements: Moral Shoulds Legal Shoulds Laws of the Universe Shoulds David and Rhonda provide vignettes illustrating the tremendous emotional damage that can result from "Shoulds" and describe a number of strategies for combating them, including: Positive Reframing the Semantic Technique Socratic Questioning the Acceptance Paradox The final podcast in this series will focus on the two types of Blame: Self-Blame, which nearly always marches hand-in-hand with Self-Directed Shoulds Other-Blame, which nearly always marches hand-in-hand with Other-Directed Shoulds Rhonda and David

Today we feature a brilliant and beloved colleague, Dr. Alex Clarke. At the start of today's podcast, Alex describes his unexpected journey from psychoanalysis / psychodynamic therapy to TEAM, but discovered that TEAM can actually be viewed as a type of psychoanalytic therapy. In fact, the two fathers of cognitive therapy, Albert Ellis, PhD, and Aaron Beck, MD, began their careers as psychoanalysts. They were simply looking for specific techniques to help their patients develop rapid and tangible change, and not just understanding that unfolds over a period of years. David and Alex discuss some of the surprising overlaps between TEAM and psychodynamic therapy, as well as some of the striking differences. Similarities Changing the Focus: Often there's tension in the room, especially during therapy sessions. When you bring it to conscious awareness in a kindly way, it will often lead to therapeutic breakthrough. The Relationship Journal: This is a rapid way to highlight the recurring patterns that cause conflicts in intimate relationships. Interpersonal Downward Arrow: This is a high-speed version of psychoanalysis which reveals your "core conflict" in ten minutes, as compared with five years on the analyst's couch. Hidden Emotion Technique: This is the idea that anxious individuals are overly "nice" and feel they have to suppress certain kinds of positive or negative feelings, which then emerge, in disguised form as some type of anxiety, such as chronic worrying, a phobia, a panic attack, OCD, and so forth. Differences T = Testing techniques: Most analysts are dead set against testing, thinking it will somehow hurt or ruin the "transference." TEAM therapists are convinced it is difficult, if not impossible, to do good therapy without session by session assessments to track how patients feel, and how they feel about the therapist. E = Empathy training and methods: TEAM therapists get highly accurate and sensitive empathy ratings after every session from every patient. Many therapists get failing grades from most patients at most sessions. The patient's criticisms are not taken as evidence for the patient's distortions of the relationships, but rather as valid indicators of the therapist's actual errors. This information is used to deepen the therapeutic relationship. A = Assessment of resistance: Freud devoted his career to understanding and trying to solve the puzzle of resistance—but his free association on the couch was not terribly effective. TEAM therapists bring subconscious resistance to conscious awareness quickly, and melt it away rapidly with a variety of techniques. This opens the door to the possibility of ultra-rapid recovery. M = Methods: TEAM therapists use more than 100 methods drawn from more than a dozen schools of therapy. The therapist and patient work together collaboratively to solve specific problems, and homework between sessions in mandatory. Alex's current passions span a broad range of mental health treatment, and as a result, provide lots of great opportunities for fun and collaboration with David, as well as the rest of the TEAM community. Clinical work: Alex sees patients three days per week, using TEAM and occasionally medications if needed. Training / teaching: He teaches with David and several other experienced TEAM therapists at David's weekly training group at Stanford. The Feeling Great app: Alex is assisting David and Jeremy Karmel in the process of making TEAM Therapy accessible to everyone as an electronic app. The app will include real-life examples bringing the techniques to life along with step-by-step instructions for how to put techniques into action. Putting these powerful psychotherapy ideas and methods in patients' hands provides an exciting opportunity to accelerate healing and augment therapy, since the tool can be assigned as homework between therapy sessions. Also, when patients get stuck with topics in the app, they can discuss these with their therapists, deepen their understanding, and bring them to life through role-plays, etc. Statistical modeling: With David's mentoring, Alex is working to learn data analytic and statistical modeling methods that can help investigators explore and understand how effective psychotherapy actually works. Measurement and Search: Alex has joined David's son, Erik, on the exciting mission of promoting measurement-based and feedback-informed treatment as the standard of care in mental health. They are currently in the final phases of developing and rolling out an electronic system for use by therapists and patients to assess mood before, after, and between therapy sessions in order to assess changes in therapy as well as relapses between sessions. This system will provide unique insights for clinicians as well as patients about what's helping, what's not helping. The tool will also have a search-engine celebrating clinicians who commit use measurement consistently in their clinical work and will help patients find clinicians w

Today, the Cognitive Distortion Starter Kit Continues with Emotional Reasoning Rhonda begins by reading a beautiful emails from a listener who was greatly inspired and helped by the personal work Marilyn Coffee did on several previous podcast. I also give a brief shout out for my new book, Feeling Great, which can be pre-ordered on Amazon now (see below for the link). Rhonda and David begin with a brief overview of Emotional Reasoning. this is a term i coined when I first created the list of ten cognitive distortions in the mid-to late 1970s. There is the definition: Emotional Reasoning is when you reason from how you feel. Here are several examples: "I feel like a loser, so I must really be a loser." "I feel hopeless, so I must be hopeless." "I feel anxious, so I must be in danger." "I feel like a bad therapist, so I must really be one." "I feel judged. This means that people are judging me." "I feel guilty. This means that I did something bad." Emotional Reasoning is a distortion because your feelings all result from your thoughts. And if your thoughts are distorted, then your emotions / feelings will not reflect reality. Sometimes, your feelings are no more realistic than the images you see in funhouse mirrors in an amusement park. This is worth knowing because for decades mental health professionals have promoted the ideas that getting in touch with your feelings is the key to mental health. There's truth in everything, and this is sometimes true. Being open with your feelings can be an important key to intimacy and to genuine relationships with others. But your feelings can also deceive you. For example, the feeling of hopelessness is always based on distortions and is never true. But sometimes believe it so strongly that they attempt suicide as the only escape from their suffering. David and Rhonda discuss examples of emotional reasoning and the techniques that can be helpful, including, but not limited to: The Double Standard Technique The Socratic Method Truth Based Techniques, such as: Examine the Evidence The Experimental Technique The Survey Technique David describes a father who was convinced he was a bad father because he shouted at his sons, and Rhonda describes an aspiring writer she recently treated who felt like she was dull and unimportant prior to a meeting with prospective agents. We are nearing the end of the distortion series, but still have two mega-important distortions to discuss: Should Statements Blame David mentions that Emotional Reasoning is not only important in emotional problems like depression and anxiety, but also in anger and conflict with others, as well as racial and religious bias. You feel like other racial or religious groups are inferior, and you feel superior, so you think you are right! Thank so much for listening. If you like our podcasts, tell your friends, colleagues, and patients about them! This is all volunteer work, so our only marketing budget is your good will. Each month our downloads are increasing, thanks to you, and we will hit three million downloads early next year or late this year. Rhonda and David

Today, Rhonda and David discuss seven great questions submitted by podcast fans like you! Are depression and anxiety states of self-hypnosis? How do you deal with somatic symptoms in TEAM? Should we forgive Hitler and Stalin? What if a patient feels stuck and unable to identify emotions? Do you still really believe that depression and anxiety, regardless how severe, can be treated even without the use of prescription drugs? Do you have to work on your negative thoughts the moment they appear? What role, from your years of practice, does spirituality have in the psychotherapy? Are depression and anxiety states of self-hypnosis? Hi David, I have two questions after listening to Corona Cast 7: "My Struggle with Covid-19! Is it REALLY True that only Our Thoughts Can Upset Us?" I was struck by thinking of anxiety as the result of hypnotizing ourselves into believing our fears. Can depression by thought of in a similar way, except that we hypnotize ourselves into believing our distorted thoughts about ourselves? How do you deal with somatic symptoms in TEAM? Can you do an episode about how to deal with unpleasant somatic situations, as Michael was experiencing during the recording, that suggest there might be some psychological distress but don't seem to have thoughts associated with them? Thanks! Hi Derek, Another great couple of questions, thanks! Will add these to the next Ask David podcast, but the short story is yes, for sure—both depression and anxiety can be thought of as states of self-hypnosis, or trances, because you believe the messages you give yourself, (eg your negative thoughts) that are not true. I think one could add other positive and negative emotions to the list as well, including anger--believing the other person really IS wrong, bad, inferior, and so forth--as well as mania and narcissism, telling yourself that you really ARE a superior person, etc. This is a hugely important topic, and "emotional reasoning" fuels these trances: I FEEL worthless / inferior, so I must BE worthless / inferior, and so forth. With regard to your second question, you might want to listen to yesterday's live session with Sarah, (Podcast 193, https://feelinggood.com/category/dr-davids-blogs/feeling-good-podcast/) since it focuses on intense somatic sensations generated by emotions, and you can actually hear the exact moment of recovery, when the physical sensations disappeared. David Should we forgive Hitler and Stalin? Hi Dr. Burns, Do you honestly think what Hitler and Stalin did should be forgiven? Albert Ellis said one should. I disagree! Tom Hi Tom, I only help people with problems they are asking for help with. I am not an evangelist or moral authority! David What if a patient feels stuck and unable to identify emotions? A new comment on the post "Uncovering Self-Defeating Beliefs (SDBs)--For Therapists (and Interested Patients) Only!"/ Hi Dr. Burns, Awesome blog post! Your accessible and kind demeanor shine through clearly. What if a client feels stuck and unable to identify emotions? Holly Do you still really believe that depression and anxiety, regardless how severe can be treated even without the use of prescription drugs? Hi Doctor Burns, My name is Jasmine, and I just started going back to therapy about a year ago. I have really improved, and both my mom AND my therapist recommended you HIGHLY. I'm a millennial and I'm just happy you are still alive! I also wanted to ask, do you still really believe even today that depression and anxiety, regardless how severe can treated even without the use of prescription drugs? I am asking because I just bought about three of your books and want to make sure that your confidence in these theories has not wavered. Sometimes I feel like a lost cause because this is the first time in my life that I am truly dealing with and facing my own problems instead of turning the other cheek. Also, how are you doing, sir? Jasmine Hi Jasmine, Doing great, thanks! The new techniques have added even more power to cognitive therapy. Check out my free Feeling Good Podcasts, free depression class, and more on my website, www.feelinggood.com. All the best, David PS My latest book, Feeling Great, can be pre-ordered on Amazon and will be released in Sept. Check our the link below. Do you have to work on your negative thoughts the moment they appear? Hello David, My name is Shivam, I wanted to ask you a question regarding the double column technique for disputing your thoughts. Do we have to work on that moment(upsetting) immediately as it happens or we can work on it later when we get free time? How often should we do it? Its very effective but consumes a lot of time as I keep writing on and on. Any suggestions? I really appreciate that you reply me back. Thanks for everything. love Shivam. What role, from your years of practice, does spirituality have in the psychotherapy? From: Jerry Souta Subject: spirituality in psychotherapy David: Your seminar today (Psychotherapy Leading Voices) wa

Today, Rhonda and David discuss three great questions submitted by podcast fans like you! This thoughtful question is from our beloved Rhonda! . . . And the answer may surprise you! When something terrible happens, like being raped or having your house burn down, or being a victim of racial discrimination, doesn't the event itself upset you? Do you really have to have a negative thought before you can feel anger, fear, grief, or worthlessness? Hi David! For example, if our house burned down and we lost everything, or we or someone we loved was raped--doesn't the event affect you directly? Do you really have to have negative thoughts before you can feel sad, depressed, anxious or angry? Do all of our feelings REALLY result from our thoughts? What about people who have been treated unfairly or been discriminated against because of their race, religion, gender identity, etc. Aren't their feelings a direct result of their experience and not just their thoughts? Rhonda What do you do when patients fall in love with you? Hi David and Rhonda, My name is Ben and I live in Maryland. I started listening to the feeling good podcast about 3 years ago when I was in a period of life transition. The podcast has been incredibly helpful to me as I dealt with my childhood trauma, explored my motivations and drives for life, and reoriented my personal relationships and career, away from what I thought I should be doing, toward what I love and deeply want for my life. In part because of the podcast's inspiration, I have decided to pursue a master's degree in social work, and hope to become a psychotherapist. Thank you for all that you do, and the amazing help you have been to me personally. I do have one question. In one past episode. You mentioned the possibility of using five secrets to defuse the situation when a patient falls in love with the therapist because they feel understood and cared for. This has happened to me a few times when I talk with a friend about their personal difficulties, and they begin to develop feelings for me. I would like to keep these relationships friendships, rather than romantic. I would love to have your advice on how best to both inoculate against and resolve such situations. Thank you again. Ben What can you if your boss is not empathic? Hi Dr. Burns, You guys are always so good at empathy. I'd love to hear one day your method about how to cope when there is lack of empathy, but you still have to keep a relation. For example: when your boss doesn't empathize with you and his message makes you feel bad, but you still need the job. I had an experience like that and it really hurt the ego. Cheers, David. Have a great day! Andres Hi Andres, One can always learn a lot from one exchange with the boss. What did he say and what, exactly did you say next? Waiting for empathy from others is never something I have recommended! That's a really long wait! But you CAN discover how you are provoking the very problem you are complaining about if you have the courage. This empowers YOU to change. David Questions on the next Ask David: Are depression and anxiety states of self-hypnosis? How do you deal with somatic symptoms in TEAM? Should we forgive Hitler and Stalin? What if a patient feels stuck and unable to identify emotions? Do you still really believe that depression and anxiety, regardless how severe, can be treated even without the use of prescription drugs? Do you have to work on your negative thoughts the moment they appear? What role, from your years of practice, does spirituality have in the psychotherapy? Rhonda and David

Podcast #200: Meet Linda Jackson! We celebrated our one hundredth podcast with an interview with Professor Mark Noble, who talked about TEAM-CBT and the brain. Today, we celebrate our two hundredth podcast with another special guest, Linda Jackson, the publisher at PESI Publishing and Media Company. You may know of PESI for their work in continuing education programs as well as training products for mental health professionals. You may not be aware that PESI is the publisher of my new book, Feeling Great, which will be released in September, 2020. One focus of our interview with Linda was the teamwork that is so important between any author and his or her publisher, as well as the editor. I have been really thrilled with the incredible teamwork and support that PESI has provided on this project, under Linda's skillful leadership. That was my strong motivation in selecting PESI, and I'm really glad I made this choice. It will be their first general public "self-help" book, and I hope it is a huge success for them, and for me! Rhonda asks how this book compares with my first book, Feeling Good. It is the first true sequel, although I have written many spin-off books based on the cognitive therapy techniques I first described in Feeling Good. But now, after 40,000 therapy sessions with individuals struggling with mild to extreme depression and anxiety, as well as four decades of research on how psychotherapy actually works, I have many powerful new techniques that you can learn about in Feeling Great. Feeling Great is based on the TEAM-CBT that has evolved in the past ten to fifteen years in my weekly psychotherapy training and development group at Stanford. My book Feeling Good was about cognitions, and how to crush distorted thoughts. What I have learned over the past 40 years of practice, research and teaching is that cognitions, while massively important, are not the only dimension in change. Of course, it is still true that when you change the way you think, you can change the way you feel, but now there is another powerful component: many people seem, tp get stuck in depression or anxiety and resist change. They sometimes "yes-but" their therapists and often fail to do psychotherapy homework between sessions. Why? In Feeling Great, you will discover why people resist change and you will also learn how to eliminate resistance. The developments have ushered in the era of ultra-rapid recovery from depression and anxiety. Therapists who are interested in learning these new techniques will now have a clear guide, and members of the general public who are struggling with negative feelings will have the chance to use these techniques on their own, whether or not they are in treatment with a therapist. Linda talks about her personal history and how she happened to find a career in publishing. She describes her passion for writing, journalism and editing, going all the way back to her teenage years, something that I can totally identify with. Linda also describes her background in marketing, and her appreciation of its importance. You could have the greatest book in the world, but without a strong marketing effort, it will just sit on bookstore shelves unnoticed. Linda explained that PESI has been absolutely committed to publishing practical guides that therapists can use to improve their clinical work. But now, PESI is branching into publishing books for the general public as well, because people want answers to their questions of how to deal with feelings of depression, anxiety, and inadequacy. Linda said that PESI was not looking to publish a self-help book, but when someone in their organization heard that David was looking for a publisher, they felt it was "meant to be" that they would publish his new book. Linda believes that this book is going to help so many people who want to "feel great." Something I (David) have deeply appreciated about working with Linda and her PESI team has been the comradery of the writing, editing and publishing process. We discuss my brilliant editor for Feeling Great, Jenessa Jackson, who happens to be Linda's daughter-in-law. I (David) felt especially lucky to work with Jenessa, who not only provided incredibly helpful editing, but her background in neuroscience as well as clinical work were tremendously helpful. She clearly "got" my message, including the special chapter on "micro-neurosurgery" by Professor Mark Noble. I also am especially grateful for the marketing support PESI is providing for my new book. I described the complete lack of support I had from the publisher of Feeling Good shortly after it was first published. That was understandable, because at the time I was an unknown author of a book on depression, and the president of the company (William Morrow & Co.) was convinced that Feeling Good had little or no commercial potential. As a result, in those early years after it was first published, I had to do everything on my own—and it was really hard! I encountered r

Today, the Cognitive Distortion Starter Kit Continues with Labeling Rhonda begins by reading two beautiful, inspiring emails from listeners, and I give a brief shout out for my new book, Feeling Great, which can be pre-ordered on Amazon now (see below for the link). Rhonda and David begin with a brief overview of Labeling. There are two types of Labeling: Self-Labeling and Other-Labeling: Self-Labeling is where you attach a negative label to yourself, such as "I'm a loser," or "I'm a failure." Self-Labeling can be further divided into Labeling your role or Labeling your "self." Here are some examples of Labeling your role: "I'm a bad father," or "I'm a bad mother," or "I'm a lousy teacher," and so forth. Here are some examples of Labeling your "self:" "I'm a loser," or "a failure," or "worthless," or "defective." Other-labeling is exactly the same, except that it's directed at some other person, as in "he's a jerk," or "she's a loser." Labeling can be extremely hurtful, causing intense depression and anxiety, as well as anger, hatred and rage. However, labeling is a distortion, because a human being cannot be captured by a label. Humans are more like rivers that flow--in this direction and that direction, without a specific "shape." We have many, many dimensions, perhaps an infinite number! Many techniques can be helpful for Labeling, but it is always necessary to use any technique in the context of working systematically with the TEAM model, and doing great T = Testing, E = Empathy and A = Assessment of Resistance before trying any M = Methods. It's almost never a good idea to throw techniques at patients without these other vitally important steps first. And if you're working on yourself, it will be vitally important to do the A step before the M step too! David and Rhonda illustrate two techniques that can be especially helpful for Labeling: Let's Define Terms and Be Specific. They do a role play to bring the first technique to life, and play an actual recording of a portion of a TEAM session to bring the second technique to life. We are nearing the end of the distortion series, but still have three hugely important distortions to discuss: Emotional Reasoning Should Statements Blame Thank so much for listening. If you like our podcasts, tell your friends, colleagues, and patients about them! This is all volunteer work, so our only marketing budget is your good will. Each month our downloads are increasing, thanks to you, and we will hit three million downloads early next year or late this year. Rhonda and David

Today, Rhonda and David discuss ten great questions submitted by podcast fans like you! I can't find any distortions in my thoughts! What's the cause of this? Crushing Negative Thoughts. Do you have to write them down? Can't you just do them in your head? PTSD Question: Does the trauma have to be life-threatening and experienced in person/ How can I get over anxiety and panic? Do demons cause depression? How is Sara now? Is anger just "ossified tears?" How do you explain the basic concepts of CBT and cognitive distortions to patients who are not familiar with your work? Can I help myself as much as Rameesh did? How can I start a self-help group based on your book, Ten Days to Self-Esteem? How can I find my favorite podcast? I can't find any distortions in my thoughts! What's the cause of this? A new comment on the post "001: Introduction to the TEAM Model" is waiting for your approval https://feelinggood.com/2016/10/27/001-introduction-to-the-team-model/ Hi Dr. Burns, I just ordered your book and am writing my cognitive distortions daily. I ran into one I did not know how to label it. I am a 73-year-old, attractive woman, When I see a young beautiful woman having a great time, say in an ad, I feel angry, sad and jealous. This does not apply to family members only strangers. charlotte Crushing Negative Thoughts. Do you have to write them down? Can't you just do them in your head? A new comment on the post "190: How to Crush Negative Thoughts: Overgeneralization" is waiting for your approval https://feelinggood.com/2020/05/11/190-how-to-crush-negative-thoughts-overgeneralization/ Dr. Burns, Why is writing the negative thought down important? Can't I just pinpoint it in my head and simply switch the negative thought to positive one? I know it will not work but i am not able to convince others or myself why I have to write them down. Why is the writing process so important? After practicing for a while will you have the habit of think positively? I am wondering why some people have this way of positive thinking without even practicing? Toni PTSD Question: Does the trauma have to be life-threatening and experienced in person/ A new comment on the post "147: High-Speed Treatment of PTSD?" is waiting for your approval https://feelinggood.com/2019/07/01/147-high-speed-treatment-of-ptsd/ Hi David, I am a fan of your great work and contribution to psychology. I have a question about PTSD: does it necessarily have to be life-threatening in person or can it be caused for example by a threat via online message? Thank you! MB Thanks, MB, great question. Only your thoughts can upset you, not the actual trauma, so the answer is yes. Anything that is profoundly upsetting is profoundly upsetting, period! There is no objective way to measure the impact of any trauma other than via your own thoughts and feelings! This is so important, and yet most of the world, including those who have written the DSM-5 (and all earlier editions) / don't yet "get it." The DSM states that for a diagnosis of PTSD, you have to have some trauma that is "objectively horrific." But there is no such thing! david How can I get over anxiety and panic? Debby asked a question about podcast 189: How to Crush Negative Thoughts: All-or-Nothing Thinking I have your book When Panic Attacks. I am at a loss at what to use to get over anxiety and panic. It is exciting because you said that you can get rid of both fairly soon; which would be great Hi Debby, Thanks for your excellent question! The Daily Mood Log described (I believe) in chapter 3 of When Panic Attacks is a great place to start. Do it on paper, and not in your head, focusing on one specific moment when you were anxious. Thanks! One teaching point is to focus on one specific moment, and not try to solve anxiety or any mood problem in generalities. A second teaching point is to record the situation, your feelings, and your negative thoughts you were having at that moment. This is always the starting point for change! You'll find tons of resources on my website, feelinggood.com, including the show notes for all the podcasts with links, search function, and way more, all for free. You can learn a great deal if you put in the time and effort. For example, I am now creating a free class on anxiety and it will soon be available on my website! David Do demons cause depression? Brian W. commented on Podcast 189 on All-or-Nothing Thinking Hi Dr. Burns, Amazing podcast as always doctor Burns! Question: have you ever encountered anything in your patients that you might consider supernatural? I'm Catholic and there's the idea that demons can cause depression or mental illness. I know it sounds crazy, but I've seen weird things. Thank you. Brian Thank you for your question, Brian. Depression results from negative thoughts, not demons. That's good because you can learn to change the way you think and feel. The type of therapy I do is entirely compatible with all religions, including Catholicism, and there is ofte

Loneliness has existed since the dawn of time. I frequently receive questions from lonely individuals wanting to know how to connect, and how to find companionship, intimacy and love. Lonely men ask me, "How do I talk to women?" Lonely women ask, "How can I find a good man?" Regardless of your gender or gender identity, you may struggle to find a loving romantic partner for a variety of reasons, some of which I have outlined in my book, Intimate Connections. Although dating can be an incredibly stressful, disappointing, and time-consuming hassle, there are tremendous rewards for those fortunate enough to connect and develop an intimate relationship. So today, we address some of those issues. Our special guest today is Dr. Matthew May. He is a former student of mine, a good friend of David and Rhonda, a regular on the podcast, and a loving wonderful man. Today, Matt brings us a wealth of information for those interested in improving their dating lives, based both on his clinical work, as well as his own experiences overcoming social anxiety, falling in love and being in a loving relationship. Matt begins with an inspiring reminder of why we would go through all the trouble, stress and disappointment inherent to dating, highlighting some of the rewards that await those who are persistent, including how good it feels to be understood, accepted, loved and cherished by someone who feels the same towards us. The poetry of his writing is beautiful and inspirational. He also provides some common-sense guidelines for individuals who are interested in dating, so they can do so safely. We then delve into more psychologically complex and personal matters. Here are Matt's tips on maintaining safety when you are dating someone you don't know for the first time--for example, it might be someone you may have met on the internet. Although these tips are primarily for the protection and safety of women, they may also be helpful to men who are dating. 1. The first time you meet someone you've met on the internet, meet in a public place, like a restaurant or coffee shop, where you'll be safe. 2. Use your own transportation. Don't let someone you've never met pick you up, because then you'll be vulnerable in case things don't go well. 3. Tell someone you know where you're going, and when you're going to return. 4. Get to know the other person as much as possible. What does s/he do, who are his or her friends, and so forth. 5. Don't provide any identifying information, including your date of birth, to anyone you've just met on the internet, as you could be vulnerability to identity theft. Sometimes the most charming people are scam artists. 6. Listen to your intuition. If you have a creepy feeling about someone you're thinking of dating, pay attention to it. Something might be "off" about the other person. 7. Don't drink too much, as you could become a victim of date rape, especially if the man slips a sedative chemical in your drink. 8. Give (or ask for) consent prior to any touching. Matt emphasizes that emotional vulnerability is the price tag on intimacy, and this can be frightening because we all naturally fear rejection. Matt defines emotional intimacy as being seen as our true and vulnerable self, so we are accepted for who we really are. He talks about how most of us have a deep yearning for this kind of relationship, and yet struggle to be vulnerable and open in ways that make intimacy possible. Rhonda, Matt and David describe the delicate balance between game playing--which can be crucial in the early stages of dating--and vulnerability, which can lead to a meaningful and lasting relationship. Some people try to skip the game-playing stage, thinking it is too superficial, and try to jump right into vulnerability the moment they meet someone they like. This often leads to rejection. People like to have fun, and you don't always have to be "heavy" or overly "sincere." But too much game-playing can leave you feeling lonely as well. I describe a patient I once treated who was almost unbelievably successful in the dating arena. You might even say he was an incredibly effective womanizer. But he felt tremendously lonely and anxious on the inside. He was handsome and charismatic, and got tons of sex, but wasn't really happy. Matt describes another common barrier to successful dating, especially in men: entitlement and anger. He says that he, like many lonely men, used to think that "women should like me the way I am," and "I shouldn't have to put on airs to date." Years ago, I pointed out that Matt was not dressing in a very sexy way, and suggested a change might be in order. Matt insisted that he shouldn't have to, and that women should love him just as he was! I asked Matt to fantasize about his ideal woman. Matt described a woman who's looking terrific--great clothes, nice hair, makeup, and so forth. Then I pointed out that most women are looking for pretty much the same thing--a man who dresses well and looks his best. I

in today's podcast, Rhonda and David address eight fascinating questions submitted by fans like you: What's the difference between David's Therapist Toolkit, his eBook (Tools, Not Schools, of Therapy), and the EASY Diagnostic system? Is there a dark side to human nature? Is being "forceful" or confronting patients ever important in therapy? What's the 5-session schizophrenia cure? How do you suddenly switch into "Sitting with Open Hands" during a session? Questions about OCD Questions about racism What if there are more advantages than disadvantages in perfectionism? What's the difference between the Toolkit, the eBook, and the EASY Diagnostic system? I am a Licensed Clinical Social Worker (LCSW) and I am interested in either the Toolkit or the EASY diagnostic tool. It looks like the Toolkit includes quite a few questionnaires so I am wondering if I would need both. I would love to have a comprehensive checklist to give to clients during their initial assessment so I originally looked into the EASY Diagnostic tool. I'm just looking for a little guidance on which one would be the most helpful and if I would actually need both. Thanks so much! Cindy What do you think about the idea that there's a dark side to human nature? Are humans inherently good, as so many mental health professionals seem to believe? It could be entitled, "The Dark Side of Human Nature," or "Is there REALLY a dark side to human nature?" Jeremy Rhonda and David believe that human beings have positive loving impulses and dark violent impulses as well, and that both are an inherent and basic aspect of human nature. They discuss several aspects, including: The example of cats. They are genetically little serial killers. They love to capture and torture rodents, even if they have had a loving childhood. Many people love violent revenge movies and video games. Many people love killing animals, chopping their heads off, and mounting them on the wall, in much the same way that human serial killers get intense excitement from their killing and torturing, and they also keep trophies. David argues that it is important for therapists to recognize and address the dark side—areas where therapists will typically get in trouble due to blindness / denial / rationalization of negative motives, and excessive idealism. Problematic areas for therapists can include: the suicidal patient the violent patient—David describes a woman who was plotting to kill her husband. disability patients with a hidden agenda of remaining disabled. patients who don't want to do their therapy homework people, for the most part, don't get addicted because they're depressed, anxious, or lonely, but because it's really awesome to get plastered / high. Many, and perhaps all humans, like to judge others and feel superior to them, and also enjoy exploiting others, but our denial can be intense. People enjoy bullying people. It makes you feel powerful and generates feelings of excitement. We acknowledge that although the dark side to human nature may be strongly influenced by our genes, the environment we grow up in can also have a strong impact on our thoughts, feelings and impulses. Is being "forceful" or confronting patients ever important in therapy? This is another great question submitted by Jeremy Karmel. David gives many examples of times when it is absolutely necessary to be forceful and confrontational in therapy, but this requires a strong therapeutic relationship with the patient and perfect empathy scores and high levels of trust and mutual respect. Therapeutic examples where forcefulness or confrontation may be important include: Exposure techniques in the treatment of anxiety. The patient will nearly always "wimp out" at the last minute, and here is where the therapist needs to push—but most therapists will back off out of misguided "niceness." Pushing the patient to view his/her own role in a relationship conflict instead of buying into the idea that the patient is the innocent victim of the other person's "badness." The new CAT technique in the Externalization of Voices is yet another example where gentle confrontation can often lead to rapid enlightenment. Another example is use of Changing the Focus, suddenly drawing the patient's attention to "Have you notice what just happened here between us?" This can be helpful when there's an awkward or adversarial or evasive dynamic going on between therapist and patient. Yet another example is the Gentle Ultimatum in dealing with Process Resistance. In all of these examples, many, and likely most therapists don't do well, due to "niceness" and fear of conflict. What's the 5-session schizophrenia cure? Hello David: I recall you saying in one of your trainings given in San Diego a while back that you could "cure Schizophrenia in 5 sessions" using the T.E.A.M. protocol you taught us. Is there a special protocol for this disorder? One of my clients would very much like to know. I hope that this finds you, your family and everyone

Today, the Cognitive Distortion Starter Kit Continues with Magnification and Minimization Rhonda begins by reading two beautiful, inspiring emails from Heather Clague, MD and Dipti Joshi, PhD. Heather and Dipti are dear friends and esteemed colleagues of David and Rhonda. Rhonda and David begin with a brief overview of distortion #6: Magnification and Minimization. Magnification is when you blow things out of proportion. This is common in anxiety and is also called "Catastrophizing." For example, during panics patients often tell themselves—and believe—that they are on the verge of something catastrophic, like a stroke, a sudden, fatal heart attack, or losing their minds and becoming hopelessly psychotic. Minimization is just the opposite. You shrink the importance of something like your good qualities or the things you've accomplished. Minimization is common in depression. Magnification and Minimization almost always play a big role in procrastination as well. For example, you may Magnify the enormity and difficult of the task you've been putting off, and Minimize the value of just getting started on it today, even if you only have a few minutes. I sometimes call this distortion the "binocular trick" because it's like looking through the opposite ends of a binocular, so things either appear much larger or much smaller than they actually are. Techniques that can be especially helpful include Examine the Evidence, the Semantic Technique, Little Steps for Big Feats, the Experimental Technique, the Double Standard Technique, and Externalization of Voices / Acceptance Paradox. Rhonda brings these techniques to life in a description of a depressed man she recently treated who's been divorced for 2 to 3 years, and living alone due to the Shelter in Place orders during the Covid-19 pandemic. Although he's lonely, he's telling himself that he's "too depressed and scattered" to be in a relationship. At the start of the session, he feels: sad, 90% panicky, 50% ashamed, 50% worthless 50% alone, 90% hopeless90% frustrated, 90% upset, 90%. Rhonda describes her skillful and compassionate TEAM treatment of this man, starting with the Magic Button, Positive Reframing, and Magic Dial, followed by Identify the Distortions, the Paradoxical Double Standard Technique, and Externalization of Voices (including the Acceptance Paradox, the Self-Defense Paradigm, and the Counter-Attack Technique, or "Cat") Rhonda brings these techniques to life in a description of a depressed man she recently treated who's been divorced for 2 to 3 years, and living alone due to the Shelter in Place orders during the Covid-19 pandemic. Although he's lonely, he's telling himself that he's "too depressed and scattered" to be in a relationship. At the start of the session, he feels: sad, 90% panicky, 50% ashamed, 50% worthless 50% alone, 90% hopeless90% frustrated, 90% upset, 90%. These techniques were tremendously helpful, and at the end of the session, he no longer believed his negative thoughts about himself and his negative feelings all fell to zero. He recovered, essentially, in one extended (3-hour) TEAM therapy session. David and Rhonda discuss the impact of this type of experience on the therapist as well as the patient. Obviously, the patient feels fantastic, but Rhonda said she also felt "rejuvenated," with much warmth and kindness. I (David) always feel this as well at the end of an amazing session. Rhonda and David

Today, the Cognitive Distortion Starter Kit Continues with Jumping to Conclusions Rhonda opens today's podcast by reading beautiful email comments from Kevin Cornelius and Thai-An Truong. Both are dear friends and colleagues of Rhonda and David. Then Rhonda and David discuss Jumping to Conclusions, which is the fifth cognitive distortion. It's defined as jumping to conclusions that aren't necessary supported by the evidence. There are two common forms: Fortune Telling and Mind-Reading. Fortune-Telling: You tell yourself that bad things are about to happen. There are two common examples: Hopelessness: You tell yourself that things will never change, that you'll never recover, or that your problems will never be solved. David explains why this distortion is impossibly distorted and virtually never true. And yet, when people are depressed, they nearly always fall victim to the belief that things will never change. It's much like being in a hypnotic trance, because you are telling yourself and believing things that can't possibly be true. Anxiety: You make catastrophic predictions that gradually exaggerate any real danger. All anxiety results from this distortion. For example, if you have a fear of flying, you may be telling yourself that the plane could run into turbulence and crash. Anxiety is also a self-induced hypnotic trance, because you are giving yourself and believing highly irrational messages. For example, one of David's graduate students screamed loudly when she saw his meek little kitten, Happy, because she had a cat phobia and was telling herself that cats are extremely violent and dangerous. Mind-Reading: You assume that you know what other people are thinking when you really don't. There are three common examples: Social Anxiety / Shyness: For example, other people are judging you and can see how anxious you are. You may also assume that other people rarely or never get anxious and that they wouldn't be interested in you. Relationship Conflicts: You may tell yourself that the other person only cares about himself/herself and that s/he is intentionally being "unreasonable." You may also do the opposite type of mind-reading and assume that others are quite impressed with you when they're actually turned off or feeling annoyed with you. Anxiety: You make catastrophic predictions that gradually exaggerate any real danger. All anxiety results from this distortion. For example, if you have a fear of flying, you may be telling yourself that the plane could run into turbulence and crash. Anxiety is also a self-induced hypnotic trance, because you are giving yourself and believing highly irrational messages. For example, one of David's graduate students screamed loudly when she saw his meek little kitten, Happy, because she had a cat phobia and was telling herself that cats are extremely violent and dangerous. Depression: You tell yourself that nobody loves you or cares about you. Many of the Truth-Based Techniques can be useful, such as Examine the Evidence, the Experimental Technique, or the Survey Technique. Motivational Techniques like Positive Reframing can be tremendously helpful. And Role-Playing Techniques like Externalization of Voices with the Acceptance Paradox can also be very useful. David and Rhonda play a short audio clip from the treatment of a severely depressed man named Bradley with a history of extreme abuse growing up. He is struggling with feelings of hopelessness, which he rated at 80 (on a scale of 0 to 100) due to these two thoughts: I'm damaged beyond repair so nothing can help. Psychotherapy homework can't possibly help so there's no use trying it. Prior to the audio clip, David and Bradley have done Positive Reframing asking: What do your negative thoughts and feelings show about you and your core values that is beautiful and awesome? What are some advantages, or benefits, of your negative thoughts and feelings? David and Bradley then attack his negative thoughts using a variety of role-playing techniques, with many role reversals. By the end of this approximately 13-minute excerpt, Bradley no longer believes these two thoughts and his feelings of hopelessness have dropped to zero. We are incredibly grateful to "Bradley" for giving us permission to publish this very personal and inspiring audio clip! Thanks for listening! Rhonda and David

On February 24, 2020 we published Podcast 181, "Live Therapy with Sarah: Shrinks are Human, Too!" This was a live session with Sarah, a certified TEAM-CBT therapist, conducted at my Tuesday psychotherapy training group, because Sarah was struggling with intense anxiety, bordering on panic, during therapy sessions with her patients. It was a phenomenal session with outstanding results. The Hidden Emotion technique was the main focus of that session, bringing to conscious awareness some feelings of anger and resentment that she'd been sweeping under the rug. This is a common cause of anxiety. But a month or so after that session, Sarah relapsed in a big way, so I agreed to treat her again during the psychotherapy training group at Stanford, and Dr. Alex Clarke was my co-therapist. This time, we used very different treatment techniques. Once you've recovered, the likelihood of relapse is 100%--that's because no one can be happy all the time. We all hit bumps in the road from time to time, and when you do, your "fractal" will come into prominence again. This means that the same kinds of negative thoughts and feelings will return in an almost identical form. This can give you the chance to defeat them again and strengthen the positive circuits in your brain. That's exactly what happened to Sarah. Approximately one month after the first treatment session, she had a viral infection, and began taking large amounts of Advil to combat the symptoms. This led to severe feelings of nausea, followed by panic. Multiple trips to the doctor failed to reveal any diagnosable cause for her somatic symptoms, aside from the possibility of Advil side effects. However, the discomfort was so severe that she panicked, fearing that she had a more severe medical problem that the doctor had overlooked. She lost 13 pounds over the next two months, and requested an emergency TEAM-CBT session, which Dr. Clarke and I were very happy to provide, since live work almost always make for superb teaching. If you take a look at Sarah's Daily Mood Log, you'll see that the upsetting event was waking up Sunday morning still sick and anxious for the 100th day in a row. She circled nine different categories of negative emotions, and all were intense, with several in the range of 80 to 100. and she had many negative thoughts, including these. Please note that she strongly believe all of these thoughts: Negative Thoughts % Now 1. I should be able to defeat my anxious thinking and reduce my suffering. 95 2. If I can't heal my own anxiety, I'm an inadequate hack of a TEAM-CBT therapist. 95 3. I was strong, confident, vivacious. Now I'm fragile, weak, and self-doubting. 100 4. My anxiety is slowing me down—I should be able to do more and take on more. 100 5. Something serious is wrong with my stomach, but now with Covid-19, I won't be able to get medical intervention and testing. 70 6. I'm not as effective in my clinical work when I'm upset and anxious. 85 7. I might get panicky during a session and screw up. 80 8. I should always do more. 85 After empathizing, I asked Sarah about her goals for the session. She said she wanted greater self-confidence and less anxiety, and said her husband had theorized that if the anxiety disappeared, her somatic symptoms would also go away. But when we did Positive Reframing, Sarah was able to pinpoint more than 20 overwhelming benefits of her intense negative feelings, including many awesome and positive qualities and core values that her negative thoughts and feelings revealed about her. This always seems to be a shocking and pleasant discovery for the patient! At this point, we used the Magic Dial to see what Sarah wanted to dial her negative feelings down to, as you can see here. Then we went on to the Methods portion of the session, using techniques like Identify the Distortions, Externalization of Voices, Acceptance Paradox, and more. We also had to revert back to the Assessment of Resistance once again when Sarah began to fight strenuously against giving up her self-critical internal voice. We did a Cost-Benefit Analysis on the advantages and disadvantages of being self-critical and not accepting her fragileness, weaknesses, and flaws. Once we "sat with open hands" and listed all the reasons for her to continue criticizing herself, she suddenly had a change of heart and really poured herself into crushing her negative thoughts. It was interesting that as she began to blow her negative thoughts away, she suddenly got hungry for the first time in months! If you click here, you can see how she felt at the end of the session. It was a mind-blowing session, with much potential for learning. Rhonda, Dr. Clarke and I hope you enjoy it! Here were some "teaching points I sent to the tuesday group members after the session. This could not have been done in a single session. At least in my hands, a two hour session is massively more cost-effective than a bunch of single sessions. But even then, you have to have a plan and mov

"I don't matter!" Did you ever feel like you aren't important? Did you ever feel like you don't matter? These thoughts are extremely common and can be extremely painful. I know from my clinical experience over the years, with more than 40,000 hours of therapy with people struggling with mild to extreme depression and anxiety. I know from personal experience as well, because I've been there personally at times! And one of the reasons I love doing therapy is because of the joy of helping someone transform these feelings of inadequacy and tears into feelings of joy and exuberance, and even laughter. Today, my highly esteemed colleague, Matthew May MD, and I, work with our highly esteemed and beloved colleague and podcast host, Rhonda Barovsky, on concerns that emerged when a scheduling difficulty made it difficult for Rhonda to join a podcast recording on "The Phobia Cure" which was going to feature Matt May MD doing live exposure with a colleague named Danielle who has an intense fear of leeches. I suggested that Matt, Danielle and I could do the podcast without Rhonda, to save her from having to commute from her office in Walnut Creek, California to the "Murietta studios" twice in one week. (It's a 90-minute commute in both directions, and sometimes traffic makes it even worse.) When Rhonda read this email, she was flooded with negative emotions, which you can see on pages 1 and 2 of her Daily Mood Log at the start of her session. As you can see she felt down, anxious, ashamed, inadequate, rejected, self-conscious, angry, jealous, and more, and these feeling were intense. Have you ever been suddenly and unexpectedly triggered like that? What triggered Rhonda's feelings? According to the TEAM-CBT treatment model, our negative feelings are not the result of what happens, but how we think about it. So, what were the thoughts that triggered Rhonda's angst? Take a look at the negative thoughts on her Daily Mood Log. As you can see, she was telling herself that She didn't matter and wasn't important. David didn't value her. She shouldn't have such strong negative feelings, like jealousy. The people listening to the podcast (like you, for example) will think she looks like an idiot and will judge her. She shouldn't be taking up time and space on the podcast in the "patient" role again. One of the things I like about the TEAM model is that it gives us a clear blueprint about how to proceed. One of the things I love about Rhonda is her openness, vulnerability, courage, and intense desire to teach and reach out to others, like yourself. And one of the things I admire so intensely about Matt is his tremendous kindness and compassion which are coupled with extraordinary technical skills. I feel very blessed to have Matt and Rhonda as colleagues and friends! In the podcast, we go through the TEAM model, step by step, starting with T = Testing, E = Empathy, A = Assessment of Resistance, and M = Methods. We encountered some tears, some memories of childhood and tons of laughter as well. During the Assessment of Resistance, we used the Straightforward Invitation, Miracle Cure Question, Positive Reframing, and Magic Dial. To me it is always surprising to see how many positives are embedded in our so-called "negative" feelings and "negative thoughts." Positive Reframing nearly always eliminates resistance and opens the door to rapid change. You can look at Rhonda's Positive Reframing list on page 5 of the attachment. You can also take a look at her Emotion's table when she filled in the Goal column on page 3 of the attachment. The first thought Rhonda wanted to challenge was "I don't matter," and we started with the Downward Arrow Technique to identify the Self-Defeating Beliefs that gave rise to this thought, as you can see on page 4 of the attachment. Rhonda also told a moving story about her father, and how her belief that she was not important may have gotten started. She also told a beautiful story about reconciling with her father eight years before he died. We used several methods to challenge and crush the thought, "I don't matter," including Identify the Distortions, the Double Standard Technique, the Externalization of Voices, the Feared Fantasy, the Acceptance Paradox, and Examine the Evidence to crush this thought. Several role reversals were necessary before Rhonda knocked the ball out of the park. The first negative thought is generally the most difficult to crush. Once Rhonda no longer believed this thought, she could easily challenge and defeat the rest of her negative thoughts as well, resulting in a dramatic transformation in how she was feeling, as you can see on page 3 of the attachment. It seems like when you crush one negative thought, there is a sudden change in the brain, as if the negative circuits get turned off and the positive circuits get turned on. You will have the chance to hear this first hand when you listen to the live session. If you'd like to take a peak at Rhonda's final Daily Mood Log, y

This is the fourth in our podcasts series on the best techniques to crush each of the ten cognitive distortions from my book, Feeling Good: The New Mood Therapy. Today, we focus on Mental Filtering and Discounting the Positive. (This will be the last Episode recorded remotely with poor sound quality. We thank you for your perseverance listening to it, and guarantee better sound quality in the future with our new recording equipment.) Mental Filtering, You focus on something(s) negative, like a mistake you made, and ignore or overlook the positives. This is like the drop of ink that discolors the beaker of water. Discounting the Positive(s). this is an even more spectacular mental error. You insist that the positives about yourself or others don't count. In this way, you can maintain a uniformly and totally negative view of yourself, the world, or other people. David and Rhonda discuss the fact that humans can be very biased in our perceptions of things that are emotionally charged. For example, if you are firmly committed to some belief, you might look for evidence that supports your belief, and discount evidence that contradicts your belief. Similarly, if there is someone you strongly admire, you may selectively focus on the positive things they do or say, and discount or dismiss things they do or say that might be quite offensive. And when you're ticked off at somebody, you probably focus on all the things they do or say that turn you off (mental filtering) and discount the positive things that they do or say. For example, when they say something kind or supportive, you might think, "S/he doesn't mean it," or "isn't being genuine. They're just acting fake." In this way, you convince yourself that he or she really is "bad." When you're depressed or anxious, you'll do this to yourself as well, thus intensifying your negative thoughts and feelings. For example, a teenager with extremely intense depression, strong suicidal urges, and anger told me that human beings were inherently selfish, insensitive, and bad. When I asked her how she'd come to this conclusion, she described seeing some kids in her dormitory who were joking in a cruel, insensitive way about girl with depression, and said that if you're looking for her, you can probably find her sitting on the edge of her dormitory window, meaning that she's probably about to jump. She also described seeing a homeless man on her way her therapy session, and said that no one really cared about him. Of course, these observations were at least partially valid, since human beings certainly DO have the capacity for great self-contentedness, insensitivity, and cruelty. But was she involved in Mental Filtering, and focusing only on the negatives? I asked her if she could think of any times in the past several weeks when someone had been cruel or insensitive to her. She couldn't think of a single instance. David and Rhonda provide additional examples, some personal, of Mental Filtering and Discounting the Positive, and suggest techniques that can be helpful when combating these distortions, including Positive Reframing, Examine the Evidence, the Straightforward Technique, and Double Standard Technique. David tells a moving story that he also told on his Tedx talk in Reno, about an elderly Latvian immigrant who made a suicide attempt because she thought she'd never accomplished anything worthwhile or meaningful. In the next podcast in this series, David and Rhonda will discuss the TEAM-CBT techniques that can especially helpful for the next distortion, Jumping to Conclusions. David D. Burns, MD / Rhonda Barovsky, PsyD

This is the third in our podcasts series on the best techniques to crush each of the ten cognitive distortions from my book, Feeling Good: The New Mood Therapy. Today, we focus on Overgeneralization. There are two common forms of Overgeneralization: You generalize from some specific flaw or failure to your "Self." So, instead of telling yourself that you failed at this or that, you tell yourself that you are "a failure" or "a loser." You generalize from right now to the future, using words like "always" or "never." For example, you may tell yourself, "Trisha (or Jack) rejected me. This always happens! I must be unlovable. I'll be alone forever." Overgeneralization is also one of the most common cognitive distortions, and it causes depression as well as anxiety. I believe it is impossible to feel depressed or hopeless without Overgeneralization. The antidote to Overgeneralization is called "Let's Be Specific." Instead of thinking of your self as a "bad mother" or "bad father," you can focus on the specific thing you did that regret, like shouting at your kids when you were upset. Then you can think of a specific plan to correct this problem, like talking things over with your kids and letting them know that you love them and feel badly that you snapped at them. David and Rhonda also talk about the idea that abstract concepts like "worthless" or "bad" or "worthwhile" or "good" human beings are meaningless. Good and bad thoughts, feelings and behaviors certainly exist, but there is no way to measure or judge the value of a human being. In the next podcast in this series, David and Rhonda will discuss the TEAM-CBT techniques that can especially helpful for the next distortion, Mental Filter and Discounting the Positive. David D. Burns, MD / Rhonda Barovsky, PsyD