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

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

Rhonda begins by reading several brief heart-warming endorsements from listeners like you. We are grateful for all of your kind and thoughtful emails endorsing our efforts! Announcement: My upcoming one-day workshop with Dr. Jill Levitt on the "Cognitive Distortion Starter Kit" on May 17, 2020 WILL happen. It will be exciting and entirely online so we hope you can join us from wherever you are. See the write-up below. We are joined in today's podcast by Michael Simpson, who was among the first to contract the Covid-19 virus in New York. Michael was the star of Feeling Good Podcast #169: More on Social Anxiety. The Case for Vulnerability. I have repeatedly pointed out that our feelings do NOT result from what happens—but rather, from our thoughts about what's happening. This idea goes back at least 2,000 years, to the teachings of Epictetus, but people still don't "get it." People still think that negative events can have a direct impact on how you feel. But that belief makes you the victim of forces beyond your control, because we cannot, for the most part, change what happens—there's no way we can snap our fingers and make the Covid-19 virus disappear, but we CAN change the way we think about it. I have also pointed out that the negative thoughts that upset us when we're depressed and anxious will nearly always be distorted and illogical—remember, depression and anxiety are the world's oldest cons! But is this really true? Michael explains that when he contracted the Covid-19 virus on March 12, 2020, his first reaction was not fear, but excitement because he thought, "I'm getting it early, and when I recover, I'll probably have some immunity." But he WAS fearful. Of being intubated? Of a long hospital stay? Of death? No! What were his negative thoughts? Michael was telling himself things like this: People will shun me because I've got the virus. People won't want to hang out with me any more. People will judge me as weak and unappealing. Women won't be interested in me. My friends won't want to talk to me. These thoughts triggered powerful feelings of shame and anxiety. Can you see any of the familiar cognitive distortions in Michael's thoughts? Here are a few of the ones I spotted: Mind-Reading: Thinking you know how others are thinking and feeling without any real evidence: Fortune-Telling: Making frightening predictions that aren't based on any real evidence. Emotional-Reasoning: Reasoning from how you I feel. Michael feels anxious and ashamed, so he thinks others really will judge and reject him. Should Statements: Michael seems to be telling himself that he should be far better than he is to be loved, admired, and accepted by others. Self-Blame: Michael seems to be beating up on himself and telling himself that he's not good enough. Michael describes his decision to start posting his symptoms and insecurities on Instagram as a way of testing his fear which he described as intense. To his surprise and relief, he received something like 150 responses that were overwhelmingly loving and supportive. Michael was so excited by this feedback that he is thinking of starting his own podcast, where his guests will openly discuss vulnerable and personal topics. We look forward to that! I think it could be quite popular because so many people feel lonely and anxious due to hiding how they really feel, and putting up a false front to the world. Michael also expands a bit on David's concept of "fractal psychotherapy." That's the idea that all of our suffering results from one tiny pattern of irrationality that repeats itself over and over in many different situations, and ever single time you get upset—whether it's depression, anxiety, anger—it will be that same fractal flaring up again. Michael said that his fractal is "others will judge me and leave me." Other fractals might be "I'm defective," or "I'm not important," or "I'm inferior to others." The goal of therapy is to give you specific skills that you can use to blast your own fractal every time it's causing problems for you. On a future podcast, (May 25, 2020) we will, in fact, do live therapy with a professional woman you might recognize who had the belief that she wasn't important. So stayed tuned!

This is the second in a series of podcasts by David and Rhonda focusing on the best techniques to crush each of the ten cognitive distortions I first published in my book, Feeling Good: The New Mood Therapy. Today, we focus on All-or-Nothing Thinking. that's where you look at the world in black-or-white categories, as if shades of gray do not exist. For example, if you're not a complete success you may tell yourself that you're a complete failure. All-or-Nothing Thinking is one of the most common cognitive distortions, and it causes or contributes to many common forms of emotional distress, including: perfectionism depression Social anxiety-- performance anxiety public speaking anxiety shyness hopelessness and suicidal urges anger, relationship conflicts, and violent urges habits and addictions and more However, this distortion can be also be helpful to you, and may reflect some of your core values. For example, your perfectionism shows that you have high standards, and won't settle for second-best may motivate you to work hard and do excellent work prevents you from glossing over your failures and mistakes intensifies your emotional life, which may feel like a glorious roller coaster ride, with intense ups (when you do well) and equally intense downs (when you fall short.) So, before you can challenge a negative thought with this, or any distortion, you'll have to decide why in the world you'd want to do that, given all the benefits of your negative thoughts and feelings. One of the possible down sides of All-or-Nothing Thinking is that it simply does not map onto reality. There is little in the universe that is 100% or 0%. Most of the time, or even all of the time, we're somewhere between 0% and !00%. For example, this podcast is not incredibly fantastic, or absolutely horrible. It is somewhere in-between, and will hopefully be of some value to you. While it clearly won't solve ALL of your problems, it may be a useful step forward. We describe a number of example of All-or-Nothing Thinking, including a physician who was trying to diet and ended up binging on a half gallon of ice cream, and a suicidal young woman with incredibly severe depression who was involved in self-mutilation. There are many ways of crushing the negative thoughts that contain All-or-Nothing Thinking, including Thinking in Shades of Gray. Although that might sound rather drab in comparison to the drama of All-or-Nothing Thinking, you may discover that the world becomes far more colorful when you learn to think in shades of gray! In the next podcast in this series, David and Rhonda will discuss the TEAM-CBT techniques that can especially helpful for the next distortion, Overgeneralization. David argues that Overgeneralization is arguably the cause of all depression and much anxiety, and that the first person to recognize and solve this dilemma was the Buddha, 2500 years ago. More on that topic next week! David D. Burns, MD / Rhonda Barovsky, PsyD

On April 9, 2020, David and Rhonda did a live TEAM-CBT session with Dr. Taylor Chesney, a former student of David's who is now the head of the Feeling Good Institute of New York City. Her husband, Gregg, is an ER / ICU (Emergency Room / Intensive Care) doctor in New York, and she was terrified he might contract the corona virus and die. Gregg was also terrified, as he had to intubate two of his colleagues who are struggling in the ICU, and recently had trouble breathing. He is working long hours and lives in a separate apartment to protect Taylor and their three young children. The response to that podcast was extremely positive. Here's an email from a therapist in India, Nivedita Singh: Dear Dr Burns, Rhonda and Taylor, Just finished listening to your 4th podcast of the Corona series. What an emotional roller coaster learning and healing journey it's been. Can never ever thank you enough. Living far away in India and watching the Corona story unfold on the international news channels has been overwhelmingly scary for most of us, especially those who have our kids attending different schools in the United States. They share their fears and anxieties or protect us (their parents) by withholding it ... both of which makes us feel helpless and fills us with dread. The podcast today built some amazing perspective. Taylor is a Braveheart to Gregg being a Superhero. The podcast was so pure, had such integrity and absolute raw honesty! It required great courage from Taylor to allow her vulnerability to surface and an equal amount of brilliant skills set by both the therapists to communicate empathy that soothed the right spot not just for Taylor but for everyone of us across the globe who are dealing with the pandemic. When you addressed the distortions you were addressing all of us and our anxieties.The role play method had us confronting our own demons! Yes! All of us on this planet who have families stranded somewhere ... who are battling the virus ... or fighting in the front-lines, felt therapeutically addressed. I personally found myself choking when Taylor did, relaxing when she relaxed and found myself to be gripped by fear when she became vulnerable again. I was on the rollercoaster with her. By the time the podcast drew to an end I could sense my shoulders relaxing ... my breathing getting even and my fists unclenching. Something in the head or somewhere inside of me felt right. I insisted my family and friends listen to the podcast ... and the unanimous feedback was that plenty of pennies dropped for all of us at different times in the podcast. You, Dr Burns and Rhonda made all of us feel less anxious, less fearful and more in control of our emotions; and also compassionate and super, super proud of the Greggs and Taylors of the world. I am extremely grateful to Taylor (who I have met as a beautiful and driven young professional; and I got to see the devoted mum and wife in her) for letting us in to be a part of her journey. Wish her and her family lovely times ahead.This too shall pass ... Stay safe. Take care. Warmly and even more awestruck (by you Dr Burns). Thank you again for giving us TEAM. Nivedita Singh (Your biggest fan this side of the Pacific). One week after the recording of that podcast, Taylor learned that Gregg, has, in fact, been struck by the Covid-19 virus, so her worst fear has become a reality. What do you think happened? Did the monster have no teeth, as David sometimes argues? Listen to this powerful podcast and you will find out! David describes several patients he treated who had intense fears of going bankrupt, who did, in fact, go bankrupt while in treatment. What happened when their worse fears were realized--and why? The cognitive model states that only our thoughts can upset us, and that the thoughts that upset us will be distorted. Depression and anxiety, David argues, are the world's oldest cons. Could the cognitive model be correct in this era where we are fighting something that IS real and IS dangerous? During today's podcast, Rhonda asks Taylor about her romance with Gregg, how they met, what happened on their first date playing frisbee in Central Park, and how their relationship evolved. Taylor recalls the psychodynamic training she received during her graduate work in clinical psychology, which was all about listening without teaching patients to use specific tools to change. Taylor's teachers explained that there was no point in trying to change until you discovered the cause of your problems. Gregg did not agree and urged Taylor to think more about helping her patients change their lives, using specific tools. After all, a medical doctor doesn't just help patients understand why they have pneumonia--the goal is rapid cure whenever possible--understanding the causes doesn't necessarily help or lead to change. In addition, the causes of all psychiatric problems are currently unknown, so the focus on endless talk to understand the causes of depression, anxiety, relati

This is the first in a series of podcasts by David and Rhonda focusing on the best techniques to crush each of the ten cognitive distortions in David's book, Feeling Good: The New Mood Therapy. David and Rhonda discuss the amazing positive feedback that Rhonda received following her two recent podcasts doing live personal work. David emphasizes that being open and genuine about your own flaws and insecurities can often lead to far more meaningful relationships with others. This is a paradox, since we often hide our shortcomings, fearing others will judge and reject us if they see how we really feel, and how flawed we are. David and Rhonda begin the discussion of the Cognitive Distortion Starter Kit with a review the three principles of cognitive therapy: Our positive and negative feelings do NOT result from what happens in our lives, but rather from our thoughts about what's happening or what happened. Depression and anxiety result from distorted, illogical, misleading thoughts. What you're telling yourself is simply not true. Depression and anxiety are the world's oldest cons. When you change the way you THINK, you can change the way you FEEL. This can usually happen rapidly and without drugs. The first idea goes back at least 2,000 years to the teachings of the Greek Stoic philosophers. Although the idea that our thoughts create all of our feelings is very basic, and enlightening, many people still don't get it! This even includes lots of therapists who wrongly believe that our feelings result from what's happening to us! David describes an innovative "Pepper Shaker" game devised by George Collette, one of his colleagues in Philadelphia to make the hospitalized psychiatric patients aware, through personal experience, that their feelings really do result from their thoughts. The game can be done in a group setting, and is entertaining. Rhonda suggested that the therapists who attend David's Tuesday training group at Stanford might enjoy this game as well! There are key differences between healthy and unhealthy negative emotions. Healthy negative feelings, like sadness, remorse, or fear, also result from our thoughts, and not from what is happening to us. However, the negative thoughts that trigger healthy feelings are valid and don't need to be treated or changed. In contrast, unhealthy negative feelings, like depression, neurotic guilt, or anxiety, always result from distorted negative thoughts. David and Rhonda briefly describe each of the ten cognitive distortions, with examples. They warn listeners that the goal of these podcasts will be to learn how to change your own distorted thoughts, and not someone else's. Pointing out the distortions in someone else's thoughts or statements is obnoxious and will nearly always lead to conflict. David and Rhonda do a humorous role-play to illustrate just how incredibly annoying it is when you try to correct someone else's distortions, or when someone tries to correct your own distorted thoughts! David and Rhonda remind listeners to focus on one negative thought from a Daily Mood Log, like "I'm defective" or "my case is hopeless," and to remember that the thought will typically contain many distortions, and possibly all ten. This means that there will be lots of techniques—often 20 or more—to help you crush the thought. They also discuss the new idea that you can do Positive Reframing with cognitive distortions as well as negative thoughts and feelings. In the next podcast in this series, David and Rhonda will discuss the TEAM-CBT techniques that can especially helpful for the first distortion, All-or-Nothing Thinking. David D. Burns, MD / Rhonda Barovsky, PsyD

Recently we did a follow-up podcast with Dr. Michael Greenwald, who bravely volunteered to be the patient in the live therapy demonstration on the evening of Day 1 of the fall Atlanta intensive. My co-therapist was Thai-An Truong from Oklahoma City. Although it was a total blow-away session, we did not think the audio was good enough for a podcast, because we only recorded it on Michael's cell phone. However, our beloved colleague, Dr. Brandon Vance from Oakland, offered to improve the audio quality, so we are now presenting it to you! The audio is not quite as good as a typical podcast, but is good enough, especially after the first few minutes. The podcast includes the entire session, without commentary, as well as the 15 minute Relapse Prevention Training at the end of the workshop on day 4. Because the entire audio is about two hours long, feel free to take a break half way through, perhaps after the E = Empathy portion of the session, or the A = Assessment of Resistance, and then listen to the last half later on. If you like, you can take a look at his Daily Mood Log while you are listening. The session was incredible, and half of the audience were in tears at the end. You may be, too! And thanks, once again, for your bravery and incredible gift to all of us, Michael! Michael works in Woodland Hills and is offering free monthly TEAM therapy practice sessions at his office to therapists in the greater Los Angeles area. I am hoping these will eventually morph into the first Feeling Good Institute in Southern California. Make sure you contact Michael if you are interested joining his weekly practice group ([email protected]). He is a skillful therapist and teacher, and, as you're about to discover, a totally delightful person! Thanks for listening today, and thanks for all the kind comments and totally awesome questions you submit every day! We greatly appreciate your support! Let us know if you like these extended live therapy sessions. We can break them up, if you prefer, into shorter podcasts with commentary, or even publish them as optional extra podcasts on a different day of the week. If you would be interested in some awesome training with Thai-An Truong, ncluding free monthly TEAM-CBT webinars, you can contact her at www.teamcbttraining.com. David and Rhonda

Today, Rhonda and David have the honor and pleasure of interviewing Dr. Jeffrey Zeig, the beloved founder and head of the Milton H. Erickson Institute in Phoenix, Arizona. Every four years, Jeff sponsors the awesome Evolution of Psychotherapy Conference, which draws more than 7,000 mental health professionals to hear all of the most famous and best psychotherapy teachers and innovators in the world to beautiful Anaheim, California for five days. This year, it will be December 9 to 13, 2020. In this far-reaching interview, Jeff talks about the history of psychotherapy, beginning with Freud's work beginning in 1885, all the way up to the first Evolution of Psychotherapy Conference on the 100th anniversary of Freud's origins, in 1985. He explains that up until the beginning of World War II, psychotherapists were focused on the WHY of emotional problems, in spite of the fact that the causes of depression and anxiety were then, and still are, completely unknown. Then, around 1944, therapists began to focus on the question of how we can best help people heal, change, and grow, in spite of the fact that the causes have yet to be discovered. This was a welcome and sensible shift, but led to a proliferation of hundreds of competing "schools" of therapy, most of which claimed to "know" the causes of psychological problems and also claimed to have the "best" treatment methods. Jeff's goal in creating the Evolution conference in 1985 was to bring together the best from all the schools of therapy to share ideas and focus on the common healing factors that all forms of effective therapy share. To Jeff's surprise and delight, the conference was an immediate hit, with more than 7,000 participants from around the world, and was sold out well ahead of time. Jeff also discusses his own creative and imaginative philosophy and approach to therapy, which he describes as a magical experience, requiring great skill, much like a musical creation or theatrical, and not a cookie cutter formula taken from the pages of the latest treatment manual for depression or this or that anxiety disorder. Jeff is one of the pioneers and masters of "indirect hypnosis," which originated with his mentor, Milton Erikson. Jeff fondly and tenderly describes his early days with Milton Erikson, who he describes as a wizard and genius, and likely one of the greatest therapists of all time. Erikson was also an inspiration to Jeff, and to all who had the good fortune of knowing him, because of his own extremely physical limitations caused by polio, and how he transcended those limitations and transformed them into strengths. So, mark your calendars for the Evolution Conference this December 9 - 13. It will be a chance for you to hear and meet many your own therapy heroes first-hand and to learn from superb teachers. I'll be there too, so make sure you say hello. I don' t know yet what topics I will be speaking on, but will post them on my workshop page as soon as I find out. And if you're a struggling, starving student, as I once was, Jeff wants you to know that they will need many helpers at the conference, and the helpers receive generous discounts! Now, that's a deal you can't beat! You'll network with colleagues from around the world in a gorgeous setting. Thanks for listening today, and thanks for all the kind comments and totally awesome questions you submit every day! We greatly appreciate your support! David and Rhonda

David and Rhonda are joined in today's podcast by Drs. Alex Clarke and Diane Schiano, as well as Jeremy Karmel, who are all members of David's Tuesday training group at Stanford. Alex is a clinical psychiatrist and TEAM therapist who practices at the Feeling Good Institute in Mountain View, California, and Diane is a research psychologist and licensed marriage and family therapist. All three helped in the design and analysis of the survey data. We published the survey in a blog entitled "How Are You Feeling Now?" on March 26, 2020 . To review the full report of our findings, you can click here. I (David) have been curious about occasional polls of our listeners to see if we can get meaningful results to potentially interesting questions. So this was a kind of pilot study to see if negative and positive feelings have changed in our fans since the advent of the corona pandemic. You are probably aware of the Brief Mood Survey that TEAM therapists ask patients to complete prior to and just after each session to find out how effective the session was. This tool has been incredibly powerful, because therapists and patients alike can find out right away how much improvement the patient experienced in depression, suicidal urges, anxiety, anger, happiness and relationship satisfaction in every single session. I developed an even shorter version of my Brief Mood Scale to measure similar negative and positive feelings, and all variables can range from 0 (not at all) to 100 (extremely.) So for example, a score of 25 on depression would indicate mild depression, and a score of 100 on happiness would indicate extreme happiness. In other words, high scores on the negative feelings indicate greater distress, while high scores on the positive feelings indicate greater feelings of happiness and relationship satisfaction. In the survey, we asked people like you how you are feeling right now, and how you were feeling just before learning about the corona virus. The goals of the informal survey were to answer these questions: Will people respond to the survey and can they provide meaningful information that can be analyzed statistically? Are people feeling more distress now? If so, have the negative feelings of depression, anxiety, anger and hopelessness changed more in men or women? Have the positive feelings of happiness and relationship satisfaction changed in men or women since just before the start of the pandemic? How have therapists fared, as compared with non-therapists? The five of us discussed the survey findings, which can be summarized in this way: 205 of the people who subscribe to my WordPress blogs completed the survey within a couple days. 62% of them were women and 37% were therapists. There were no gender differences in the therapists. How are You Feeling Now? Changes in Negative Feelings Since Corona Prior to the corona pandemic, the means of the negative mood variables varied from 13.2 (on a scale of 0 to 100) for hopelessness to 24.1 for anxiety. Keeping in mind that a score of 25 indicates "mild" symptoms, this means that all of these negative feelings were slightly elevated, but the elevations were minimal to mild. At the current time, all four negative feelings have increased significantly, ranging from 23.7 for hopelessness to 38.5 for anxiety, so the negative feelings are now mild to moderate. Prior to the corona pandemic, there were no significant differences in any of the negative mood variables in men vs. women. There have been significant increases in negative feelings since that time, but the greatest increases occurred in women. In fact, in women, the negative feelings approximately doubled. This means that the women who completed the survey, on average, now report feeling moderately depressed, anxious, angry and hopeless. For men, in contrast, the only negative feeling that increased significantly was anger. There were no statistically significant differences in anger levels in men vs. women before the corona pandemic and there are no significant differences now. How are You Feeling? Changes in Positive Feelings Since Corona Prior to the corona pandemic, the means of the happiness and relationship satisfaction scales were 55.6 and 58.6 (on a scale from 0 to 100), meaning they were just a tad better than moderate. This indicates that there was quite a bit of room for improvement in positive feelings prior to the pandemic. At the current time, the mean of happiness has dropped to 41,1 but relationship satisfaction has held steady at 56.8 (not a significant change.) There were no significant differences in happiness in men vs women before the pandemic, and there are no differences now. Happiness has decreased in both men and women, and the decreases have been similar in men and women. In contrast, relationship satisfaction did not differ in men vs. women at either time point, and there have been changes in relationship satisfaction in men or women since the pandemic. This is encouraging, and means

Rhonda and David address five fascinating questions in today's podcast, including these: "I'm incredibly shy. How do you talk to girls?" How did you get over your fear of vomiting? Do you still use behavioral techniques like Exposure? Should I try to include the E and A of TEAM when trying to crush my negative thoughts on my daily mood log? And how would I do this? Please give us a podcast on how to express anger. Nandini writes: I have zero experience dating and talking to girls. I don't know how to even make girl as friend. Whenever I talk to a girl, the next day I think "How should I talk to her?" Should I go to her because now she wants me to talk to her? Which makes me very nervous. And also. if am talking to a girl I think about when I will have to go to her next time. When I'm doing my work, I think should I go to her, because she works in our office. Means I don't know how to do that! Can you help? Rhonda and David respond with some simple advice, but encourage all listeners to use the search function on his website to get lots of great links to helpful material on just about any mental health topic, including flirting, dating, shyness, or just about anything. In additon, my book, Intimate Connections, could be really helpful to Nandini, as well as my books, When Panic Attacks and The Feeling Good Handbook, that all have extensive sections on anxiety. You can find all of them at my books page (https://feelinggood.com/books/). In addition, we've recently featured several podcasts on shyness and social anxiety, including: 128: Intense Social Anxiety–I'm Losing Control! What Can I Do? 134: Smashing Shyness: Part 1 135: Smashing Shyness: Part 2 169: More on Social Anxiety–the Case for Vulnerability 142: Performance Anxiety: The Story of Rhonda, Part 1 143: Performance Anxiety: The Conclusion 088: Role-Play Techniques —Feared Fantasy Revisited How did you get over your fear of vomiting? DB, I know you probably don't remember me because it's been years since we emailed, but you helped me via your Ask The Guru section of your old website years ago and we occasionally emailed back and forth after that. Which reminds me to once again thank you for your books and how you've dedicated your life to your work. It has made a difference in my life and I would imagine literally millions of others. What a wonderful thing. I stumbled upon an article about you in the Stanford Magazine from 2013 and learned something I didn't know -- you suffered at one time from a fear of vomiting. I've dealt with that since I was a kid. It's not as severe now as it once was, but I'm wondering what CBT methods might be useful for that particular issue. (No chance I'm taking ipecac syrup!). I know you're busy so I understand if you can't answer, but wanted to reach out anyway. Thanks in advance, Steve Do you still use behavioral techniques? Dear Dr Burns, I really appreciate your efforts in this area cognitive behavioral therapy, but your efforts and techniques are so powerful and you use them so efficiently that almost no time you have to use the behavioral part of it as patients seem to be relieved enough with cognitive work. One thing I am curious about is that if you can't get enough response with cognitive work, and if you have to use the exposure model, and the patient is afraid of exposure because he or she goes into a severe state of anxiety, depersonalization or derealization symptoms and feels like gonna go crazy and lose control, would you still push him or her to the cognitive exposure and are there any risks of it? Thank you very much. Jordan Should I try to include the E and A of TEAM when trying to crush my negative thoughts on my daily mood log? And how would I do this? Dr. Burns, It would be impossible for me to heap sufficient praise over you and your podcasts because I've really gained an intangible amount of benefits and continue to learn something actionable from both on a weekly basis. I'm currently finishing Feeling Good Together and am finding the experience transformative. I wanted to see if I could ask you a question regarding the Daily Mood Log and crushing negative thoughts. I'm completely on board with the notion of fractal psychotherapy and the idea that all of our negative emotions will be captured in a single negative thought and by crushing it, we will feel substantial relief and even euphoria. I've been using the Daily Mood Log to inconsistent effect. I write down my negative thoughts, identify the distortions and then identify statements to attack that thought that are 100% true. Perhaps I am rushing through the exercise too quickly, as I try to make it a daily habit. But is it possible I'm missing an element? I've noticed in your live therapy that you allocate a sizable chunk of time to Empathy and Agenda Setting. Is it possible that the E and A in TEAM's absence in my Daily Mood Log is stunting my progress? Is there a way and should I be implementing both into the exercise? I would appreciate any in

David and Rhonda are joined in today's podcast by Dr. Taylor Chesney, a former student of David's who is now the head of the Feeling Good Institute of New York City. She is a prominent TEAM-CBT therapist and trainer, and specializes in the treatment of children and teenagers. Taylor kindly agreed to do some live work today on her panic and despair because of the impact of the pandemic on her family. Her situation is especially challenging and poignant because her husband, Gregg, is a highly esteemed Emergency Room / Intensive Care physician in New York, and he is constantly working to save the lives of Covid-19 victims. Ten days ago he moved to a separate apartment several blocks away so he will not put his wife and children in harm's way in case he contracts the Covid-19 virus. But will he, himself, be struck down by this vicious virus? He told Taylor that he recently had to intubate several of his colleagues, which is horrifying. Taylor fears that she may lose her beloved husband, and that her three children may have to grow up without a father. She also feels overwhelmed because she's supporting many people now. David begins with a brief overview of the cognitive model, including several key points: All negative feelings result from thoughts, and not from what's actually happening. So even in a crisis that is as real and devastating as the Covid-19 pandemic, all of our emotions will still result from the way we think about it. Remember the teachings of Epictetus 2,000 years ago, when he wrote: "People are disturbed, not by things, but by the views we take of them." This is potentially empowering, because we usually cannot change the fact—the pandemic is real and we are powerless to make it disappear—but we may be able to change our perceptions (eg thoughts, or "cognitions") about what's happening. There's a healthy and an unhealthy version of every kind of negative feeling. For example, healthy fear is not the same as unhealthy anxiety; healthy sadness and grief are not the same as clinical depression; healthy remorse is not the same as neurotic guilt. And so forth. Our goal is not teaching you how to be happy all the time no matter what—that would be absurd—but simply to reduce or eliminate unhealthy negative feelings. Healthy negative feelings result from valid negative thoughts, and do not have to be "treated." Unhealthy negative feelings, in contrast, result from negative thoughts that are distorted and illogical. David reminds us that even in a crisis, depression and anxiety are still the world's oldest cons, and that you CAN change the way you feel. But is this possible? It just doesn't sound right! Can Taylor really change the way she thinks and feels when the crisis is so overwhelming and so real? And can you? As the session unfolds, Taylor tearfully describes her intense fears for her husband, who she loves so greatly, as well as their three young children. She says that 75% of the time, she's "okay," when she's awake and involved with caring for her kids, but 25% of the time—especially late at night when she's alone with the kids—things get pretty desperate, and sobs for 30 minutes or more while experiencing "sheer terror." What's making the situation more painful is that Gregg is temporarily living six blocks away in order to protect his family in the event he does contract the potentially deadly virus. Taylor says that "it feels like we're kicking him out. He's at war. He's fighting, struggling, suffering." She says he's passionate about his work, but she wishes he'd quit! Take a look at Taylor's Daily Mood Log at the start of the session. As you can see, she is focusing on how she is feeling every night before going to sleep. She circled seven different categories of negative feelings, and all are intense, including the depression, anxiety and frustration clusters (all are 100%), the lonely and hopeless categories (both 90%), as well as feeling "bad" (50%.) You can also see the negative thoughts she recorded. She is telling herself that: Negative Thoughts % Now 1. I shouldn't have to do this alone. 90 2. I can't handle parenting alone. 70 3. I shouldn't burden Gregg with my feelings. 70 4. I should share my feelings. 50 5. I should be strong and tough. 80 6. I'll let my patients down if I don't have enough time for them. 50 7. I'll lose Gregg. 50 - 100 8. I shouldn't have to do this. 100 9. I should be able to work and support my family while Gregg stays at home safely. 50 You can also see that her belief in these thoughts varied from 50% to 100%. After empathizing for 30 minutes, Rhonda and David asked about her goals for the session, which would be to turn down the intensity of her negative feelings. Together, Rhonda, Taylor and David do Positive Reframing, asking two questions about each negative thought and feeling: What does this negative thought or feeling show about Taylor that's positive and awesome? What are some benefits, or advantages, of this negative thought or feeling? Together

My mother won't follow my advice! David and Rhonda are joined in today's podcast by Alex Clarke, MD, a former student of David's who is practicing TEAM therapy at the Feeling Good Institute in Mountain View, California, and by Zeina Halim, a TEAM therapist and student in David's Tuesday Stanford psychotherapy training group. In our last two podcasts (Corona Cast 1 and 2) (links) we focused on the impact of the corona crisis on internal feelings like depression, anxiety, panic, hopelessness, and so forth. In this week's Corona Cast 3, we will switch our focus to the impact of the pandemic on personal relationships, using a real example. Zeina was concerned that her mother, aged 72, was not being sufficiently careful about social distancing. Zeina felt panicky because she feared her mother might get the virus and die. However, Zeina's mother is very self-reliant and independent, and didn't take kindly to Zeina's frequent reminders to do this or do that so as to be safe. They ended up arguing and feeling frustrated with each other. Perhaps you've also run into problems with friends and loved ones because of the corona crisis. When people get confined into close quarters, under conditions of intense stress and uncertainty, clashes are almost inevitable. When you're angry with someone , you'll nearly always be viewing the other person in a distorted way. For example, you may be telling yourself that s/he "should" not think, feel or behave the way he or she is thinking, feeling, or behaving. Of course, this is a classic other-directed "should statement." Or you may be telling yourself that the other person is being "stubborn" or "unreasonable" (Labeling; Mind-Reading). Or you may tell yourself that you're right and the other person is wrong (All-or-Nothing Thinking; Blame). And in most cases, you'll be telling yourself that the conflict is the other person's fault and that you're the innocent victim of his or her bad behavior (Blame.) These are just a few of the cognitive distortions (link) that fuel conflict. But it's these distorted thoughts, and NOT what the other person is thinking, feeling, or saying, that actually causes your negative feelings. You are making yourself angry--the other person is NOT causing your anger or frustration! You are creating these feelings. And the thoughts that trigger these feeling are wrong thoughts. This can be a VERY hard pill to swallow. You, and not the person you're mad at, are triggering your feelings of frustration and anger. In addition, the thoughts that upset you are not valid. They're distorted, and just plain WRONG. If you don't like this message, you might want to stop reading! I get it! It is SO MUCH more rewarding to blame the other person! In today's podcast, we discuss and illustrate a sophisticated TEAM-CBT technique called "Forced Empathy" (link). Forced Empathy forces you see things from the perspective of someone you're at odds with. It will ONLY be effective if you want a closer relationship with the person you're at odds with. If you want to remain in battle--as most people do--then you're welcome to do that. Go for it. If, in contrast, you do want to feel closer and more loving, Forced Empathy can lead to a helpful shift in how you think about the person you're angry with. When you suddenly see things through the eyes of the person you're angry with, you may suddenly discover that your thoughts about the other person's motives were not correct. Alex and David describe how the technique works in a step-by-step way, and then illustrate it with a role-play between Zeina and her mother. This is a recreation of the technique they used live in the Stanford Tuesday group a couple weeks before the recording. Forced Empathy proved to be extraordinarily helpful to Zeina, and brought tears to her eyes. Once she saw things from her mother's perspective, the tone of their interactions suddenly softened, and the tension was replaced by feelings of love and acceptance. Zeina was surprised to discover that, among other things, her mother, while not wanting to die, had no fear of death, but didn't appreciate being constantly told what to do, or what not to do, and that she loved and admired Zeina tremendously. Zeina also discovered that in the highly unlikely event that her mother did die, she would want to spend her last days or weeks with her Zeina, feeling close, and loving one another, instead of arguing. Is this relevant to you and your friends and loved ones? In today's podcast, we talk about how you can improve your relationships with friends and loved ones during these challenging times using the Five Secrets of Effective Communication. We emphasized one of the important take home messages in podcast 164 on "How to Help, and How NOT to Help." Sometimes, people just want someone to care about them and listen, without having someone trying to help them or give them advice. Learning to do this can be incredibly freeing, but it's not easy, because so many of us are add

With the "Shelter in Place" orders in California, we are recording these podcasts from our homes instead of from the Murietta Studios. The sound quality may not be as high as usual while we are learning to use the new technology. (I apologize for the echo in this week's podcast. It won't be there again-Rhonda) Let us know what you think! Thank you, David & Rhonda David and Rhonda are joined again in today's podcast by Jeremy Karmel, who is working with David on the new Feeling Great app. In our first Corona Cast, we promised to present an example of how TEAM-CBT can be helpful for individuals who feel depressed and anxious about the personal impact of the pandemic. Rhonda kick starts today's session by describing her treatment with a patient we're calling Alice just a few days ago. Alice woke up feeling stressed and having trouble settling in and getting to work. If you click here, you can see how she filled out the first few steps of the Daily Mood Log just before the start of her session with Rhonda. The Upsetting Event was simply waking up and feeling out of sorts. She circled and rated her negative emotions, which were fairly intense, especially the feelings of depression, anxiety, inadequacy, despair, frustration. Her anxiety was only minimal, but she was also feeling tremendously "jittery." Why was Alice feeling so upset? Her feelings didn't result from the corona virus epidemic, but from her thoughts about it. As you can see, she was telling herself: 1. This could be the new normal. 2. My life is going to waste. 3. I should be handling this better. 4. I could catch the virus and die. 5. No one is in charge. She strongly believed all of these thoughts except #4, which she only believed 40%. You may recall that in order to feel upset, two things must be true: You must have one or more negative thoughts on your mind. You must strongly believe these thoughts. How are we going to help Alice? In the old days, I would have jumped right in to help Alice challenge her Negative Thoughts, but now we have a far more powerful and systematic approach called TEAM-CBT, as most podcast fans probably already know! These are the four steps of TEAM-CBT: T = Testing. Rhonda tested how Alice was feeling at the start and end of the session. E = Empathy. Rhonda provided warmth and support without trying to "help" or "cheer-lead." A = Assessment of Resistance. This is one of the unique aspects of TEAM-CBT, and it's the secret of ultra-rapid recovery. Rhonda used the Miracle Cure Question, Magic Button, Positive Reframing, and Magic Dial to bring Alice's "resistance" to change to conscious awareness, then quickly reduced it before trying to "help." M = Methods. Rhonda helped Alice identify the many cognitive distortions in her thoughts. For example, her first Negative Thought, "This could be the new normal," was an example of All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Fortune Telling, and Emotional Reasoning. The goal of the M = Methods phase is to crush the Negative Thoughts that are upsetting you. Do you know how to do this? You have to come up with a Positive Thought that has two characteristics: It must be 100% true. Positive affirmations and rationalizations and half truths are worthless. Cognitive therapy is based on the Biblical idea the "The truth shall set you free." The Positive Thought must drastically reduce your belief in the Negative Thought you've recorded on your Daily Mood Log, and ideally your belief in it will go all the way to zero. In fact, the very instant you stop believing the Negative Thought, your feelings will change, and often quite dramatically. Rhonda helped Alice challenge her Negative thoughts with a powerful technique called the Externalization of Voices. For example, Alice was telling herself that "I should be handling this better" because she'd been having trouble adjusting to the home isolation and had been procrastinating instead of focusing on her writing, and she was also telling herself that "My life is going to waste," thinking she'd be procrastinating and feeling miserable forever: "The new normal." The Positive Thought that crushed it was, "I have a lot of experience as a self-starter, and I've got eight weeks of free time now to write, which is pretty awesome. In addition, I can give myself a break, instead of putting myself down, and give myself a little to regroup!" After all, there are hundreds of millions of people around the world who are feeling isolated and in distress, and probably most of them aren't being nearly as productive as they usually are, but clearly, that isn't going to go on forever! Instead of putting yourself down, you can give yourself some support and encouragement, in exactly the same way you might talk to a dear friend. Once Alice crushed her Negative Thoughts with strong Positive Thoughts, her feelings suddenly changed. Although the session was only one hour long, Alice experienced incredible improvements in ho

With the "Shelter in Place" orders in California, we are recording these podcasts from our homes instead of from the Murietta Studios. The sound quality may not be as high as usual until we all get the necessary recording equipment, and learn the new technology. Please bare with us during this transition. Thank you, David & Rhonda David and Rhonda are joined in today's podcast by Jeremy Karmel, who is working with David on the new Feeling Great app, and Dr. Alex Clarke, a former student of David's who is practicing TEAM therapy / psychiatry at the Feeling Good Institute in Mountain View, California. One of our loyal podcast fans, Phil McCormack, sent a heartwarming email which read, in part: In light of the pandemic taking us into uncharted territories, I thought it might be interesting to hear of some tips from you that would help folks deal with the situation, kind of like the David's Top Ten Tips podcast but this one focused on the hysteria which is prevalent as I write. I'm sure your fans would appreciate it and it might be a good jump start for your new book and app, both called Feeling Great. I realize you are incredibly busy and don't expect an answer. And if you want to tell me to screw myself, I can use your techniques to handle that! I responded like this: Thanks, Phil. I'm trying to put together at least two or three podcasts on the coronavirus from a variety of perspectives! Might read you question to kick start the first one we do, if that's okay. david Phil immediately shot back this email: You're an animal! I have no idea of where you get all your energy and motivation–obviously your techniques work (drug free!) so that must be part of it! Kudos to you for all your effort. It is so, so much appreciated!! I sincerely hope you someday get the recognition you deserve!!! I think Feeling Great might be your ticket... Hope so. Please feel free to read question and thanks for not telling me to "screw myself!" Really appreciate that! Phil How cool is that! Rhonda and I are planning several podcasts on this important topic including today's as well as a podcast on how Rhonda used TEAM to help a woman with severe feelings of depression, anxiety, inadequacy, despair and frustration about the current corona crisis in a single session. We are also planning podcasts on how to communicate with friends and loved ones during the crisis, as well as a survey to assess changes in mood (depression, anxiety, anger, relationship satisfaction and happiness) since the corona virus hit, and possibly more. When the survey is ready, we'll announce it and send you a link in case you'd like to let us know how you've been feeling, and how your feelings might have changed since the virus hit! Rhonda kick starts today's session by reading a list of negative thoughts from folks who are freaked out about the corona virus, including these: Negative Thoughts with Probable Cognitive Distortions The world will turn into an apocalypse. I'll be a carrier and won't know it and then I'll infect my partner and children who will get really sick. I'm divorced and I think my ex- will try to keep me from my kids. She won't be as vigilant as I am about keeping our kids healthy. They'll get sick and infect me. I'm looking for a job right now, but no one will be hiring for a long time and I'll never get a job. I won't have enough money to pay my rent and I'll be evicted from my apartment and end up homeless (or) my business will go out of business. I won't have enough money to have fun for several months. My parents will contract the virus, especially one of my parents who has some chronic health stuff, and get really sick or die. I'm going to get cabin fever. I will lose a sense of self/connection to reality with how surreal everything is. People in my life will die from the virus. * * * Negative Thoughts that are Probably Not Distorted The numbers of infected people are way higher than what's being reported because there's no testing The pandemic is worsening. The pandemic will get much worse than we realize now. Needier populations -- people who have lost work who really need it (restaurant workers, hotel, caterers, production staff, people with no savings, etc) — will suffer. The social fabric is going to break down. Things are going to continue worsening as climate change worsens. I live too far from my parents to help take care of them. Rhonda, Alex, David, and Jeremy begin by discussing several of the basic ideas of TEAM-CBT. We feel the way we think. In other words, the events of this world—like the corona virus—cannot have any effect on how we feel. All of our negative and positive feelings result from our thoughts, or "cognitions." This idea goes back nearly 2,000 years to the teachings of the Greek Stoic philosopher, Epictetus, who said that people are disturbed, not by the things that happen, but by our views of them. Some negative feelings are healthy and some or not. Healthy fear is not the same as neurotic anxiety. Healthy sadn

Today, Rhonda and David answer several challenging questions submitted by listeners like you. What schools of therapy are embedded in TEAM? Do negative feelings cause negative thoughts? Or do negative thoughts cause negative feelings? Or both? Or neither? "Can TEAM-CBT help bipolar patients during the depressed phase?" How do you make Externalization of Voices work? I get stuck! For example, my patient said, "It's unfair that I cannot get a job!" Is there a cure for OCD? 1. What schools of therapy are embedded in TEAM? Dear Dr. Burns, I have some questions specifically about T.E.A.M. therapy. You mention in a blog post that T.E.A.M. therapy "integrates features and techniques from more than a dozen schools of therapy." I'm aware of many of the CBT techniques you use, but I don't think I've read yet of any technique belonging to any other schools of therapy. Would you be so kind as to mention such techniques? Madelen Hi Madelen, This is important because I believe we need to get away from competing schools of therapy and need to create a new, data-driven structure for therapy based on research on how therapy works, which is what TEAM is. At the M = Methods part of the session, you can include methods from any school of therapy. Here are some of the schools of therapy that I draw upon TEAM-CBT. Individual / Interpersonal downward arrow: same (psychoanalytic / psychodynamic) Flooding / Experimental technique: behavior therapy (exposure) Externalization of Voices: Gestalt / Psychodrama / Buddhism Acceptance Paradox: Buddhism Self-Defense Paradigm: REBT CBA / Paradoxical CBA / Devil's Advocate: Motivational techniques Identify the distortions / examine the evidence: cognitive therapy Empathy: Rogerian (humanistic) therapy Five Secrets / Forced Empathy: Interpersonal therapy Shame-Attacking Exercises: Humor-based therapy / Buddhism Be Specific / Let's Define Terms: Semantic Feared Fantasy: Role-Playing / Psychodrama / Exposure One-Minute Drill / Relationship Probe: Couple's Therapy Time Projection / Memory Rescripting: Hypnotherapy Anti-Procrastination Sheet: Behavioral activation therapy (Lewinsohn-type therapy) Brief Mood Survey / Evaluation of Therapy Session: data-driven therapy Talk Show Host / Smile and Hello Practice / Flirting Training: Modeling / teaching effective social behavior Storytelling: indirect hypnosis. Positive Reframing: Paradoxical psychotherapy. Hidden emotion technique: psychoanalytic / psychodynamic Do you need more? Can provide if you want. Let me know why you have this particular interest!At any rate, I really enjoyed and appreciate your thoughtful questions, thanks!David 2. Do negative feelings cause negative thoughts? Or do negative thoughts cause negative feelings? Or both? Or neither? Hello Dr Burns, I would like to thank you for your podcasts. I greatly enjoy listening to them and find them very much helpful both in my personal life and my work as a psychologist. I do have a question: you talk about how cognitive distortions cause anxiety and depression. Are cognitive distortions also a result of depression and anxiety? For instance, if a person was to become depressed after experiencing loss, would they then discount the positive in their lives to a larger extent, for example? Thank you very much! Audrey Hi Audrey, Yes, depression creates a negative bias in perceptions, so you pick out information and details that support your distorted thoughts, like "I'm a loser" or "my case is hopeless." My research, which I'll report in my new book, Feeling Great (sept 2020) indicates that negative thoughts trigger feelings of depression and anxiety, which, in turn trigger more negative thoughts. This is a negative vicious cycle. There is also a positive cycle, in that positive thoughts that you believe to be true trigger positive feelings, which, in turn trigger more positive thoughts! Thanks for the question, Audrey. david 3. "Can TEAM-CBT help bipolar patients during the depressed phase?" Name: Sarah Comment: Hi, Dr. Burns. I am a big fan of your work and very much enjoy reading your blogs and listening to you and Fabrice on you weekly podcasts. I am writing with a question that has to do with the depression side of bipolar disorder and the potential usefulness of CBT. I have not heard you speak about this topic before. My sister in law lives in Switzerland and has been diagnosed with a fairly severe case of bipolar disorder. She does not cycle rapidly, but her manic and depressive states are quite severe. In fact, she has been hospitalized several times during her manic episodes. For the first time in her life, I believe my sister in law has finally accepted the fact that she is bipolar, and she is actively pursuing treatment and trying to get better. After hearing me talk about all the great information I have learned from you, my husband has hunted down several CBT practitioners in Switzerland, in the hopes that changing my sister in law's thoughts will help her navigate the overwhelming

Today, Rhonda and David talk about how to give potentially hurtful feedback when you sense racial bias in a friend or colleague. She describes an incident in her office where the glass coffee table in her waiting room was found smashed and shattered when her office mate "Steve" (not his real name) arrived Monday morning. Although many people, including the cleaning crew, had used the office over the weekend, Steve asked Rhonda to discuss the broken table with someone who uses her office on the weekends, Kenya. Kenya is African American, and a highly esteemed professional and beloved friend and colleague of Rhonda's. Rhonda thought there was implicit bias being played out in this situation but did not know how to discuss it with Steve. But how can she convey these feelings to her office mate, who conveyed the impression that a black man must be the one who broke the table? David suggests one of the advanced communication techniques called "Changing the Focus" discussed and demonstrated in a previous podcast #158. They illustrate how to apply that method to the current situation, and struggle a bit along the way! David reiterates the story of when he was accused of being racist at a psychotherapy workshop near the Texas / Mexico border, and how his own teachings in that very workshop saved the day for him. He emphasizes that it can be so painful to be accused of racist tendencies, or to discover them in yourself, and that this is another case where the cover-up is far worse than the crime! David and Rhonda

Today, Rhonda and David answer three great questions submitted by listeners like you. I am confused about the terms, negative and positive distortions. Help! "How do you treat an "existential crisis?" Can you use the Five Secrets with someone in a hypo-manic state? Won't agreeing with their accusations just make things worse? 1. I am confused about the terms, negative and positive distortions. Dear Dr. Burns, I do have one question about terms I have heard on the podcast. The terms that confuse me are "negative distortions" and "positive distortions." I think I understand that they are both "bad" distortions, but the positive distortions are distortions related to moods or thoughts that are unhealthily high or "up," such as in mania or narcissism. And negative distortions are the ones related to lower mood states/depression. Is this correct? I don't know if it is a brain thing, but even though I think I understand the concepts, my brain still seems to automatically think of positive distortions as good, and so I become quite confused when trying to understand how to fight them or help someone else fight them . . . Thank you again, so much, for all of your hard work on the podcast, as well as your diligence in training therapists in your TEAM model. I am a super-fan of the model already after only a week or so of listening! And the Five Secrets have challenged me to examine my communication abilities much more honestly and helped me in several important interactions already (even as a novice making many mistakes😬). Thank you, thank you, thank you! Please also tell Fabrice and Rhonda many thanks for all of their hard work and excellence as well. They both bring such gifts and refreshing honesty, brilliance and genuineness to the discussions. I especially admire Rhonda for sharing her personal work. Such powerful and transformative stuff! It gives me hope that someday I might be a fraction as brave to DO that kind of work, much less share it openly with others for their benefit. What a generous as well as brave thing to do! I feel so hopeful and encouraged to know there are therapists like you, Fabrice, and Rhonda helping people to heal from vast amounts of mental and emotional suffering. I can't wait for TEAM to be as commonly known everywhere as CBT is now. Sign me up to volunteer for any promotional efforts if that is ever needed! For now, I will continue to tell everyone, including quite a few other counselor friends, about the podcast and the TEAM model. Sincerely, A new super-fan podcast listener, Holly Miller Hi Holly, Many people are confused, so this is a great question! Rhonda and I will gladly discuss this on our podcast. And thanks for your kind words! david 2. Can you use the Five Secrets with someone in a hypo-manic state? Won't agreeing with their accusations just make things worse? Hi David and Rhonda, Thank you so much for the podcast. I have been an avid listener since the early days of the podcast, and it has helped me through very difficult times and still is. My question is related to my relationship with my future to be divorcee. She is at times in a hypo mania state due to her bipolar illness (which is diagnosed and treated). Is it possible to use the five secrets of effective communication with someone who is in a state of hypo mania? I feel that agreeing with unreasonable accusations and complains is not helping at all and only causes her to hold to these claims. I know that you usually like to relate to specific correspondence but it is more of a general question. I hope you can give me some guidelines on what works and what doesn't. Thanks! Al Hi Al, The devil is in the details. Can you provide a specific example of one thing she said, and exactly what you said next, that you need some help with? General questions about the Five Secrets are NEVER productive. Great question, thanks! david David D. Burns, M.D. Hi Dr. Burns, Thanks for the prompt reply. Well, I was asking a general question if it is possible at all to use the 5 Secrets with someone who is totally unreasonable? She would say "You started to be a father when you decided to divorce" referring to the fact that I am claiming for joint custody. The fact of the matter is that she has been going in and out of long depression periods and manic periods and I had to take care of the kids, maintain the house and keep a job (working from home). I would answer that I was there taking care of the kids all the years and now that I decide to break I want to keep my fair share of the time with them. Prior to that she always claimed that I am not a good spouse although I took care of her during all the years and had at times to reduce my workload in order to be available for the kids and her. So, the claims and accusations are always discounting what I did for her and the kids. And she is not accepting the fact that she has been ill and that this had a toll on the family. She says I need to look forward even though these episodes on hypo

In my workshops and weekly training group for community therapists at Stanford, we often include personal work as a part of the training. The personal work can help in several ways: When you've successfully done your own personal work, you will feel greater joy and energy in your personal life and in your clinical work as well. You will have a much deeper understanding of how TEAM-CBT actually works. You will be able to deliver faster and deeper therapy to your patients. You'll be able to tell your patients, "I know how you feel, because I've been there myself. And what a joy it's going to be to show you the way out of the woods, too!" Those who observe the therapy develop a greater understanding of how the fine points of effective therapy. When the person in the "patient" role has a profound change, we all share that joy and feel inspired by the miracles that can often be accomplished in a relatively short period of time. As they say, "seeing is believing." Rhonda recently surveyed some of our listeners about live therapy we sometimes offer on our podcasts—do you prefer to have the live therapy presented all at once, in an extended, two-hour podcast, or split up over two or more podcasts with expert commentary along the way? Our listeners were split on this. So today we are presenting an actual and dramatic therapy session in its entirely. If you don't have two hours to listen all at once, you can stop after an hour or so, and then return to the last portion when you have more time. And please let us know what you think of this live therapy podcast format! In today's session, we are very grateful to Sarah, a certified TEAM-CBT therapist, for allowing us to share her very personal and powerful session with you. Sarah was having intense anxiety during her sessions with patients, and her anxiety was bordering on panic. This is actually not unusual. In my experience, most shrinks struggle with feelings of insecurity from time to time. But when we shrinks experience insecurities, we often feel strong shame as well, telling ourselves that we "should" have it all together because we are supposedly "experts." I'm no exception! I can remember how anxious I used to feel on Sundays when I was starting out in private practice. I'd tell myself, "Wow, I'm going to have all of these high-powered patients tomorrow, and what if they notice that I don't actually know what I'm doing half of the time!?" But then, halfway through Monday morning, it would dawn on me that my patients didn't seem to notice or care about my flaws, and I'd relax! Although Sarah brought a Daily Mood Log to the session, listing all of the negative thoughts that were triggering her anxiety, along with many other intense negative feelings, the session took an unexpected turn in the direction of the Hidden Emotion Model. We've done several podcasts on this powerful technique before, and now you have the chance to see how it works first-hand! Instead of challenging Sarah's negative thoughts, as we usually do, we asked whether there was something bothering Sarah that she wasn't telling us about, due to her arguably excessive "niceness." I think you'll enjoy listening, and you may learn a little, too! My co-therapists for this session included Dr. Rhonda Barovsky, my beloved and brilliant podcast host, as well as Kevin Cornelius, MFT, a fabulous TEAM therapist whom I've recently featured in a recent blog! Rhonda and I want to thank you, Sarah, once again, for your tremendous courage and generosity! David and Rhonda

Rhonda and David are joined today by Jeremy Karmel who is working with David on a new Feeling Great app. Rhonda begins by reading several amazing emails from fans whose lives have been changed by the podcasts as well as David's books, including Jessica, Tim, and Mike. Thank you, everyone, for such kind and thoughtful comments! This great photo of Rhonda is courtesy of Nancy Mueller, a local photographer who kindly took some pics at my home in Los Altos, California. David describes his upcoming book, Feeling Great, which will be released in September of 2020. It will move well beyond his first book, Feeling Good: The New Mood Therapy, all will incorporate all of the latest hi-speed treatment techniques in TEAM-CBT (aka "Feeling Great Therapy.") David describes his excitement about the team he is working with to publish his latest book, including Linda Jackson at PESI (the publishing company), and Jenessa Jackson, his editor. Jeremy describes why he approached David to develop a Feeling Great app. As a Stanford student, he was depressed and had to drop out of school for semester. Antidepressants and talk therapy had done nothing for him, so he was feeling hopeless. Then Jeremy discovered one of Dr. Burns' students, Dr. Matthew May, and recovered in just two weeks, which was mind-blowing. Matt was one of the first practitioners in the world to use the new TEAM-CBT, Jeremy felt a tremendous drive to make these powerful new techniques available to people around the world. David and Rhonda, of course, share this goal! In fact, Rhonda has recently gone to Mexico City as well as India to support the sudden and strong emergence of TEAM-CBT in those countries. Rhonda asks Jeremy many questions about the amazing recovery he experienced in his work with Dr. May, and how he's been doing since. Then Rhonda, Jeremy, and David address a number of intriguing questions about the new app. For example, there is tremendous evidence from research that David's first book, Feeling Good, has significant antidepressant effects. In fact, many published studies have confirmed that more than 50% of depressed individuals will recover or improve dramatically within four weeks if you just give them a copy of the book. Is it possible that an app that incorporates all the great methods in Feeling Good, plus all the new techniques in TEAM-CBT, could be even more effective? And if so, would this mean that an electronic app could even outperform human therapists as well as antidepressant medications? David says that this has been his dream for more than 40 years, and he thinks this is a definite possibility. Jeremy agrees, since the app, now in creation, has the potential to be far more powerful and systematic than reading a book or even going to a therapist. Rhonda asks: "Are you trying to put human therapists out of business?" David believes that there will always be a place for human therapists, since the person to person support and connection is invaluable and desperately needed. However, the Feeling Great app can actually be a friend of human therapists, just as his book, Feeling Good, has been, working hand in hand with therapists helping to accelerate the recovery of their patients. In addition, the app can bring rapid help and relief to millions of people worldwide who cannot afford therapy, and those who simply cannot find effective therapy. David emphasizes the goal of having an entirely free version of the app for people without resources. Rhonda asks: "Will you be doing research as well as self-help "treatment" with the new app?" The answer to that is absolutely, yes, and the implications for incredible research into the causes and treatments for depression, anxiety and relationship problems are immense, especially if thousands or even tens of thousands of individuals use the Feeling Great app. For example, David has developed many psychological assessment instruments to help therapists and patients alike, but the costs and time required to develop and validate even a single short test can be substantial. In contrast, one might get more than enough data to evaluate a new instrument in just one day, which is mind-boggling. In addition, every time someone uses the app, we will learn more and more about what works, and what does not. This type of analysis is vitally important, but practically impossible, or at the very least arduous and confusing, when working with human therapists, due to the complexity of what's happening, and the intense bias of therapists and researchers alike. The computer, by way of contrast, does not mind being wrong and moving in different and more promising directions! Rhonda, Jeremy and David will let all of you know when a beta version of the new app, is available, and hopes that many of you will try it out and let us know what you think! David will also let you know when pre-ordering for his new book, Feeling Great will be available as well! David and Rhonda Thanks for listening to today's podcast! David

Rhonda and David are joined today by Dr. Michael Greenwald, who was in the studio following his recording of last week's podcast. We address a fascinating question submitted by a podcast fan: Sally asks" "How can I help my depressed husband who is leaving me?" Hello Dr David, My husband is going through severe depression and anxiety. He blames me frequently for all the bad decisions he made, and he says he married the wrong woman. He regrets almost every decision he made and says he made the decision [to marry me] under my pressure. Our marriage of 20 years is almost leading to separation. I don't want to separate, but I don't know how I can improve the situation. He doesn't want to go to any doctor. Do you think if I decide to go to TEAM certified therapist, they can work on me to get him out of his depression? If yes, how many sessions will it take? Sally David, Rhonda and Michael discuss this sad and difficult situation that Sally describes. Feeling loved and cared about is vitally important to nearly all of us, and when an important relationship is threatened, it can be extremely painful. It sounds like Sally's husband may be on the verge of leaving her. David describes a powerful and paradoxical strategy he described in Feeling Good: The New Mood Therapy, that he has often used to help abandoned wives. The approach is the opposite of "chasing," and is based on experimental research on the most effective ways of shaping the behavior of rats! It also sounds like Sally and her husband have some significant difficulties communicating in a loving and supportive way, like nearly all couples who are not getting along, and certainly some couples therapy or consultation might be a useful step. However, the prognosis for couples therapy isn't terribly positive unless both partners are strongly committed to each other, and willing to work on their own problems, as opposed to trying to change or "fix" the other person. We place a strong emphasis on the Five Secrets of Effective Communication, especially the listening skills, when criticized by a patient, family member, colleague, or just about anyone. If Sally committed herself to learning to use these skills—which are NOT easy to learn—she might be able to develop a more loving and satisfying relationship with her husband, whether or not they separate or stay together. David expresses the opinion that her fixation on "helping" or "fixing" him might be misguided, and might actually irritate him and drive him away. Rhonda, Michael and David illustrate David's "Intimacy Exercise," which is a way of learning to use the Five Secrets, and they practice with three of the criticisms Sally has heard from her husband: "You pressured me into marrying you." "You're to blame for all the bad decisions I've made." "I married the wrong woman." After each exchange, the person playing Sally's role receives a grade (A, B, C, etc.) along with a brief analysis of why, followed by role-reversals. These role play demonstrations might be interesting and useful for you, too, because you'll see how this exercise works, and your eyes will also be opened to just how challenging it can be to respond to a painful criticism in a skillful way, and how mind-blowing it is when you do it right. You will also see that trained mental health professionals often make mistakes when learning these skills, and how you can increase your skills through this type of practice. David emailed Sally with some additional resources that could be helpful to her. Hi Sally, Thank you so much for your question, and for giving us the permission to read and discuss your question on a podcast. We will, however, change your name to protect your identity. For referrals for treatment, you can check the referral page on my website, or go to the website of the Feeling Good Institute. There may be some excellent therapists in your area, too. I would recommend the recent Feeling Good Podcast on "How to Help, and How NOT to Help." . The idea is that listening is sometimes far more effective and respectful than trying to "help" someone who is angry with you. Also, the podcasts on the Five Secrets of Effective Communication, starting with #65, could be helpful, along with my book, Feeling Good Together. There's also search function on almost every page of my website, and if you type in "Five Secrets," you'll get a wealth of free resources. Your husband might benefit from my book, Feeling Good: The New Mood Therapy, available on Amazon for less than $10. Research studies indicate that more than 50% of depressed individuals improve substantially within four weeks of being given a copy of this book, with no other treatment. However, the depressed individual must be looking for help, and it's not clear to me whether the treatment is more your idea, or his idea. You seem to be asking for training in how to treat your husband. Perhaps, instead, you could learn to respond to him more skillfully and effectively using the Five Secrets. Le

In today's podcast, Rhonda and David are honored to interview Dr. Michael Greenwald, a courageous clinical psychologist who helped make the Atlanta Intensive a truly amazing event. Michael volunteered for the live demonstration to work on his lifelong problem with social anxiety, which seems to be a popular topic these days, and likely a personal problem for many podcast fans. My co-therapist was Thai-An Truong, a highly respected TEAM therapist and TEAM therapy trainer from Oklahoma City. Thai-An also joins today's podcast via Zoom and dialogues with Michael for the first time since the intensive. The session with Michael was powerful and inspiring, with a good 50% of the audience in tears (of joy) at the end. Michael recorded the session on his cell phone, but the quality was not up to the quality of our podcast recordings, so he agreed to fly up to the "Murietta Studios" from his home in Los Angeles so we could at least describe what happened and share the magic with you. If we can find a way to do some sound enhancement on the cellphone recording of the session, we will likely publish it as a separate mid-week podcast for those who like to hear the incredible therapeutic process unfolding in real time. If you review Michael's Daily Mood Log at the start of the session, you'll see that he was feeling depressed, anxious, ashamed, worthless, lonely, self-conscious, discouraged and stuck, and all of these feelings were intense. In addition, he told us that he wasn't feeling much joy, self-esteem, pleasure or satisfaction in his life. But the strongest feeling was anxiety. He said that coming up on stage to face his fears was an enormous challenge, and that this was the first time he'd ever done something like this. We will do T = Testing again at the end to see what changed, and by how much. We'll also ask Michael to complete the Empathy and Helpfulness surveys, so we can find out how he experienced Thai-An and David during the session. You may be saddened by the upsetting event Michael recorded at the top of his Daily Mood Log, which was "sitting with my son and trying to make conversation with him." He said their conversations were always pretty superficial, and that he would typically leave the room after short interactions with his son because he felt so anxious. Here's an example of a typical exchange. Michael's son, a graduate student in clinical psychology, was working on his applications to internship programs. Michael: What's up? Son: I'm working on my applications to internship programs. Michael: That's good. How's it going? Are you getting them in on time? Son: Yah, it's fine. Michael: Are you completing them? Do you want me to look at them? Son: All fine. If you review the negative thoughts on Michael's Daily Mood Log, you'll see that he felt like a failure as a father because he did not know how to get close to his son or how to tell him just how much he loved him. He was telling himself things like this: Something is wrong with me because I can't talk to him. 100% I am failing him as a father. 100% He deserves so much better than me. 100% He must wish he had a different father. 95% And more. I was sad to see that Michael had been beating up on himself pretty badly for years, and I'm pretty sure that the therapists in the audience felt the same way, because it was so clear that he was a tremendously humble, giving and loving father who was totally devoted to his sons. I found myself thinking, "My gosh, I wish I'd been half the father that Michael is!" The E = Empathy phase of the session lasted about 30 minutes. Michael indicated that Thai-An and I had done a good job, and that he felt understood and accepted, so we went on to A = Assessment of Resistance in a step-by-step manner, using these tools: The "Invitation Step" to find out if he was ready to roll up his sleeves and get to work on his social anxiety The "Miracle Cure" question to find out what he hoped would happen in the session The "Magic Button," to see if he'd want all of his negative thoughts and feelings to disappear suddenly, just by pushing it "Positive Reframing," asking Michael these two questions about each negative thought or feeling: "What does this negative thought or feeling show about you and your core values that's positive and awesome?" "What are some benefits, or advantages, of this negative thought or feeling?" At first, these questions didn't make any sense to Michael, since he was so used to thinking about his negative thoughts and feelings in a negative light, thinking they were "bad" and were the result of some kind of personality defect or mental disorder, like "social anxiety disorder" described in the DSM5. This is also the hardest part of TEAM-CBT for therapists to learn, because it is so anti-intuitive. But as the list of positives grew, Michael began to "get it," and we could actually see his mood lightening up before our very eyes. It was so cool, and this was the first hint the audience had that somethin

Rhonda, Fabrice, and David discuss psychedelic-assisted psychotherapy, Fabrice's wonderful new marriage, his fascinating new podcast (http://peaceatlast.us/), and more. David and Rhonda are thrilled to have our beloved friend and colleague, Dr. Fabrice Nye, as the special guest on today's podcast. Many of you will remember Fabrice as the man who gave birth to the Feeling Good Podcast, and acted as host for the first 133 podcasts. Fabrice describes many events since he turned over the reins to Rhonda earlier this year, including his recent marriage and move to the beautiful but fire-ravaged Russian River area roughly 100 miles north of San Francisco. However, Fabrice still maintains his clinical practice on a part time basis in Redwood City, in the San Francisco Bay area. The main focus of today's podcast is Fabrice's participation in promising new research on the treatment of PTSD. The participants in the study are veterans receiving psychotherapy that is assisted by treatment with MDMA during extended treatment session. MDMD is also known as the party drug, Ecstasy. However, the MDMA used in the research is chemically pure, whereas Ecstasy is generally obtained on the street and may not be pure. Fabrice describes MDMA as an "empathogen" that makes people more loving and more in touch with their emotions. This can make it easier for patients with PTSD to talk about their traumatic experiences and painful feelings, which people with PTSD usually try to avoid. Avoidance makes all forms of anxiety much worse, where as exposure is usually beneficial. Patients in the study received three treatment sessions, and a preliminary analysis indicated that one third of them improved to the point that they no longer had symptoms severe enough to be diagnosed with PTSD. Further studies are in progress, including a study with a control group, as well as follow-up studies to find out whether the improvement continued and whether some of the patients relapsed. Fabrice also describes the fascinating new trend in treatment of a variety of conditions with psychedelics, including psilocybin, mescaline, and ayawauska. I expressed my personal support for this trend, as these substances have been used by hundreds, if not thousands of years, for spiritual purposes by indigenous people throughout the world. And perhaps the coolest thing we learned was that Fabrice will be starting his own terrific podcast entitled PeaceAtLast.us about the time today's podcast will be published. PeaceAtLast.us will focus on the overlap between spirituality and psychotherapy, a topic that I have always found extremely interesting and helpful in my own clinical work using TEAM-CBT. You might want to check out the new Fabrice podcast! I know that Rhonda and I will! After the podcast, we received the following email from Fabrice, which includes many resources for those of you wanting more information about psychedelics and psychotherapy, as well as his new podcast. Hi David and Rhonda, It felt so good to be reunited with you for an hour. Wish we didn't have to cut it so short. Here are some of the links that you may want to provide to your listeners. Multidisciplinary Association of Psychedelic Studies (MAPS), which sponsors and funds the Phase 3 trial of MDMA-assisted psychotherapy for PTSD: https://maps.org/ Michal & Annie Mithoefer, lead researchers for the study: https://mapspublicbenefit.com/staff/michael-mithoefer-m-d/ Psychedelic research at Johns Hopkins University: https://hopkinspsychedelic.org/ Roland Griffiths, main researcher for psilocybin studies at JHU: https://hopkinspsychedelic.org/griffiths List of federal clinical trials involving psychedelics in the U.S.: https://clinicaltrials.gov/ct2/results?cond=&term=psychedelic&cntry=US Article on how to have a legal psychedelic experience (but not necessarily a safe one): https://psychedelic.support/resources/legal-ways-to-pursue-psychedelic-experiences/ And finally... Here's how to find my new podcast, to be launched on February 6, 2020: http://peaceatlast.us/ Fabrice Nye [email protected]

Rhonda and David discuss two challenging questions submitted by listeners like you. Question #1: Cindy asks: My suicidal daughter refuses to talk to me! What can I do? Comment: Dear David, I stumbled upon you teaching in another podcast a few months ago. Immediately I was stunned by how much your words echoed in my mind. I have listened to your book three times in Audible and many of your podcasts. You Changed my life!!! I am much more relaxed now and I can sleep!!! I talked about you with my massage therapist and she bought your book for her daughter (who has anxiety attacks) and her niece. Her daughter is an aspiring artist who said that she would buy your book and give them away to teens when she becomes famous. I now ask you to change another life, that of my daughter's. She has been depressed for more than 20 years, suicidal (bought a noose, watches suicide movies, talked about ways to kill herself) and no therapists could help. We went to therapy together this past summer and it only ended that she abruptly canceled and is no longer responding to me by any means: phone, text, card, or email. The last time I saw her was late August and she was very down and had very poor personal hygiene. I have since sent her a loving text at least every other day, I offer to drive to her city (an hour away) to have dinner with her, I sincerely apologized for everything I could think of that I have done wrong since she was a child, I sent gifts to her by mail, I invite her to come for holidays, I ask her cousins to call (she did respond to them). No response to me at all. I am wondering how to communicate with a loved one who just totally shut you off. Always your fan, Cindy Thank you, Cindy. Sorry to hear about your daughter, very concerning. My heart goes out to you. Our own daughter had a rough time as a teenager, too, but now is doing great. I hope things evolve with your daughter, too. This podcast may help: https://feelinggood.com/2019/10/28/164-how-to-help-and-how-not-to-help/ as well as this one: https://feelinggood.com/2019/02/04/126-how-to-communicate-with-someone-who-refuses-to-talk-to-you/ The first podcast highlights common errors in trying to "help" someone who is hurting, and emphasizes how to respond more effectively, using the Five Secrets of Effective Communication. The second podcast illustrates how to get people to open up using one of the advanced secrets called "Multiple Choice Empathy / Multiple Choice Disarming. My book, Feeling Good Together, explains these techniques in detail, with practice exercises, and includes an entire chapter on how to talk to someone who refuses to talk to you. You can learn more on my book page. (https://feelinggood.com/books/). Some support from a mental health professional might also be helpful to you, as these techniques sound simple, but are actually challenging to master. Your daughter might also benefit from my book, Feeling Good: The New Mood Therapy (https://feelinggood.com/books/). It is not a substitute for treatment from a mental health professional, but research studies indicate that more than 60% of the people who read it improve significantly in just four weeks. It is inexpensive, and I've linked to it if you want to take a look. All the best, David Question #2: Lorna asks: How can I deal with my jealousy? Comment: Hi David, I've recently discovered your books and your podcast and CBT has really been helping me in my personal life. I really want to thank you for all the amazing work you do!! The issue I'm having however seems to still really get my moods down and I was wondering if perhaps you could offer some general advice via the podcast. I'm in a great relationship but the ex-girlfriend of my partner has recently moved back to the city where we live and now we are in similar social circles. They were together for a very long time and now I'm really struggling with the prospect of spending time with her. When we all spend time together, it's actually fine, but afterwards I really struggle with thinking about them together, getting to know her and thinking about her personality and how we compare. I think most people would find this uncomfortable, but it really has triggered a downward spiral for me. My partner and I argued about it and I struggle to let things go that were said in arguments. Do you have any advice on dealing with a situation of an ex-partner being on the scene and perhaps how to not dwell on things that were said during arguments? Thanks, Lorna Hi Lorna, Thanks, might work. What does this mean: "Do you have any advice on dealing with a situation of an ex-partner being on the scene and perhaps how to not dwell on things that were said during arguments?" The rest of the email seems to suggest feelings of jealousy, insecurity, and so forth, as if she is a threat to your current relationship. is this correct? David Hi David, Thanks so much for getting back to me! I don't actually think she is a threat to our relationship, and don't feel

Rhonda and David address a question from Karolina, a therapist in Poland who was failing with a depressed patient who felt totally convinced he was a "useless" human being. I think you will find their discussion of this case fascinating, as it deals with the cause of practically ALL therapeutic failure, and illustrates the solution al well, using TEAM-CBT methods and concepts. Today's podcast is intended for therapists and patients alike! For the show notes, we are including the email David received from Karolina, as well as his initial response. Dear Dr. Burns, I've been listening to your podcast for 6 months now and it's been so helpful with my work as a therapist as well as in my personal life. I'm starting to develop a habit of considering every unwanted state with a "what does it say that's awesome about me?" and I'm much happier now :). I'm wondering if you'd consider helping me some more. I have a client who's been struggling with depression for many years. At the moment he's doing ok and his mood is up. Lately the topic of his uselessness came up again and he's willing to work on that. He said he'll consider the possibility that he's not a useless human being and asked me to not to dismiss the possibility that he is - that's how he'll know that I'm not just trying to cheer him up. It's been bugging me ever since. Although I've agreed, I really can't find in me any part that is ready to think that. I strongly believe he's not a useless person. I can't imagine labeling anyone in that way and in his case it feels so personal as I like him very much and I care about him. I'm starting to have dreams about our next session when I fail him by trying to convince him to think as I do. How can I be open about our conclusion when my mind is already fixed? Any thoughts on this would be deeply appreciated. Best wishes from Poland Karolina Hi Karolina, Thanks! The term has no meaning. It is just a vague put down, like what a bully might say. I might ask him what time of day he was feeling useless, and then have him fill out a Daily Mood Log for that moment, step by step. We can only help him at one specific moment. You can use a large number of techniques but must first get an A on Empathy, and then do effective paradoxical agenda setting, starting with the Paradoxical Invitation Step and then asking "what type of help would you be looking for?" then you can do the Magic Button and Positive Reframing. All of the negative thoughts and feelings on the Daily Mood Log will be advantageous and will show something about him that is awesome and positive. You should be able to generate a list of at least 25 overwhelming positives. Then you can use the Magic Dial. When you get to M = Methods, you can put the thought, "I am a useless human being" in the middle of a recovery circle, and then select a minimum of 16 methods to challenge it. You can start with Identify the Distortions. There are likely at least 9 distortions in the thought, including AON, OG, MF, DP, MAG / MIN; ER; LAB; SH; SB. You can try, "let's define terms," and ask what's the definition of a "useless human being"? You'll find that no matter how you try to define it, The definition will apply to all human beings. The definition will apply to no human beings. The definition does not apply to him. The definition does not make sense. The definition is based on some kind of arbitrary cut-off points. You can do this as a role-play, being a close friend trying to find out if you're useless, and asking him for guidance on how to find out. You can do the Paradoxical Double Standard Techniques, Downward Arrow, Hidden Emotion, Externalization of Voices, Acceptance Paradox / Self-Defense Paradigm, Examine the Evidence, Semantic Method, and on and on. The problem is NOT that he's a "useless human being" but rather that he's obsessing and wasting time on a meaningless construct, and beating up on himself. The whole key to success will be agenda setting. You can take the position that maybe this is not something that he really wants to challenge, since it may be working for him, and also reflects all those 25 wonderful things about him. The whole key to success will be agenda setting. You can take the position that maybe this is not something that he really wants to challenge, since it may be working for him, and also reflects all those 25 wonderful things about him. Remember that just about 99.9% of therapeutic failure results from Agenda Setting errors. Is this something you want to help him with, or something he is desperately asking you for help with? I am almost 100% positive that this is your agenda, not his. In fact, your need to "help" him with this may actually keep him stuck. In fact, here is the proof. You write: "I'm starting to have dreams about our next session when I fail him by trying to convince him to think as I do. How can I be open about our conclusion when my mind is already fixed?" If you don't understand this, I recommend some supervision from a T

People in the featured photo for today's podcast. Back row: Amir, David, Rhonda, and Dave. Front row: Steve and Barb This will be our first podcast of 2020, so we wanted to make it a really good one! Rhonda, Dave and I are very proud to welcome Steve Reinhard and his wonderful wife, Barb, on today's podcast. Steve and Barbara flew in from Colorado to join the Sunday hike and do this podcast in the "Murietta Studios" following the hike. Steve is a former electrical contractor and lay minister, and is the first certified life coach to be admitted into the TEAM-CBT certification program at the Feeling Good Institute in Mt. View, Ca, (link). The following is a heart-warming email I received from Steve prior to the show. Subject: Re: looking forward Hi David, Woohoo! We are partners in crime! I'm feeling super comfortable now. Thanks David for your generous invitation! I'm happy to jump on any of the 3 options you suggested for the show. I'd love to hear your stories, especially those of undistorted sadness where you celebrated with tears, aware of the suffering we folks tend to keep hidden. I cry a lot these days, laugh a lot too. In that regard I'd love to have my own personal Ask David session. David, I love the old, demented, weak human guy, while admiring the pioneering, genius who teaches so clearly & humanly. My questions wouldn't be so much for me to learn or be taught but to connect with you. I'm crying as I write. As a listener I want to connect with the human, David. May or may not be something you want to do. We have loads to interact with. Yep, I take a "spiritual " approach & would love to interact with you being anti-religious. Listeners might find this helpful & it sounds fun to me. A great opportunity for me to experience a death of the ego & the acceptance paradox which I have found liberating before I knew what it was called. I'd love to talk about what it's like to be diagnosed with blood cancer and holey bones & some of the nutty things we say to each other when we don't know what to say. Empathy in the Five Secrets way is extremely rare from my distorted perspective. Aging & being willing to challenge the many shoulds & shouldn'ts that accompany things being different than they were last year would be fun to talk about. I can't keep track of the # of times folks repeat "getting old is hell", same with cancer, vision problems, walking problems, drug side effects. I would love to hear your stories & experience as an old demented guy who can't walk as fast as he did a couple years ago. Thanks for your generous invitation. I still find it surprising that I get to have this experience with you all. I'm really looking forward to today's show. Steve We began the podcast with a discussion of the role of lay therapists in the field of mental health. Coaching is newly emerging field of counseling that does not require graduate work in psychiatry, psychology, social work, or counseling. In the past, coaches have not been permitted to enter the TEAM-CBT certification program. However, Dr. Angela Krumm, who is the head of the FGI certification program changed that policy specifically so that Steve—and now, other certified coaches as well--can be certified in TEAM-CBT, and I applaud this change. The role of lay therapists has always been highly controversial. I can recall that when I was in college in the 1960s, there was a lively debate about so-called "lay psychoanalysts." Previously, you had to be an MD to be a psychoanalyst, but over time, non-MDs were permitted to become psychoanalysts. To my way of thinking, this debate has always been more about power and the protection of territory than about skill or the capacity to heal. Now we are seeing the same questions being raised about certified life coaches. In my experience, graduate training doesn't always guarantee that someone will be a skillful therapist, and sometimes the opposite is true. In fact, in my experience, the LESS previous training therapists have, the easier they are to train in TEAM-CBT, because they don't have so much training they have to "unlearn." The Buddhists say that an empty cup is better than a full cup, because the full cup spills over when you try to pour the wine. Of course, there's a downside, too, since therapists can also be sometimes exploitative and can be hurtful to patients. This includes coaches as well as mental health professionals with graduate training. Next, we asked Steve about the role of spirituality in his TEAM-CBT counseling, since he is a also a lay minister. I am convinced that the spiritual dimension can be important and powerful in therapy, and that at the moment of our deepest change, the change is not only psychological, emotional, and behavioral, but also spiritual, because we may suddenly "see" things from a much deeper perspective. Much in TEAM-CBT is easily integrated with spirituality. For example, the Acceptance Paradox is an inherently spiritual technique that can play an important role in re