Podcasts about ask david

Episode 12 – Semi Truck Wrecks: The Mechanic's Perspective with guest Gary McMinowayListen to more episodes of After the Crash:https://www.ckflaw.com/after-the-crash-podcast__This podcast will dive deep into what happens after a crash caused by a semi or other commercial motor vehicle. It is the goal of the podcast to provide information that victims of semi-truck wrecks or those who have suffered serious injuries, brain injuries, or the death of a loved one, need to know. Information is power, and David Craig works to empower the listener by interviewing the top experts involved in these cases.David W. Craig is the managing partner at the law firm of Craig, Kelley & Faultless LLC.He is board certified in Truck Accident Law. David sits on the board of regents for the Academyof Truck Accident Attorneys (ATAA) and has over 30 years of experience representing truckaccident victims. David is a member of the Multi-Million Dollar Advocates Forum and a proudrecipient of the Thurgood Marshall “Fighting for Justice” Award. He was also named a top 10trucking trial lawyer in Indiana by the National Trial Lawyers Association.David also is the author of the book, Semitruck Wreck: A Guide for Victims and TheirFamilies, which is available on Amazon and Audible. It is also available on other audiobookplatforms like Apple Books, Scribd, Booktopia, and Audiobooks.Download Semitruck Wreck for FREE:https://www.ckflaw.com/truck-accident-ebook__Website: https://www.ckflaw.comFacebook: https://www.facebook.com/ckflaw LinkedIn: https://www.linkedin.com/company/craig-kelley-&-faultless-attorneys-at-lawEmail: info@ckflaw.comPhone: 1-800-ASK-DAVID

#254, Ask Matt, Rhonda, and David (with the famed Dr. Rutherford Knows) Today we are again joined by the fantastic Dr. Matthew May for an Ask David. Rhonda and I are thrilled that Matt will be joining us every month. His input will give you a broader range of insights and answers to your many excellent questions! Here are the questions we will address on today's podcast. Karine asks: How can I help my daughter with anorexia? Shirley asks: How can you deal with people who are emotionally abusive, using the Five Secrets of Effective Communication? Guy asks: Are there any Five Secrets practice groups I could join? * * * Karine asks: How do I help my daughter with anorexia? Hello Dr. Burns, I am trying to help my daughter who is starting to have anorexia with your book as the consultations are not working and we are waiting on a list for a specialist which can take months or even year here in Quebec. I have read both of your last books and i am getting good to use it for social anxiety. However. i can't see exactly how to apply it for eating disorder. I asked her to list the benefits she gained from not eating and i am trying to help her see the cognitive disorder in it but it is much harder (ex: i loose weight quickly...which will do ... ) i may help her see the cognitive disorder in the « which will do ... » but not in the « i will lose weight » statement ). Could you help me see the pattern i should follow please as i really think your technique can help her faster and better than the traditional psychologist conversation. Regards Karine * * * Shirley asks: How can you deal with people who are emotionally abusive, using the Five Secrets of Effective Communication. Hello David and others, I have been convinced how important using the Five Secrets of Effective Communication are. I do have a question about living with a person who is emotionally abusive. He uses his criticisms of others to manipulate and control them. How do you accept the criticism of such a person who is taking advantage of you accepting the criticism. My soul wants to rebel against these criticisms and against the person who is trying to manipulate me. How do you navigate such a relationship when the abuser will never acknowledge that they are abusing others. He lives in a fantasy world of excuse making and blaming others. Also, how do I acknowledge my weakness and allow the “death” of my ego to happen? Thanks for your consideration and help. Shirley We reviewed this problem and describe how we treat relationship conflicts using TEAM-CBT. This involves giving up blame and examining your own role in the problem. You will discover--and this might be disturbing, or enlightening, or both--that you are contributing in a BIG way to the very problem you're complaining about. You can review Shirley's partially completed Relationship Journal if you link here. * * * Guy asks: Are there any Five Secrets practice groups I could join? David, Please consider asking one of your skilled therapists to create a Five Secrets of Effective Communication "Practice Group." Possibly the group could be run weekly (virtually) and it would be an opportunity to repeatedly practice each of the secrets. I practice on my own, but I know that learning is often strongest when working with others. Guy Marshall David's Response Hi Guy, Ana Teresa Silva has a five secrets zoom practice group. Check with her! They are just getting started. ateresasilva6@gmail.com We have an exciting podcast scheduled the next time Matt visits. We will address the many controversies around exposure therapy, and will be joined by a patient Matt recently treated with the fear of leaches! We will also address some of the hundreds of questions submitted by the more than 6,000 fans who registered for my free 90-minute presentation on rapid Recovery from Anxiety which was sponsored by PESI. All the best, Rhonda, Matt, and David (plus Rutherford) If you would like to contact Dr. May, you can reach him at: www.MatthewMayMD.com. Matt added that people interested in treatment can schedule a free 15-minute phone call there, my schedule permitting. Dr. Rhonda Barovsky practices in Walnut Creek, California, but due to Covid-19 restrictions is working mostly via Zoom, and can be reached at rhonda@feelinggreattherapycenter.com. She is a Level 4 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. Check out her new website: www.feelinggreattherapycenter.com.

Episode 11 – A Crash Survivor's Perspective with guest Dawne McKayListen to more episodes of After the Crash:https://www.ckflaw.com/after-the-crash-podcast__This podcast will dive deep into what happens after a crash caused by a semi or other commercial motor vehicle. It is the goal of the podcast to provide information that victims of semi-truck wrecks or those who have suffered serious injuries, brain injuries, or the death of a loved one, need to know. Information is power, and David Craig works to empower the listener by interviewing the top experts involved in these cases.David W. Craig is the managing partner at the law firm of Craig, Kelley & Faultless LLC.He is board certified in Truck Accident Law. David sits on the board of regents for the Academyof Truck Accident Attorneys (ATAA) and has over 30 years of experience representing truckaccident victims. David is a member of the Multi-Million Dollar Advocates Forum and a proudrecipient of the Thurgood Marshall “Fighting for Justice” Award. He was also named a top 10trucking trial lawyer in Indiana by the National Trial Lawyers Association.David also is the author of the book, Semitruck Wreck: A Guide for Victims and TheirFamilies, which is available on Amazon and Audible. It is also available on other audiobookplatforms like Apple Books, Scribd, Booktopia, and Audiobooks.Download Semitruck Wreck for FREE:https://www.ckflaw.com/truck-accident-ebook__Website: https://www.ckflaw.comFacebook: https://www.facebook.com/ckflaw LinkedIn: https://www.linkedin.com/company/craig-kelley-&-faultless-attorneys-at-lawEmail: info@ckflaw.comPhone: 1-800-ASK-DAVID

#251, Ask Matt, Rhonda, and David (with the famed Dr. Rutherford Knows) Today we are again joined by the fantastic Dr. Matthew May for an Ask David. Rhonda and I are thrilled that Matt will be joining us every month. His input will give you a broader range of insights and answers to your many excellent questions! Today's questions were submitted by the more than 6,000 people who registered for my free talk on July 8, 2021 on the Rapid Treatment of Anxiety Disorders which was sponsored by PESI. I was very grateful to PESI for organizing this event, since it was open to shrinks as well as the general public, and that is the same audience that Rhonda and I are trying to reach with our Feeling Good Podcast. By the way, thank you for your ongoing support of the Feeling Good podcasts. Our four millionth download should happen in August! Please keep telling friends about the podcast if you think they might be interested. The very shy but erudite Dr. Knows may again join us and make an occasional comment. Let us know if you like his input and want to hear more from him in future podcasts. If you don't like him, we can quietly sweep him to the sidelines. Here are the questions we'll answer today: Hello Dr Burns, excited to be here at your talk today. Could you tell us more about dependency on anti-anxiety medications (benzodiazepines like Valium, Librium Ativan, Xanax, and so forth) and how to inform the client about the dangers of addiction? If this treatment you describe for anxiety disorders is 'rapid' does it linger? Is this rapid response you describe in your treatment of anxiety disorders merely first-aid? Am I right in assuming that the sustained work of psychodynamic therapy, body work, and so forth will still be required? Can you discuss any published or ongoing empirical research on the efficacy of TEAM-CBT compared to other therapy techniques? How does Rational Emotive Behavior Therapy (REBT), developed in New York by the late Dr. Albert Ellis in the 1950s, fit into the picture? How does the cognitive distortion, Fortune Telling, apply to specific phobias? Rhonda, Matt, Rutherford, and I thank you for joining us today, and hope you enjoyed the dialogue! Rhonda, Matt, and David (plus Rutherford)

Episode 10 – Pick the Right Lawyer for Your Semi-Truck Wreck Case with guest Michael LeizermanListen to more episodes of After the Crash:https://www.ckflaw.com/after-the-crash-podcast__This podcast will dive deep into what happens after a crash caused by a semi or other commercial motor vehicle. It is the goal of the podcast to provide information that victims of semi-truck wrecks or those who have suffered serious injuries, brain injuries, or the death of a loved one, need to know. Information is power, and David Craig works to empower the listener by interviewing the top experts involved in these cases.David W. Craig is the managing partner at the law firm of Craig, Kelley & Faultless LLC.He is board certified in Truck Accident Law. David sits on the board of regents for the Academyof Truck Accident Attorneys (ATAA) and has over 30 years of experience representing truckaccident victims. David is a member of the Multi-Million Dollar Advocates Forum and a proudrecipient of the Thurgood Marshall “Fighting for Justice” Award. He was also named a top 10trucking trial lawyer in Indiana by the National Trial Lawyers Association.David also is the author of the book, Semitruck Wreck: A Guide for Victims and TheirFamilies, which is available on Amazon and Audible. It is also available on other audiobookplatforms like Apple Books, Scribd, Booktopia, and Audiobooks.Download Semitruck Wreck for FREE:https://www.ckflaw.com/truck-accident-ebook__Website: https://www.ckflaw.comFacebook: https://www.facebook.com/ckflaw LinkedIn: https://www.linkedin.com/company/craig-kelley-&-faultless-attorneys-at-lawEmail: info@ckflaw.comPhone: 1-800-ASK-DAVID

What are macronutrients and why should I pay attention to them? What is David's #1 tip for better health? How do I get out of a rut? What do we need to know about menopause? Where should I travel now that things are opening back up? What is David currently investigating? This week on the SuperAge podcast, David Stewart answers your questions. He discusses his personal journey to better health, breaks down macronutrients in simple terms, gives his #1 health tip, shares his advices on how to get out of a rut and more!What you will learn:What macronutrients are and why you may want to pay attention to themHow to get out of a rutWhat to do for better healthWho David trusts when it comes to brain health and Alzheimer's research How David got his health to where it is today “The longer that I'm alive, the more that I value it.” “I recommend using the word ‘yes.' Just say 'yes' to pretty much everything that you can, anything this side of life threatening.” “I think so many of us, myself included, are somewhat checked out about what our bodies need at any certain point in time.”  To have your questions featured on future solo SuperAge episodes, DM us on Instagram @weareageist.Listen to the SuperAge podcast wherever you stream your pods. https://www.weareageist.com/category/superage-podcast/

Podcast 248 Ask David and Rhonda! In today's podcast, Rhonda and David answer some fascinating questions submitted by listeners like you! We both thank you for your interest in our show, and for your kind comments and terrific questions! The Questions Kati asks: I notice that in your therapy sessions, the negative feelings of most of your patients are reduced all the way to 0%, and many become euphoric. I was wondering whether this somewhat contradicts the idea that our negative feelings are useful to us in some way? Kati also asks: Do you believe that empathy can be ‘taught'? Yiftah asks: How could one dangle the carrot effectively and responsibly when offering a cognitive exposure exercise? Yiftah also asks: From your experience can you give examples of cases in which cognitive exposure may not be as safe or as effective? Esther asks: You say there is no convincing or consistent evidence to support most psychodynamic claims about the causes of things. What you said resonates, but aren't you also just making claims? I have a psychodynamic supervisor, and am struggling to choose between empirically validated treatments and traditional psychodynamic approaches. Sean asks: Burns, what can you do when you are using the disarming technique and the person keeps interrupting you? Ben asks: Since exercise improves the mood of some people who are feeling down, doesn't this prove that physiologic changes can improve mood, as opposed to changing negative thoughts? The Answers  Note: The answers below were based on David's email exchanges with the people who asked the questions and were created before today's podcast. Therefore, the podcast may contain new and different information from these show notes. Hopefully, both the show and the notes will be helpful to you. Rhonda and David   Kati asks I notice that in your live therapy sessions, the negative feelings of most of your patients are reduced all the way to 0%, and many become euphoric. I was wondering whether this somewhat contradicts the idea that our negative feelings are useful to us in some way. David responds Hi Kati, thank you for the kind comments! It is great to get negative feelings to zero and experience enlightenment and joy. However, no one can be happy all the time, so you will have plenty of opportunities to "learn" from negative feelings again. In addition, there is a difference between healthy and unhealthy negative feelings. Healthy sadness is not the same as clinical depression, healthy fear is not the same as a phobia or panic attack, healthy and unhealthy anger are quite different, and so forth. There will bumps in the road of life for all of us at times. * * * Kati also asks Do you believe empathy can be “taught?” As a mum (of a 15 and a 10 year old girls) and a (HS) teacher I notice some people seem to have it more ‘innately' than others but would also love to think it is an aspect that can be intentionally developed in others in some way. If you think like me, I would love to hear your thoughts on how that could be done (i.e. what practices or strategies would be most helpful to use with young people in particular). I am still in awe that we can have a sort of conversation with such a brilliant and creative mind and I humbly hope you can address these two questions either in one of your podcasts or by responding to this message. In admiration, Kati David responds Thanks again, Kati, With regard to empathy, it is something that can be learned, but it takes commitment and practice. A good first step is the book I wrote on this topic called Feeling Good together. In addition, there is, as you say, an "aptitude" that people have for this or any skill, with a tremendous variability in the population. But regardless of your natural aptitude or lack of it, you can learn and grow tremendously. I started out with very poor listening skills. You can also search for Five Secrets of Effective Communication on the website, using the search function, and you'll find lots of podcasts teaching these skills. david * * * Yiftah asks How could one dangle the carrot effectively and responsibly when offering a cognitive exposure exercise? Dear Dr. Burns, I love your podcast and books. They have completely changed my practice and had helped my personally. In particular it was great to hear you working with Dr. Levitt with cognitive exposure, and your discussion about it. I have two questions regarding cognitive exposure with PTSD (for the podcast. First, how could one dangle the carrot effectively and responsibly when offering a cognitive exposure exercise? David responds Hi Yiftah, I try to deal with the Outcome and Process Resistance issues prior to agreeing to help any patient with anxiety. I might say something like this: “Jim, I'd really love to help you with your fears of X (whatever it is), and I'm pretty convinced that if we work together, you can make some great progress in overcoming your fears. I have more than 30 great tools to help you overcome anxiety, and you're probably going to love all of them except for one, exposure. Confronting your fears is just one tool among many, but is a vitally important part of the process, and cure is usually impossible without exposure. “For example, I may ask you to do is (I explain the type of exposure we might use.) I know that will be terrifying, and it needs to be terrifying to be effective. I'll be with you every step of the way, of course. But I need to know if you'd be willing to do that type of thing if I agree to work with you. “I know you've told me that you've had many therapists in the past who did not use exposure, and that might be why their treatments were not as effective as you'd hoped. And if you absolutely don't want to use exposure, I would totally understand and support you, but sadly could not agree to treat your fear of X.” * * * Yiftah also asks From your experience can you give examples of cases in which cognitive exposure may not be as safe or as effective? You have a lot of experience with successful exposure treatments, but I had never worked with PTSD. And I hear some "PTSD experts" say that cognitive exposure is a dangerous process that can backfire. And according to papers I've read it doesn't always help. In other words, assuming that one had worked correctly with the Empathy and Assessment of resistance phases: how safe and how effective is prolonged cognitive exposure with severe PTSD? From your experience can you give examples of cases in which cognitive exposure may not be as safe or as effective? I mean are there some conditions or distorted thoughts that categorically need to be dealt with successfully before going for exposure? For example, would there be any special considerations when working with patients with thoughts connected to shame, self-blame and hopelessness, as well as habits and addictions, or relationship issues? Thank you Yiftah David responds Thanks again! Let's assume that you are treating a veteran who is paranoid and living alone in the woods, who tells you that he is afraid of “losing it” and blowing people away with his automatic rifle. I would not want to have him fantasize blowing people away in order to overcome his fear, especially if he is prone to violence and has poor impulse control, and is psychotic. This could conceivably trigger him to do something violent, and I'd have a hard time explain my therapy methods to the police after he kills many people in the local mall. At the same time, the vast majority of anxious people who are afraid of doing something horrible or violent have OCD, and are totally safe. So, it takes judgment. Powerful techniques require therapists with exceptional skills, training, and thoughtfulness. It ALWAYS pays to be thoughtful and cautious! And this has nothing to do with cognitive exposure per se, but all of the > 100 techniques that I use. They can all hurt, including empathy, if not done skillfully, and with compassion. Backfiring occurs when therapists don't do or know how to prepare the patient for the methods you plan to use. Anytime you “throw” techniques at patients, you are asking for trouble. Remember, TEAM is a systematic, step-by-step package that is done as a sequence. Your patient has to give you an “A” on empathy before you can even go on to the Assessment of Resistance. My experience has shown me that most therapists, including the so-called experts, do not know how to get an A grade on empathy, and may not have outstanding empathy skills. Trust is so important in the treatment of anxiety, and always has to come first. Before using any M = Methods, you will need to address the patient's Outcome and Process Resistance, and get some agreement on what you plan to do and how you plan to do it. Should we not use a technique because it doesn't always work? All techniques often fail. TEAM is based on “failing as fast as you can!” If you can't use a technique that sometimes fails, then you can't use ANY technique! Also, I never treat anxiety with one technique. I use a great many techniques drawn from four very different treatment models: the Cognitive Model the Motivational Model the Exposure Model the Hidden Emotion Model I sometimes get tired / annoyed with so-called experts who love to spout off, saying things that to my ear sound like half-truths. But then again, I do the exact same thing! At any rate, neither Jill nor I have ever had a bad outcome with any form of exposure, but we are both pretty careful, and try hard to be compassionate and to prepare the patient. You have to be thoughtful and careful. For example, Shame Attacking Exercises can be life changing, but they require half a brain on the part of the therapist. For example, I wouldn't throw someone with poor interpersonal skills into a potentially awkward or hurtful Shame Attacking Exercise. All powerful techniques have the potential to heal or harm. The same scalpel that a surgeon uses to save a life can also be used by a murderer to slit someone's throat. d * * * Esther asks You say there is no convincing or consistent evidence to support most psychodynamic claims about the causes of things. What you said resonates, but aren't you also just making claims? I have a psychodynamic supervisor, and am struggling to choose between empirically validated treatments and traditional psychodynamic approaches. Hi David, I absolutely love your stuff! I've used some parts of feeling good in my practice as a therapist and in my personal life for some time, but I've recently gotten much more into your teachings and I've been thinking a lot about TEAM-CBT. And thank you for providing all these free resources for the public! In episode 230 (about 22 minutes in) Rhonda asked you about a common psychodynamic type of claim- “a child of alcoholics either become an alcoholic, marries an alcoholic or becomes a therapist of an alcoholic.” You responded by saying “people love those kinds of theories because people want to think they know the causes of things.” Then you went on to disagree, claiming that there isn't much evidence to support these types of claims. At first what you said very much resonated with me, and yet I began to think about it and realized the irony in your response: you had explained people's tendency to come up with such theories with your own cause (“people want to think they know the causes of things”), something which I doubt you've been able to test in a research study (though perhaps I'm wrong!) And yet what you said still resonates with me and highlights the crux of my question: isn't there any value in intuition (without any evidence) in determining the causes of things? For instance, I think your causal explanation here is highly intuitive. (Even though an alternative explanation could have involved something not inherently psychological, like “people err because they think correlation implies causation” or something. This is not just a theoretical question for me. I currently work under a wonderful supervisor who takes a psychodynamic approach to many issues, and I am very suspicious of some his theories, but it seems that he is a great therapist. Further, I think that many people in school and in the early stages of practice (including myself) are conflicted about whether or not they wish to train further in evidence-based approaches or in a psychodynamic type of school. I think this important question is sometimes at the root of the issue. (Although psychodynamic theories are sometimes not at all intuitive.) For a practical example- something I always found intuitive is the role low self-esteem seems to play in people with inflated egos or the role it can play with those who have anger issues (In which the ego or anger serve to “compensate” for the low self-esteem). When I was working with a client who suffered in these two areas, I began by educating him about this notion (which resonated with him) and we began to address his low self-esteem. Later, however, I happened across an article claiming that this intuitive notion is not supported by research. It called into question many of my intuitions when conceptualizing cases and treating my clients. Finally, I just picked up a copy of “Feeling Great” (it's awesome, by the way!) and I noticed you talked about the hidden emotion technique. Once we're on the topic of evidence; do you have any evidence that this particular technique is helpful? Is there research backing such a technique? (I'm particularly suspicious of it given its psychodynamic flavor :) I apologize if you've addressed these questions somewhere already- I've only just begun to avidly read your stuff and listen to your podcast. Thank you so much! Esther David responds Hi Esther, This is an important email and if I can find the time, and may address it in an Ask David. You write: “This is not just a theoretical question for me. I currently work under a wonderful supervisor who takes a psychodynamic approach to many issues, and I am very suspicious of some his theories, but it seems that he is a great therapist.” It's great that he is a great therapist, and it will be fun for you to learn from him. There are two caveats, perhaps. First, therapists' views of changes in the negative feelings of their patients, like depression, are not especially accurate, so his self-report of his effectiveness may not have a lot of credibility. I have measured therapist accuracy in a study at the Stanford Hospital, and found an accuracy of only 3% in detecting changes in depression, even after exhaustive, systematic interviews with patients about how they feel. Second, most therapists have only a placebo effect, although they will strenuously insist it ain't true! And their effectiveness is almost definitely not the result of the specific tools they are using, but other factors. Many outcome studies have been consistent with this type of conclusion. But still, learning from the wisdom of an older therapist can be awesome! With regard to the Hidden Emotion Technique, it IS a kind of modernized psychodynamic technique. I don't think it has been studied, but I no longer keep up with research. I find it exceptionally helpful in myself (I am anxiety prone) and in about 50% or more of anxious patients. And I have found I can engage in really rewarding conversations with psychodynamic therapists when I describe this technique. I enjoy this type of dialogue, challenging our favorite ideas. Have you ever heard of the “confirmation paradox?” My memory is that if theory A predicts observation B, and you see observation B, you may wrongly conclude that theory A is confirmed. For example, the theory that the sun revolves around the earth predicts that the sun will come up in the east in the morning and set in the west in the evening. So, we do see that every day, and we wrongly conclude that we have confirmed our theory that the sun revolves around the earth. Same is true for psychological theories about the causes of depression or whatever. The problem is that your observations also confirm a large number of alternative theories that all would have predicted the same thing. You can disconfirm a causal theory with data based on an experiment or natural observation, but you cannot actually confirm any theory in science. You can only say that your data are consistent with this or that theory, and that you have failed to disprove your theory based on your observations. I tested many theories about the linkages between Self-Defeating Beliefs (SDBs), like Perfectionism, and changes in negative feelings over time in several hundred patients treated at my clinic in Philadelphia. The data was not consistent with causal linkages between SDBs and negative feelings, even though there were strong correlations between them at both time points, and even though changes in SDBs were strongly correlated with changes in SDBs. david PS You might enjoy this psychoanalysis poem by another Esther who is a member of our Tuesday TEAM training group at Stanford. GOODBYE TO ALL THAT: THE JOY OF PRACTICING PSYCHOANALYSIS No more forms, no need for technique No more brain strain week after week, Ditch those methods — fifty, a hundred, A thousand ways I might have blundered.   So long agenda, don't mention homework Just perfect that withering shmirk. Surveys, grades, throw them away You know it's sex, whatever they say.   Gone for good are your twelve distortions, Out with charts and their crazy proportions. Is that a purse I see before me? Nope! It's your mother's vagina. You think that's a joke?   Such progress we are making you must admit Only ten years and we are ready to dip Into that complex where troubles all lie The mom you must marry, the dad who must die.   Two hundred sessions a year and each one two hundred Over ten years $400,000! I sundered… WHAT? I was…er… giving thought to your dream (And the cabbage I missed doing TEAM.)   How can you say you're worse off than before While standing in front of Enlightenment's door? You say you've awakened to find I'm a nitwit, & at last you're done with all of this horseshit!   Goodbye, my patient, there's the door, A pity you are so very sore. But let me say just one thing more — You really are a frightful bore.   — Esther Wanning * * * Sean asks Dr. Burns, what can you do when you are using the disarming technique and the person keeps interrupting you? I've recently been practicing the 5 secrets and I am still learning how to apply the techniques. I listened to many podcasts and I'm reading your books/doing the exercises. I'm a complete believer in your method! Thank you! During the disarming, if the person continues to aggressively interrupt and ask pointed questions, how do I continue to stay engaged in the conversation? I repeat the steps. I agree/try and find the truth, paraphrase the comments, along with practicing feeling/thought empathy. The person continues to interrupt, argue, blame, and ask questions to prove their point. Do I just continue to try the secrets? In the moment it seems like it's impossible, but I stay committed. Thanks Sean David responds Hi Sean, I have often said that these abstract questions have very little value. The devil is in the details, the specific example. If you give me an example of what the other person said, and what, exactly, you said next, I will probably, or almost certainly, be able to show you what your errors were, and how you are forcing the person to keep attacking you. However, this can be painful, to suddenly see how you are causing the exact problem you are complaining about. But also freeing. So, the answer, in short, is that you are probably not using the Five Secrets correctly, but you get lots of credit for your efforts, and some feedback may help you. d PS Sadly, I never got a specific example from Sean. That is too bad, because abstract questions and answers never have much, if any, practical value or impact. All the learning is in the specific example, which becomes a mind-blowing learning experience. But, sometimes people don't seem to “get” this message! * * * Ben asks Since exercise improves the mood of some people who are feeling down, doesn't this prove that? Hello David! I am a frequent listener of your podcast, and am currently going through your new book, "Feeling Great". The importance of treating depression at specific moments in time, addressing self-defeating beliefs, and the death of the "self" are all topics that are of particular interest to me. I have a question for you. You make the claim that depression & anxiety always result from distorted thoughts -- that our thoughts always cause our feelings. If that is the case, what do you make of the research that shows that aerobic exercise can be an effective treatment for them? Doesn't that indicate that there could be a physical basis for some cases of anxiety & depression? I have certainly found exercise to be tremendous help for me in keeping my anxiety at bay -- a vigorous session of exercise just seems to "slow down" my mind or reduce the volume of the voice that's always chattering away in the background for hours afterward. Could people be getting more depressed and anxious because they simply don't move as much or as vigorously as our bodies have evolved to? Thank you for your amazing work and the generosity with which you share it. I've recommended your podcast to many people, and will continue to do so! Take care, Ben David responds Hi Ben, Great question. I like your critical thinking! To test this idea, we would, of course, have to measure the positive and negative thoughts of individuals who are, and individuals who are not, helped by exercise. You cannot just assume something either way. I believe that all change in moods, regardless of the treatment intervention, is mediated by a reduction in the distorted thoughts that trigger the depression. This is a testable hypothesis. Many people tell themselves things like, “Oh, I'm exercising now, this will really help me, I'm keeping up with my commitments to my health,” and so forth. I, for one, have never had a mood elevation from exercise. My daughter finds exercise very helpful. I suspect you will find a sharp reduction in negative thinking in individuals who are helped by exercise. We have to be careful about jumping to conclusions about causality. I have a mild case of sciatica, and a medication like Tylenol makes the pain disappear. Does this mean that sciatica is due to a Tylenol deficiency? I did a study with an N of 1. I asked a severely depressed man to fill out a part of a Daily Mood Log every evening. He recorded the situation, then circled and rated his feelings, and then recorded his negative thoughts and how much he believed them. Then he flipped a coin and either jogged for 45 minutes or worked on challenging his distorted thoughts for 45 minutes. In both cases, after 45 minutes he recorded any reductions in his negative thoughts and feelings. The days when he worked with the DML he experienced pronounced reductions in his belief in his negative thoughts and in his negative feelings. The days he jogged, in contrast, there were no reductions in his negative thoughts or feelings. analysis of the data with structural equation modeling confirmed that the change in his negative feelings was caused by the reduction in his belief in his negative thoughts. Just a small pilot study, and could be done on a larger group. However, the researcher would have to have a sophisticated understanding of how the DML works, and how to elicit distorted thoughts from people who are depressed and anxious. david Ben's reply Wow! I didn't expect such a quick and thorough reply! Thank you, David. Love the Tylenol example. Such a powerful way to demonstrate the hazards of assuming causality, and also show me how easy it is to assume causality without even realizing I am doing so. Your study of the severely depressed man was ingenious as well. It gave me some good food for thought about *why* exercise might be so helpful for me -- that I can't assume that it's because I've manipulated my physiology in some way. It could very well be that I end up feeling good because I have pursued a difficult activity that I value, and thus feel as though I have accomplished something. I can see why someone who *doesn't* rely on accomplishments to feel "worthwhile" or doesn't even think of exercise is an accomplishment might not get the same boost. Indeed, there have almost *certainly* been times that I've exercised and felt WORSE afterward, but I'm mentally filtering those instances out. Like when I've gone for a run even though I was supposed to be getting dinner ready, and then the family is frustrated w/ me and hungry! ;-) I don't really get to bask in the glow of Accomplishment(tm) then! Take care, and thanks again! -Ben David responds again Hi Ben, Thanks. I ‘ve always said the thing about exercise raising brain endorphins was just something someone made up, but people wouldn't listen to me for the most part. I pointed that human brain endorphins cannot be measured, so there cannot be any evidence all for this theory. I recently said an article where they blocked brain endorphin receptors in people who got the runner's high. They still got the runner's high, proving brain endorphins could not possibly be involved! People tend to believe what they want to believe, regardless of the evidence. We see this in politics and in religion in a big way, but it is true in all walks of life. david Rhonda and David

Ask Rhonda, Matt, and David! Tips for Joy and more! In today's Ask David, we are honored to feature Matthew May, MD, a former student of David's during his psychiatric residency training, and now esteemed colleague. Rhonda and David are thrilled that Matt can join us, not only because he is a dear and loved colleague, but also because he is one of the greatest therapists on planet earth! Plus, he's an incredibly gentle and compassionate man. Rhonda Asks: What is the most effective way to help a suicidal patient? Rhonda Asks: How would you teach, the technique, Thinking in Shades of Grey to therapists or patients? Brian Asks: Any tips for joy? ThisLife asks: "Could you possibly explain why Albert Elis thinks the three valid uses of shoulds are valid, and provide the source where he explain this point, if convenient?” Mark Asks: Why is trying to change a person or help fix a person's emotional problems insulting? And how can I stop this habit? Along the same lines, EJG asks, “What's the best way to help people who don't want any help?” Rhonda and David

Episode 9 – Settlement Videos with guest Bobby CraigListen to more episodes of After the Crash:https://www.ckflaw.com/after-the-crash-podcast__This podcast will dive deep into what happens after a crash caused by a semi or other commercial motor vehicle. It is the goal of the podcast to provide information that victims of semi-truck wrecks or those who have suffered serious injuries, brain injuries, or the death of a loved one, need to know. Information is power, and David Craig works to empower the listener by interviewing the top experts involved in these cases.David W. Craig is the managing partner at the law firm of Craig, Kelley & Faultless LLC.He is board certified in Truck Accident Law. David sits on the board of regents for the Academyof Truck Accident Attorneys (ATAA) and has over 30 years of experience representing truckaccident victims. David is a member of the Multi-Million Dollar Advocates Forum and a proudrecipient of the Thurgood Marshall “Fighting for Justice” Award. He was also named a top 10trucking trial lawyer in Indiana by the National Trial Lawyers Association.David also is the author of the book, Semitruck Wreck: A Guide for Victims and TheirFamilies, which is available on Amazon and Audible. It is also available on other audiobookplatforms like Apple Books, Scribd, Booktopia, and Audiobooks.Download Semitruck Wreck for FREE:https://www.ckflaw.com/truck-accident-ebook__Website: https://www.ckflaw.comFacebook: https://www.facebook.com/ckflaw LinkedIn: https://www.linkedin.com/company/craig-kelley-&-faultless-attorneys-at-lawEmail: info@ckflaw.comPhone: 1-800-ASK-DAVID

On this episode of the Boiling Thoughts podcast David talks about the reason why he turned down a modeling career, his plans on visiting New York, introduces a new segment called "Ask David" and much more!

Ask Rhonda, Matt and David! Ask David #243 May 24, 2021 David and Ronda answer your questions about the role of hope, treating court-ordered patients, suicide threats, being a virgin, and moral scrupulosity. Guest expert, Dr. Matthew May, joins us for this fascinating podcast featuring questions from fans like you!  V3A asks: What is the role of hope? EdG asks: How would you deal with a patient who doesn’t like you or doesn’t want to come for treatment, but has been required by either an employer or the courts? Preetika asks: Recently, a client said she felt suicidal and that made me feel suicidal about anything untoward happening on my watch! I was ‘scared stiff!’ Please do a podcast if possible on therapist fears and dilemmas. Dale asks: How would you do Positive Reframing with someone who is suicidal? Miho writes: From church and from my parents, I have been told repeatedly I need to save myself for marriage thus this has been my core belief when I am dating. Although it had never bothered me before, now that I am in my last 20s it seems I have heightened anxiety and misaligned expectations when dating as literally no one around me thinks in this way, and I have been told I do not "look" like I am inexperienced. May I know which would be the best tool for combatting other people's opinions when it really does seem that their opinion is the "truth" of the world? Robyn writes: I would very much like to hear about how you treat patients suffering OCD with moral/religious scrupulosity. * * * V3A asks: What is the role of hope? Hi David, how do you fit the cultivation of hope into TEAM-CBT? Being such an important aspect of recovery, it seems to be most needed in those that most need help, creating a seemingly unwinnable situation for those people. If someone has enough hope to seek treatment, is that enough to make a recovery? * * * EdG asks: Just listened to Podcast 025 on how to relate to a patient you dislike, Very useful! What about the opposite situation? How do you deal with a patient who may have a hidden agenda, like coming to you in order to avoid a legal problem or because s/he was ordered by an employer or the courts? Thanks, EdG. That's sometimes fairly easy, and might make this an Ask David. I once told such a patient that if he wanted to work with me he'd have to have an agenda of something he really wanted to change, and he would also have to do tremendous amounts of psychotherapy homework, and that this was non-negotiable, and that he or she might prefer going to another therapist who would be more of a pushover! In my limited experience, this was very effective, and seemed to motivate the man who came to me. He did, in fact, work tremendously hard! david PS We can get Rhonda's take on it, as she does forensic work. * * * Preetika asks: Recently, a client said she felt suicidal and that made me feel suicidal about how anything untoward happening on my watch! I was ‘scared stiff!’ Please do a podcast if possible on therapist fears and dilemmas. Dear Dr Burns, Thanks for sharing your wonderful podcasts, they are of immense value. I have been using your brief mood surveys and though I found it tiresome initially, I realized its value when I I uncovered suicidal thoughts in a patient that came forth only because of repeating the mood survey each session. Further, do you think a brief behavior survey at the start of a session is beneficial to record sleep, eating, and self harm patterns is needed to assess how clients are doing in between sessions? Does it have value? Recently, a client said she felt suicidal and that made me feel suicidal about how anything untoward happening on my watch! I was ‘scared stiff!’ Please do a podcast if possible on therapist fears and dilemmas. Thanks for so many continuing insights and for making therapy feel real, Preetika Hi Preetika, Perhaps you can search on website using search function and find the podcast on suicide prevention. Then let know what you think. When you use the Brief Mood Survey and Evaluation of Therapy Session, you said it was tiresome at first. What were your scores on the Empathy Scale? Scores below 20 are failing grades. Most of my colleagues, and myself, find this anything but "tiresome," but rather dynamic and fantastically challenging. Also, what percent reduction do you see in patient's depression scores within sessions? This shows your level of skill and effectiveness. 25% to 35% reduction within a session is a fairly good benchmark of sorts. This is called the Recovery Coefficient. Have you looked at that? I find it pretty exciting, and also challenging, especially when the scores don't change, and also when they do1 Thanks for the great question. David * * * Dale asks: How would you do Positive Reframing with someone who is suicidal? Would you suggest that it says that they have a strong self-awareness of the severity of their hopelessness that protects them from more disappointments? Or perhaps a wake-up call message from there awareness of some kind? All the best Dale Hi Dale, Suicide is handled differently, in part due to the legal stipulations that make therapists guilty, and you can use the search function to find and listen to my podcasts on this topic. Thanks! David * * * Miho writes: From church and from my parents, I have been told repeatedly I need to save myself for marriage thus this has been my core belief when I am dating. Although it had never bothered me before, now that I am in my last 20s it seems I have heightened anxiety and misaligned expectations when dating as literally no one around me thinks in this way, and I have been told I do not "look" like I am inexperienced. May I know which would be the best tool for combatting other people's opinions when it really does seem that their opinion is the "truth" of the world? Hello Dr. Burns, First of all, thank you (and Rhonda!) so much for providing us with a great podcast. It has helped me tremendously and it is great to hear both of your voices. Your book "Feeling Great" is amazing as well and I just can't find enough words to express my gratitude for all that you do. I have 2 questions regarding romantic relationships and your opinion would be much appreciated if you have time. (I am a female in my late 20s) 1) I feel that I tend to associate past events to the present, for example when a guy tells me that he is busy with work, even if he is genuinely busy and there is proof, I remember the time my ex-boyfriend made that excuse to actually hide the fact that he was going out clubbing and doing drugs. It is not that I don't trust the person in front of me, but rather the feelings of anxiety from past creeps up on me due to those thoughts and makes me insecure (if that makes sense). I am not sure which tool I should use to get over this kind of thinking, as in the moment when I reframe my thoughts it works, but soon after another example would set me off again. 2) From church and from my parents, I have been told repeatedly I need to save myself for marriage thus this has been my core belief when I am dating. Although it had never bothered me before, now that I am in my last 20s it seems I have heightened anxiety and misaligned expectations when dating as literally no one around me thinks in this way, and I have been told I do not "look" like I am inexperienced. May I know which would be the best tool for combatting other people's opinions when it really does seem that their opinion is the "truth" of the world? Warmest regards, Miho Hi Miho, Thanks. I will add this to the Ask David list. It will take some time, as we have lots of great questions listed at the moment. I resonate, though, as I was raised in a religious family and told not to kiss girls, etc. which was, I think, damaging.. Sex is natural and inevitable, and perhaps best left “undemonized.” At any rate, you would need to decide on your own moral values, and then we could deal with any fears of disapproval from one side or the other. Really love and appreciate your openness. d * * * Robyn writes: I would very much like to hear about how you treat patients suffering from OCD with moral/religious scrupulosity. Dear David and Rhonda: Thank you so much for your calming, effective and often laugh-out-loud funny podcasts, filled with a generosity of wisdom. I deeply appreciate them and recommend them to others also. They have helped shape my view of CBT into something far more empathetic and human. I would very much like to hear about how you prefer to treat patients suffering OCD with moral/religious scrupulosity. I understand that exposure with response prevention is considered the standard treatment, but I don't understand how this works directly with fears about things that are unethical or immoral. For example, a deeply law-abiding person who is afraid of accidentally breaking the law ("was I speeding? I need to check if that was a police camera! what if I was doing something illegal and I didn't realise it?") or a very kind person who goes out of their way not to kill anything due to fear of consequences in the afterlife ("did I just step on an ant? I'd better check the soles of my shoes in case! I don't want to wash my hands in case it kills skin mites!") And would it change anything in your approach if the patient was someone who had had negative experiences with the law through no fault of their own (ie validating their fear)? Or who had a sincere belief that they should pray to be forgiven or purified for their perceived "sins" (a coping behavior which isn't negative in itself)? How do you even go about creating willingness in the patient to see these behaviors as problematic? It seems like it is much easier to treat for a fear of cats - it's easy to make an exposure ladder to the actual fear, it's ethical and safe to expose the patient, and the experience can ultimately be very positive - which is quite reinforcing. But what do you do when the patient is suffering from a good quality taken too far (obeying the law, refraining from killing etc.)? Obviously you can't invite them to break the law or kill things because that's not moral or ethical, so I'm assuming you can only ask them to sit with the discomfort of uncertainty? Is that just as good as working with the direct object of fear itself? Or have I missed something? I'd love it if you could talk about scrupulosity sometime! Thank you very much again. Kind regards Robyn Hi Robyn, If you like, I will include in an ask david. The short answer is one that I give every week on the podcasts—I don’t throw techniques at folks based on a diagnosis or problem. As often as I say it, people don’t seem to get it, and this is the biggest problem in our field—trying to figure out how to “help” or rescue our patients. Of course, cognitive flooding might be one of 15 or 20 methods I might use, and there are tons of others, but first one has to find out what, if anything, the patient wants, and then deal skillfully with Outcome and Process Resistance. This MUST come before trying any methods. More on this when Rhonda and I discuss your excellent question. d Matthew May MD practices in Menlo Park, California. He is on the adjunct faculty in the department of psychiatry at Stanford and practices in Menlo Park, California. Although most psychiatrists rely primarily on medications, Matt tells me that the majority of his depressed and anxious patients recover rapidly without medications as a result of his proficiency with TEAM-CBT. He is also a superb teacher and has a weekly online supervision group for mental health professionals interested in learning and refining TEAM therapy skills. You can contact him via his website. Next week, Matt will join us again in a fascinating podcast on the paradoxical Nature of TEAM-CBT! Don’t miss it! Rhonda and David

Episode 8 – Certified Financial Planner Susan Elser on Protecting SettlementsListen to more episodes of After the Crash:https://www.ckflaw.com/after-the-crash-podcast__This podcast will dive deep into what happens after a crash caused by a semi or other commercial motor vehicle. It is the goal of the podcast to provide information that victims of semi-truck wrecks or those who have suffered serious injuries, brain injuries, or the death of a loved one, need to know. Information is power, and David Craig works to empower the listener by interviewing the top experts involved in these cases.David W. Craig is the managing partner at the law firm of Craig, Kelley & Faultless LLC.He is board certified in Truck Accident Law. David sits on the board of regents for the Academyof Truck Accident Attorneys (ATAA) and has over 30 years of experience representing truckaccident victims. David is a member of the Multi-Million Dollar Advocates Forum and a proudrecipient of the Thurgood Marshall “Fighting for Justice” Award. He was also named a top 10trucking trial lawyer in Indiana by the National Trial Lawyers Association.David also is the author of the book, Semitruck Wreck: A Guide for Victims and TheirFamilies, which is available on Amazon and Audible. It is also available on other audiobookplatforms like Apple Books, Scribd, Booktopia, and Audiobooks.Download Semitruck Wreck for FREE:https://www.ckflaw.com/truck-accident-ebook__Website: https://www.ckflaw.comFacebook: https://www.facebook.com/ckflaw LinkedIn: https://www.linkedin.com/company/craig-kelley-&-faultless-attorneys-at-lawEmail: info@ckflaw.comPhone: 1-800-ASK-DAVID

Upcoming Workshops The Cognitive Distortion Starter Kit With David Burns, MD A One-Day Workshop on May 5, 2021 Click here for more information including registration! 8:30 AM to 5:00 PM West Coast Time: 7 CE Credits   Bringing TEAM-CBT to Life in Real Time Two Live Therapy Demonstrations with Drs. David Burns and Jill Levitt REGISTRATION CLOSES AT 5:30 PM PACIFIC TIME ON SATURDAY 5/15/21. NO EXCEPTIONS. Live Online Workshop with David Burns, MD and Jill Levitt, Ph.D. Click here for more information including registration! May 16, 2021 | 7 CE hours. $135 8:30 AM to 4:30 PM West Coast Time   Binoy asks: How does one know that a thought is a good one or a bad one? Or put in another way, how do I know if my fortune telling thought is really a fortune telling one? What is the basis? Binoy also asks: Is there something called “objective truth” that we can all agree on? Kristina asks: I have been labeled codependent in therapy. Is it a true label? . . . Do you believe in highly sensitive or empathetic people that can feel others energy? Fabrice asks: What do you think about this definition of the “self?” Don asks: Is TEAM as effective as you say? Binoy asks: I live in an Arab country and some of the things on your list of Shame-Attacking Exercises could get me arrested. Is there a better way to overcoming anxiety? * * * Binoy asks: Hi David, I just listened to podcast 079: “What's the Secret of a "Meaningful" Life? Live Therapy with Daisy." One of the questions that came across my mind is, how does one know if a negative thought is a good one or a bad one? Or put in another way, how do I know if my fortune telling thought is really a fortune telling distortion? What is the basis? Hi Binoy, thanks! Excellent question I might address on a future Ask David podcast. However, I would need you to give me a specific example of a thought you want help with. Specifics typically lead to illumination, whereas abstract thoughts sometimes lead to endless pontification. Binoy also asks: “Hi David, I did listen to the podcast #20 on “The Truth About Antidepressants.” I wish everyone agreed that there is something called objective truth. This is a question about truth or the existence of objective truth. Is the popular ideology that there is nothing called objective truth (everything is relative) correct? How can we talk about truth in a way that will help us be on the same page? So, I hope to hear from you again! Hi Binoy, this is also an abstract question, best answered through specific examples. For example, I can explain the concept of controlled outcome studies to test a drug against placebo, but even there you can find lots of ways to challenge any scientific study. We can also talk about distorted negative thoughts that trigger negative feelings like depression and anxiety. These thoughts are not really true. but we always focus on one specific thought at a time, and only from someone asking for help. I do not pontificate about “truth” in some abstract sense! All the best, david * * * Kristina asks: I have been labeled as codependent in therapy. Is it a true label? Hi Dr. Burns, Thank you so much for all your services and help that you offer Dr. Burns. It has been life changing and I’m just starting to help myself out of this anxiety and depression. I wanted to ask how you feel about the terms, codependency and boundaries. I have been labeled codependent in therapy and is it a true label? Do you believe in highly sensitive or empathetic people who can feel others’ energy? Thanks again for all you do! Thank you, Kristina   Hi Kristina, I had to look up the term. According to dictionary.com, someone who is codependent “is in a relationship in which one person is physically or psychologically addicted, as to alcohol or gambling, and the other person is psychologically dependent on the first in an unhealthy way.” David and Rhonda can mention: the “codependency” and compulsion to “help” or “rescue” that often gets therapists into trouble with patients. This is a kind of addiction that therapists have, and is the main cause of therapeutic failure. that I work with specifics more than labels. For example, if a patient wanted help with “codependency,” I would ask him or her to describe a specific time on a specific day when this seemed to be a problem. Then I’d figure out what was going on, and find out if it was an individual mood problem or a relationship problem. After empathizing, I would find out what, if anything, the patient wanted help with, and then I’d bring the resistance to change to conscious awareness. My research on empathy indicates that even therapists are not accurate in sensing how their patients feel. The same is true, I believe, of the general public. People vastly overestimate their capacities to understand how others are thinking and feeling, and this is super easy to demonstrate with simple experiments using rudimentary statistical analyses. David * * * Fabrice asks. What do you think about this definition of the “self?” Hi David & Rhonda, Start with this: When I refer to my "self," I am speaking of the sum of my experiences and the trails they have left in my mind, my body, and my life circumstances, as well as the material things that are associated with me, beginning with my body, symbolized by the name printed on my ID card. This "self" has certain characteristics, including past actions, habits, patterns, qualities, flaws, etc. So, the first question is, how can you say that this "self" does not refer to anything? I know very well who I am, and I am distinct from any other "self" that presents him/herself to me. The second question is, based on the previous definition, why can't I pass judgment on the different attributes of that "self"? If that self has never been able to solve a linear equation, can't I call it "bad at math?” If that self almost always turns in its assignments after the deadline, can't I call it "slow" or "procrastinating?” And so on. I agree that passing negative judgment on a self can lead to that self having some unpleasant emotions, but that doesn't mean that those judgments are meaningless. I suspect that some listeners were turning over thoughts like these in their minds. I hope that gives you something to sink your teeth into. I'll try to be more specific about future episodes. Take care, Fabrice Nye Hi Fabrice, Thanks! When I get time to redo the deleted chapter on the “self” from Feeling Great, I can perhaps include these questions, although I did pretty much cover them in several of the later chapters in Feeling Great on the impossibility of judging the “self,” as opposed to things we think, do, or say. My problem is that people don’t “get” or “grasp” what I’m trying to say. Below, you seem to think I believe the “self does not exist,” and you have some excellent attempts to define it and prove that it does exist. At least that’s my take on it. My position is radically different. To me, the statement “the self does not exist” and “the self does exist” have no meaning. The statement, “I don’t know if the self exists” also has no meaning to me. This is language that is “out of gear,” so to speak, as Wittgenstein might say. You can press on the accelerator all you want, but the car won’t move forward when it is not in gear. But most people, nearly everybody in fact, have tons of trouble grasping this. You probably “get it,” I don’t know! I am just referring to your email, where you say the self is such and such. Nouns do not always refer to “things” that could “exist” or “not exist.” Still, when I say this, it goes in one ear and out the other, I’m afraid! And that was why Wittgenstein was intensely lonely and frustrated, and often depressed, and perhaps why he never attempted to publish anything during his life. You can certainly say, “I’m not very good at math. In fact, I’m below average at math.” This means that your math skills are below average. Does it also mean that your “self’ is below average? Many of my skills and attributes are below average, but that does not upset me or threaten my feelings of self-esteem for two reasons: I don’t believe that my worthwhileness as a human being depends on anything. I don’t believe that “worthwhileness as a human being” has any meaning. I don’t believe the statement, “the self exists,” has any meaning. What would it be like if “the self” didn’t exist? What are we actually talking about? But if I judge my “self” to be “inferior” or “worthless” or “below average,” that type of self-critical thinking can cause a lot of emotional pain, and can, in extreme cases, even lead to suicide, thinking that “I am not good enough.” david I asked Fabrice if he wanted to comment on my response above, and if I should include it in the show notes. He gave a really cool answer: Hi David, Yes, you can absolutely include it. From your response here, you ought to make it clear that your point is that the language is not meaningful, therefore the word, "self," is not meaningful. But you may need to delve deeper into this. If you do that, you're going to end up at the same place the Buddha ended up when he discovered the ultimate emptiness of things. Of course, he didn't talk about "things," since that's meaningless too, just emptiness. Fabrice Nye By the way, you may enjoy Fabrice’s new podcast. Here’s the link: https://podcasts.apple.com/us/podcast/peace-at-last/id1496573038 The following email might also help. Hi Rhonda, Here is the other Ask David with the remainders from our last one. If we use this one, let’s please be sure to include your through about your “self” as “a mom,” “a psychologist,” and so forth, and how I responded to it, as I thought that was really helpful. We can judge and talk about what we DO, and not what we ARE. We can use the word, “self,” in a variety of ways that are meaningful. For example, Behave yourself. This means stop behaving badly. Just act like yourself on the date. This means don’t try to impress your date. Instead, show an interest in him / her. Why you write, try to tune I on your true “self,” and stop acting so fake. This means you need to change your tone of voice when you write. Share more of your feelings and vulnerabilities. All these uses have specific meanings. They are not metaphysical or philosophical claims, just attempts to influence someone’s thinking, feelings, or behavior. “Self” is just a sound that comes out of your mouth. It is not an esoteric or metaphysical “thing” that could “exist” or “not exist.” Aristotle thought that nouns were descriptions of “things” that existed in some ideal alternative reality. For example, he thought that tables are just imperfect examples of some perfect essence of “tableness” that exists somewhere. This erroneous view of language gave rise to most of the problems in philosophy, as well as most of our emotional problems of feeling we have a “self” that isn’t important, or isn’t worthwhile, or isn’t good enough, and so forth. d * * * Don asks: Is TEAM as effective as you say? Hi Dr. Burns, I feel compelled to say, with the greatest respect and affection, that the very concept of successfully treating my lifelong battle with depression, anxiety, and ocd within a few hours seems, at face value, far too good to be true! Is it really possible? I've endured countless disappointments and treatment failures from many, many therapists, all of whom wasted months or even years of my time, essentially to no avail. Tell me again: Is short term treatment, as described, as potent as TEAM promises. It's just so hard to believe! DBs Comment: Don went on to describe chronic severe mood problems and recent intense feelings of anxiety due to medical problems in his family. Hi Don, Good questions. Here are some thoughts. Effectiveness depends on the skill of the therapist, and TEAM is challenging to learn. I’ve been at it for more than 40 years, and have used T = Testing at every session with every patient. This has been my greatest teacher—my patients. Some of my students have achieved high levels of skill, and they are the ones who have put in tremendous effort to learn. There are not yet many of them, sadly, and that’s why I’m working on an app. . . . So I can make these tools available to large numbers of people who are suffering. We will be starting a new beta test in a few weeks. It is in progress, and very labor-intensive to develop, but if it works, it will be fantastic. An inexpensive way to find out if TEAM is for you, and you have perhaps done this already, would be to read Feeling Great and do the written exercises while reading. Then you’ll find out if you like the new methods, and if they are helpful for you. I assume you’ve already read Feeling Good and done the exercises. Is that correct? The results I report are the results of my work with patients, using TEAM. I only report truthful things, and don’t fabricate results! I am analyzing a huge data base of thousands of TEAM therapists at the Feeling Good Institute, but it is a naturalistic study, and interpreting the results is challenging for a variety of reasons. The mean reduction in depression scores in a large number of severely depressed individuals in four or five sessions was 59%, which is excellent. It is little bit hard to interpret that result because when patients recover, they drop out of treatment, so the mean depression score in the data you analyze at any session is the mean of those who are still in treatment who have not yet recovered. Therefore, the analysis is potentially biased in a negative direction, if you see what I mean. My published research shows that psychotherapy homework is crucial to success. Some patients are strongly opposed to doing homework, and they are likely served better by therapists who do not believe in the value of psychotherapy homework. The rapid recovery I see is in the treatment of depression and anxiety. Relationship problems are much more challenging to treat due to the intense resistance people have to looking at their own role in a problem instead of blaming others. Habits and addictions can be slower and more challenging, too, since the temptations to give are so pervasive and powerful. Thanks! I hope this information in helpful for you. Here’s an afterthought. Sometimes when people ask me if this will really work, they are actually skeptical or even annoyed, and expressing resistance or a lack of enthusiasm for the treatment techniques I have created. I do not try to sell patients on anything, and feel strongly that people should find an approach they are enthusiastic about, even if it is radically different from the methods I have developed! I strongly applaud skepticism and critical thinking, but it is also true that trust and TEAMwork are vitally important dimensions of successful treatment. If a patient is putting up a wall and resisting, that must be dealt with first before there is any chance for success. The approach to resistance is radically different from answering questions as I am doing here. I hope that makes sense! Here’s the type of thing I’m saying, or trying to say. If you’ve been burned in the past, and had negative therapeutic experiences, it would make sense that you’d be reluctant to trust, or to hope, or to collaborate, for fear of being let down yet again. I would want to bring this issue to conscious awareness at the start of therapy with anyone who has strong feelings of skepticism, and anyone who is saying “prove it to me” when we start therapy. Almost all the patients I’ve treated have had months, years, or decades of failed therapy in the past. But that’s not so crucial. The crucial question is, can we work together with some trust and enthusiasm and teamwork? And are you willing to do what will be necessary for a positive outcome? This might include doing regular psychotherapy homework, being willing to use Exposure techniques for anxiety, like OCD, and so forth. Lots of people don’t want to do homework or use exposure, and they may have other objections to the treatment, which I honor. I don’t try to persuade or twist arms, since those approaches are doomed to failure. Not sure if this makes sense, or if I’ve expressed my thinking clearly. david * * * Binoy asks: I checked the list of shame attacking exercises you have suggested for social anxiety. I live in an Arab country. Some of the things on the list could get me arrested. Is there a better way to overcoming anxiety? Hi Binoy, Perhaps you can tell me what Shame Attacking Exercises would get you arrested! Since I’ve listed more than 100, perhaps you could choose ones that will not get you arrested! In addition, I never throw techniques at people based on a diagnosis or problem, but work systematically using T, E, A, and M. In addition, I use four treatment models, and more than 50 techniques, when I am treating any form of anxiety. There is a free anxiety class on my website. Check it out!  

Episode 7 – Cell Phone Data Collection with guest Benjamin BierceListen to more episodes of After the Crash:https://www.ckflaw.com/after-the-crash-podcast__This podcast will dive deep into what happens after a crash caused by a semi or other commercial motor vehicle. It is the goal of the podcast to provide information that victims of semi-truck wrecks or those who have suffered serious injuries, brain injuries, or the death of a loved one, need to know. Information is power, and David Craig works to empower the listener by interviewing the top experts involved in these cases.David W. Craig is the managing partner at the law firm of Craig, Kelley & Faultless LLC.He is board certified in Truck Accident Law. David sits on the board of regents for the Academyof Truck Accident Attorneys (ATAA) and has over 30 years of experience representing truckaccident victims. David is a member of the Multi-Million Dollar Advocates Forum and a proudrecipient of the Thurgood Marshall “Fighting for Justice” Award. He was also named a top 10trucking trial lawyer in Indiana by the National Trial Lawyers Association.David also is the author of the book, Semitruck Wreck: A Guide for Victims and TheirFamilies, which is available on Amazon and Audible. It is also available on other audiobookplatforms like Apple Books, Scribd, Booktopia, and Audiobooks.Download Semitruck Wreck for FREE:https://www.ckflaw.com/truck-accident-ebook__Website: https://www.ckflaw.comFacebook: https://www.facebook.com/ckflaw LinkedIn: https://www.linkedin.com/company/craig-kelley-&-faultless-attorneys-at-lawEmail: info@ckflaw.comPhone: 1-800-ASK-DAVID

235: Anger in Marriage Several months ago. a professional dancer named Brian emailed me with an Ask David question on how to deal with anger in marriage using the Five Secrets of Effective Communication. I was pretty excited because anger in marriage is a problem nearly everyone can identify with, and something we all need some help with! Brian and his family Brian said that he and his wife, Michelle, have been married since 2009, and while he loves Michelle a great deal, their relationship runs hot and cold, with frequent angry clashes. I asked Brian for a specific example, including a partially filled out Relationship Journal (RJ), so I could get some details on what his wife said to him, and what, exactly, he said next, during one of their conflicts. Brian and his wife, Michelle The analysis of this exchange will provide us with a crystal clear example of the type of problem they are struggling with, along with the opportunity to pinpoint the specific errors Brian is making in responding to his wife’s criticisms. In the example he sent, she said that he wasn’t doing enough to help put the kids to bed one night, and he responded by saying nothing. He analyzed his response with the EAR technique from my book, Feeling Good Together. By ignoring her, it was obvious that failed on E = Empathy (he did not acknowledge how she felt), and A = Assertiveness (he did not share his feelings), and on R = Respect (he did not express any warmth, respect, or love for her.) He was able to see that this response will make the problem worse and force her to keep criticizing him. When he ignores her, she feels even more hurt, ignored, abandoned, and unloved. As a result, she’ll keep criticizing him since he hasn’t yet listened or “gotten it.” So although he feels like an innocent victim, he’s actually the secret creator of his own interpersonal reality. In other words, he forces her to do the very thing he’s complaining about. That’s the purpose of the Relationship Journal (RJ) —to help you see your own role in a conflict. It’s an amazing but pretty painful tool that’s potentially liberating. At my urging over the past several months, Brian worked really hard studying the Five Secrets of Effective Communication (LINK) and doing the written exercises in Feeling Good Together. After a rocky start, with some notable failures in his attempt to improve his interactions with his wife, he slowly began to “get it,” and their relationship began to improve a lot. Brian joins us today to describe his journey, and share his excitement about my first book, Feeling Good, as well as Feeling Good Together. I am really proud of what Brian has accomplished through commitment, practice, and hard work, as well as his courageous willingness to look at his own role in the problem. This is nearly always painful, and requires the “great death” of the “self,” or “ego.” During today’s podcast, we practiced with the “Intimacy Exercise.” This exercise can help you improve your skills with the Five Secrets. Here’s the way it works. To get things started, either Rhonda or David will play the role of Brian’s wife, and Brian will play the role of himself. We will criticize Brian in the way his wife sometimes criticizes him, and then he will respond, using the Five Secrets. For example, she recently said: “When I was on the phone with my best friend, you were rude and selfish, and making too much noise with the video you were creating.” Then he responded and we gave him a grade, and pointed out what he was doing right and what he was doing wrong that needed improvement. If you check your ego at the door, this can be a great, but challenging, way to learn! Brian gave himself a C on his response, which you’ll hear in the podcast, and Rhonda agreed. She also gave him a C. I gave him a B, as I thought he did some pretty cool things while making several errors. Here’s where he needed improvement. His use of the Disarming Technique needed upgrading. He didn’t strongly and directly endorse the truth in his wife’s criticism. For example, he might say something like this: “You’re right, I was being insensitive and selfish, and I’ve done that to you so often over the years.” His response would benefit from the inclusion of some “I Feel” Statements,” since it sounded a bit mechanical. For example, he might say, “I feel really sad and ashamed to hear you say that I was selfish and insensitive, because you’re absolutely right, and I love you so much.” There was no Stroking, and I included one way to do this in the “I Feel” response I just described. His Thought Empathy was good, but there was no Feeling Empathy. In other words, he did not mention how sad, hurt and angry his wife might be feeling. He did not finish with a sound use of Inquiry that would invite his wife to open up even more. For example, he could end by asking her to tell him more about how she feels when he’s being insensitive and selfish, and how hurt, angry, and lonely she might feel. Brian was non-defensive and open to this feedback. Then we did role reversals to give him the chance to try these new approaches and boost his grade. Here’s a comment he wanted me to share with you: Learning and implementing the 5 Secrets of Communication literally helped to save my marriage. The breakthrough came for me when I was really able to grab hold of Feeling Empathy, and really delve deep into understanding how my actions hurt my wife. This was one of the hardest challenges I've ever had in my life but the deeper I got into my wife's heart and mind, the more my anger dissipated and was replaced by empathy, warmth and love for my wife. I am no expert by any stretch of the imagination and in the podcast, both Rhonda and David went over some really cool role play to help sharpen my skills in the 5 Secrets. My hope is that by sharing my story it will help to provoke some helpful thoughts in the listener to help them continue to grow in their relationships. Brian Brian also said that he is a Christian, and loves Jesus, and that one thing he appreciates about the Five Secrets is that it is deeply connected to Christian teachings. For example, here’s a quotation from Matthew 7:3: “And why beholdest thou the mote that is in thy brother's eye, but considerest not the beam that is in thine own eye?” I strongly agree with Brian’s take on this, and believe that the Five Secrets of Effective Communication can be viewed as both a psychological and a spiritual tool. I would add that the Five Secrets, as well as all of the techniques in TEAM-CBT, are compatible with most if not all religious traditions. I have often said that the moment of profound change—the moment you recover from anxiety or depression, for example—will nearly always have a spiritual meaning, but the details of your interpretation will depend on your religious or philosophical upbringing. I like to emphasize this because my father was a Lutheran minister, but he seemed pretty suspicious of psychiatrists, thinking that psychiatry and religion were inherently at odds with one another. Some deeply religious people have seen me, as some kind of pariah, or enemy of religion. When I lived in Philadelphia, I went to Lancaster, Pa, on ten consecutive Saturday mornings to teach CBT at a beautiful religious hospital there. I enjoyed teaching their staff a number of new techniques for treating depression. They told me that one of the local evangelists had a Saturday morning radio show, and that whenever I came to town, he would say, “the snake has returned to Lancaster” on his show! I think it is because I quoted the Buddha on something, and some of the more conservative folks didn’t take kindly to that comment! I guess they thought that the Buddha was the same as the devil! I see religion and psychotherapy, in contrast, as synergistic. Although all of my work is totally secular, and based on research and clinical experience, the overlap of TEAM-CBT with all religious traditions is clear and unmistakable. I love it when clergymen, rabbis, or imams attend my workshops and point out the common grounds with what I’m teaching and their theological beliefs. We did more role playing during the podcast, as Brian also wanted to focus on his feelings of insecurity resulting from relentless self-critical thoughts, like, “I suck at dancing, so I’m worthless”. We used THE Externalization of Voices along with the Acceptance Paradox, the Self-Defense Paradigm, and the CAT (Counter-Attack Technique) to challenge his negative thoughts. We also used Positive Reframing to reduce his resistance to giving up his self-criticisms. We did a number of role plays with role reversals, just as we’d done earlier when practicing the Five Secrets. Brian was incredibly fun to work with, and Rhonda and I developed great affection and admiration from him. We’ll try to post some follow-up, too, once Brian has had the chance to listens to the audio with his wife We can perhaps get her responses to the show and include them in the show notes. There were at least two keys to the rapid progress Brian has made learning to use the Five Secrets of Effective Communication with very little input from me. He is very much in love with Michelle and intensely committed to improving their relationship. He has high standards and is willing to put in the work that is necessary to master the Five Secrets of Effective Communication, not only in his interactions with his wife, but also with people in general. He has also been willing to put in the work to learn to change the way he thinks and feels, so he can modify his internal dialogue as well as the way he communicates with others. Your internal and external dialogues will often fuel each other. You know that Brian is a professional dancer. Can you guess what he does for a living? I was surprised and delighted to learn that Brian runs a Break Dance School in Long Beach, California, for children, teens, and adults. Here is the link in case you want to contact him or sign up for some awesome break dance classes! Webreakdance.com Instagram.com/Webreak Here are some awesome video links you can watch: Webreak Soul Evolution Crew Performance: https://youtu.be/M4FzENnYXj4 Brian Breakdancing Solo: https://www.instagram.com/tv/CHjr8yXhGk7/?igshid=1341ipmr311ho

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

Episode 6 – Medical Life Care Plans with guest Shirley DaughertyListen to more episodes of After the Crash:https://www.ckflaw.com/after-the-crash-podcast__This podcast will dive deep into what happens after a crash caused by a semi or other commercial motor vehicle. It is the goal of the podcast to provide information that victims of semi-truck wrecks or those who have suffered serious injuries, brain injuries, or the death of a loved one, need to know. Information is power, and David Craig works to empower the listener by interviewing the top experts involved in these cases.David W. Craig is the managing partner at the law firm of Craig, Kelley & Faultless LLC.He is board certified in Truck Accident Law. David sits on the board of regents for the Academyof Truck Accident Attorneys (ATAA) and has over 30 years of experience representing truckaccident victims. David is a member of the Multi-Million Dollar Advocates Forum and a proudrecipient of the Thurgood Marshall “Fighting for Justice” Award. He was also named a top 10trucking trial lawyer in Indiana by the National Trial Lawyers Association.David also is the author of the book, Semitruck Wreck: A Guide for Victims and TheirFamilies, which is available on Amazon and Audible. It is also available on other audiobookplatforms like Apple Books, Scribd, Booktopia, and Audiobooks.Download Semitruck Wreck for FREE:https://www.ckflaw.com/truck-accident-ebook__Website: https://www.ckflaw.comFacebook: https://www.facebook.com/ckflaw LinkedIn: https://www.linkedin.com/company/craig-kelley-&-faultless-attorneys-at-lawEmail: info@ckflaw.comPhone: 1-800-ASK-DAVID

Ask David: Questions on self-esteem, recovery from PTSD, dating people with Borderline Personality Disorder, recovery on your own, and more! Jay asks: Is psychotherapy homework still required if you’ve recovered completely from depression in a single, extended therapy session? Is Ten Days to Self-Esteem better than the single chapter on this topic in Feeling Good? Are people who were abused emotionally when growing up more likely to get involved with narcissistic or borderline individuals later in life because the relationship is “familiar?” Many patients can read your books and do the exercises and recover on their own. Is a teacher or coach sometimes needed to speed things up? Is it possible for a person to become happy WITHOUT needing anyone else if they have had depression in past and/or PTSD? Also, how would Team-CBT address treating PTSD? PTSD can involve a person having multiple traumas. * * * Is psychotherapy homework still required if you’ve recovered completely from depression in a single, extended therapy session? Thanks, Jay, I will make this an Ask david, if that is okay, but here is my quick response. Although many folks now show dramatic changes in a single, two-hour therapy session, they will still have to do homework to cement those gains, including: Listening to or watching the recording of the session Finish on paper any Daily Mood Log that was done primarily in role-playing during the session. In other words, write the Positive thoughts, rate the belief, and re-rate the belief in the corresponding negative thought. Use the Daily Mood Log in the future whenever you get upset and start to have negative thoughts again. I also do Relapse Prevention Training following the initial dramatic recovery, and this takes about 30 minutes. I advise the patient that relapse, which I define as one minute or more of feeling crappy, is 100% certain, and that no human being can be happy all the time. We all hit bumps in the road from time to time. When they do relapse, their original negative thoughts will return, and they will need to use the same technique again that worked for them the first time they recovered. In addition, they will have certain predictable thoughts when they relapse, like “this proves that the therapy didn’t rally work,” or “this shows that I really am a hopeless case,” or worthless, etc. I have them record a role-play challenging these thoughts with the Externalization of Voices, and do not discharge them until they can knock all these thoughts out of the park. I tell them to save the recording, and play it if they need it when they relapse. I also tell them that if they can’t handle the relapse, I’ll be glad to give them a tune up any time they need it. I rarely hear from them again, which is sad, actually, since I have developed a fondness for nearly all the patients I’ve ever treated. But I’d rather lose them quickly to recovery, than work with them endlessly because they’re not making progress! People with Relationship Problems recover more slowly than individuals with depression or anxiety for at least three reasons, and can rarely or never be treated effectively in a single two-hour session: The outcome and process resistance to change in people with troubled relationships is typically way more intense. It takes tremendous commitment and practice to get good at the five secrets of effective communication, in the same way that learning to play piano beautifully takes much commitment and practice. Resolving relationship conflicts usually requires the death of the “self” or “ego,” and that can be painful. That’s why the Disarming Technique can be so hard for most people to learn, and many don’t even want to learn it, thinking that self-defense and arguing and fighting back is the best road to travel! * * * Is Ten Days to Self-Esteem better than the single chapter on this topic in Feeling Good? Yes, Ten Days to Self-Esteem would likely be a deeper dive into the topic of Self-Esteem. It is a ten-step program that can be used in groups or individually in therapy, or as a self-help tool. There is a Leader’s Manual, too, for those who want to develop groups based on it. * * * Are people who were abused emotionally when growing up more likely to get involved with narcissistic or borderline individuals later in life because the relationship is “familiar?” I was involved with a woman with Borderline Personality Disorder, and it was exhausting! Why was I attracted to her? Thank you for the question, Jay. Most claims about parents and childhood experiences, in my opinion, are just something somebody claimed and highly unlikely to be true if one had a really great data base to test the theory. We don’t really know why people are attracted to each other. Many men do seem attracted to women with Borderline Personality Disorder. Perhaps it’s exciting and dramatic dynamic that they’re attracted to, and perhaps it’s appealing to try to “help” someone who seems wounded. Good research on topics like this would be enormously challenging, and people would just ignore the results if not in line with their own thinking. Our field is not yet very scientific, but is dominated by “cults” and people who believe, and who desperately want to believe, things that are highly unlikely, in my opinion, to be true. I do quite a lot of data analysis using a sophisticated statistical modeling program called AMOS (the Analysis of Moment Structures) created by Dr. James Arbuckle from Temple University in Philadelphia, someone I admire tremendously. This program does something called structural equation modeling. In the typical analysis, the program tells you that your theory cannot possibly be true, based on your data. If you are brave, this can lead to radical changes in how you think and see things, especially if you are not “stuck” in your favored theories. But this type of analysis is not for the faint of heart. All the best, David Here is Jay’s follow-up email: HI Dr. Burns, As you know A LOT of people attribute their present problems (depression / anxiety / relationship conflicts / addictions) to their "abusive" or "toxic" relationship with their parents. It is interesting that it seems some people internalize negative beliefs about themselves based on what their parents said to them on a consistent basis. But it seems you are saying the data does not support that theory. Jay Thanks, Jay, I’m glad you responded again. There may be some truth to those kinds of theories. We know, for example, that abused or feral cats often have trouble with trust. So, we don’t want to trivialize the pain and the horrors that many humans and animals alike endure. At the same time, people are eager to jump onto theories that “sound right” to them and serve their purposes, and most of these theories are not based on sound research. Here are two examples from my own research. I tested, in part, the theory that depression comes from bad relationships, and also that addictions result from emotional problems. I examined the causal relationships between depression on the one hand and troubled vs happy relationships with loved ones on the other hand in several hundred patients during the first 12 weeks of treatment at my clinical in Philadelphia, and published it in top psychology journal for clinical research. (will include link) That was because there were at the time two warring camps—those who said that a lack of loving and satisfying relationships causes depression, and those who said it was the other way around, that depression leads to troubled relationships. And the third group said it worked both ways. My study indicated that although troubled relationships were correlated with depression, there were NO causal links in either direction. Instead, the statistical models strongly hinted that an unobserved, third variable had causal effects on both simultaneously. This is the only paper in the world literature that I am aware of that has tested the causal links between intimacy and depression, but because the results did not satisfy anyone, the paper is rarely or never quoted, and did not seem to influence those who were advocates of one or the other theories. As they say, wrong theories die hard. Here’s the reference: Burns, D. D., Sayers, S. S., & Moras, K. (1994). Intimate Relationships and Depression: Is There a Causal Connection? Journal of Consulting and Clinical Psychology, 62(5): 1033 - 1042. I also looked at the causal links between all kinds of emotional problems and all kinds of addictions in 178 or so patients admitted to the psychiatric inpatient unit of the Stanford Hospital. I was unable to confirm any significant causal links between depression, anxiety, loneliness, anger, and so forth and any kind of addiction (overeating, drugs, alcohol, etc.) The only possible causal link I could find was a small causal link of depression on reducing the tendency to binge or overeat. This was a secondary and unpublished analysis of data I collected in validating my EASY diagnostic system. I don’t mean to encourage insensitivity to suffering or and I don’t want to stop or stifle creative thinking about the causes of depression and anxiety and addictions. I simply want to emphasize that the causes of depression, and most other emotional problems, are still totally unknown. That is a very simple statement, but it seems to me that most folks don’t “get it,” or don’t want to hear it. Maybe we all want to explain things, or blame others, or think of ourselves as “experts,” or perhaps we feel uneasy with thinking that we don’t yet know the causes of most psychiatric problems, like depression and anxiety or troubled relationships. It may be comforting to think we do know the causes of negative feelings or human conflict. This is my thinking only, and I’m often off base! Tell me what you think. David

Episode 5 – "Protecting Your Financial Future With Structured Settlements" with guest Todd MorrowListen to more episodes of After the Crash:https://www.ckflaw.com/after-the-crash-podcast__This podcast will dive deep into what happens after a crash caused by a semi or other commercial motor vehicle. It is the goal of the podcast to provide information that victims of semi-truck wrecks or those who have suffered serious injuries, brain injuries, or the death of a loved one, need to know. Information is power, and David Craig works to empower the listener by interviewing the top experts involved in these cases.David W. Craig is the managing partner at the law firm of Craig, Kelley & Faultless LLC.He is board certified in Truck Accident Law. David sits on the board of regents for the Academyof Truck Accident Attorneys (ATAA) and has over 30 years of experience representing truckaccident victims. David is a member of the Multi-Million Dollar Advocates Forum and a proudrecipient of the Thurgood Marshall “Fighting for Justice” Award. He was also named a top 10trucking trial lawyer in Indiana by the National Trial Lawyers Association.David also is the author of the book, Semitruck Wreck: A Guide for Victims and TheirFamilies, which is available on Amazon and Audible. It is also available on other audiobookplatforms like Apple Books, Scribd, Booktopia, and Audiobooks.Download Semitruck Wreck for FREE:https://www.ckflaw.com/truck-accident-ebook__Website: https://www.ckflaw.comFacebook: https://www.facebook.com/ckflaw LinkedIn: https://www.linkedin.com/company/craig-kelley-&-faultless-attorneys-at-lawEmail: info@ckflaw.comPhone: 1-800-ASK-DAVID

Podcast 224 Ask David January 11, 2021 Ask David featuring more challenging and interesting questions. Josh asks: What are the most effective types of psychotherapy homework assignments? Hassam asks: How would you treat my severe OCD? Exposure doesn’t seem to be working! And Joe asks: Would you say that the secret to overcoming OCD is willpower? Ted asks: Does any psychiatric disorder result from a chemical imbalance in the brain? Brian W. asks: Burns, could you do a video on how to use CBT for stress? Thanks. Clarity asks: Is it too late to be a beta tester for your app? Simon asks: Is there a podcast that you can recommend for general depression, and how to find out what is wrong? Stephanie asks: My patients don’t recover as rapidly as your patients. Am I doing something wrong? I’m feeling a lot of anxiety and self-doubt! * * * Josh asks: What are the most effective types of psychotherapy homework assignments? Hi David, thanks for all your work. It has been very helpful. You mention That doing homework is essential to recovery from anxiety and depression. Any homework you recommend? I am going to buy a few of your books and have the worksheets from the Neil Sattin podcast. Anything else that will benefit? Josh Hi Josh, It depends on the type of problem you are working on. I can work up an answer, perhaps, if you want to tell me! I did not hear from Josh, but Rhonda and I summarize the best kids of psychotherapy homework for: depression anxiety relationship problems * * * Hassam asks: How would you treat my severe OCD? Exposure doesn’t seem to be working! Hi David, I love your work on the podcast. I have not yet found a copy of any of your books in Lahore (where I live), but I have grown to understand your philosophy through your podcasts. Episode 162 disturbed me a little. I suffer from severe OCD and its cousin, depression. And the "high-speed cure" in the title really attracted me. But I had buyer's remorse. Why? Because it does not work like that for most people. The guest on your show, had a few exposures, and BAM, cured. I have tried exposure many many times, and it very minimally helps in lowering the threat of the obsessions. I feel that this was a Magic Pill kind of account, and at the risk of judging a person's pain, I think your guest had a relatively mild (as compared to me) OCD. I would really love it if you could talk about Pure OCD (the type I have), and how it can be resistant to exposure. The intrusive thoughts/obsessions continue to be extremely, EXTREMELY, painful. This "high speed cure" idea seems dismissive of the seriousness of my condition. Please keep up the great work. And I hope to read your books one day. Thanks Hassam (Therapist in training) Thanks Hassam, sometimes, therapy is much harder, as you say! Good point. I often get slammed when I present patients who recover rapidly, especially patients who have had incapacitating symptoms for years or even decades of failed therapy. This is disappointing to me, as my goal is to bring hope to people that rapid and meaningful change IS possible. To be honest, I don’t like it when I get slammed for presenting cases of rapid recovery. Some people think I am a con artist! Yikes! Of course, everyone is different, and some people will be more challenging to treat. One thing I learned when I was in private practice is that you can never tell ahead of time who will recover rapidly and who will take much more time. I’ve had patients I thought would be super easy to treat who responded much slowly than I predicted, and many who I thought would be nearly impossible to treat who responded almost overnight. You’ve mentioned that exposure has been of limited value for you. I totally agree and saw that early in my treatment of anxiety that exposure alone is often quite ineffective. That’s why I argue so strongly that exposure is not a treatment for OCD or for any form of anxiety. It is just one tool among many I use in the treatment of anxiety. I use four very different treatment models with every anxious patient: The Cognitive Model The Motivational Model The Hidden Emotion Model The Behavioral (Exposure) Model Unless you understand and use all four models, the prognosis might be somewhat guarded, as you’ve discovered. In contrast, when you use all four strategies, your chances for success increase tremendously. For example, prior to using Exposure in the episode you listened to, I spent about 25 minutes with Sara using the motivational and cognitive models, which really helped. Focusing on one method alone will often not be terribly effective, especially if you’re looking rapid, complete, and lasting recovery. However, occasionally one method will work, so therapists and patients alike get focused on some single approach they’ve learned, thinking they’ve found “the answer.” There’s a great deal of information on the treatment of anxiety disorders using these four models on my website, www.feelinggood.com. I often urge listeners to use the search function on my website, and everything will be served up to you immediately. You can learn all about these four powerful models. In addition, if you were looking for more techniques, you might want to take a look at my book, When Panic Attacks, which describes 40 potent anti-anxiety techniques. You can order it from Amazon. My psychotherapy eBook, Tools, Not Schools, of Therapy, might also be helpful for therapists who want to learn more about the treatment of depression and anxiety with TEAM. It is an eBook, and order forms are available on my website, www.feelinggood.com, in the resources tab, and also in my store. Thanks for your excellent question! david And Joe asks: Would you say that the secret to overcoming OCD is willpower? In reply to Joe. I use four treatment models in the treatment of all anxiety disorders, including OCD. Certainly, the willingness to use Exposure is required, but Exposure is only one of many helpful methods for OCD. You can search for anxiety treatment on my website, and you’ll find many good podcasts. Also, there is a free anxiety class on my website. My book, When Panic Attacks, is another great resource with more than 40 techniques to combat all forms of anxiety, including OCD. You can find all my books on AMAZON, or on the books page on my website. david * * * Ted asks: Does any psychiatric disorder result from a chemical imbalance in the brain? Hi Dr. Burns, It says in your book, When Panic Attacks, p. 49, 3rd paragraph, you said that there's not a shred of evidence that there's any chemical imbalance for any psychiatric disorder. Does that include schizophrenia or bipolar or OCD?  Haldol works for me for schizoaffective....controls dopamine in brain? Ted Hi Ted, There are likely one or more biological factors that contribute to schizophrenia as well as full blown bipolar disorder (with true manic episodes.) We do not yet know what those causes are. However, the brain is not a hydraulic system of chemical balances and imbalances, or perhaps more like a supercomputer. I am not aware of any neuroscientists who believe in the crude “chemical imbalance” theory. We simply don’t know what the causes are. Meds can definitely help with the symptoms of schizophrenia and mania as well. This tells us nothing about causes. Aspirin can help with a headache, but headaches are not due to an “aspirin deficiency” in the brain. Computers often crash, but I’ve never heard of a computer problem that was caused by a “silicon imbalance” in the chips. Hope that helps. Psychotherapy can definitely help with feelings of depression and anxiety, but is not a cure for schizophrenia or mania. I would hate to have to treat any psychiatric problem with drugs alone! I like to treat humans, not “diagnoses,” but it can helpful to be aware of diagnoses like schizophrenia, or schizoaffective, or bipolar I, for example. Hope that is helpful! And just my thinking, too, not “written in stone.” david * * * Brian W. asks: Burns, could you do a video on how to use CBT for stress? Thanks. Hi Brian, Thanks! One point is that people are often looking for “formulas” or general solutions to buzzwords like “stress.” The key to TEAM is to focus on one specific moment, and to work with it in an individual way, never using non-specific solutions like exercise, meditation, deep breathing, dietary changes, and so forth. But as you can see, this is tough for many people to grasp. The failure to understand the importance of specificity is one of the big problems in our field, and it is a problem for therapists and patients alike. There are no very good solutions in the clouds of abstraction, because we are all unique. I asked Brian for specific examples, and he wrote: “Work pressure, obnoxious bosses, nagging family members, drug addicted family members, and inability to pay bills are a few.” I responded, Thanks, these are all totally unique with different solutions. Perhaps you can focus on one and provide a couple details. david Brian responded, Thanks. Whichever one you think is best. Stressful thoughts. Also how to change stressful thoughts when they're automatic. Hi Brian, There an infinite variety of "stressful thoughts," and they all have unique, non-overlapping solutions. Could you tell me about one thought you had at one specific moment? david During the podcast, I made some additional comments on dealing with stress using TEAM: Stress is a fairly non-specific word for feeling upset or distressed. I like to use and measure specific emotions in my patients, like depression, anxiety, guilt, shame, inadequacy, hopelessness, frustration, anger, and so forth. But for some people, “stressed” may be more acceptable than words like “depression,” which may carry more stigma. However, there is a somewhat specific meaning to stress, which means overwhelmed by having too much to do and not enough time to do it all. This can sometimes result from taking on too much, and having trouble saying no. Reasons for this difficulty being assertive include: Conflict Phobia Excessive Niceness Submissiveness / Pleasing Others Fear of missing out on something cool and exciting to do NY TV story on “stress” and my ten distortions General tools for dealing with patients who feel “stressed out.” Daily Mood Log Relationship Journal Brief Mood Survey You can take a thought on a DML and do a downward arrow—you will typically come to several common Self-Defeating Beliefs, such as Perfectionism Perceived Perfectionism Approval Addiction Submissiveness Worthlessness schema Conflict Phobia / Anger Phobia Superman / Superwoman Specific Tools Positive Reframing “No” Practice * * * Clarity asks: Is it too late to be a beta tester for your app? Hi Clarity, Thanks! You can sign up at www.feelinggood.com/app * * * Simon asks: I have a question for you. I am very depressed at the moment, and I don't know what is wrong, or I have difficult to find out what thought is giving me the down-feeling ☹ Is there a podcast that you can recommend for general depression, and how to find out what is wrong?Thanks for the sooooo great in inspiration. Thanks Simon. I will include your question in an upcoming Ask David, but here’s a start. Focus on one moment you were upset, and tell me how you were feeling and thinking at that specific moment, and record the information on a Daily Mood Log. If you listen to live therapy on the Feeling Good Podcasts, or read one of my books, like Feeling Good or Feeling Great, you will get a step by step introduction to TEAM therapy. Thanks! d PS There is at least one podcast on how to identify your negative thoughts and generate a Daily Mood Log. You can use the search function on the website to find those or podcasts on any topic, but here’s the link since the search function is not working properly at the moment so I’ll have to fix it. (https://feelinggood.com/2018/03/05/078-five-simple-ways-to-boost-your-happiness-5-you-can-change-the-way-you-feel/) PS PS I want to thank Simon for creating time codes for all 50 techniques on podcasts 93 (https://feelinggood.com/2018/06/18/093-fifty-ways-in-fifty-minutes-part-1/) and 94 (https://feelinggood.com/2018/06/25/094-50-methods-in-50-minutes-part-2/) entitled, “Fifty techniques in fifty minutes.” His time codes allow you to find the description of any techniques of interest. * * * Stephanie asks: My patients don’t recover as rapidly as your patients. Am I doing something wrong? I’m feeling a lot of anxiety and self-doubt! Hi David, I hope this is the right address to which to send an "Ask David." I am a huge fan of your work and cannot thank you enough for making your therapy techniques so accessible. And thank you for taking audience questions! I am in the process of learning TEAM and notice myself getting more skilled, slowly but surely.  There are times I hear you help patients recover in a single session. So far, I have not found myself able to help patients that quickly. I've felt disappointed about this, and it's led to anxiety and self-doubt ("I need to learn TEAM faster so I can help my patients as quickly as possible," "This should be happening quicker."). I am wondering how logical it is for me to expect myself to help patients recover in a single session. Is it reasonable to assume I may have to practice TEAM for some time and go through several training experiences before I can help patients change that quickly? Thank you again!! Stephanie David and Rhonda discuss ways of improving over time and reducing the pressure on yourself if you are a therapist.

The Jealousy Addiction! What Can You Do When Good Things Happen to Bad People? Hi podcast fans! Thanks for your wonderful support in 2020. You helped us hit our three millionth download. I wanted to give a shout out to my fantastic hostess, Dr. Rhonda Barovsky, who has brought magic to the Feeling Good Podcast! This is our first podcast of 2021. It is a really good one, I think. A tremendous amount of work has gone into it, both in the weeks prior to the podcast, as well as in the creation of the detailed show notes for those who want to study and understand exactly how TEAM therapy works for the thorny and almost universal problems of jealousy and anger. Much violence in the world, especially in couples, results from these feelings. I want to thank Bridget for her tremendous courage in giving us all this wonderful gift to kick off the new year! For therapists and therapy students, this show, with the show notes, should be a rich source of learning. David And, I, Rhonda wants to thank Dr. Burns for the incredible contribution he has made to the field of mental health treatment and for the honor of being part of the Feeling Good Podcast! Rhonda Bridget asks: Can you help me with my feelings of intense jealousy? Hello David & Rhonda, I’ve had this issue for a while now, and I’m wondering if others deal with it as well. If I find out that someone I dislike has something good happen in their life, I get extremely upset, frustrated, angry, jealous, & resentful. It will eat away at me, sometimes for weeks. The thing is I’m happy with my life & wouldn’t actually want to trade places with these other people, but it’s like just the fact that they get to be happy when they are a “bad person” & don’t deserve it upsets me. By “bad person” I mean people who are manipulative, liars, cheaters, etc. I’ve always been a person who is big on justice. I don’t want to focus on these other people anymore. I don’t want to care. Any help would be greatly appreciated. Thank you, Bridget David's Comment I was pleased to receive this email, as jealousy IS a big problem, and one I have not focused on specifically in my books or podcasts. I exchanged several emails with Bridget who graciously gave me permission to feature her work in today’s podcast. When people share their vulnerabilities openly, it is a gift to the rest of us, since the teaching and learning potential is great. In addition, most of us feel close to people who open up and share the inner feelings and insecurities that most of us hide. This is an action that requires great courage, and often results in even greater rewards. Bridget is also interesting because some fans have criticized me for featuring mental health professionals when I’m doing personal work. I do that because I’m no longer in private practice, and do not carry liability insurance. When I do personal work with therapists, it is in the context of their training, and is not considered an ongoing therapeutic relationship. But today, I have decided to bring you some really challenging work with someone who is not a therapist, but a married woman who works as a product manager for a high-tech company. Of course, I have disguised her identity. The emotions she is asking for help with, jealousy and anger, are the toughest emotions to challenge, far harder than depression or anxiety. That’s because the thoughts that trigger depression and anxiety involve Self-Blame and self-criticism, so you tend to feel worthless or inferior. Crushing self-critical thoughts leads to relief and joy. But the thoughts that trigger jealousy and anger typically involve Other-Blame and other-criticism, which is far tougher to defeat, because blaming others can be associated with exciting feelings of moral superiority. (You will notice below that I am embedding the PDFs of Bridget's work in the show notes, as opposed to linking to them as I usually do. Let me know which format you prefer. Thanks! david) STEP 1: Record your negative thoughts and feelings at a specific moment Here was my response to Bridget: Thanks, Bridget! On the attached DML, fill out the event, circle and rate emotions, and record and rate belief in negative thoughts. Scan back to me, and then I'll have further instructions. d Hi Dr. Burns, Here is my DML. Thanks! Bridget's DML at the beginning of the intervention. Notice that the belief in the NTs are all high, and the negative feelings are intense. STEP 2: Positive Reframing Hi Bridget, You’re moving fast! Way to go! Great example! Now list answers to these two questions about every category of negative feeling. What does this negative feeling show about you and your core values that’s’ positive and awesome? What are some benefits, or advantages, of this negative feeling? You can also do this with a couple of your negative thoughts. david Hi Dr. Burns, Some of these were difficult to find positives, but I do truly believe everything I wrote. This is Bridget's Positive Reframing Table. The items in caps were suggested by David, and she endorse these as well. Hi “Bridget,” You did great work on Positive Reframing. I have added several more things in caps in the right-hand column. Delete or edit that are not valid or don’t ring true. Would love to see your edited version. Once you are done, use the % Goal column at top of emotions table to do the following. Imagine you had a Magic Button, and if you pressed it, all your negative thoughts and feelings would vanish, and you’d be euphoric with no effort. However, all these benefits and beautiful things about you would go down the drain at the same time. So, answer this question: Why in the world would you want to do that? Then, answer this question for each negative feeling: “Given that there are many genuine benefits of this feeling, would there be some level I could dial this feeling down to if I had a Magic Dial? For example, my unhappiness is at 100%. Would there be some ideal level of unhappiness that would be less painful, but would still allow me to have the benefits and positives associated with this feeling? Would 40% be enough, for example? Or maybe even 20%” If this makes sense, fill in the %Goal column for each negative feeling. Thanks! david STEP 3: Magic Dial Hi Dr. Burns, Thank you! I actually really liked & agreed with everything you added. Those all seem true to me, so I left them on there and did not change it. I put in percentages for my goals on the daily mood log. I think it's good to keep quite a bit of those feelings after seeing the benefits. Bridget's DML with Goal column filled it  STEP 4: Positive Thoughts Hi Bridget, Perfect, and you are moving fast. So cool! Now I want you to choose one thought to work on first. Identify the distortions in it with abbreviations in the Distortion column. Then see if you can generate a positive thought with the help of the attached booklet, which is for your eyes only. Please do not send to anyone!  It is written for therapists but will be great for you, too, hopefully! Please note the Necessary and Sufficient Conditions for an effective and helpful Positive Thought: It has to be 100% true. It has to reduce your belief in the Negative Thought. Reach out if you need help or if something isn’t clear. david Hi Dr. Burns, I was able to reduce the belief in the thought to 50%. Just because she lives in a nice house in a warm location doesn't mean that's guaranteed happiness. There's a lot of factors involved that could change at any moment. Bridget's DML with first Positive Thought. As you can see at the link, she believes the PT 100%, and this reduced her belief in the NT to 50%. Hi Bridget, Well done! If 50% is low enough, we can move on to another thought. Another distortion in the thought is Mind-Reading, since our assumptions about how other people feel are rarely valid. My research has shown that shrinks cannot even know how their patients feel, even at the end of a therapy session. So, we don’t actually know how she feels most of the time, or at any specific time. In addition, you are saying that it’s unfair that people with poor character can have lots of money and nice things, and this is a source of anger. That’s the “should” telling yourself this “should not” happen. It is so EASY and ENTICING to feel this way. And we certainly see lots and lots of ugly, repulsive, mean-spirited people with tons of money and stuff! It’s unfortunate. Albert Ellis used to point out that we may not like certain things, but it’s not true that they “should not” happen. For example, we don’t like the fact that our cats like to capture, play with, and kill little creatures. But it’s not true that they “should not” do that because it’s their nature. For myself, I’d rather hang out with people I like and respect and feel comfortable with, as opposed to these “hot shot” types. I’ve treated some very wealthy narcissistic individuals, one in particular, and it was incredibly unpleasant. I had no longing at all to live his lifestyle—in a mansion in Southern California filled with priceless antiques and stuff—but miserable relationships with other people he was trying to control since it seemed like his only thing—brag and try to manipulate people. I prefer people who are more on the humble side! Just some babbling. If 50 is good enough—since there IS truth in the thought, time to tackle another. You’re doing great! david Hi Dr. Burns, I worked my way through all my negative thoughts, & I ended up surpassing all of my goals for my negative emotions. Some of the thoughts were hard to challenge. I think the "shoulds" do get in the way a lot for me. And I also do a lot of fortune telling I noticed. I did some cognitive flooding and imagined her being hand fed grapes by the pool, her husband telling her how wonderful she is, her saying "I just love my life", and it all seemed so ridiculous then. There's no way that's how the majority of anybody's days are. I feel much better about it now. Let me know if you have any other thoughts. Bridget's completed DML Notice that she believed all of her PTs 100%, and there was a nice reduction in her belief in the NTs, along with a reduction in her negative feelings.  But was this enough? Had we gone far enough. Only Bridget can answer this question! Hi Bridget, This is fantastic, thanks! Can I use all this great work in an Ask David? We might record it Friday, tomorrow. Are you satisfied with where you’re at now? If you want to bring feelings down further, we can attack a couple of the thoughts that are still at 50%, but not necessary. The question will be how many of the negative feelings you want to retain, and it’s cool that you have surpassed your goals! Very cool, and might be helpful to others. let me know if you give permission to use this personal but terrific material in a podcast. Tons of jealousy in the world! David Hi Dr. Burns, Yes, you can definitely use everything we did here. I think it will help others. I think I’m ok with leaving the thoughts at 50% for those 2. Bridget STEP 5: Additional Methods Hi Bridget, While jogging, I realized that I forgot to comment on your creative use of flooding. I had thought of that also as another useful technique, and there you went and did it before I had the chance to suggest it! You are probably the first person in the world to use flooding for jealousy—usually it is for anxiety, as you likely know. I’ve attached a flooding flowsheet if you do more. The goal would be to see if you can work your jealousy up to higher and higher levels, and keep it as high as possible. I also thought of a ton of additional techniques we could use in challenging any of your negative thoughts, like the Individual and Interpersonal Downward Arrow, to get at the core beliefs underneath the jealousy, and lots more cool techniques. But we may not need any more techniques! Like scheduling time each day to make yourself as jealous as possible, say for one minute, or five minutes, or whatever. I was also curious about your prior experiences with this woman. I’m sure there’s a story behind your negative feelings David Hi Dr. Burns, I actually haven't ever met this woman personally. I guess I've seen her as the enemy ever since I started dating my husband. I saw all their old pictures on Facebook & messages between them, & I had this intense rage about it. My husband told me that she had not been faithful to him throughout their entire relationship, but he kept sticking it out with her. So anyways, I had this intense desire to find out more information constantly. I was looking her up online all the time, trying to find out more. It was an obsession at times. At first I thought I just needed to know what it was about her that he liked so much that he was willing to be with her all those years despite everything she had done. Eventually I realized I was doing it to prove to myself that she was not better than me, that her life was not better. But then it's like I was finding out the opposite. I found out about her marrying into that rich family, saw pictures of her and her husband traveling the world together, then buying this big beautiful home. I was filled with jealousy and rage. I thought here she strung my husband along for years and stole his prime years from me, and now she's living it up! Never paying the price. So yeah I suppose that's the long back story behind it. Wow thanks, Bridget, I really appreciate your candor! It all makes sense now. I’m so sorry she has been haunting you and making your life unhappy at times. She sounds, to me, like a pretty unhappy person, bitter and tortured and maybe trying to impress people with her “things.”. Not my kind of folk at any rate! When I was in grammar school, someone asked me if I was going to any Halloween parties, and I said I hadn’t been invited to any. I told my mother, if memory is correct, and she said why don’t I have a Halloween party? So, the next day at school I said if anyone hadn’t been invited to a Halloween party, they can come to my Halloween party. I had an older sister who helped prepare it to be this really neat party, but I didn’t know if anyone would come as I didn’t feel like I was one of the “popular” people. I might have been more of an intellectual nerd or something like that, and I wasn’t very attractive. But I was really happy when practically the whole class came, and we had the best party ever. Ever since then, I think I’ve kind of preferred the “unpopular” people, and to this day it is the same. I have tons of friends I totally love in low places. Anger and jealousy are, to my way of thinking, by far the hardest emotions to get rid of. It can be done, as you’ve shown, but it ain’t always easy. And what you’re doing totally rocks! Kudos! It was hard for me to shake it in the early days of my career. Now, these emotions never bother me, although I am joyfully angry from time to time! And thanks, too, for such rapid responses! I love the humorous imaging you created of her sitting around the pool being fed grapes, exotic wines, and rare chocolates by her dutiful slave husband, and perhaps a couple servants as well! Happy Thanksgiving, and thank you for giving of yourself!! David Hi Dr. Burns, That is a great story. I hope I can one day rid myself of those emotions like you were able to. I really appreciate you taking the time to work with me & spend so much time on this issue. I am just so grateful! I look forward to the podcast. Happy Thanksgiving! Hi Dr. Burns, Thank you! I actually got the idea by using that cheat sheet for the recovery circle from your new book Feeling Great, which by the way I love. It's like the Bible of cognitive therapy. I have so many spots bookmarked and go back to it all the time. I did the Downward Arrow technique, & it helped reduce my beliefs in the thoughts even more. I don't think that I made the wrong choices in life just because I have to work hard to get by. If I had made other choices, then I might never have met my husband or adopted my cats or maybe I would've never even discovered your books and connected with you which changed my life. I was able to reduce my belief in the thought "It’s not fair I have to work so hard just to get by" to 20%. For my other thought "She gets to live this happy life after how she’s manipulated and treated people poorly for years" I also did the Downward Arrow. That made a big difference as well. Just because she is happy doesn't mean that me doing the right thing has been for nothing. I'm glad I can confidently say I believe I'm a good-hearted, caring person. Her happiness will never change that about me. That thought is also now reduced to 20%. I'm feeling pretty dang good right now! I think I will take your advice and continue to do the cognitive flooding a little each day until the thought has no merit anymore. Link to her downward arrow work Hi Bridget, Thanks for all the positive feedback and hard work. I have more ideas, a lot more actually, if you want to push things further at some point, but doesn’t hurt to take a breather when you have climbed to the top of a mountain! Warmly, david Hi Dr. Burns, I’m always open to more ideas to try. Wouldn’t hurt. Maybe I could even get my belief in the thoughts to 0 eventually. * * * I offered to send Bridget a copy of my video, “Overcoming Toxic Shame,” since she was feeling some shame about carrying this burden alone. * * * Hi Dr. Burns, Yes, you are the only person I’ve ever told this to. I definitely fear being judged & rejected in this situation. I feel like I shouldn’t care so much what everyone else is doing in their lives & just focus on my own life. I feel ashamed & embarrassed of my online stalking too. The thing is that when I “play detective” & find out new information about her online I get this sort of high off it. It can be exciting, but then it always just ends up leading to me feeling bad about myself. So, as you can see there are advantages & disadvantages to doing it. I have done online stalking with other people too & told my husband about it when I would find out something upsetting or just interesting information. Sometimes he would make a face & say why would you be looking them up. And then I’d feel ashamed. I just feel like he does not approve of that behavior, & I can’t blame him. If the roles were reversed, it might make me a little suspicious of his intentions. Maybe even a little concerned. I do have a DVD player & would be very interested in seeing that video you mentioned. STEP 6: A New Idea: Is this actually a habit / addiction? Hi “Bridget,” Your video is ready for shipping, and the next mail package pick up at our house will be tomorrow or Wednesday. It will come express mail, so you should get it later this week. I had one other thought. If your habit of checking up on people gives you a high, but also leads to negative feelings, one could view this problem in the context of habits and addictions. You would have to think about that and see if it is valid or not. I don’t know for sure. But if it is, then abstinence might be helpful, too, since continually re-engaging with your checking up on people might keep fueling your feelings of jealousy. So, giving up this habit might be a price you’d have to pay to escape completely from this problem. Again, just speculation. At any rate, two chapters on habits were not included in my new book due to length, but they are available for free on the home page of my website. It offers one unpublished chapter, but there are actually two. If you are interested in this approach, download the chapters and see what you think, and maybe do some of the written exercises like the Triple Paradox, for example, and let me know what you think, too! Sincerely, David Hello Dr. Burns, I read the extra chapters, and they are great. It's too bad they couldn't have been included in the book because I bet they would help so many people. I did all of the exercises & found them very helpful. I especially loved using the decision-making tool for this. I would never think to compare disadvantages of 2 situations like that. I was actually surprised at how much of a "slam dunk" the option of "stop checking up on people entirely" was. I didn't expect that. I want to change because I'm tired of comparing myself & my life to other people. I also don't want to sit around waiting for justice then getting upset when the opposite happens. I spend too much of my free time thinking about these people I don't even like. I'm letting them win by caring. I also don't want to feel like I'm keeping secrets from my husband. The less I know, the better. All signs point to stopping the behavior. I just hope I can do it! Attached are the exercises I did. Would love your thoughts/feedback. Bridget You can link to Bridget's Triple Paradox and work with the Devil's Advocate tool. If you're interested, you can also review her work with the powerful Decision-Making Tool that I created 40 years ago. For more information, you can download the two free unpublished chapters on Habits and Addictions that I omitted from my new book, Feeling Great, due to length. You will find those chapters for free on the homepage of my website, www.feelinggood.com. Hi Bridget, Forgot to write back, I thought all your work was awesome! Incredible. Thanks, and kudos!! Hope you got or soon get the Melanie video. Apology for slowness. We adopted an incredibly 6-year old cat at the Humane Society, but ran into some temporary complications and now all is well. Plan to integrate her with our 3-year old feral cat, Miss Misty, at the end of a week keeping them separated. The new lady is a purring machine! Her owner died, and then she was adopted and returned, so she is terrified that she’s not “good enough” and fearful that we’ll send her back. We are totally in love with her, but had to take her back for a check-up for ring worm as the Humane Society called and said she had an accidental interaction with a ring worm cat. But they didn’t find anything. It was super-traumatic, since we had to put her back in the carrying cage, and she was desperate, thinking we were returning her. It was heart breaking, once of the worst experiences of my life! But now she’s back with us and looking forward to meeting her new “sister,” Miss Misty. Fortunately, she gets along really well with other cats. But we don’t know about Miss Misty! David Hi Dr. Burns, Aww poor kitty! That is so awesome you decided to take in another cat. I love how passionate you are about them. I loved your story of Obie in your book and how you dedicated it to him. I could really identify with it. We took in a feral kitten this past fall, and it went from him running away from us if we were within 10 feet of him outside to him being a permanent inside cat. Just last night he hopped on the couch next to me and laid on me purring while I put my arms around him like a teddy bear. It was so special! I haven't gotten the Melanie video yet, but I will definitely let you know once I receive it and watch it! -Bridget Hi Bridget, Thanks! Congrats on your kitten! Heaven! d Commentary Here are my random comments / observations. Bridget got a really rapid and fairly dramatic response. This was due, in large part, to the fact that she did all of her homework, and she did everything right away. When I worked with individuals when I was I private practice, doing homework was required, not optional. Many people want to just come and talk to their shrink once a week, but, at least in my experience, this has never once been effective. Bridget was motivated. She asked for help, and worked hard to get that help. Motivation is the key to overcoming depression, anxiety, relationship problems, and habits and addictions. Most religions have the concept of “ask and ye shall receive.” Without the asking, there will be little or no “receiving!” Bridget conquered two of the most challenging of all emotions on her own. I did provide some guidance via email comments, but she did the heavy listing. Over time, new insights develop. Therapy and self-help are fluid in this regard. The idea that this problem could be viewed as a habit or addiction suddenly popped into my mind and clicked, and provided another powerful tool for defeating this problem. Rigid formulaic treatment is less effective, but many therapists and many people in general are looking for “formulas” and secrets of overcoming this or that problem. Methods and tools are great, but formulas leave a lot to be desired. I don’t think that Bridget’s response was any slower than when I do live personal work sessions with therapists. It took longer, since we had to exchange a series of emails. But the total contact time was still in the range of an extended (two hour) therapy session. This demonstration may not satisfy the doubters, but it might at least help a little. The effective ingredient is TEAM, applied systematically with warmth and compassion. I am incredibly indebted to Bridget, and hope you also appreciate her brave contribution! It is not easy to bare your soul to the world, but the world deeply appreciates this type of openness, because most of us suffer in secret, adding loneliness to the equation. When you open up, your worst part sometimes gets magically transformed into your best part. It is a little like emotional alchemy, turning your emotional mud into gold! I hope you enjoyed today's podcast, and a got a feel for how a TEAM therapist might treat someone struggling with intense jealousy and anger. These are topics not often discussed in the psychotherapy world, so hopefully this podcast will be a useful contribution to a challenging topic! Rhonda, Bridget, and David

Podcast 222 Ask David December 28, 2020 Ask David featuring five challenging questions. Jay asks: How do you treat individuals with personality disorders using TEAM-CBT? Jeff asks: Can you talk more about the “great death” of the therapist’s “helping” or “rescuing” self? This was really helpful to me! Darkmana asks: Hey David, are there any books about Buddhism you would recommend? I can see you’re a fan of it from Feeling Great! Angela asks: What’s a perfect score on your empathy test? Margaret asks: What can you say to a patient who doesn’t want to push the Magic Button? * * * Jay asks: How do you treat individuals with personality disorders using TEAM-CBT? Dr. Burns Have you considered doing a podcast on using TEAM-CBT or CBT for Borderline, Narcissistic and Histrionic Personality Disorders? The interesting thing is those with personality Disorders seem to blame everyone and everything for their problems but themselves Also, what if anything could individuals do to not get attracted or quickly eject when they encounter these folks. One theory is that folks with abusive or neglectful parents are vulnerable. Because the chaos and drama is familiar. I think many therapists avoid folks with pd no? Particularly patients with Borderline PD. It's interesting in that kids have years of relating to parents with personality disorders. So how would TEAM-CBT help? Just curious what your experience and Rhonda too Jay Rhonda and David talk about how TEAM-CBT developed out of David's treatment of large numbers of individuals with Borderline Personality Disorder, and what some of the treatment strategies are. * * * Jeff asks: Can you talk more about the “great death” of the therapist’s “helping” or “rescuing” self? This was really helpful to me! Hi Dr. Burns, I loved what you've taught on the death of the selves - and recently read the Four Great Deaths of the Therapists Ego in your new book, Feeling Great. One part that I found so helpful was the death of "The Helping, Rescuing Self." I think I've believed that's my purpose. That's why I'm there. I'm there to "help" the client feel better and live a full, rich, meaningful life. That's something I've struggled with - because if I'm not there to help, what am I there for? And if I don't FEEL like I've helped, then I've failed the client. I'd love to hear this concept expanded on. I think many therapists, coaches, etc. would benefit from seeing how they can work with clients without thinking they have to help or rescue them. Thank you, Dr. Burns. P.S. Your new book is a goldmine. Enjoying it immensely. * * * Darkmana asks: Hey David, are there any books about Buddhism you would recommend? I can see you’re a fan of it from Feeling Great? Hi Darkmana, Thank you for your question. I'm sure there are many great books out there, but I have never studied Buddhism or read anything about it. I just sort of make things up! David will tell his Buddhism story when eating in a noodle house with his son Erik. Rhonda has invited the Dalai Lama to appear on a Feeling Good Podcast. It seems like a long shot, but it would be delightful to have the chance to chat with him, as there is so much overlap between Buddhism and TEAM-CBT! I would guess that he likely has a good sense of humor, since humor and laughter can be such great ways of grasping certain ideas and achieving enlightenment. I have heard that the Buddha talked about the “Great Death” of the self. In Feeling Great, I talk about four “great deaths” that correspond to recovery from depression, anxiety, relationship problems, and habits and addictions. I’d love to hear the Dalai Lama’s thoughts about this. There may be large numbers of “Great Deaths,” I suspect. To me, “reincarnation” is something that happens when we are alive, and not something that happens after our bodies die! However, I think most Buddhists might fiercely oppose my thinking in this regard. I think that “literalism” is one of the problems with most organized religions. Stories that are intended to convey wisdom and insight are taken as literally true. * * * Angela asks: What’s a perfect score on your empathy test? Hello David, In the weekly practice group that I host, the question came up today “what does Dr. Burns mean by no less than 20?  Is it the first section titled “Therapeutic Empathy” which is 20 points total, or the entire survey which is 20 questions? Warmest blessings, Angela Poch, RPC-C Hi Angela, Thanks, yes that is correct. 20 on the empathy scale is the lowest passing grade. A score of 19 and below indicate some significant failure in the therapeutic relationship / empathy. Since we are hoping for failure, I try to make failure as easy as possible! That’s part of my “anti-perfectionism” philosophy. I encourage the four “great deaths” of the therapist’s ego, and this is the first of the four deaths. * * * Margaret asks: What can you say to a patient who doesn’t want to push the Magic Button? Hi Dr. Burns, I attended your intensive in Atlanta and am working on my level 3 certification. TEAM CBT has transformed my life personally and transformed my practice professionally. I will be forever grateful to your hard work and dedication in developing this approach. My burning question is about the magic button / magic dial. After the positive reframe, when we ask, " With all these awesome things your negative emotions show about you and all the benefits you get from them, why would you want to press this button?"  Ninety five percent of the time my clients argue for change and that is great. My problem is when they say, "I guess I wouldn't want to press that button."  I feel like I am cheating them by not offering the magic dial. It seems like all or nothing thinking. If you press the magic button, "all" of these positive things will go away. They never get the chance to even learn about the magic dial and then may never get the chance to learn about cognitive distortions and all of the other cool methods you and others have created. My clients always benefit from the positive reframing. How much do they have to argue for change? How critical is this? Maybe I am thinking about this all wrong. I can really use some guidance. Thank You so Much, Margaret McCall I just realized my pun with "Burn"ing question- that was not intentional, lol Hi Margaret, Great question! Will add it to an Ask David. Quick answer: you can agree that it is not a good idea to press the Magic Button,  and ask them what their NTs and feelings show about them that is positive and awesome, and also ask them why they might NOT want to push the Magic Button, and then once again paradox them. All you have to do is say “Good thinking. Let’s list all the really GOOD reasons NOT to press that button.” Then you go right into Positive Reframing, followed by the Magic Dial. Also, if they do not want help, which is often the case with relationship problems as well as habits and addictions, you can just ask if them if there is anything they DO want help with! It is not my job to persuade the patient to work on something. It is the patient’s job to persuade me to help him or her! Rhonda and David

Podcast 221 Ask David December 21, 2020 Today’s Ask David features five challenging questions submitted by listeners like you! Sumaya asks: I recently bought Feeling Great and can’t find the chapters on Habits and Addictions in the book. Could you please clarify? Jay asks: Can you provide more specific information on the contrasts between Feeling Good, The Feeling Good Handbook, and Feeling Great? Rizwan asks: How would you use the Five Secrets to respond to a truly irate patient? Casey asks: How do you treat resistant autism patients with All-or-Nothing Thinking? Debby asks: What’s your definition of a violent person? Today’s podcast begins with season greetings for people of all (or no) religious faiths. Rhonda reads a moving email submitted by a listener who was helped by the recent two-part Sunny series on the Approval Addiction. David gives a plug for his upcoming workshop with Dr. Jill Levitt on “Defeating the Beliefs that Defeat You and Your Patients” on February 28. 2021 (include link.) We also give a shout for Sunny’s recently opened private practice, which offers super rapid treatment and a user-friendly fee schedule. Sunny can be reached at: Sunny Choi, LCSW sunny@bettermoodtherapy.com Better Mood Therapy rhonda's exciting new Feeling Great Treatment Center is now open for business as well. She can be reached at rhonda@feelinggreattherapycenter.com. And now—your cool questions! * * * Sumaya asks: I recently bought Feeling Great and can’t find the chapters on Habits and Addictions in the book. Could you please clarify? David explains that the two “lost” chapters on habits and addictions are available for free on the homepage of www.feelinggood.com. I had to cut about ten chapters from Feeling Great due to length, but put them on the homepage since the techniques for treating habits and addictions are new, innovative and powerful, and may help some folks. * * * Jay asks: Can you provide more specific information on the contrasts between Feeling Good, The Feeling Good Handbook, and Feeling Great? Dr Burns Is it possible for you and Rhonda to do a podcast about Feeling Great book and Feeling Good and Feeling Good Handbook? I sat down to hear the similarities and differences and target audiences etc. Very in depth etc but podcast 213 seemed to me to get derailed into the four ego deaths of the therapist and the four ego deaths of the patient. I am not minimizing the value of discussing Ego deaths. But it seems like you never really addressed the similarities and differences in the three books. One thing I have not heard you discuss is that powerful section in Feeling Good on preventing setbacks. Love addiction etc. Addressing the core beliefs that trigger recurrent depression in some people. Also the expectations of doing a two-hour session vs doing the daily mood log for 15-20 minutes per day over a few months ( in the Self Esteem section of Feeling Good.) I thank you Sincerely Jay Thanks, I DO meander! Both a curse and a blessing, as my mind works like that, with new ideas popping in all the time. First, here are the differences between the three books: Feeling Good is a beautiful presentation of the basics of cognitive therapy, including how to crush distorted thoughts and modify self-defeating beliefs like the Achievement, Love, and Approval Addictions, as well as Perfectionism and Perceived Perfectionism. The books focuses on depression, including suicidal urges. This book was published in 1980 and has sold more than 4 million copies worldwide. It has received a number of awards and has been named the top depression self-help book, from a list of 1,000 books, by American and Canadian mental health professionals. The Feeing Good Handbook has more exercises and a broader range of topics, including depression, anxiety, and relationship problems, as well as a special section for therapists on how to help challenging, difficult patients. This book was published in 1988 and has sold roughly two million copies. Feeling Great was published in September of 2020. It updates all the tools and techniques in the prior two books, but also includes powerful new techniques to overcome therapeutic resistance. It also includes a section on more spiritual (but still practical) techniques, including the four “Great Deaths” of the self. Feeling Great has a special section on how to crush each of the ten cognitive distortions, plus many real case examples with links to the actual therapy that you can hear online in my Feeling Good Podcasts. This is important because some readers may not believe that people with chronic and severe depression and anxiety can recover more or less completely in a single, two-hour therapy session. Toward the end there of Feeling Great there is a special chapter by the famed neuroscientist, Professor Mark Noble from the University of Rochester, on how TEAM quickly modifies specific circuits in the brain to achieve ultra-rapid recovery. The stance of the therapist has changed significantly in Feeling Great, as compared with the earlier books. Instead of trying to “help,” the therapist becomes the voice of the patient’s subconscious resistance, and makes the patients aware that their symptoms of depression and anxiety are not the result of what’s wrong with them, like a “chemical imbalance in the brain,” or a “mental disorder” described in the DSM, but rather what’s right with them. And the moment the patient suddenly “sees” this, recovery ill be just a stone’s throw away. Feeling Great was based on 40 years of research on how psychotherapy actually works and more than 40,000 hours of therapy with depressed and anxious individuals, including many with severe and chronic problems. TEAM is not a new school of therapy, but a structure for how all therapy works. * * * Rizwan asks: How would you use the Five Secrets to respond to a truly irate patient? Dear David I suggest one imaginary statement from an irate patient: “Your therapy is not working. In last one year I paid you $1500. And I am nowhere near completing the therapy successfully with you. I am broke. I can’t pay you anymore. I need to quit. How you could you do such a thing to me?” How would a therapist reply to this using 5 secrets? Rizwan David and Rhonda emphasize the importance of session by session testing so this unfortunate situation does not develop, and role play how to respond effectively using the Five Secrets. The importance of the Disarming Technique is highlighted, and training methods are illustrated, along with the philosophy of "learning through failure" or "joyous failure." * * * Casey asks: How do you treat resistant autism patients with All-or-Nothing Thinking? I am a behavior support specialist working with people with Autism, all across the spectrum of the diagnosis, as well as with people with intellectual disabilities, cerebral palsy and down syndrome. Not to be confused with an ABA therapist, I am more of a traditional therapist who uses eclectic strategies and methods to help the people I support. I also work mainly with adults because, sadly, the system often forgets them and they do not have as many services as children. Because I work on helping people change their behavior, it is a logical conclusion that I have to help them work to change their thoughts first. Thankfully my graduate school program was very CBT focused (Go IU School of Social Work!). Since then I have found your podcasts and books immeasurably helpful in enhancing my practice and use the methods you teach whenever possible. When working with people with Autism I often run into All or Nothing thinking, catastrophizing, and unfortunately a lot of treatment resistance because most of the people I support are “Involuntary” clients who have been sent to therapy by their family members. I have two questions: First, what is the most powerful method for defeating All-or-Nothing Thinking? Second: I know you talk a lot about agenda setting to combat treatment resistance. How do you balance the wishes of the parents (or guardians) vs. the willingness on the part of the patient to change? I struggle with this daily and could use some advice. Thank you and Rhonda so much for the amazing podcast, the books, and the wealth of information about TEAM-CBT. I have also attended several of your trainings and plan to attend more this year because our annual conference was cancelled, so I’m left to get 10 CEUs on my own and your trainings have been very helpful in fulfilling this need! Also, Rhonda: You are amazing and I hope you know it! Casey P.S. I also promoted you a lot on my Instagram channel @passionplanhappiness when I did a series on unhelpful thinking styles. I couldn’t find an Instagram page for the podcast so I just mentioned it by name. Do you have an Instagram channel? Hi Casey, Thanks, I can include this in an Ask David, and you might also want to try out one of the introductory 12 week TEAM classes sponsored by FGI, feelinggoodinstitute.com, as a lot of practice is usually needed to grasp and implement techniques and ideas that might seem simple. I do not ever treat people against their will, who are involuntary. This is not treatment in my opinion, and is rarely or never effective. However, I would offer to treat the parents if they wanted help with parenting skills for the child. Also, you might want to check out the podcast on the best techniques to treat AON! Use search function on my website. All the best, david David D. Burns, M.D. David and Rhonda talk about techniques to combat All-or-Nothing Thinking as well as how to set the agenda and sit with open hands with patients who are in therapy involuntarily. * * * Debby asks: What’s your definition of a violent person? Hi Doctor Burns, I have a question on what you consider a” violent person” to be. For example, If someone feels like punching someone out, doesn’t does that make them a violent person just for feeling it? I would say no because they never acted on it. Debby Hi Debby, You may be trying to define something that does not exist. Violent urges exist in varying degrees at varying times in all human beings. Violent thoughts, feelings, urges and actions exist. But a “violent person” does not exist. My thinking only, and many will undoubtedly “violently” disagree, and not even comprehend, perhaps, what I am saying. Humans have a dark side, and the extent is on a bell-shaped curve. The denial of the dark side is arguably worse than the dark side, since violence is generally carried out in the guise of some religious principle, or some kind of “truth.” david Hope you enjoyed today's podcast! Rhonda and David

Does money buy happiness and love? Listen to this interview with David Meltzer, Co-founder of Sports 1 Marketing and formerly CEO of the renowned Leigh Steinberg Sports & Entertainment agency - the inspiration for the movie, Jerry Maguire. David’s goal is to empower over 1 billion people to find happiness consciously and subconsciously. In today’s episode of Leadership Live, David Meltzer speaks about the definition of happiness, happiness myths and his own story of the pursuit of wealth and happiness until he came to a new understanding. Tune in to this episode to learn how to connect to your own sense of self-worth through exploring different sides of joy. Happiness is a virus and it strengthens us mentally and physically. Do you have it?   Timestamps: 0:50 David Meltzer - intro 4:15 The definition of happiness - it’s a virus that strengthens us mentally and physically 5:01 How can you tell if someone is happy? 7:17 Ego-based consciousness  8:19 Childhood lessons in happiness  10:17 Does money buy happiness? 13:37 The wake-up call that changed everything 14:55 Describe happiness in three words -  15:30 Inspiring over a billion people 16:57 The most common happiness myth  18:37 The worst and the best things David has bought 22:15 Finding happiness in a time of crisis 26:06 Morning person or night person? 26:20 Biggest vice? 26:35 Favorite book? 27:03 Be kind to your future self and do good deeds.   Resources:  PODCAST WEBPAGE: www.daphnahorowitz.com/podcastlive Connect with David: Website: https://dmeltzer.com/ Instagram: https://www.instagram.com/davidmeltzer/  Facebook: https://www.facebook.com/davidmeltzer11/   Ask David a Question- Text him: (949) 298-2905 LinkedIn: https://www.linkedin.com/in/davidmeltzer2/ Subscribe to David’s Youtube Channel: https://www.youtube.com/channel/UCflt1OopRWIApMOjVgZyJ6Q  BOOK a coaching session with Daphna Horowitz HERE: https://daphnahorowitz.com/services/#leadership-coaching  https://daphnahorowitz.com/resources/#giveaways  Purchase the book on AMAZON:  https://www.amazon.com/Weekly-Habits-Extraordinary-Leaders-Horowitz/dp/B08JDTRK9H/ref=sr_1_1?crid=24SK3E4DFMJMQ&dchild=1&keywords=daphna+horowitz&qid=1605772332&sprefix=daphna+ho%2Cstripbooks-intl-ship%2C379&sr=8-1    Connect with Daphna:   Official website: www.daphnahorowitz.com  LinkedIn:  https://www.linkedin.com/in/daphnahorowitz/ Youtube: https://www.youtube.com/user/daphna1231 Facebook: https://www.facebook.com/PEACSolutions/

Today's Ask David features four terrific questions. Kevin asks: Why is the concept of worthwhileness and worthlessness so important to people and their emotional health? Vallejo asks: Does the statement, "WHY AM I ALWAYS THE LAST ONE TO FIND OUT ABOUT ANYTHING?” correspond to overgeneralization, or self-blame? I’ve been listening to the early podcasts on the ten positive and negative cognitive distortions. David P asks: Do you think there is anything to be gained from a daily gratitude log, to go along with the daily mood log? Harvey asks: I don’t see how Positive Reframing actually contributes to the therapy. Kevin asks: Why are the concepts of worthwhileness and worthlessness so important to people and their emotional health? Hi David, I have a quick question about the concept of being a worthwhile human being. Suppose a person believes they are unconditionally worthwhile, what are the implications of this? Why are the concepts of worthwhileness and worthlessness so important to people and their emotional health? Best Regards, Kevin Hi Kevin, Thanks! That’s a very important question. However, it is abstract and philosophical. I have found that philosophical discussions tend to go on endlessly with resolve. In contrast, when someone asks for help with a specific moment when she or he was upset, then I can usually show that person how to change the way she or he is feeling. And when that happens, the person generally suddenly “sees” the solution to some very profound philosophical or spiritual questions. All that being said, I’ll take a crack at it. The goal of TEAM therapy is not to go from thinking that you’re a worthless human being to thinking that you’re a worthwhile human being, but to give up these concepts as nonsensical. Specific activities, talents or thoughts can be more or less worthwhile, but a human being cannot be more or less worthwhile. We can judge specific events, actions, and so forth, but not humans. At least I am not aware of how to validly judge a human being, or a group of humans. We can only judge their actions, attitudes, thoughts, and so forth. Unconditional self-esteem is definitely better than conditional self-esteem, since you don’t have to be perfect or a great achiever or a great anything to be “worthwhile,” but you are still focused on being "worthwhile." I'm not sure what that means, but there is a downside, to my way of thinking. If you think you are worthwhile because you are a human being, does that mean that you are more worthwhile than animals? Lots of people abuse animals, hunt animals, and so forth, which many people find immensely disturbing. These are some of the consequences of thinking that animals are less worthwhile, for example. Not sure that helps, but like your line of questioning! David Kevin follows up: What is the implication then of giving up these concepts at all? I assume that thinking that you have unconditional worthwhileness because you are alive or to drop these concepts entirely have the same emotional implications for people. What are these implications? For example, if I think that worthwhileness and worthlessness are meaningless concepts, so what? What’s the point? What do I gain? Hi Kevin, Let me start by saying, once again, that I am not an evangelist spreading the “gospel,” so to speak. My goal is simply to help people who are struggling with feelings of depression, anxiety, and self-doubt. So, if your way of thinking about things is working for you, there’s no reason to change. But my focus is always on someone who is suffering, and that’s where these concepts can sometimes be important. I can tell you what I gained by giving up the idea that I could be, or needed to be “worthwhile” or “special.” I gained a great deal of joy. It was a lot like escaping from a mental prison. It freed me to find incredible joy in the “ordinary” events of my daily life. It also freed me from fears of “failure” or not being “good enough.” Depression always results from Overgeneralization--you generalize from failing at something specific to thinking you are a failure as a human being. Without Overgeneralization, I think it is safe to say that it is impossible to be depressed. For example, if you measure your worthwhileness based on your achievements and success, you may feel excited when you succeed and devastated or anxious when you fail, or when you are in danger of failing. I'm not sure if this addresses your excellent question! A young woman told herself that she was "unloveable" when she and her boyfriend broke up after two years of going together. Can you see that she thinks she has a "self" that can be "loveable" or "unloveable?" This thought was very disturbing to her, as you might imagine. Relationships do not break up because someone is "unloveable," but because of specific factors or events that drive people apart. Once you zero in on why the relationship failed, or more correctly, why the two of you broke up, then you can pinpoint the causes and learn and grow so you can make your next relationship even better. There are tons of specific reasons why people break up! But if you think that you’re “unloveable,” or tell yourself that the relationship was “a failure,” then you may get stuck in a morass of negative feelings. But it’s not even true that the relationship was a failure.” That’s All-or-Nothing Thinking, since all relationships are a mixture of more or less successful aspects. You could even tell yourself that a “failed” relationship was a partial success, since you successfully learned that this isn’t the person you’re going to spend the rest of your life with. What’s in it for you to give up Overgeneralization and All-or-Nothing Thinking, as well as the concepts of being a “worthwhile” or “worthless” human being? That’s a decision each person can make. There are benefits as well as problems with these ways of thinking. For example, let’s say you’re depressed and think of yourself as “defective.” This is a common negative thought, and it is based on the idea that a human being could be more or less worthwhile, or thinking that your "self" can be judged or rated. So, you could do two Cost-Benefit Analyses. First, you could list the advantages and disadvantages of thinking of yourself as a “defective” human being. Then balance the advantages against the disadvantages on a 100-point scale, assigning the larger number to the list that seems more important or desirable. Second, you could list the advantages and disadvantages of thinking of yourself as a human being with defects, and once again balance the list of advantages against the disadvantages on a 100-point scale. This is just a subtle change in semantics, but the emotional implications can sometimes be pretty powerful. As I mentioned at the top, philosophical debates are just debates. Fun, perhaps, but not terribly useful. I’m more interested in magic, or miracles. That’s what happens at the moment of profound change, which can ONLY happen by focusing on one specific moment when you felt upset and needed help. When you do that, everything becomes radically different, and real change can occur. And at that magic moment of change, the solutions to all of the problems of philosophy will often suddenly become crystal clear. Or, to put it differently, the philosophical debates will suddenly become, without meaning to sound harsh, almost a waste of previous time. Our current semi-feral cat loves my wife, but is only starting to trust me, so I’ve been working at gaining her trust and learning to understand her non-verbal and somewhat complex efforts to communicate. Yesterday she roller over on her back and stretch out her front and back paws to expose her tummy to the max, and she let me pet her tummy for quite a long time, purring loudly the whole time. I don’t care if she’s “worthwhile,” or if I’m “worthwhile,” and have no idea what those terms could even mean. But petting her tummy—now, that’s something that’s REALLY worthwhile! david Hi David, You and Albert Ellis are my heroes. Without your books, I always wonder what path I would have taken in life! Thank you. I had a quick question about self-acceptance. One of the reasons I feel that I’m fully unable to embrace it (and I think this is common) is that I’m afraid that I will lose out on motivation to work hard towards my goals. I think this partially true because my conditional self-esteem has caused me to work hard on a lot of things including CBT! Do you have any good ways to combat this exact notion, that if I accept myself I will simply become complacent and therefore I can’t? Looking forward to Feeling Great! Best Regards, Kevin Hi Kevin, There’s a lot of truth in what you say. Early in my career I also had a tendency to base my self-esteem on my achievements and productivity, both in my research and in my clinical work as well. I did accomplish quite a lot, but things were a bit of a roller coaster. When I thought I was doing well, I felt terrific, but when I thought my research was failing, or when I was stuck with a patient, I got quite anxious and frustrated. These feelings didn’t always foster positive outcomes. Now I no longer feel that my “worthwhileness” as a human being depends on my successes. In fact, I don’t even have the concept anymore. Now, I think my writing skills are very good, especially my skills in explaining complex ideas in fairly simple terms. But I do not think this makes me “more worthwhile.” Sometimes my writing, or my interactions with people, or my jogging, and many other things I do aren’t very good. But I don’t think these problems and flaws make me any less “worthwhile.” Take our little adopted feral cat, Miss Misty, that I mentioned in my last email. Misty does not care how “worthwhile” I am. However, she’s totally delighted if I pet her, let her out in the back yard to explore, or give her a piece of cat candy, or if I play with her. She is enlightened because she judges what I “do,” not what I “am.” Will you become less productive or unmotivated when you give up these concepts of “worthwhileness?” That has not been my experience. I am the busiest and most productive now than at any previous time of my life. I’m now 78, and life is a ball. I have tons of fabulous colleagues to collaborate with and we’re working on all kinds of super-exciting and challenging projects. When we don’t have “selves” that we need to protect, or feelings of “worthwhileness” that we need to defend, we can listen to criticisms and collaborate without feeling threatened, and use the information to improve what we’re doing! Hope that makes sense! david * * * Vallejo asks: Does the statement, "WHY AM I ALWAYS THE LAST ONE TO FIND OUT ABOUT ANYTHING?” correspond to overgeneralization, or personalization cognitive distortion? I’ve been listening to the early podcasts on the ten positive and negative cognitive distortions. Hi Vallejo, Rhetorical questions are technically not considered Negative Thoughts because they contain no distortions. However, this question is actually a Hidden Should Statement, and a great example of Other Blame as well. You need to change rhetorical questions into statements, like: “It’s unfair that I’m always the last one to find out about anything. This shouldn’t happen all the time!” And, as you point out, it is also a gigantic Overgeneralization. Thanks, Vallejo! On the podcast, David will talk about some of the rules for generating Negative Thoughts. * * * David P asks: Do you think there is anything to be gained from a daily gratitude log, to go along with the daily mood log? Dr. Burns, I'm a big fan of your work, and have now finished "Feeling Great" and loved it. I know you approach depression from a clinical background, but do you think there is anything to be gained from a daily gratitude log, to go along with the daily mood log? It seems like my negative thoughts are automatic, and I have to work to counter them. Maybe, if I have to force myself to think of a few things I really am grateful in my life, instead of only focusing on countering the negative automatic thoughts, it would be beneficial? Also, is there a role for altruistic volunteering in alleviating depression? Thank you. david p Hi David P, Anything that works for you is strongly recommended. I do a lot volunteer teaching, and also treat therapists and students for free, and i enjoy that a great deal! So go for it and let me know if it is effective! I often feel grateful for a lot of things, and people, and animals, like our cat, who "almost" loves me! As for me, I never use non-specific, formulaic approaches that one practices over time, hoping some good will come from it. So I never prescribe meditation, a daily gratitude log, prayer, aerobic exercise, dietary considerations, vitamins, and so forth. You can do these things if you like, but they are not “therapy” to my way of thinking. I only use specific techniques to crush a patient’s unique negative thoughts of dysfunctional ways of communicating with others during conflicts. Therapy is a lot like learning to play the piano, or going to a tennis coach to improve your game. Specific practice is needed, not prayer, gratitude journals, or the like. And my focus is on high speed, total and lasting change right now, if possible. david * * * Harvey asks: I don’t see how Positive Reframing actually contributes to the therapy. Hi Dr Burns: Thank you for this great podcast. I was particularly impressed by and related to the idea of “Beating Up On Yourself.” I think it is so easy to fall into that trap. My question is that I don’t see how the positive reframing aspect of TEAM actually contributes to the therapy. Once you did the reframing with Neil, you didn’t seem to go back to it. So why is that a necessity thing to do? I understand that the positive side of negative thoughts could cause resistance to give up the negative thoughts, but that didn’t seem to be dealt with. Thank you so much for these podcasts and I have just started to read “Feeling Great”. Maybe you go into the positive reframing aspects and benefits more in the new book. Thanks, Harvey. Hi Harvey, The session you are referring to was a while back, but by memory my thinking was that the Positive Reframing was not a particularly powerful tool for Neil, and I think he thought that also. It is not the case that any one tool--and I have created / learned more than 100 methods--will be effective for everyone. That's why it's so great to have a huge palette of tools and techniques, so you can find the path forward for many patients, and not just a few! Some people think that if a technique is not helpful for one patient, then it is no good. Some people also think that one technique, like meditation, or exercise, or medication, should be "the answer" for everyone. My experience is radically different, and it is hard for me to even comprehend how people can get sucked into some of these notions--but they do! Positive Reframing is one of the great breakthroughs in TEAM-CBT, and it opens the door to ultra-rapid recovery. In fact, I usually (but not always) see a complete or near-complete elimination of negative feelings in one extended (two-hour) therapy session. Here are some reason why Positive Reframing can be helpful: When you see that your negative feelings are the expressions of your core values, rather than your defects, this reduces feelings of shame, so you might feel a little better right away. You don’t have to shoot for perfection, or complete recovery, but rather a reduction in your negative feelings. This is pretty sensible, and more realistic and relaxing than shooting for total change. In addition, you are no longer fighting against your negative thoughts and feelings.  Your resistance to change will diminish because you can honor your negative thoughts and feelings, and work to reduce them rather than thinking you have to change completely. You’re in control—the therapist is not trying to “sell you” on something. “Selling” nearly always triggers fairly strong resistance. You may suddenly see the benefits of many of your negative thoughts and feelings, so you no longer feel so “broken” or defective. When you "listen" and finally hear what your negative thoughts and feelings are trying to tell you, the volume and intensity of your negative thoughts and feelings will suddenly diminish, like a balloon with a hole in it. Thanks for listening today! Rhonda and David  

Ask David featuring four terrific Should questions, and more questions about “asinine, stupid, narcissistic, self-serving humans! “ Oliver asks: Can a thought be thought as moral or immoral? Vincent asks: I have suffered from depression for about 3 years and say to myself, "I should have gotten better sooner." Isn't this "should" appropriate? Charles says: Your concept of “no self” shot my anxiety way up and made me feel hopeless. . . . It makes me feel worse than before! Michelle asks: How is your requirement that new patients must agree to not make any suicide attempts for the rest of their lives any different to a “suicide contract” which you mention are not effective? Brian asks: I’ve done a few things that made me feel intensely guilty. . . . The knowledge that I didn’t do what I should have done led to a lot of guilt and shame, and eventually depression. Just wondering your thoughts on this Carrel asks: I'm a Democrat in Texas. How can we use disarming to heal the political rifts in our country? Natasha asks: How do I stop the dark thoughts of wishing harm to come to stupid humans who do asinine, narcissistic, self serving, irresponsible things—like driving massive, loud pickup trucks around the neighborhood, honking incessantly as they wave their 20 ft political flags; or bringing the family for a paddle boat ride in the local pond, taking delight in teaching their human offspring to paddle the boat as quickly as they can to chase after the beautiful, innocent geese and ducks trying earnestly and fearfully to swim to safety. and more.   Dear Dr. Burns, Can a thought be thought as moral or immoral? In many podcasts and articles, you use "Thou Shalt Not Kill" to demonstrate morally should statement, which is one of the 3 valid should statements in English. I'm still somewhat confused about this concept. To tell you where I get stuck, I come up with three thought experiments. Imagine the following situations in which a should statement may come to mind: Situation 1 Lisa stole some money from a grocery store. When arrested by police, Lisa said with tears, "I shouldn't have stolen money. I feel ashamed for what I have done." In this case, it is obvious that "I shouldn't have stolen money" is a morally should statement, and also a legally should statement, because Lisa did something that violates the law and her moral principle. DAVID’S COMMENT: YES, YOU ARE CORRECT. LISA’S STATEMENT CAN BE CLASSIFIED AS A LEGAL SHOULD AND A MORAL SHOULD. Situation 2 One day, Bob went to Walmart to buy a suit. When he was passing by a shelf, a thought appeared in her mind. "What would happen if I steal this suit? I really want it, but I have very little money." When he came back home, he talked to himself," I shouldn't have felt the urges to steal things. And I shouldn’t have thought about stealing the suit." DAVID’S COMMENT: THESE WOULD NOT BE CONSIDERED VALID SHOULD STATEMENTS BY MOST PEOPLE, SINCE WE HAVE FREEDOM OF THOUGHT. HUMAN BEINGS HAVE ALL KINDS OF FANTASIES AND URGES ALL THE TIME—AT LEAST I KNOW THAT I DO! AN URGE ONLY BECOMES IMMORAL OR ILLEGAL WHEN YOU ACT ON IT. HOWEVER, ALTHOUGH I DO NOT THINK THESE ARE VALID SHOULDS, BUT I TRY NOT TO IMPOSE MY VALUES ON OTHERS FOR THE MOST PART. I AM A SHRINK, SO I WORK WITH PEOPLE WHO ARE ASKING FOR HELP. FOR EXAMPLE, PEOPLE WITH OCD OFTEN PUNISH THEMSELVES JUST FOR HAVING “FORBIDDEN” THOUGHTS, FEELINGS, OR URGES. THE FIGHT TO CONTROL THEM IS THE ACTUAL CAUSE OF THE OCD. THE SHOULDS TYPICALLY MAKE THE PROBLEM WORSE, NOT BETTER. SELF-ACCEPTANCE CAN BE ONE OF MANY HELPFUL TREATMENT STRATEGIES. RELIGION CAN SOMETIMES BE A SOURCE OF OPPRESSIVE SHOULDS, ESPECIALLLY THE MORE FUNDAMENTALIST TYPES OF RELIGION. RIGIDITY MAY BE A PARTIALLY INHERITED TRAIT. FOR EXAMPLE, MANY RELIGIONS AROUND THE WORLD PROMOTE THE IDEA THAT HOMOSEXUALITY IS “WRONG” AND THAT PEOPLE “SHOULDN’T” HAVE URGES AND ATTRACTIONS TOWARD PEOPLE OF THE SAME GENDER. THIS IS AN AREA WHERE “SHOULD STATEMENTS” BECOME HIGHLY CONTROVERSIAL, AND ARE OFTEN A SOURCE OF HORRIFIC HATRED AND VIOLENCE, SOMETIMES IN THE NAME OF SOME “HIGHER POWER.” Situation 3 Lucy was buying fruits in a grocery store when she found that a man was taking an apple off the shelf and hiding it in his clothe! Obviously, the man was stealing an apple. Lucy was very angry and said, "the man shouldn't steal things from the store. It's not right!" In this case, Lucy didn't steal apples, the man did. But Lucy made a moral judgement about the man's behavior, not Lucy's behavior. Then is this should statement valid for Lucy? DAVID’S THINKING. TO MY WAY OF THINKING, YES THESE ARE VALID LEGAL SHOULDS AND MORAL SHOULDS, SINCE OUR CIVILIZATION (AND ALL CIVILIZATIONS) HAVE DECIDED THAT STEALING IS ILLEGAL, AND IS ALSO CONSIDERED MORALLY WRONG IN MOST RELIGIONS: “THOU SHALT NOT STEAL” IS, I THINK, ONE OF THE TEN COMMANDMENTS. THE GOAL IS NOT TO CLEAN UP YOUR SPEECH SO THAT YOU NEVER USE SHOULD STATEMENTS THAT DO NOT FIT INTO ONE OF THE THREE VALID CATEGORIES OF LEGAL SHOULDS, MORAL SHOULD, AND LAWS OF THE UNIVERSE SHOULDS. AT LEAST I HAVE NO INTEREST IN THAT. MY GOAL IS TO HELP PEOPLE WHO ARE SUFFERING BECAUSE OF SHOULD STATEMENTS. sincerely Oliver   Hi David, What is it with "shoulds" related to recovery from depression? I suffer from depression for about 3 years and say to myself "I should have gotten better sooner." Isn't this "should" appropriate? Because who really wants to suffer through this agony? Greetings from Geneva. Vincent Hi Vincent, "I wish I had gotten better sooner." This is a correct statement without the "should." This simple shift in language is called the Semantic Technique, and it was developed by Dr. Albert Ellis who kind of gave birth to cognitive therapy in the 1950s, along with Dr. Karen Horney about the same time. Instead of using a should, you use “it would be preferable if” or “I wish X was true.” In addition, it isn't actually true that you "should" have gotten better sooner! The universe does not always conform to our expectations. Just because we want something, it doesn't follow that it "should" happen. I'd love to have a new Tesla sports car, at least in fantasy, but it isn't true that I "should" have one. It would be “great” if you had gotten better sooner, that’s absolutely true. “I should have gotten better sooner.” That’s totally false. In addition, although one might think that no one would "want" depression, my research and new clinical work indicate that resistance is nearly always the key to recovery. In other words, people do cling to depression, anxiety, troubled relationships, and habits and addictions, but don’t realize why they are resisting change. Once you suddenly see why you are resisting, your resistance paradoxically disappears, and recovery is then just a stone’s throw away. You can learn more about this in my new book, Feeling Great, available now on Amazon. Thanks! PS let me know if you like the new book, and if you find it helpful! All the best, David   A new comment on the post "108: Do You Have a "Self?"" is waiting for your approval Author: Charles Dr. Burns, First off I want to say thank you. Your work has been helping me through my anxiety. However, I really struggled with this podcast. The concept of no self shot my anxiety way up and made me feel hopeless. It made me feel almost as if I was not real or that there is nothing worth striving for. I love helping people. But I feel like I don’t have a purpose if I don’t have a self. It makes me feel worse than before. David’s answer. Hi Charles, The “great death” of the self is a challenging concept, and while it is incredibly liberating, lots of people—most, in fact—don’t “get it.” Some get angry. Some struggle with trying to understand what this could possibly mean. And some find the concept very threatening. That’s why I deleted the chapter from my book. In fact, a couple extremely brilliant and interested colleagues totally couldn’t grasp it, and felt frustrated by my writing on the concept. sometimes, ideas are so simple and basic that people cannot grasp them. The Buddha ran into this problem 2500 years ago. People thought he was fantastic, but almost none of his followers experienced the enlightenment he was so excited to teach them. The 20th century philosopher, Ludwig Wittgenstein, ran into the same problem. He solve all the problems of philosophy, but when he was alive, it was rumored that only seven people in the world, including one of his favorite students, Norman Malcolm, could grasp what he was saying. He went in and out of intense depression and loneliness during his life, in part because of his frustration with trying to teach the obvious. In my book, Feeling Great, I teach that there are actually four “Great Deaths” for the patient, corresponding to recovery from depression, anxiety disorders, relationship conflicts, and habits and addictions. There are also four “Great Deaths” for TEAM therapists. Those sections might be helpful for you! In addition, I focus on the fact that people can never judge your “self,” only something specific that you think or do. Depression cannot exist on the specific level, only up in the clouds of abstraction. For example, Overgeneralization is one of the ten cognitive distortions I described in my first book, Feeling Good. When you Overgeneralize, you see a negative event as a never-ending pattern of defeat, and you might also Overgeneralize from some specific flaw or defect to your “self.” You will read about an attractive and vivacious young professional woman who had the thought, “I’m unloveable,” when her boyfriend of two years broke up with her. This is classic depression thinking, and “self” thinking. She thinks she has a “self” that can be loveable or unloveable. But this is simply not true, and it’s not productive, because she’ll spend all her time ruminating and feeling worthless. An alternative is to focus on why the (overall excellent) relationship didn’t work out, and what she can do to change and learn and grow, so as to make the next relationship even better. You can pick up on the details in the chapter on Overgeneralization if you’re interested! As I point out in Feeling Great, the “death of the self” is not like a funeral, it’ like an incredible celebration of life. Death of your old concept of what you are is liberating, and leads to instant rebirth. My teachings cannot make you happy or unhappy. Your thoughts about what I’m saying create all of your feelings, positive or negative. At any rate, thank you for a most important question that most of my audience will definitely related to. As an aside, I lost my “self” years ago, and what a relief that was. Sadly, it comes back to life from time to time, and then I struggle again, until I realize what’s happening. One day, what I’m saying may make sense! In the meantime, please accept my apologies concerning the “self!” If it gives you comfort to believe you have a “self,” no problem. But the “self” is just a concept, and not a “thing” that could exist or not exist. When you lose your precious and protected “self,” you lose nothing, because there was never anything there in the first place! But while you lose nothing, you do inherit the earth, as nearly all great religious leaders—Buddha, Jesus, and others—have taught us. David   Hi Dr. Burns, I’ve just listened to your podcast episode on suicide and found it really interesting and useful but I have a few questions. Firstly, how is your requirement that the patient agree to not make any suicide attempts for the rest of their life any different to a ‘suicide contract’ which you mention are not effective? Also, you talk about doing this assessment at the intake and making non-attempts a condition of therapy. If the patient/client agrees to this, why then do you continue to monitor suicidal thoughts in each session in the BMS? Presumably because the agreement is no guarantee of cessation of thoughts. Surely if you’ve told them it’s a condition of therapy with you to not make any attempts then they’d be likely to not tell you about them even if they occurred, and don’t see how setting the initial ground rule resolves the problem. And lastly, when suicidal thoughts, urges, or fantasies do come again in the BMS how do you handle it then? Do you tell them you’ll end therapy, say “but you promised”? Looking forward to your reply. Thanks, Michelle. Hi Michelle, I have scheduled your email for an upcoming ask david episode, and will use your first name unless you prefer that i use some other name. Here is a brief reply. Most patients with borderline personality disorder will become enraged by the gentle ultimatum at the initial evaluation, and if they decide this is not the type of therapy they want, so be it. The techniques I use will not be effective with patients who continue to threaten suicide. TEAM therapy requires TEAM work. Most, nearly all, patients will "get it" and will decide to continue with the therapy. They can have suicidal thoughts and urges, and we can work on them together in therapy. However, to my way of thinking, it is important that they therapist and patient be protected, in a safe environment. If the patient starts threatening to make a suicide attempt, then they will need another form of more intensive treatment like hospitalization, day care, or intensive outpatient treatment. These are options I cannot personally provide for them. I monitor suicidal urges before and after each session with every patient with no exceptions to protect the patient and to protect myself as well. Thanks! PS the suicide contract is an agreement not to attempt suicide "while we are working together." This is very weak, as the patient can suddenly decide he or she is dropping out of therapy and making a suicide attempt. And this often happens. My contract is more demanding, and intentionally so. Patients must also agree to do psychotherapy homework, too. Some patients want to make the therapist a hostage with suicide threats, which can and so work as a form of manipulation and hostility. Then the therapist is in an almost constant state of agitation, anxiety, and frustration. If I allow a patient to make my life miserable, how can I teach that patient how to be happy? We are all ONE—we go up and down together. If I allow you to make my life miserable, then I am allowing you to make your own life miserable, too. David   Hello David, Thank you so much for everything you do. I’ve listened to all of your podcasts, and read most of your books, and am very grateful for the changes you, Rhonda, Fabrice and the rest of the team have made to my life. I’ve just listened to this episode, and there’s one thing I’m struggling with, which is the concept of the moral should. I’ve done a few things that made me intensely guilty – one in particular was not standing by and supporting a friend who needed people when he was going through a particularly hard time. He was angry and disappointed with me, and, in hindsight, rightly so. He has since forgiven me but I still struggle with it. I feel that supporting him was a moral should. The knowledge that I didn’t do what I should have done led to a lot of guilt and shame, and eventually depression. You say that a moral should is valid; so therefore, I feel that my negative thoughts on this are not misguided but valid – I did something morally wrong and deserved to feel bad for it. Just wondering your thoughts on this. Thanks again, and keep up the good work! Hi Brian, thanks! Would love to include this on an Ask David, using just your first name, or even a fake name if you prefer. A quick response might be to ask how many minutes per day would you like to dedicate to feeling guilty? And for how many days, months, or years? In your spiritual or religious beliefs, is a person supposed to feel intensely guilty forever? Most of us have done things we are ashamed of, or feel guilty about. How much guilt and shame would you recommend for me, for example? And what is the goal of the guilt and shame? And how guilty would you recommend I feel, between 0% and 100%? That's one approach. Another approach would be A = Assessment of Resistance, listing what the guilt shows about you that's positive and awesome, and then asking yourself why in the world you'd want to let go of the guilt, given all the many real positives. Then you might validly decide to “dial it down” to some more acceptable level. For example, if you now feel 90% guilty, perhaps 15% or 20% would be enough. In addition, you could also decide how many minutes of guilt you would recommend. If you now feel guilty about eight hours a day, would 10 minutes be enough? If so, you could schedule your “guilt periods” ahead of time, and then really work hard at feeling guilty during those ten minutes. Then, when you’re done with your “guilt work,” you can return to joyous and loving living! Also, instead of one ten minute daily guilt binge, you could schedule, for example, three guilt binges, each three minutes long, in the morning, at lunch time, and in the evening, like three pills the doctor prescribed! David In reply to Dr. Burns. Hi Dr Burns, Thanks so much for your quick response! I really appreciate your advice; I will dedicate a bit of time today to approaching it the way you say. And also, I’d be delighted if you included it on a podcast! You can use my first name by all means. Thanks again! Brian   Comment from Carrel I'm a Democrat in Texas. How can we use disarming to heal the political rifts in our country? How does one find agreement across that ever-widening divide? Carrel David’s reply Hi Carrel, It’s really tough, for sure! Have you listened to my podcast on this topic? There is a search function on my website. If you type in “political divide,” this podcast will pop right up: “127: How Can We Communicate with Loved Ones on the Opposite Side of the Political Divide?” Let me know what you think! David David emphasizes the value of the search function. Often you can find your questions have already been addressed. In addition, the many podcasts on the Five Secrets of Effective Communication could be invaluable (links), and the emphasis would be on using the Disarming Technique to find some truth in what the other person is proclaiming and arguing for. But first, you have a decision to make, and this is always based on ONE person you may want to interact with. First, ask yourself if you do actually want a better relationship with person X, Y, or Z. There is no rule that says we have to get along better with everyone. I think that Joe Biden is doing a pretty good job of promoting unity, and not diverseness in our country. Hopefully, the forces of love and unity will win out over the forces of hatred and war, but it’s not at all clear what direction our country is heading for. And we’re seeing now that at times the tensions are become so intense, and the hatred so strong, that violence is once again on the increase. In the next Ask David we'll have a really cool session devoted to the intense anger that many of us feel when confronted by human behavior that strikes us as narcissistic, vicious, self-serving, and aggressive. This topic should appeal to lots of people! And we have a wonderful question from a woman who's feeling pretty darn enraged! David and Rhonda  

The road to walking fully in your purpose is full of roadblocks. Ask David! His acts of service, bravery, and respect got him in a lot of trouble! In this episode, we will explore the realities of success and why you can't give up! We discuss how David's problems centered around his ability to be available.

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 angela@feelinggoodinstitute.com 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 hope this note finds you well. I'm writing for a few reasons. The first is to thank you for your podcast and related resources. I found your podcast and started listening at the beginning of COVID-19 (mid-March) because I was feeling acute anxiety. The T.E.A.M. approach and your teaching are such an amazing gifts. The positive reframing in particular is truly life changing and revolutionary for me. Considering what my negative thoughts show about me that's positive and awesome and then finding the cognitive distortions has provided me such relief. I have been so excited about T.E.A.M. therapy that I often discuss it with my husband, friends, and family. I really loved David's comment in the most recent podcast that good therapy isn't evangelizing; rather it's letting the patient define problems and goals within his/her own values. I also liked your comment that doing therapy well is like an artform or a dance- that's such a beautiful sentiment, and I've been able to see the conversational "dances" you perform in the amazing, transformative, empathic live therapy sessions with Michael, Rhonda, Sarah, and others. These sessions have often brought tears to my eyes. This brings me to my second reason for writing. Listening to the podcast has been transformative for me in another way- it's made me seriously consider becoming a therapist myself. I have considered this possibility over the years, but now that I'm familiar with the T.E.A.M therapy approach and can see how helpful it is, I'm excited to explore this path more. I have a B.A. in psychology so I would need additional education- do you have suggestions for masters programs that you think would provide good alignment with the T.E.A.M. approach? I live in Charlottesville, Virginia and have two young children, so a local or online program may be the best bet for me. Thanks in advance for any ideas you may have. All the best to you, Molly Hurt Thanks, Molly. We can read your wonderful email on an Ask David if that is okay with you, but here is the quick answer. In graduate school, you don’t typically learn much that is useful. It is more getting a license to practice, then you learn from mentors, workshops, etc. The FeelingGoodInstitute.com has training and certification programs, including 12 week beginner classes in TEAM that are excellent. The whole area of coaching is emerging now too, and the certification is rather informal. If you get a degree like a masters degree in social work online, and then get licensed to do therapy, that is one approach, but there are many ways to get certified—counselor, psy d degree, marriage and family therapy, and so forth. So in short, I would, personally, find some way—the easiest way—to get certified so you can legally do therapy. But concentrate on learning TEAM as the tool to use. In California, as an aside, anyone can call themselves a “psychotherapist,” but you need the degree and license to call yourself a “psychologist.” Good luck, and thanks again! david Why are should statements considered distortions? Thanks for your quick and helpful reply. It's useful to have a better sense for how to prioritize my time and training. I'm excited to continue to explore T.E.A.M. therapy! And you are welcome to read my email on the podcast, thanks for asking. If I may, one other question for you: how do you recommend someone defeat "should" statements when his/her behaviors aren't healthy or beneficial? For example, "I should not overeat when anxious" or "I should not procrastinate" or "I should not be impatient with my daughter." I understand that saying "should" in these cases adds pressure and can lead to shame, but I don't see the distortion in these statements. In other words, these statements may not be helpful to a patient, but how are they not 100% true? I would appreciate any additional guidance you can offer on what I find to be the most difficult cognitive distortion! Thanks again to both of you for generously sharing your loving and kind approach to helping people deal with their problems and feel better. The impact you're having is profound. I love listening to you empathize with patients- it makes me strive for building an even more loving connection with my husband and daughters, as well as others in my life. Best, Molly Hi Molly, You may want to listen to podcast #205 pm Should Statements. You can also find a lot in my books, like Feeling Good, which you may have already read. There is also a chapter on how to crush should statements in my new book, Feeling Great, which will be released on September 15, 2020. Shoulds are distortions because they are not valid. It is not true that you “should not overeat when anxious.” You SHOULD overeat when anxious because it is very appealing, tasty, and makes you feel better. A correct statement would be, “It would be preferable if I did not overeat when anxious.” This statement removes the shame and pressure, while honoring your goal. There are three correct uses of should: the moral should (thou shalt not kill), the legal should (you should not drive 90 miles an hour because you’ll get a ticket) and the laws of the universe should: this pen should fall to the floor if I drop it because of the force of gravity. But overeating when anxious is not immoral or illegal, and it does not violate the laws of the universe. So it is not a valid use of the word. There is a podcast on this, I think, and you can search for it on my website use the search function. 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) was awesome! What role, from your years of practice, does spirituality have in the psychotherapy? Is there a correlation between spirituality and between feeling good/feeling great? Thank you for time taken in response to my in questions! Blessings! Jerry Souta, Jr. (MSW/LCSW/MDIV) Thanks, Jerry. I will answer this on an Ask David, we will be recording it soon. Your question will be featured on a Feeling Good podcast. The short answer is yes. Deep and rapid change nearly always involves a spiritual dimension, for example, one of the four “Great Deaths” of the self. There’s a whole section on this in my new book, Feeling Great.

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 often a spiritual dimension in recovery. All the best, david How is Sara now? Is anger just “ossified tears?” Dear Dr Burns, Though doubting that you’ll ever read or answer this, nevertheless I’ll cast it to the cloud for something-or-other! I’m an old fossilised blind British harpsichordist (good combo?!!) and a devoted fan of your podcasts, as well as selectively slowly making my happy way through the 27 hours of RNIB’s Talking Book version of ‘Feeling Good’ (Must tell you that the Braille Music Translation Programme I use invented by a great buddy in Pa. is called ‘Goodfeel’, so you guys must have something in common!). Alas I have 2 questions. First, as a ‘floating’ OCD sufferer for 70 years or so, I wildly enjoyed Sara’s ‘high speed cure’ in podcast 162. However, surely with this new Coronavirus threat – the virus remaining on cardboard for around 24 hours and other surfaces including shopping for at least 2 days or more -, her cure must have now been reversed? The fact, and I mean from much research ‘fact’ is that ‘what you touch could kill you’. Sure, it might not but, in as bad health otherwise as I am, I believe it’s imperative to be as careful as pos. which, courteously put, is screwing my brain! How about Sara?! Finally, well I suppose it’s a comment more than a question. I’ve been enjoying and, indeed, beginning to benefit from your section in the book on anger. I wonder though whether, unless I haven’t got there yet (which is eminently possible!!), you might have left out one aspect of anger? I’ve often thought that it, as well as hatred and violence could be designated ‘ossified tears’ and, believe me, in my case, if so, they’ve turned into unbreakable rocks!! Keep up the great work, Dr Burns. We all need such an unique communicator and erudite intellect as you, oh and I fervently hope you can stay clear of this virus. Very best and thanks, John Henry (Not the old American horse, . . . but rather a British, almost human John Henry!! David and Rhonda respond to both of John's questions! How do you explain the basic concepts of CBT and cognitive distortions to patients who are not familiar with your work? Hi David and Rhonda, You previously answered a question of mine on your podcast. It was quite helpful, thanks! I have a new unrelated question. While the live sessions have been very illuminating in many ways, your patients have always been trained therapists who are already familiar with the concepts of CBT and cognitive distortions. I understand this is an ethical necessity. As a family physician I struggle with that first step - how do you introduce the concepts of CBT and the cognitive distortions to non-therapist clients? I imagine it must take at least a full session just to do education on the distortions. This may be a question best for Rhonda. Thanks again! Calvin Hi Calvin, Thank you for another great question. If you prescribe the book, Feeling Good, it can help you and your patients in three ways. First, they’ll get all the concepts and some sound psychoeducation, saving you time. Second, the book is at least as effective as antidepressants, so it is prescribing something that may be very helpful with no side effects. Third, it will be a test of their motivation. Motivation appears to have a massive effect on recovery from depression. Also, there are tons of great classes in TEAM for beginners if you check them out at FGI (www.feelinggoodinstitute.com). There are also free classes on depression and other topics on my website, www.feelinggood.com. These classes may also help your patients. On the show, Rhonda will explain how she introduces these topics to her patients as well! All the best, David Rhonda’s note to Calvin: You flatter me, because all questions are best answered by David, but I will give it a try. I do ask all my patients to read David's book Feeling Good, which is superb at describing what CBT is and why it is effective. I have an intake telephone call with all my new patients before we start working together, and before they read Feeling Good. In that call I explain CBT like this, imagine a triangle that has Thoughts, Feelings and Behavior at each point. Your thoughts drive your feelings and your behavior. So, if you can change the way you think, you can change the way you feel. David gives the example of someone walking in the woods who hears a twig break. Imagine that hiker thinking that a murderer is creeping behind him or her, what do imagine he or she would feel? But imagine that same hiker thinking that his or her best friend is joining the hike? What would he or she feel then? There are lots of examples like that: two students who have studied the same amount. One walks into the test room thinking, I did a good job studying, the other walks into the test room thinking I should have studied more. Who do you think will do better on the test? This is an actual study that has been done, and if you guessed the student thinking more confidence did better, you would be correct. It makes logical sense. I don't explain cognitive distortions in my intake discussion, but when we first start working with a Daily Mood Log, after we have gone through T = Testing, E = Empathy, and after A = Assessment of Motivation, when we are going through the M = Method "Identify the Distortions" for the first time. I explain that cognitive distortions are embedded in our negative thoughts, and they are simply ways that our mind convinces us of somethings that aren't really true. By this time patients have read part of Feeling Good, so they have more psychoeducation. But I find if patients still don't understand the concept of cognitive distortions, as we go through the Identify the Distortions method, they soon understand what distortions are. I hope that makes sense, and that you find this helpful, Rhonda Can I help myself as much as Rameesh did? Hello Dr David, I saw how Ramesh changed dramatically and I want that kind of change in my life. but I am doubtful. It was you who managed to melt away his resistance using different techniques. Is it possible that we can manage to change ourselves so effectively? Shivam Hi Shivam, Thank you for this incredibly important question. Research indicates that many people have been helped by reading my books and doing the exercises, such as Feeling Good. Motivation and hard work are critically important in personal change and recovery. I am also working on a new app, and hope to get data to answer this exact question! Best of luck! Will make this an Ask David question, as it is so important! David How can I start a self-help group based on your book, Ten Days to Self-Esteem? Dr Burns, I know your book, Ten Days to Self Esteem, has a group leaders manual. Can anyone start one of those groups of do you have to be a therapist of some sort? Has anyone told you that they started one? How did they say it went? Any tips for starting one? Thanks Richard Hi Richard, Many pilot studies using this program with lay leaders have been effective. The program at my hospital in Philadelphia, also using lay leaders, was very effective. David How can I find my favorite podcast? Hi David I am a therapist and was reminded of one of your podcasts as I was listening to a particular patient. I wanted to share the episode and then couldn’t find it so felt silly. It was an episode where a father (perhaps Indian? Maybe a doctor?) empathizes and listens in a whole new way to his adult son and has a miraculous turn of events in the relationship- simply by being present and not being defensive when the son tells him how he feels about his father. It was beautiful and moving. A great example of “opposite action”- agreeing with the criticism rather than defending against it. Does that episode ring a bell and can’t you point me in the right direction to retrieve it? I know how busy you are. Thank you for your wonderful podcast and for any help you can provide. Thanks, Pam Hi Pam, It might be the follow-up to the live therapy with Mark. Use the search function on my website. He is from Iran, and is an OB-GYN doctor who has faithfully attended my Tuesday training group for years. He is one of my favorite people. Learning the Five Secrets takes lots of commitment and practice. He has formed his own Five Secrets practice group with friends and colleagues who are not shrinks. They’ve met weekly for years, so his skills are quite refined now. Thanks! David On the podcast, I emphasize the search function you can easily find on every page of my website, www.feelinggood.com. Pam’s comment on the Five Secrets is also important. Desire, commitment and ongoing practice are the keys to mastery! Rhonda and David  

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 at the Feeling Good Institute doing well and being healthy. Kind regards, Leslie David explains that he has always insisted that schizophrenia is an organic brain disorder that sadly cannot be cured with drugs or psychotherapy. However, drugs often plan an important role in treatment, and compassionate psychotherapy can also be extremely helpful. The goal is to help the patient develop greater self-esteem and improved relationships with others. He describes the innovative group CBT program he developed at his hospital in Philadelphia which served a large population of homeless individuals as well as individuals suffer from severe schizophrenia. He also points out how easily one can get severely misquoted, and appreciates the chance to set the record straight! How do you suddenly switch into “Sitting with Open Hands” during a session? This is yet another great question from our friend and colleague, Jeremy Karmel. David and Rhonda compare good therapy to dancing, having to often change courses instantly when the patient begins to resist and fight the therapist. Questions about Obsessive Compulsive Disorder (OCD): I hope this a place where I can submit questions for "Ask David." Are there manifestations of OCD that have common links or hidden emotions? Do you hear one person's description of their OCD and immediately have an idea of what might cause it? For example: do a majority of contamination OCD sufferers have a common reason for that specific "type" of OCD? Do sufferers of something deeply distressing like pedophile OCD all have feelings of shame that manifest in that OCD, where the "what if" would result in probably the most shame they could ever feel? David and Rhonda discuss the Hidden Emotion Technique which can be invaluable in the treatment of OCD. Questions about racism Hello David and Rhonda, Thanks for your amazing podcasts, I have listened to a lot already. And thanks Rhonda for bringing this important subject to the table. :) What if “Steve” had said that indeed he is racist and can't stand African Americans or South Americans, what would Rhonda answer to that?! It would become difficult for me to keep a friendship-like relationship with someone who is at the extreme opposite on sensitive subjects. I am open to any point of view, I don't need to be disarmed here. :) David, I'm so looking forward to your Feeling Great book!!! Rhonda and David discuss two opposite strategies for dealing with someone with strong racist tendencies. What if there are more advantages than disadvantages of perfectionism when you do a Cost-Benefit Analysis? This is a question from a user who wishes to remain anonymous. Rhonda and David talk about the fact that perfectionism, like all Self-Defeating Beliefs, has many advantages as well as disadvantages. And if the advantages outweigh the disadvantages, it’s working for you, and it’s not something the therapist would need to help you with. There’s a difference between neurotic and healthy perfectionism. Many of the great historical figures, like Edison, for example, worked relentlessly and would not settle for failure. And we are all the beneficiaries of that type of genius and intense commitment to the healthy pursuit of excellence! Therapy is all about helping people who ask for help. It’s not about evangelism! David and Rhonda    

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 input you have on this question and I look forward to continuing to listen to the podcast as new episodes come out, along with your new book and App! Best regards, Tommy Dr. Burns, Thank you! I’d be happy for you to use my first name. I’ll look out for it in the upcoming podcasts. Have a great rest of the week. Tommy Please give us a podcast on how to express anger! Hey Dr. Burns, I’m loving the podcast, and my favorite podcasts are the Ask David and Live Treatment ones! Also, I can’t wait for the new app and book! I did have a question, which I can go into more detail if need be. Specifically, what podcasts and book would you recommend for anger? I’m unsure how to express anger in a productive way (in my relationship), and would love more guidance and practice prior to trying to use the 5 secrets “live”. Thanks in advance! Thanks for listening today, and thanks for all the kind comments and totally awesome questions! David and Rhonda

Augusta, Georgia native Angela Marshall, is a motivational presenter, bestseller author, creative content consultant, ex-NFL wife and business owner of “In Other Words, By Stone.” Also known as “Author Stone,” she is a positive words powerhouse that utilizes her personal life experiences of struggle, strength and success to captivate audiences and readers abroad. Angela is also a community advocate, youth mentor and supporter. Angela resigned from twenty years in the corporate world to embrace the purpose that has pursued her throughout life - to be unmasked, unchained and untamed. She struggled through a lavish but sorely lacking lifestyle as a former NFL wife. That chapter in her life produced the transparency in her inspiring inquiring minds want to know auto-biography, 'Reality to Rags to Riches; The Story and Life of an Ex-NFL Wife." Angela is also a featured author in the “Women Who Lead” anthology that chronicles successful women across the globe. Angela has been featured on the following platforms; Worlds Most Amazing People, Conversations with Klarque, Born To Write, Awake & On Purpose, Hero Show, Your Superior Self, Unsung Heroes, Truth No Chaser, Boss Babe Life Hacks, Make Every Second Count, Support is Sexy, Shine Your Light, Humanity Matters, D & J Power Hour, The UnStoppable Show, Power of The Purse, Coffee Over Suicide, Reach Your Peek, VIP Concierge Events, Mastermind DMV, Judy Hoberman-Selling in a Skirt National Show, Head 2 Head Podcast, Courageous Conversations with Sheree-Now Network, Business Mindset, Professional Women’s Networking Association, Walker Baptist Association Congress of Christian Education, Write the Book Now!, The Beauty Essentials Show, IlikeEbooks, HomeTown Reads, Write Globe, Ask David.com, Poetry Ponderings Podcast, Speakersphere.com, Women Who Lead, Unconventional Leaders, The Great Escape Show, The Grind Entrepreneurs Network, The Nalarance Davis BlogTalk Show and First Lady Enterprises. She is also a member of Professional Women’s Networking Association, Speakersphere Organization, The African American Entrepreneur Club- Florida, The P.E.E.R Group Professionals, Women Who Lead Anthology and the African American Authors for Literacy Campaign. Angela's Links - Angela's Website From Reality To Rags to Riches, The Story of an Ex-NFL Wife

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

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 recovery from depression and anxiety. One of Steve’s motives I doing this podcast was to have his own Ask David session, and one of his questions was, “What is it like to be regarded by many people as a guru?” I described the blessings as well as the occasional curses and problems that come with this moniker! Then the conversation turns to Steve’s devastating diagnosis of blood cancer—multiple myeloma—just over a year ago, and how hard and frustrating it has been for Steve to get people just to listen and provide support, including his doctors, and how incredibly meaningful it is when people express simple compassion and love. Steve also talks about how he has decided to accept his cancer, and not to “fight it” or to go to war with his body. And acceptance does not mean refusing treatment—Steve is receiving chemotherapy for his multiple myeloma. The acceptance we are describing is more of a mind-set of peacefulness. We also talked about the fact that the problems of aging are not unique, but are simply the problems of living, problems we can encounter at any age. The whole basis of cognitive therapy is that our feelings result from our thoughts, and not the circumstances of our lives. This is a very optimistic message because we often cannot change the facts of our lives, but we can do a great deal to change the way we think and feel. I ended the podcast by raising the question of “Sadness as Celebration.” I asked whether tears and feelings of sadness in response to the suffering of others might actually be one of the highest experiences a human being can have, and is perhaps the deepest meaning of spirituality. I described a somewhat bizarre experience I had on the Nevada desert when I was a Stanford medical student in the 1960s—it was an experience I have kept secret for nearly 50 years, and talk about for the first time on this podcast. After the podcast, I emailed Rhonda to get her “take” on the show. Usually, we focus on specific techniques our podcast fans might want to learn. But this time, we just kind of were “hanging out” together, so I was concerned and feeling a bit self-critical. I was also concerned that I may have sounded like a loony at times on the show, since my personal story was perhaps over the top. Here’s how Rhonda replied: Hi David, As I was listening to the Steve podcast, it struck me that it was really friends talking, getting to know each other, sharing stories and joking around and being serious sometimes. That's why I thought it was really lovely. I listened to Steve's podcast after dinner. I loved it! You are so charming, and tell sweet stories that open up your life to the listener. I think everyone will love how endearing you are. Steve was articulate, vulnerable and open. While it's not an episode where you are teaching anything specific, it is a lovely podcast and I think regular listeners will love the opportunity to get to know you. Rhonda So, let us know what you think! Thank you, Steve and Barbara, for your generous appearance on today’s show. And we also thank YOU for tuning in today! Rhonda and David PS After the show, Rhonda and I got this great email from Steve: Hi David and Rhonda, Just getting back to communicating after a full & thrilling trip to California! Arrived home Monday evening, then off to Chemo center most of Tuesday & now regaining energy. I like your show notes David—mucho. Really enjoyed the hike, lunch, getting to sit in on Amir's podcast, then to interact with David, Barb, & Rhonda. Loved your stories, David, and the whole experience of tears and celebrating sadness. Oh yea, and the big kiss on the lips! A lot of other ideas & questions have popped into my thinking since the podcast. One being that us Christians are pretty judgmental. This is supremely true, and is probably one of the best-selling points of religion that's kept hidden behind the smoke and mirrors. It's so much fun to judge folks, look down on everyone else and have that feeling of moral superiority! Probably better than LSD I'm guessing. What bugs me about "religion" most is how many folks suffer under the whip of having to improve and become better and jump over impossible standards. Of course, they could move on to the Acceptance Paradox and right into celebrating sadness in a split second if they wish. What wonderful time it was with you all. Feeling grateful to share life with each of you. Love you, Steve Second PS: If you are looking for CE credits or training in TEAM-CBT, my upcoming workshop on therapeutic resistance on February 9, 2020 will be a good one. See below for details and links!  David

Happy Holidays to everyone! Today's podcast is nestled between Hanukkah (on the 22nd) and Christmas Eve (on the 24th.) We send our warmest greetings to all of our listeners of all religious faiths. Today, Rhonda, Dave and David discuss three questions you have submitted: Does emotional trauma cause brain damage? Do you have to have a good cry when something traumatic happens? Why does avoidance make anxiety worse? 1. Is it true that emotional trauma affects the brain? Hi again Dr Burns, I love the 5 secrets, and have had great success in my new job by implementing them! I keep listening to all the 5 secrets podcasts over and over to keep it fresh for me and really loved the podcast on advanced techniques. My question today is about how trauma affects the brain. ‘Trauma’ is the new buzz word in education, and psychologists are creating presentations geared for teachers and other school professionals that claim the “trauma-affected brain” is altered and cannot learn as easily. They allege imaging technology can prove this. Do you know if PTSD/trauma actually impacts a person’s ability to learn? I thought that it was the negative thoughts that interfere with attitudes toward learning, not an actual brain impairment. Another term that is used frequently is “intergenerational trauma”, meaning if my parent experienced trauma, it could be passed down to me and therefore impact my ability to cope with life stressors. Any thoughts? Any credible research you are aware of? In the Ask David, could you also include your opinion on how Adverse Childhood Experiences impact people's mental health and ability to cope?  There are a range of experiences cited in studies from moving around a lot in childhood to witnessing a murder to molestation.  After listening to your podcast episode 147 (Garry with PTSD) I was satisfied with the effectiveness of TEAM to treat trauma rapidly.  But then I remembered a documentary I had seen about 'feral children' who were extremely neglected as children, and I wondered if there are some cases where the psychology or potential of a person is forever impacted by an adverse childhood experience.  Your take? All the best, Jackie Educational Consultant Mountaintop School Division Answer David finds these buzzwords and buzz-theories somewhat misleading, and sometimes even pseudo-scientific. He has treated large numbers of patients struggling with the effects of severe trauma, and has found that trauma patients are usually the easiest to treat and the quickest to learn. David like to focus on rapid healing, using TEAM-CBT, rather than sending people the message that they are impaired, damaged or defective because of some emotionally traumatic experience. In fact, nearly all humans have experienced quite a lot of traumatic events, which can range from mild to extreme. And lots of us have some degree of brain damage. My brain (David Burns) was squashed at birth, for example, and there are certain cognitive functions that I’m not very good at. For example, for some reason, I can't often find something that's right in front of me, and I have lots of trouble remembering names and faces. I just try to accept my many shortcoming and work around them. The problem is rarely our flaws or imperfections, but rather the distorted negative messages we give ourselves; messages that generate anxiety, fear, inadequacy, shame, and so forth. Of course, animals and humans with traumatic experiences at a young age, or any age, may struggle with fear and may seem, as you say, "feral." My wife and I (David) have adopted many feral cats, and have found that consistent warmth and love can lead to dramatic changes and the development of trust. We all have a history, and every person's story and suffering deserve respect and profound compassion. 2. What’s displacement? Is it true that you have to have a good cry when something traumatic happens? Hi there again, I've been practicing TEAM-CBT for a year while at the same time studying Dr. Gordon Neufeld's theories on the need for "tears of futility" for true healing (including adaptation, maturation and development of resilience). He states that if we only work on the cognitive level, we risk to just displace the symptoms in our clients and they would miss out on maturation and adaptation. I'm wondering if you have ever seen a displacement of the symptom in treating your patients with TEAM-CBT? In most live sessions I've seen with you you seem to have this gift / skill to make it safe for the client to let the tears flow and that this often seem to be the moment when a breakthrough is about to happen. So I wonder if you think the client needs to shed tears or at least feel the feelings of futility or "true sadness" before we should move forward to methods (in addition to getting perfect empathy scores)? And what role you think tears play in the healing process? Would love to hear your thoughts on this! (See my last e-mail if you want more details to why I'm asking.) Thanks, Warmly, Malena Answer I am really pleased to see that you, Malena, are a certified TEAM-CBT therapist in Sweden! I always love to hear from a fellow Swede! You are right, Malena, that emotion is very important in therapy, since it shows that the patient trusts the therapist and is willing to be vulnerable. This is a critical part of the E = Empathy in TEAM-CBT. Therapy without emotion, without tears, may be overly technical, dry and almost "empty." In addition, some patients do intellectualize as a way of avoiding emotions. I call this fear of negative emotions “Emotophobia.” I try to confront patients who do this in a gentle way. I might say, “Gee, Jim, I just asked you how you were feeling, and I notice that you didn’t really answer my question. Did you notice this as well?” This technique is called Changing the Focus, and it has to be done in a kindly, non-threatening way. We discussed it on a recent podcast that was one of our most popular. I’ve seen a patient recently who had incredible problems sharing his own feelings in interactions with his wife, and equally intense problems acknowledging her feelings. If a patient is determined to overcome this fear of his or her feelings, using the Five Secrets of Effective Communication, tremendous progress can be made, but the patient’s resistance has to be dealt with first. Early in my career, I was aware of the idea that if you don’t cry when a traumatic event, like the loss of a loved one happens, that you are setting yourself up for emotional difficulties, so I often pushed my patients to cry. And occasionally this was very helpful. But in general, I have not found it necessary to think that every patient has to cry, and it is definitely not true that crying during sessions is a panacea. During my residency training, I had many patients who cried constantly during therapy sessions without any improvement at all. They just kept crying and crying every session! You could even argue that this makes patients worse, because you continually activate and strengthen the same negative circuits in your brain. When I learned cognitive therapy, I had many tools to help patients change their lives, and that's when I became to see far more improvement and recovery. The tears were helpful, but rarely or never curative. If you are getting perfect empathy scores from your patients on the scales on the Evaluation of Therapy Session, Malena, you are doing great! Way to go! David (a fellow Swede) 3. Why does avoidance make anxiety worse? Hi Dr. Burns, I love your show and work so much. I can't wait to buy "Feeling Great." There's a question I've had for about three years that I've badly wanted to get my head wrapped around. It's in regard to something I've heard you say on a Feeling Good Podcast: "Most experts in exposure therapy or behavior therapy say that attempts to control your symptoms (of anxiety) is the cause of all anxiety." I have heard others say that too/ Why is this? I understand if you push-through an anxiety you can learn whether it's warranted or not. But how is trying to avoid an anxiety actually the cause of all anxiety? I want to be able to understand it for when I feel myself trying to move away from social anxiety I can understand at a moment's notice why doing so actually is the cause of all my anxiety. To be able to skewer the rationalizations in my mind of why I shouldn't push-through. Thank you David. Best Regards, Mark Answer Rhonda, David and Dave discuss why avoidance makes anxiety worse, and why exposure often leads to improvement or even complete recovery. David describes the incredible resurgence of his own fear of heights when he took his children on a camping adventure in Havasupai Canyon in Arizona one spring when he and his wife were living in Philadelphia, and he avoided climbing down a cliff he had climbed down many times when he was younger. Anxiety is not caused by the thing you fear, but by your distorted thoughts and fantasies. When you pull back instead of confronting the monster, you do not get the chance to discover that the monster has no teeth, so your negative thoughts and fantasies can quickly spiral out of control. We will see you again next week for our final podcast of 2019. Thanks for so many wonderful questions, and for your support during the past year. We have had more than 1.5 million downloads, thanks to you! We look forward to serving you again in 2020! If you like the podcasts, please tell your family, friends, and neighbors. You are our marketing team! And if you are a mental health professional, you might be interested in my February workshop on therapeutic resistance with Dr. Jill Levitt. It's going to be a good one, and you can find the details below. Rhonda, David, and Dave  

Today, Rhonda rejoins us as host after a three week hiatus! My neighbor, Dave Fribush, joins us as well, as we answer two thought-provoking questions! Is it possible to treat “burnout?” Can negative feelings can make physical pain worse? 1. Does "burnout" exist? How do you treat it? Comment: Hi! I have been listening to your podcast for a while now and it has helped, and has encouraged me and made me feel less alone. Thank for your work and sharing your podcast with us! My situation now is very much defined by my burnout syndrome (a medical diagnosis in Sweden, not sure about the US) and/or depression. From what I’ve learnt there is no evidence of CBT as a treatment for burnout - really nothing other than adaptations at your workplace. What triggered me to ”hit the wall” was studying too hard and not giving my body and mind time to recover. Do you have any thoughts on burnout and effective treatment of it? I feel I have made huge progress in the underlying reasons to my burnout like perfectionism, performance-based self-esteem, figuring out how I want my life to be, who I am etc (although the last one is a big one!). All this with the help of CBT and other sorts of therapy. What remains is mental fatigue, on and off anxiety, not being able to focus and hardly any mental or emotional resilience. Through healthcare, you are basically treated for depression, the treatment being anti-depressants. I’ve been on sick leave full time for over four years now, am in my late twenties and am constantly frustrated, sad and feeling stuck. I want to get going towards this life I now know that I want but I don’t seem to get any better. I eat and sleep well and exercise. I realize this could be a complete medical question but nobody REALLY seems to know anything about burnout. A long question but hey ho :) Would be grateful for any thoughts you might have, thanks again! Sincerely, Elisabeth Hi Elisabeth, I’m sorry to hear that you’ve been struggling for some time, but I'm glad you've been making progress, and I'm so glad you wrote to me. To my way of thinking, there is really no such “thing” as burnout. Depression, anxiety, anger, and other negative feelings do exist. Burnout is just a vague buzzword for feeling upset when something upsetting has happened. When I was in clinical practice, I saw as many as 17 depressed and anxious patients in one day, and as the day went on, I just got higher and higher and more energetic. That's because I loved what I was doing and felt I had something to offer, a lot, actually. I only got "burned out," or unhappy, if I felt I had said something that hurt someone's feelings, or if I had not done a good job for someone. Then I got really upset, but it was my thoughts, and not what I was doing, that caused my feelings. That, of course, is the cognitive model. I found it helpful to zero in on one moment when I was feeling depressed, anxious, or “burned out,” and to do a Daily Mood Log focusing on that moment. I’ll attach one to this email in case you are interested. I’ve also included a completed one so you can see how it works. This is not a similar case, just something I grabbed by way of illustration. Thanks, David (a fellow Swede) On the show, I describe one of the most stressful experiences of my career, when I appeared on a Philadelphia TV show with Maury Povich, and a patient of mine threatened to commit suicide. Fortunately, the story had a surprise ending that was very positive. So my message is one of hope. The idea is to focus on some specific thing you are upset about, as opposed to getting overly focused on a concept like "burnout." I think we all feel pretty exhausted at times, and if you've been studying or working too hard, it definitely makes sense to take a break to take care of yourself. When I transferred from my residency training program at Highland Hospital in Oakland, California, to the residency program at the University of Pennsylvania, in Philadelphia, one of my supervisors gave me this advice--he told me to make sure I set aside at least one half a day a week to stare at walls. What he meant was that I was working intensely, 24/7, during the first two years of my residency, and he wanted to make sure I gave myself a break to rest from time to time. So every Sunday afternoon I just watched football games on TV, often with a cat on my lap. This was refreshing and helpful, and my supervisor's advice helped me avoid feeling guilty for not working 24/7! 2. More on physical pain. Is it really true that negative feelings can make physical pain worse? We recently did a podcast with Dr. David Hanscom, a back surgeon who emphasized non-surgical treatments for back pain that can be surprisingly helpful. In that podcast, I described my research indicating that 50% of the pain we experience can the result of negative feelings, such as depression, anxiety, and anger. And if you can reduce or eliminate those negative feelings, your physical pain will often diminish substantially, and may even disappear entirely. I first discovered this amazing phenomenon when I had a dramatic and traumatic personal experience as a medical student. One night I was drinking beer at a bar in Palo Alto, and hurt a commotion, and turned to look. A fight had broken out, and although I was not involved in the fight, I saw a beer mug flying in slow motion toward my face. It hit my jaw, and glass exploded everywhere, and blood came gushing out of my mouth.  I realized that my jaw was broken, and my front teeth were loose as well, so I ran outside to my old VW Beetle and drove at high speed to the emergency room of the Stanford Hospital. I ran inside and announced that I was a medical student and my jaw was broken. They put me on a gurney, and ordered an x-ray. I was in intense pain, and I was scared and angry, and still intoxicated, and probably wasn't the most cooperative patient. Eventually, a plastic surgeon was consulted and he talked to me after reviewing the X-ray. He explained that I had a broken jaw, and that he was going to hospital me and do surgery in the morning. He said my jaw would be wired shut for six weeks. I asked if I was going to lose my front teeth that were loose. He said he didn't think so, but that I would have a dental consult to check things out after they removed the wires on my jaw in six weeks. Then he said that he knew I was in severe pain, and that he'd ordered pain shots for me during the night. He said he wanted me to be comfortable, and explained that he wanted me to request a pain shot any time I was in pain during the night. Then he put his hand on my shoulder and said, "This is very routine, and you're going to be fine." At that very moment, my pain instantly went from severe to zero, and I did not need a single pain shot all night long. Dave Fribush emphasizes that while the surgeon's warmth and compassion were helpful, the thing that made my pain suddenly disappear was the sudden disappearance of my negative feelings--intense anxiety about losing my teeth, as well as anger at feeling that I was being neglected. And the very moment my negative feelings changed, my anger disappeared as well. My later research confirmed that negative emotions can, in fact, magnify the experience of physical pain, and that, on average, 50% of the pain we experience results from our negative emotions. This finding should provide hope for individuals struggling with physical pain, especially since this is a drug-free treatment not involving opiates. if you want to reduce your negative feelings, one approach would be to read one of my books, like Feeling Good or When Panic Attacks. They are, of course, not guaranteed to cure you, but research confirms that many people who read them do develop a more positive outlook on life and experience significant reductions in depression and anxiety. And the can be obtain inexpensively at Amazon or other book sellers.  Next week, David, Rhonda and Dave will discuss three more questions you have submitted: Does emotional trauma cause brain damage? Do you have to have a good cry when something traumatic happens? Why does avoidance make anxiety worse?  David & Rhonda

Today in this Ask David episode, David answers listener questions rapid fire style around topics like his ideal definition of success, the way he treats people, the importance of practicing gratitude and appreciation, as well as a glimpse into the personal transformations he has made over the course of this year. Links & Resources The […]

Today, Rhonda could not join us due to the religious holidays, so we have recorded several podcasts with my wonderful neighbor, Dave Fribush, as host. In addition, we are joined by Michael Simpson, a friend and colleague from New York. Dave, Michael and I answer two thought-provoking questions! 1. Working with Abused Women Hi David (and Rhonda!), I want to start out by stating how much I love your podcast. It has helped me understand myself, and, in turn, has made me a much more effective counselor. I'm a drug and alcohol counselor, working here in Los Angeles. I work primarily with women from 18 - 25 years old who have aged out of the foster care system. They are an endearing group of women, as I know you are aware (I've heard you speak of working with this population), and they just want to feel loved and worthy. However, their deep-seated beliefs of being unworthy of good things happening in their lives prevents them from attaining their goals of getting jobs, getting their children back, and gaining housing. These deep-seated beliefs are based on mistreatment by their families of origin, and their subsequent experiences in the social services system. Most were sexually abused or physically abused as children, taken out of their homes, then bounced around from one Foster Care family to the next. Despite my best efforts, the majority of these women go back out to the streets just shy of completing our 6- to 12-month treatment program. Once on the streets they return to drug dealing, prostitution, and crime. After which, if they are lucky, they get picked up and incarcerated. Many die on the streets of drug overdoses or murder. I'm using all of the tools I can to help them change their core beliefs, but it is challenging to say the least! My question to you is—is there a book coming out which goes into depth about T.E.A.M. therapy? I need to become the most effective counselor I can in order to help these women recover and lead normal lives. Thank you so much for your help! Keep up the good work. You are definitely saving lives!! Pennie Hi Pennie, Thank you so much for your question. I did work with this population at the Presbyterian / University of Pennsylvania Hospital in Philadelphia, and found the patients to be incredibly rewarding and hungry for help, love, and connection, as you have said. I’m sure it is heart-breaking for you to see so many fall short, continue to struggle, and even die on the streets. I found this population to be particularly easy and rewarding to work with because they seemed so grateful to be getting any kind of help at all. Many of our patients were homeless, and about a quarter of them could not read or write. We gave them more than eight hours of cognitive group therapy every day in a residential treatment setting, so they got 40 to 50 hours of therapy per week. The program was very inexpensive to run, and was more or less free to the participants, paid for by some type of medical assistance insurance, as well as by our hospital. Most patients showed dramatic changes within three or four days. The average length of stay was something like a week or ten days or so. In today's podcast, I describe a patient in one of our groups, a woman who was severely depressed. She thought of herself as "weak" and "a bad mother." She recovered from her depression in just 20 minutes or so when I used a TEAM-CBT method called "The Paradoxical Double Standard Technique. My book, Ten Days to Self-Esteem, is the program we used at my hospital in Philadelphia when working with this population. It is a simplified version of CBT, and it is a ten-step program that can be administered individually or in groups (which I prefer.) It is written using simple words for individuals with little education. We gave a copy to every patient entering our program, and found that really boosted our outcomes. The hospital purchased them in quantities of 50 or more, and got the wholesale price, which made the books cheaper than having to copy the materials for the patients. There's also a companion Ten Days to Self-Esteem, The Leader's Manual, that you can get as an eBook. It shows the group leaders how to set the groups up and what to do at each of the ten group sessions. There are many additional resources for you, if you'd like to learn more about CBT, as well as TEAM-CBT. First, my new book,  Feeling Great, is now at the publisher, PESI, and should be coming out in 2020. I'll update you as more details become available. But yes, it does have all the new TEAM-CBT stuff in it. It is intended for therapists as well as the general public, and features lots of written exercises while you read, so you can really master the many new methods and concepts. My psychotherapy eBook, Tools, Not Schools, of Therapy, is for therapists, and we use it in all of our TEAM-CBT training programs. It is an interactive book that shows you how to do TEAM-CBT in a step-by-step way. this book also features many challenging interactive written exercises to complete as you read. You might enjoy some of my in person workshops, as well as the many weekly online TEAM-CBT training programs at the Feeling Good Institute.  My one day workshops with Dr. Jill Levitt are really well received, and you can join online from anywhere in the world. My yearly intensives in the US and Canada are usually pretty awesome as well. I hope this information is helpful, and Iwish you the very best in the important and compassionate work you are doing with this incredibly deserving group of women who are suffering so greatly! 2. Why don’t you advocate “Wellness” or “Holistic” Approaches? A therapist named Georgina recently emailed me and was pretty excited about her clinical work which was dedicated to “Wellness” and to “Holistic” treatment methods. I mentioned in an email that I am “intensely anti-wellness and anti-holistic.” She sounded a bit shocked and added: “I'm one of those clinicians who provide consults to other clinicians on Pilates and yoga in integrative psychiatry.” Hi Georgina, Thanks for your thoughtful emails! I know my statement was “politically incorrect” in an era that emphasizes lots of non-specific treatment methods like meditation, healthy dieting, daily exercise, yoga, and so forth. The quick answer to your question, which you can also hear in the podcast on “fractal psychotherapy,” (https://feelinggood.com/2019/03/04/130-whats-fractal-psychotherapy/) is that I focus narrowly on one specific moment when the patient was upset, and if it is an individual mood problem, like depression or anxiety, I ask the patient to record his or her negative thoughts and feelings at that specific moment on the Daily Mood Log. This activates just a few brain networks, out of the billions or trillions of networks in the brain, and we selectively modify those networks using techniques specifically chosen for this individual patient. There are no no-specific interventions. The goal is rapid complete recovery followed by highly specific Relapse Prevention Training, so the patient will know exactly what to do the next time s/he falls into the black hole of depression, hopelessness, and despair. Essentially, I give the patient a little ladder that she or he can use the next time the Negative Thoughts return. No one can feel happy all the time, but nearly all people can learn to limit those bumps in the road that we all encounter from time to time. It sounds like the work you do for patients with Parkinson’s Disease is terrific, and desperately needed. My father in law died of Parkinson’s Disease several years ago, and we saw and experienced personally what a devastating and tragic disease it is. Although I do not include any ”wellness” or “holistic” tools or concepts in my treatment plans, I have nothing against aerobic exercise, yoga (my daughter totally loves it!), meditation (my host, Rhonda, is a strong advocate), or a healthy diet, or anything else someone may find fun, exciting or helpful. It’s just that I’m trained in, and have developed, highly specific, super-fast acting treatments. I believe that “non-specific techniques” have only a placebo effect on mood, although the placebo effect itself can be quite strong and potentially very helpful. In addition, I believe that non-specific techniques can ONLY change mood if you change the way you think. So, if you jog, or eat a healthy diet, or meditate daily, and tell yourself, “Wow, I’m really living a healthy life,” you will feel good if you believe this thought. The jogging or food you eat will not, itself, cure your depression, or panic attacks, or fix your broken marriage, or help you recover from OCD, or PTSD, and so forth. These conditions ARE highly treatable, however, using specific, fast-acting techniques that are individualized to you. We call this treatment TEAM-CBT. Again, I’m sure that many people will HATE what I just said, but I guess we will need some pretty refined research—research that’s never been done—to find out! The research that’s out there definitely cannot answer this question. All I offer is a quick cure for specific problems. I’m not offering “everything” to “everybody.” I am aware, too, that my answer may be cheered by some and may be angrily booed by others. I like to speak from the heart, and from my experience, but I’m often wrong, and sometimes way off the mark, so no problem if you disagree or think I’m nuts! You might also find our first and second podcasts on Mindfulness Meditation to be useful or interesting. David    

Happy Thanksgiving if you live in the United States! This is my favorite holiday, because it means just hanging out with the people you love, eating some wonderful food together, and doing simple things like a family hike, without the commercialism and "push" of some of the other holidays. I wish the very best to you and yours, too! Today, Rhonda could not join us due to Yom Kippur, the highest Jewish holy day. So we will record three podcasts with my wonderful neighbor, Dave Fribush, as host. In addition, we are joined by Michael Simpson, who flew out from New York to attend my Empathy workshop two days ago. He will also join the Tuesday group at Stanford tonight. Michael is doing a massive upgrade / fast lift of my website, www.feelinggood.com, which will likely be published by the time you read this. Let us know what you think about the new "look." Dave Fribush, Michael and I answer many thought-provoking questions submitted by listeners like you! 1. How can I overcome my fear of blushing? Hi David, Hopefully this reaches you well. I am dealing with Erythrophobia (the fear of blushing) and have been having issues with going out with friends, being in public, in work meetings, etc. The weird part is that I don't even get red, but the visualization in my head is so vivid sometimes (Kool-Aid man) that I believe it. Sometimes, if I think about it long enough (like an internal panic attack for 20+min), I get kind of red. . . . Currently, I am trying to just break this habit and I have been reading your book When Panic Attacks and it has been pretty good at helping me. I have been facing my fears and going out into public and hanging out with friends; I'm kind of anxious on the inside of getting red all of sudden, which puts me on edge. I look in the mirror and see that I am not red, but it’s been hard to train my brain to believe it. I started reading your book five days ago and it has helped a lot already. Since then, I have been able to accept I don't mind being occasionally red or nervous and I'm fairly confident, but I struggle to accept the idea of being perpetually red? Part of me wants to accept the idea that "Eff-it! If I'm red, I'm red! That's who I am,” but another part of me knows that it's not true; occasionally I might blush but it’s not the norm. Please let me know if you have any advice. I think this might be a great podcast topic because I know a lot of people with Rosacea deal with anxiety and I'm sure that would help a lot of others. Best, Alex Hi Alex, I have a awesome podcast on the fear of blushing! You might find it helpful (Podcast #88, published on May 14, 2018.) I cannot do therapy through this medium, so this is just general teaching, but exposure / self-disclosure in one method you could use. You could tell 5 to 10 strangers every day something like this: “Could I speak to you for a moment? I’ve had the fear of blushing almost all of my life, and I’ve been hiding it from everybody out of shame. But today, I’ve decided to stop hiding and being ashamed, so I’ve decided to tell people, and that's why I'm telling you.” You’ll find tons of additional ideas in the podcast and in one of my books, like the one you’re reading, When Panic Attacks, as well as The Feeling Good Handbook. Actually, blushing is NEVER a problem. The only problem is the shame. Without the shame, the blushing, like shyness, can be an asset, making you more human and more appealing. Also, on my Sunday hike yesterday, we were joined by a young Stanford dermatologist who showed us some photos and videos of a new laser treatment for rosacea, which is similar to blushing. Apparently, the treatment is quite effective. Thanks, David 2. How can you get over a broken heart? Hi David, First of all, I would like to thank you from my bottom of my heart for the wonderful jobs you are doing. I have a question regarding aftermath of divorce and searched feelinggood.com for any post but I couldn't find any. My best friend is going through divorce process and he cannot forget the good memories he had with this wife. He still loves her so much and would like to continue their relationship but she's not interested in that. They have been separated for 4 years and he tried his best to bring her back. How can I help him move forward? Those good memories are haunting him? Thanks, Didi Hi Didi, Thanks for your terrific question, as most of us were rejected by someone we loved at some point in our lives. You’re in luck! We just recorded a podcast on how to help a friend or loved one who’s hurting, and by the time you read this, it will have been published. It's Podcast #164 on “How to HELP, and how NOT to Help!” It was published on October 28, 2019. You can find the link on the list of all of the published podcasts on my website. I would definitely listen before trying to "help" your friend! Resources for your friend might include the book I wrote on this topic, which is called Intimate Connections. One of the themes is that rejection could never upset a human being—only distorted thoughts about being rejected. This book can be helpful to the many people who have been divorced, or who have broken up with someone they loved, and are having trouble getting back into the dating game effectively, as well as the many people who are having trouble getting into the dating game for the first time. Another great resource for him would be the chapter on the Love Addiction in Feeling Good: The New Mood Therapy. It describes a woman who had just been rejected by her husband, who was having an affair with his secretary, and she was telling herself that she couldn’t be happy without his love. The story had an amazing outcome, and might be very helpful for your friend. Of course, motivation is incredibly important. Your friend might not want to be “cured,” so to speak, since his depression and thoughts about his Ex keep the relationship alive in his mind, and also give him an excuse to avoid dating and developing new relationships, which can be anxiety-provoking and effortful for just about anybody! David 3. How would you treat someone with anorexia nervosa? This question was submitted by our friend, Professor Mark Noble, on behalf of one of his colleagues at the University of Rochester. I, David, explain what anorexia is, and describe my experience with an anorexia patient I treated in Philadelphia when she was discharged from the inpatient unit. I emphasize the need for the TEAM-CBT technique called the Gentle Ultimatum, since the patient didn't want o maintain her weight at a safe level, and just wanted to talk talk talk during sessions without doing any psychotherapy homework.  I also describe the “Coercive Therapy” also called Family Therapy for anorexia,  developed at the Maudsley in London, and we talk about how the same principle—getting the parents to work together on the same team, with firmness, intense mutual support, and compassionate insistence—works for almost any problem children are having. However, this requires the parents to support one another, and work together as a strong and loving team, and many parents who are in conflict will find it difficult to do this, since the urge to argue and fight can be so powerful. Then the parents sacrifice the well-being and happiness of their children in the name of ongoing war (blame, fighting, sticking up for “truth,” and so forth). Dave F. and Michael Simpson ask why this approach of getting parents to work together, can be so incredibly powerful and helpful to children. David

In today's podcast, David and Rhonda answer two questions about suicide submitted by podcast fans. Question 1. Why do shrinks kill themselves? Dear Dr Burns, Before I get to my question (which I hope you will consider addressing in your 'Ask David' segment of the podcast), I would like to extend my gratitude to you. Your book, Feeling Good, came to me at a time when I was struggling to make sense of my depression and anxiety, and it has been a vital part of my recovery journey. The exercises and the podcast have been such lifelines, and I am grateful to you for the incredible and life-changing work that you do. I know you have addressed the topic of suicide in a previous episode, but I recently was struck by a piece of news from my alma mater, the University of Pennsylvania, where a senior member of the college's counselling services (CAPS) died by suicide. Here was someone who had spent his life's work on promoting suicide prevention, and had a great deal of knowledge on resilience. How can we process/understand the decisions that someone like this might make to take his life. How can I arrive at the understanding that his decision doesn't necessarily spell doom for the rest of us? What TEAM-CBT exercises can we do to make sense of the world when it might not make much sense at first glance, during situations like these? Thank you very, very much, Sindhu Dr. David's Answer Thanks, Sindhu, this is a really great question. I’ll put this in the Ask David folder. Should I use your name? Here’s the short answer. It’s a lot like saying that an infectious disease expert shouldn’t get pneumonia, or that an orthopedic surgeon shouldn’t have back pain, or a broken leg. I know of at least three mental health professionals who have committed suicide, but my knowledge based is tiny. I’m sure there are thousands of mental health professionals who have committed suicide. People can commit suicide for many reasons, and I can only mention a few here, as my knowledge, like yours, is limited. Hopelessness is one of the most common causes of suicide in depressed individuals. Hopelessness always results from cognitive distortions, and never from a valid appraisal of one’s circumstances. Depressed people often turn to suicide, thinking (wrongly) that it is the only escape from their suffering. You may have done something that you are profoundly ashamed of, and fear it is about to be made public. Like the fellow in New York arrested for child abuse who hung himself just a few weeks ago. I am convinced that sometimes people commit suicide to get back at someone they are angry with, someone perhaps who rejected them. Physician-assisted suicide. I believe that physician assisted suicide is absolutely indicated and compassionate if someone is in excruciating pain from an irreversible terminal illness. The Achievement Addiction. Feelings of failure and worthlessness. In our culture, we sometimes (wrongly) base our feelings of self-esteem on our success in life, our income, or our achievements. And so, if your achievements are only “ordinary,” you may feel worthless, like “a failure,” and kill yourself. The Love Addiction: Many people (wrongly) tell themselves they must be loved to feel happy and worthwhile, and then kill themselves when they are rejected by someone they thought they loved and “needed.” Drug and alcohol abuse: These habit, when severe, can greatly disrupt a person’s life. They can also make someone more impulsive, and more likely to jump or pull the trigger when intoxicated. There are likely way more causes than just these common ones. For example, a psychotic process like schizophrenia might sometimes play a role as well. I suspect you may have a hidden “Should Statement,” telling yourself that a mental health professional “should not” get depressed or have the urge to commit suicide. But to me, that would be a nonsensical claim, and it isn’t even clear to me why you might think that way. In fact, most people are drawn to this profession because of their own unresolved suffering. There is, I suspect, MORE depression and anxiety in mental health professionals, but I have not seen data, so I’m not certain of this. But I’ve trained tens of thousands of mental health professionals, and pretty much ALL of the ones I’ve known personally have struggled at times, and sometimes intensely. People also ask, “Why did so and so commit suicide? S/he was so famous and loved and wealthy!” Well, famous and loved and wealthy people often suffer and commit suicide, too. Finally, I would say that suicide is both tragic and devastating—for the patient for sure, for the family and friends who typically suffer for years, and for the therapist as well. Fortunately, the family and friends can be helped, if they ask, but it is too late for the person who was depressed. And the tragedy is needless in most cases, since the patient’s intense negative feelings can be treated effectively in nearly all cases. David Question 2. How can you find out if a friend or loved one is suicidal? Many people are afraid to ask a depressed friend or family member if they are feeling suicidal, fearing this will create conflict or may even cause the person to become suicidal. For the most part, these fears are unfounded, and the biggest mistake could be avoiding the topic. Most people who are feeling suicidal are willing to discuss their feelings fairly openly. Several types of questions can be useful. Suicidal thoughts or fantasies. Most people with depression due have suicidal thoughts or fantasies from time to time, and these are not necessarily dangerous. First, you can ask, “do you sometimes feel hopeless, or have thoughts of death, or wishing you were dead?” If s/he says yes, you can ask him / her to tell you about these thoughts and feelings. You can also ask if s/he thinks of suicide as the only way out of his / her suffering. Second, you can ask if s/he simply has passive suicidal thoughts, like “Sometimes I feel like I’d be better off if I were dead,” or active suicidal thoughts, like, “Sometimes I have fantasies of killing myself.” Suicidal urges. You can ask if s/he sometimes has urges to kill himself / herself. Suicidal thoughts or fantasies without suicidal urges are usually not especially dangerous. Suicidal plans. You can ask if s/he has made any plans to actually commit suicide. If so, what method would s/he use? Jumping? Shooting? Hanging? Cutting? You can also ask if s/he has been acting on these plans. For example, if shooting is the choice, you can ask if s/he has access to a gun and bullets. If jumping is the choice, you can ask where s/he plans to jump from. Deterrents. When evaluating suicide, you can also ask if there are any strong deterrents, such as religious beliefs, impact on family and friends, and so forth. If there are no strong deterrents, the situation is more dangerous. Desire to live, desire to die. You can also ask the person how strong their desire to live is, and how strong is their desire to die? Past suicide attempts. If the person has made suicide attempts in the past, the risk of a future suicide attempt is greater. Drugs and alcohol. You can ask if the person drinks or uses drugs, and has ever has a stronger urge to commit suicide when intoxicated. This is a danger sign. Impulsiveness. Some people make suicide attempts when they’re feeling impulsive, kind of on the spur of the moment. You can ask if they every have these kids of sudden impulses. Willingness to reach out. You can ask if they’d be willing to reach out and ask for help if they ever have a suicidal urge. Honesty. You can ask if they were felt reasonably open and honest in asking your questions, or if it was difficult to answer some of the questions. Once you have explored these types of questions, you can decide whether action is necessary. If the person seems in danger of making a suicide attempt, you can bring him / her to an emergency room for an evaluation. If s/he refuses, you can dial 911 and ask for help. Generally, the police will come immediately and do a safety check, and bring the person to an emergency room involuntarily if necessary. You can also call his or her therapist and alert that person to the situation. This may all sound grim and very unpleasant, but these kinds of conversations can sometimes be lifesaving, and can protect you from much greater pain later on. In a future podcast, we will focus on this question: How do you treat someone who is suicidal using TEAM-CBT? David D. Burns, M.D. & Rhonda Barovsky, Psy.D.    

163: Ask David: Anxiety, Dreams, Cyclical Negative Thoughts, Secrets of Selling, Exposure, and more Can you treat anxiety without meds? How do you interpret dreams? Are negative thoughts cyclical? How can I get over anxiety when selling? How does exposure work? Will you teach on the East Coast again? Hi! We’ve had tons of great questions from listeners like you. Here’s the first: Question #1. TREATING ANXIETY WITHOUT MEDICATIONS Hi Dr. Burns, I would love to talk to you!!! I have been going to a wonderful counselor for several years, and he is the one who recommended your book. My question is how can you overcome anxiety without taking medicine? I have been on a very low dose medicine for years and would love to discontinue but when I try the anxiety seems to come back. Thank you. Lisa Hi Lisa, Thank you for your email! This is one of my favorite topics, since I’ve personally had at least 17 different anxiety disorders that I’ve had to overcome. That’s why I love treating anxiety. Whatever you’ve had, I can say, “I’ve had that too, and I know how it sucks! And I can put you on the road to recovery, too!” Did you read When Panic Attacks, or one of the earlier books? The written exercises would be the way to go, I think. You will find more than 40 methods in that book. Write back if you have questions after reading it. Focus on one specific moment when you are anxious, and do a Daily Mood Log, as illustrated in Chapter 3. You can also listen to the free Feeling Good Podcasts on anxiety. Go to my website, FeelingGood.com, and click on the Podcast tab. There, you’ll find a list of all the podcasts, with links. In the right hand panel of every page, you’ll find the search function. You can type in “anxiety,” or “social anxiety,” and so forth, and all the relevant podcasts and blogs will pop right up. You can also sign up in that same right-hand panel of every page so you’ll receive all the new podcasts, along with the show notes. In addition, withdrawal effects are pretty much inevitable when going off of benzodiazepines, if that is the type of medication you are taking. These are the drugs most often prescribed for anxiety, like Valium, Librium, Ativan, Xanax, and so forth. Typically, the withdrawal, which typically involves insomnia and increased anxiety, take several weeks to wear off. Your medical doctor can guide you in this. I cannot advise you about medications in this forum, so make sure you check with your doctor! David Question #2. How can you interpret dreams? Hello, Dr. Burns. I am terrified that this may be the most boring question you have ever received, but, I’ll press on none the less. I often experience very vivid dreams after listening to your podcasts. In fact, I recently dozed off after listening to one of your podcasts on procrastination (#75) and forgot to turn off my phone. In my dream I was in my childhood house and could hear you talking away in some far corner of the house and I was really getting quite annoyed and angry. I really wanted to find you to tell you to shut up, but I couldn’t get the words out. When I awoke, podcast #77 was playing, which seems to explain some of my unconscious hostility. I struggle with most of my relationships and don’t really want to deal with all the hard work I have to do to improve them. So, there you have it! Thanks for listening to me and all your Herculean efforts on behalf of all those in the struggle to grow. Mike Hi Mike, I explain how dreams function, and give an example with my dream that I had a broken jaw! Question #3. Are Negative Thoughts cyclical? David, I have a question about our strong attraction or inclination to negative thoughts. Are our psychological processes cyclical? People seem to recycle the same negative thoughts for years. Even if we produce a strong alternative thought or reattribution it may not be a default choice the next time. How can we make the alternative/ positive thoughts a conscious choice? Thanks, Rajesh Hi Rajesh: Negative Thoughts are not cyclical for the most part, but are an inherent part of our human nature. The podcast on fractal psychotherapy might be useful, since the same Negative Thoughts will tend to come back over and over throughout your life. And once you have learned how to combat those thoughts, you can use the same techniques to smash the thoughts whenever they pop back into your mind. The written exercises I describe in my books, like the Daily Mood Log, are extremely helpful, even mandatory, in building new brain networks and strengthening them through repeated practice. Bipolar manic-depressive illness is a little different, and it can be quick cyclical. (David will briefly explain this.) Thanks Rajesh for yet another great question! david Question #4. I’m in sales. How do I combat my Negative Thoughts about each person I approach? Hi David, I have been struggling with anxiety for the last 18 months and recently faced up to the fact I have also been suffering from depression. And then I discovered your podcasts. I have been spending a lot of time on the episodes I believe I can benefit from the most. I have found your solutions to be the most beneficial I have come across. Thank you for sharing your ideas and techniques with all of us! A couple of questions—How would you advise constructing a work day to reduce anxiety? I work in sales and feel anxious before every phone call or visit I encounter, and the anxiety can be for reasons that seem to be related solely to each sales encounter on individual basis! And my anxiety will grow as the day goes on. My second point would be, would there be a benefit in monitoring positive thoughts and feelings throughout the day, like happiness and hopefulness, rather than negative feelings? Hi Rudi, I’ve done a lot of sales work, including door-to-door sales when I was young. When I was 8 years old, I sold show tickets door to door. When I was a teenager, I sold Fiesta Chips, Cosmo’s Cock Roach Power, tick powder for dogs, and For Econoline Vans door to door in Phoenix. So, I feel a soft spot in my heart for everyone involved in sales! In fact, I’m still involved in sales! But these days I’m selling happiness, self-esteem, and intimacy. I think it could be useful to do a written Daily Mood Log on the anxiety you feel before one of your calls. I think you will find there are certain themes that are common to each call, such as fears of rejection, disapproval, or failure. Once you’ve dealt with these fears successfully, I think they will help in all of your sales encounters. If you send me a partially filled out Daily Mood Log, perhaps Rhonda and I could provide more specific tips on how to crush your Negative Thoughts. If you listen to Rhonda’s work on performance anxiety, you may find it extremely helpful. In addition, the Five Secrets of Effective Communication are the keys to successful sales. I used to think that you had to sell yourself, or your product, which is rarely true. I learned that the key is to form a warm relationship with your customers. David will explain what he learned from his mother, who sold women’s clothing part-time at a department store in Phoenix. Thanks, Rudi, I hope to hear more. Question #4. Why and how does exposure for anxiety work? Hi Dr. Burns, I am a big fan and believe that you are the greatest living psychologist of our time. I have seen you in person and hear your recent PESI presentation (link). Quick question, when exposure is used to get rid of anxiety, what do you think is the mechanism in the brain? It works paradoxically, instead of strengthening a neuro-network it extinguishes it. Any ideas how. Thanks for your time, and again I have learned so much from you in my over 30-year career, thank you for that also. Sincerely, Dr. Mark Hi Dr. Mark, With your permission, will include this on an upcoming Ask David on my Feeling Good Podcast, but I think you discover a couple things during exposure: When you stop running away and confront the monster, you discover that the monster has no teeth, so you go into enlightenment. This is the basis of Buddhism and the teachings in the Tibetan book of the dead. During exposure, you also discover that after a while the anxiety just kind of wears out, dwindles, and disappears. The brain simply cannot continue creating anxiety for prolonged periods of time, especially when you are doing everything you can to make it as intense as possible. You discover that you can, in fact, endure the anxiety and survive, and that you do not have to “escape” from the feeling of anxiety via avoidance. One other thing that is important is that I treat anxiety with four models, not one: 1. The Motivational Model; 2. The Hidden Emotion model; 3. The Exposure Model; and 4. The Cognitive Model. All play vitally important and unique roles in the treatment of anxiety. Exposure alone is NOT a treatment for anxiety, just one tool among many that can be helpful, and often incredibly helpful, as you’ll see in the upcoming podcast on the treatment of Sara, a woman struggling with severe OCD for more than 20 years. Great question! Hope to catch you in one of my upcoming in-person / online workshops! Thanks, David Mark’s reply and a brief final question Hi Dr. Burns, Yes, of course you have my permission to use my question! Also, I do understand your impressive approach to treatment (not just exposure), and again it is genius. I also love that you see the connection between Buddhism and cognitive restructuring, where as Dr. Beck only went as far back as Socrates and the Greek Stoic philosophers. I don’t know if you ever read the Dhammapada (best translation I found is Eknath Easwaran) as it clearly states that our life is shaped by our mind, and that our feelings follow our thoughts just like a cart follows the ox that pulls it. Thanks again! Will you be coming to the East coast again soon? Hi again, Mark, Yes, I’ll be coming to Atlanta for a four-day intensive in November! Check my workshop tab at www.feelinggood.com for more information. (https://feelinggood.com/workshops/) david David D. Burns, M.D. & Rhonda Barovsky, Psy.D.    

Today in this Ask David episode, we answer a question around the difference between being relentless and running yourself into the ground. In this episode you’ll learn: The mindset shift required to approach today with relentless passion  How you can move your life forward by silencing the repetitive thoughts that tell you that it’s more […]

Plus, Thomas Szaas, TV Shrinks, and more! David and Rhonda are joined today by David's neighbor, friend, and hiking buddy, Dave Fribush. He has incredible technological skills, and wisdom.  We thank Dave for his support of our podcasts! We open the podcast with a wonderful email from a fan named Sushant who listened to Feeling Good Podcasts for nine hours during a rigorous hike to the "Tiger Monastery" in Bhutan. You can see Sushant and his phone, showing the podcast icon, just in front of the monastery. Rhonda encourages podcast fans from around the world to send photos of yourself listening to the Feeling Good Podcast in additional unusual or exotic locations! Might be fun to see what you send to us!  Here are the questions for today's program: Ann asks: Loved your podcast (on the exposure model, #26)! But I do have a question - I have suffered from panic attacks for years - the past 2 years I've become agoraphobic and don't want to be far away from my house. So, my phobia is now "having panic attacks." Does that mean I just need to go out and have a bunch of panic attacks in public to get over my fear? The thought seems terrifying. Also, I am severely claustrophobic which affects me anytime I feel trapped (elevators, small cars, traffic, tight spaces, etc.) Is there a protocol you used to treat patients with this? Just wanted to suggest perhaps a podcast on this subject, or agoraphobia, as it does affect many people worldwide. Nathan asks: Dear David, Love your podcasts. I am currently preparing a lecture for psychology honors students here at Monash University on assessment of depression and anxiety. In your podcasts you mention that you conducted a "study on the psychiatric inpatient unit at the Stanford Hospital, in which I evaluated how accurate therapists’ perceptions of patients were after an interaction. Student researchers interviewed patients for several hours as part of a research study on psychiatric diagnosis." I was wondering if you could provide me with a reference to this study? I could not find a specific reference in your website and I would like to be able to highlight to student's the results of your research. Richard asks: I listened to your podcast on being worthwhile and found it interesting. You say all people are worthwhile. This may be true but does the whole world think this? If a person is worthwhile but the world thinks they are not worthwhile, isn't this almost as bad as not actually being worthwhile. Don't we have to play by the world’s rules, however bad, instead of our own or the Platonic rules? What do you think? Robert asks: Dear David. I am up to podcast #108. I am heading to India next month for a three-week trek and am going to download the rest onto my phone. Perhaps by the time I get back, I will be up to date! I have never heard you mention Tom Szasz, who, as I am sure you know, was making some of the same observations about the constructs of medicalizing you make back in the 1960s and maybe even in the 50s. In particular, his criticism of the psychiatric industry giving the names of diseases or syndromes to behavioral issues was very consistent with yours. Robert also asks: My other question is an idea for future podcasts and it is...How about critiquing the therapeutic approach we see so often on television and in the movies? For the lay audience, these are probably the source of much of what they know about therapy. And because these therapists are well-known and fictional, it would give you an opportunity to make critiques without having to criticize an actual person. And it could introduce some levity into what can often be quite heavy. Some of the Hollywood therapists people know best are: Judd Hirsch as the shrink in Ordinary People Lorraine Bracco as the shrink in The Sopranos Peter Bogdanovich as the shrink's shrink in The Sopranos Billy Crystal as the shrink in Analyze This! Robin Williams in Good Will Hunting Kelsey Grammer in Frasier I am sure there are many others. These are the ones who quickly came to mind I just found an article about this that might help make the case that what the public sees on TV and in the movies is not really reflective of the therapeutic process or good therapy. Here’s the link: https://www.huffpost.com/entry/therapists-on-the-big-and_b_4263798 Thanks for tuning in! David and Rhonda References for Nathan Burns, D., Westra, H., Trockel, M., & Fisher, A. (2012) Motivation and Changes in Depression. Cognitive Therapy and Research DOI 10.1007/s10608-012-9458-3 Published online 22 April 2012. Hatcher, R. L., Barends, A., Hansell, J. & Gutfreund, M.J. (1995). Patients' and therapists' shared and unique views of the therapeutic alliance: An investigation using confirmatory factory analysis in a nested design. Journal of Consulting and Clinical Psychology, 63(4), 636 - 643.  

Ask David Five Secrets Relationship Questions Kate asks: I love listening to your podcasts and am currently reading my way through your book, Feeling Good. I appreciate that you have written and spoken about relationship problems at length, but in what I have read and heard so far I do not see how this can apply to the current climate of casual dating and hook up culture which is fueled by apps such as Tinder. I don't know how it's possible to build relationships when the dominant mentality is that people are disposable. It feels like no matter how much I find truth in what my date says, stroke them and empathize with them, that they will disappear ('ghost') at the drop of a hat. I think this may be a significant problem for many of your listeners, and would greatly appreciate your thoughts, as well as any practical steps on how to date in today's world. * * *  Eli asks: Your work has helped me tremendously over the past 2 years. However, recently I’ve discovered something about myself that I don’t know how to change. I’d be really curious to hear your thoughts. For some reason, when it comes to sex, it seems that I have a lot of self-worth wrapped up in my sex drive. I’m realizing when my wife and I have sex I feel like I’m on top of the world afterwards. I feel so positive the following few days and I feel mentally and emotionally healthy. But it’s devastatingly real that the reverse is true as well... when we don’t have sex (and particularly when I reach out and she’s not in the mood) and when a week or so passes that we don’t have sex, I find myself feeling very insecure. I feel ugly, unlovable and generally less valuable as a person. Is there an exercise you would recommend for me to discover possible hidden thoughts/emotions that could be causing this? Is it possible to change this about myself? I want to have a close, intimate relationship with my wife (sexually and non-sexually) but I also want to feel valuable and positive whether or not we’re sexually active. PS - If, by chance, you address this on the podcast, could you refer to me as “Eli” or something else anonymous as you usually do. Thank you for all you have do! * * *  Susan asks: You seem like a good person to ask this question partly because you are a man. Someone I know, I won’t say whom, told me he felt emasculated when I asked him to take my car to the gas station to get the wipers replaced. He said that he should be able to replace them himself but doesn’t actually know how, so he would prefer if I took the car to the service station. I said that was stupid, granted not very diplomatic, and he said that’s what he gets for expressing his feelings, which I frequently complain he does not do. To me “emasculated“ is more of a concept or a thought. I will not get into toxic masculinity and the patriarchy, but I am curious what you think. By the way, this person and I have benefited a lot from your relationship journal exercise, thankfully we did not need it this time :-) * * *  Knaidu asks: Here’s a specific example which occurred whilst I was trying to use the disarming technique. It is one where I failed to use the technique. Anyway, I was meeting a friend of mine, and was a running a few min late for our lunch appointment. I couldn't send her text to let her know as I was driving. I arrived at least 5 min late. When I arrived she immediately said "I knew it all along, you really don't want to meet with me or actually have lunch with me!” I tried to explain that I was stuck in a traffic jam and couldn't text, but it didn’t work. Here’s what I said:  “Please Mrs. X, I was stuck in a traffic jam and that's why I am late. Have I ever said I don't want to meet with you? And if I didn't why have I bothered to arrive at all, I mean I could have just not arrived if I didn't want to meet you!" After I said that she stormed off. I am afraid I could agree with her idea that I didn't really want to meet with her, because the truth was I did want to meet but couldn't help being late. I could agree with something that was not real to me and if I did try to agree, I would be lying to her. Please help me, David and Rhonda! Thanks for tuning in, and keep the great questions coming! David and Rhonda

New Ask David Questions Kelly asks: Would love to hear a podcast about to use or not to use touch in therapy. I personally feel touch is extremely helpful (what is more natural than to hug or put a hand on someone hurting), however I believe our profession has become so “professionalized” that is leaves out such a power act of healing. Did you ever use touch when you were practicing, and do you feel it is appropriate? Against Machines Taking Over asks: You say that depression always results from distorted thoughts. But the sadness that results from a failure, rejection, or disappointment is not distorted. Can you explain a bit more about this? Against Machines Taking Over also asks: Is there something you used to advocate for before but then you changed your mind? Eduardo asks: How do you treat hypochondriasis. Almost all articles and advices I've read for hypochondriasis try to cover the writer's back by first and foremost telling you that you should get yourself checked for real causes for your concern. Eduardo also asks: I've been struggling with anxiety, and after reading When Panic Attacks, I got very interested in giving The Hidden Emotion model a try, but it seems to be structure-less. It seems to require a lot of detective work with no clear sheet or procedure. It's just Detective Work, and then do something about it. Is there some newer technique to dig into what's eating you?

Today in this Ask David episode, we answer a listener question around hard work and it’s difficult relationship with success. In this episode you’ll learn: The confusion around hard work and success, and how a deeper understanding is required to make it work for you  The misery and suffering mentality around hard work and how […]

Today in this Ask David episode, we answer listener questions around integrating the ego for greater success, the concept of false desire vs. true desire, embracing a career change to chase your passion, and a better understanding of Core Wound Diagram. In this episode you’ll learn: Holding a higher belief is a constant practice  The […]

How would you overcome the fear of aging? Can you use TEAM for sports psychology? Describe your typical day, David-- do you ever get down or anxious? Hi Listeners: Thanks for your many and awesome questions. I love to answer them! And there will be more to come in future podcasts. Your questions are GREAT!  Vipul: Tell us about your new book, Feeling Great. How will it be different from Feeling Good? And can people with schizoaffective disorder be helped? (story with Stirling Moorey) Guy: What’s a nervous breakdown? Rob: How would you treat a field goal kicker who’s afraid of missing the winning field goal? Would you use positive visualizations? Michael: How would you treat someone with the fear of aging? I turn 60 in a few months, and have been experiencing anxiety around not be able to do some of the things I love as I age. Hidem: How fast is fast? I notice your frequent use of the term "High Speed Recovery" (and even Warp Speed) when describing the benefits of TEAM CBT. How rapidly does the average patient recover? Brittany: I had an idea that I think would benefit a lot of us. I’d like you to do a podcast on a week or a day in your life. The ups & downs of your moods, triggers, etc., & most importantly how you deal with them. Do you write out your own Negative Thoughts a Daily Mood Log? Thank you for all of your great questions, comments, and testimonials! Rhonda and I really appreciate that!   David and Rhonda PS Here's a great question we did not get to today. We'll do it in a future Ask David, as it's really important.  Rubens: What can you do when you can’t identify your negative thoughts? I get anxious, but don’t seem to have any negative thoughts. Is it really true that our feelings always result from negative thoughts?  

My wife claims that I never listen! How can I possibly agree with her?  My wife left me! How can I correct the distortions in her criticisms? How can you deal with people who constantly wallow in self-pity? And more! Hi podcast fans, Today we've got some terrific Five Secrets questions that you have submitted. Mike #1: I love your Five Secrets of Effective Communication. Why does secret #4, “I Feel” Statements, not include Thought Empathy? Mike #2: I have seen communication models that include expressing and listening for needs. Aren’t needs and wants important and important to express? Al: How can I help my wife recognize her many cognitive distortions, like All-or-Nothing Thinking? It seems hopeless! Guy: If a loved one says, “You never listen,” how could I possibly find the truth in this statement? How could you genuinely agree with an All-or-Nothing statement such as, “You never ….”? Both Sonja and Eileen asked: How can you deal with someone who constantly wallows in self-pity and plays the role of victim. It's exhausting! Thanks for tuning in, and keep the great questions coming! David and Rhonda