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Live Work with Ruben: Part 1 of 2 Working with Performance Anxiety in Real Time Hosts: Kevin Cornelius, LMFT Dr. David Burns Guests: Dr. Jill Levitt Ruben Land In this live work from a recent Tuesday Group, we had the opportunity to work with Ruben, a highly capable and thoughtful clinician, who brought a struggle that many therapists quietly share: intense performance anxiety in evaluative situations, especially in the presence of authority figures or people he deeply admires. What made this work especially powerful is that Ruben was actively experiencing anxiety in the moment, allowing us to "get in the car with him" rather than talk about the problem abstractly. We began, as always in TEAM-CBT, with Testing. Ruben had completed a Brief Mood Survey, which showed relatively low baseline symptoms—just mild anxiety and minimal depression or anger. However, when we reviewed his Daily Mood Log, anchored to a specific situation (leading a group under supervision), we saw a very different picture: anxiety at 70%, feelings of inferiority and defectiveness at 80%, embarrassment at 70%. This contrast highlights a core principle: symptoms are often situational and state-dependent, and without anchoring in a specific moment, we risk missing the true intensity of the problem. From there, we moved into Empathy, where Jill did a beautiful job modeling the Five Secrets of Effective Communication. She captured Ruben's internal experience with precision: the pressure to perform, the fear of saying the wrong thing, the spiral of anxiety leading to cognitive blanking, and the secondary anxiety about appearing anxious. She also identified both the internal loop ("I'm anxious about being anxious") and the interpersonal fears ("they'll think I'm a fraud," "I'm wasting their time"). David complemented this with curiosity and gentle inquiry, helping to deepen the conceptualization without getting lost in theory. Importantly, we conducted an empathy check, asking Ruben to grade us on thought empathy, feeling empathy, and warmth. He gave A+ ratings across the board, with a slight adjustment on thought empathy when he introduced an additional element: a compulsive need to check and recheck, suggesting a subtle OCD-like process. This moment is critical—without the empathy check, we would have missed an important maintaining factor. Only after strong empathy did we move into Agenda Setting, which is often the most counterintuitive and transformative part of TEAM-CBT. David began with the Invitation, asking whether Ruben wanted help or more support. Ruben was ready to "roll up his sleeves," which is essential—no imposed agenda. Then we used the Miracle Question to clarify goals: Ruben wanted to feel less anxious, maintain fluency, and stay present in high-stakes situations. Next came the Magic Button, targeting outcome resistance. When asked if he would eliminate all his negative feelings, Ruben said no—he wanted to keep some anxiety. This is exactly what we hope for. It opens the door to Positive Reframing, where we honor the symptoms rather than pathologize them. Together, we identified numerous positive values and benefits of his anxiety and self-doubt: Anxiety motivates preparation and effort It enhances connection through vulnerability It reflects caring deeply about others and their time Feelings of inadequacy keep him humble and growth-oriented Fear of judgment protects him and signals high standards Even the thought "I might be a fraud" reflects a desire to be authentic and competent At one point, Ruben articulated that his anxiety shows he values others and wants to contribute meaningfully—this is a profound reframe. Jill and David reinforced these insights, helping him see that his "symptoms" are actually expressions of his values system in action. We also explored a key factor: his anxiety is amplified in performative, evaluative contexts, especially with authority figures, and is less intense in vulnerable, non-evaluative settings. This distinction is clinically crucial and guides both conceptualization and intervention. Another powerful moment came when Ruben acknowledged that self-disclosure reduces his anxiety, supporting the idea that "shame requires secrecy." When he hides his anxiety, it intensifies; when he shares it, it softens. This is both a therapeutic tool and a treatment target. After thoroughly addressing resistance, we moved into Goal Setting, asking Ruben not what he wants to eliminate, but what he wants to dial down. This is a hallmark of TEAM: Anxiety: 70 → 30 Shame: 30 → 20 Inadequacy: 80 → 30 Embarrassment: 70 → 20 We then transitioned into Methods, targeting the thought: "My speech is too slow, and I sound foolish, ignorant, and boring." Jill began with a classic but essential step: identify the distortions. Ruben quickly identified all-or-nothing thinking, overgeneralization, mental filter, discounting positives, mind reading, fortune telling, labeling, self-blame, and hidden "shoulds." This is an important teaching point: when a thought contains nearly all distortions, it's not a problem—it's a goldmine. From there, rather than staying intellectual, we offered multiple method pathways—Externalization of Voices, Feared Fantasy, Be Specific, and Double Standard—modeling flexibility and collaboration. Ruben chose Externalization of Voices, which became the central method. David stepped in as the Negative Ruben, delivering the attack clearly and forcefully. This is essential—the more vivid the critic, the more powerful the response. Ruben responded using a blend of acceptance ("it's true I sometimes pause"), self-defense, and realism (some people may not like it, and that's okay). He won "big," but not "huge," which is a key TEAM moment—we don't settle for partial wins. They then moved into role reversal, and this is where things deepened. When Ruben played the critic and David responded, David modeled a powerful combination of self-acceptance, counterattack, and refusal to buy into the critic's frame. He highlighted that the real problem wasn't slow speech—it was the constant inner criticism. Ruben immediately recognized this as a "huge" win. Ruben then practiced again, this time integrating acceptance, values ("my heart is in the right place"), and counterattack ("the bigger problem is your nagging voice"). This time it felt huge. Next, they targeted a different thought: "If I screw up, David will be disgusted and see I'm a worthless, selfish fraud." This brought up more anxiety, and Ruben got stuck. Jill did something very important here—she paused the method and returned to empathy, naming the pressure to "do it right" and the performance anxiety happening inside the exercise itself. After empathy, they resumed. Jill modeled a powerful response in role reversal that included radical acceptance of imperfection ("I expect to screw up"), a growth mindset ("that's why I collect feedback"), and a reframe of failure as essential to learning. She also gently challenged the distortion of David as a harsh authority figure and emphasized choosing supportive learning environments. Ruben then extended this insight even further, saying, "the more I fail, the better… the more vulnerable I am, the less I appear like a fraud." This was a genuine shift. They then moved into Feared Fantasy, with David playing "David from Hell," saying things like "you're incompetent," "you're worthless," and "you should find another profession." Ruben responded by using Be Specific, asking what exactly he had done wrong. When the answer became "you paused," the entire structure of the criticism collapsed. Ruben saw the absurdity and described the experience as a weight lifting. This is a classic TEAM moment—when global, harsh judgments are reduced to specific, manageable behaviors, they lose their power. They extended this further with the thought "I'm wasting people's time." Through additional role plays, Ruben practiced self-defense and purpose clarification, David used humor and counterattack, and Jill demonstrated Be Specific in a very precise way—asking exactly how long a pause should be, exposing the irrationality of the standard. The work then expanded to include the group. Participants used Externalization of Voices to challenge Ruben's thoughts, and Ruben responded with increasing strength and clarity, using self-acceptance and reversal of beliefs (for example, recognizing that vulnerability actually increases connection). David then introduced the Survey Technique, asking Ruben to directly check his assumptions with the group. The responses were striking—people reported never noticing pauses, experiencing him as thoughtful and engaging, and feeling more connected because of his style. This directly disconfirmed his mind reading and labeling. At the end, they returned to Testing. Anxiety went from 70 to 0, shame from 30 to 0, inadequacy from 80 to 10, embarrassment from 70 to 0, rejection from 40 to 0, and frustration from 30 to 0. Ruben reported that the change felt real and that his belief in the negative thoughts had dropped dramatically. When asked what created the breakthrough, Ruben identified two key moments. First, a deep emotional realization that the goal is actually to make mistakes—that failure is not something to avoid but something to embrace. Second, a shift in how he saw authority figures—recognizing that the perceived gap between himself and others was distorted. As that sense of separation dissolved, so did much of the anxiety. David highlighted that much of our suffering comes from that artificial separation—seeing others as powerful and ourselves as deficient. Jill added an important layer: when we assume others are harsh, judgmental, and critical, we are also distorting them, not just ourselves. Some key clinical takeaways: Externalization of Voices becomes especially powerful when it includes emotion, repetition, and role reversal. Feared Fantasy works best when the criticism becomes specific and even a bit absurd. The Survey Technique is extremely effective for dismantling mind-reading. And often, breakthrough comes when patients fully embrace failure and let go of perfectionism. Let Us Know What You Think of This Episode Please use this link to take a very brief survey and share your opinion with us about this episode Contact Information You can reach Jill Levitt, PhD Jill Levitt . Jill is cofounder and Director of Clinical Training at The Feeling Good Institute (www.feelinggoodinstitute.com) in Mountain View, California. Ruben Land is an Associate Social Worker at Feeling Good Institute. He provides psychotherapy, using TEAM-CBT, and is available to work with clients in California. You can reach Ruben at ruben@feelinggoodinstitute.com and visit him online at this link. Kevin Cornelius, LMFT is a Level 5 Certified Master TEAM-CBT Therapist and Trainer and the Clinical Director of Feeling Good Institute--Silicon Valley. He specializes in the treatment of trauma, anxiety, depression, relationship problems and insomnia. You can reach Kevin at kevin@feelinggoodinstitute.com and visit his website at www.tools4change.me. You can reach Dr. Burns at david@feelinggood.com. Feeling down in these turbulent times? Take a ride on our Feeling Great app. Feeling Great feels wonderful! You owe it to yourself to feel GREAT! Give the Greatest Gifts of ALL--Love and Happiness!
Tower of Babel 2.0 is happening NOW. Stephen of Biblical Hitmen joins Nephilim Death Squad to expose the manufactured awakening pushing humanity straight into Lucifer's false light.In this deep dive, Stephen breaks down the Great Awakening map, Edgar Cayce's Atlantis prophecies, the Hall of Records under the Sphinx's paw, and how the “Sons of the Law of One” vs “Sons of Belial” narrative is the ultimate Hegelian dialectic. They cover Alice Bailey's Externalization of the Hierarchy, Theosophy root races, Sophia as the counterfeit Holy Spirit, the Harlot of Revelation, and how Joe Rogan, psychedelics (ibogaine), Graham Hancock, Randall Carlson, and David Wilcock are all feeding the same Atlantean Gnostic gospel.David Wilcock's “return to source,” starseeds, prison planet truths, and the sudden mainstreaming of the Book of Enoch and Genesis 6 are all dissected as the next layer of deception. Stephen explains why this isn't random exposure of the New World Order — it's initiation into the New Age universal religion that counterfeits Christ.If you've ever wondered why conspiracy truth is being allowed to spread right now, this episode reveals the endgame: Tower of Babel 2.0 — humanity uniting under one “divine source” (Satan masquerading as light).Timestamps:00:00 – Intro & Announcements08:00 – Manufactured Awakening & Timing of Exposure22:00 – Great Awakening Map & Return to Source35:00 – Edgar Cayce, Atlantis, Hall of Records & Sphinx Prophecy48:00 – Sons of the Law of One vs Sons of Belial1:05:00 – Alice Bailey, Sophia, Gnostic Gospel & Harlot System1:25:00 – Joe Rogan, Psychedelics, Ibogaine & Cultural Manufacturing1:45:00 – Book of Enoch, Nephilim Debate & Why It's Being Pushed2:05:00 – Biblical Response: Gospel Over Gnosis (Ephesians 3:17-19) Support the show & get early access, ad-free episodes & community:https://patreon.com/nephilimdeath squad Guest Links:Stephen – Biblical HitmanYouTube: Biblical HitmanPatreon: patreon.com/thebiblicalhitmanSpotify / Apple Podcasts / Spreaker: Biblical Hitman Merch & more: TopLobster.com Don't forget to OBEY SUBMIT & COMPLY. Stay rooted in the true Gospel — everything else is Tower of Babel 2.0.Become a supporter of this podcast: https://www.spreaker.com/podcast/nephilim-death-squad--6389018/support.☠️ Nephilim Death Squad — New episodes 5x/week.Join our Patreon for early access, bonus shows & the private Telegram hive.Subscribe on YouTube & Rumble, follow @NephilimDSquad on X/Instagram, grab merch at toplobsta.com. Questions/bookings: chroniclesnds@gmail.com — Stay dangerous.
Why Isn't TEAM More Popular? Why Do So Many Therapists Resist TEAM CBT? Featuring Matt May, MD Why has the therapeutic community been so resistant to TEAM? This topic has been a concern to me or many years. To be honest, it isn't new. From the very start of cognitive therapy, when I was first learning it, I began modifying it to make it more dynamic, powerful, and effective. But to be honest, I ran into a small (at the time) of Beck loyalists who branded me as an "outsider," something Beck also did when my book, Feeling Good, began to sell and gain popularity. This saddened and frustrated me, and still does, but it had some great spin-off. On my own, my ideas and approaches grew rapidly, and there was no scarcity of young therapists who wanted to work with me. Below, you will ready Matt's take on why TEAM CBT has not caught on better, followed by my own thoughts. So read, and enjoy, and feel free to share your own thinking on this topic! On the live podcast, you will hear our lively discussion with our beloved and brilliant host, Rhonda! Thanks for listening today! Matt, Rhonda, and David Matt's take: Hi David, I'm excited to discuss this topic! Also, I agree we would be hard-pressed to cover it in an hour, which I believe is the goal for the podcast. So, why isn't TEAM isn't more popular? My short answer is that TEAM isn't more popular because many therapists don't want to learn it. Those reasons will vary from one person to another and relate to concepts in the model, itself, like 'process resistance' and 'outcome resistance'. While biological factors, like deficits in cognitive flexibility and neuroplasticity, the 'primacy effect' and age-related changes in the brain, combined with the complexity of the TEAM model, will make it near-impossible for some folks to learn it, these barriers are hard to address with our current technology For the purpose of this conversation, it probably makes more sense to consider the psychological barriers therapists have to adopting a model that is scientifically proven to be superior to other approaches. As a proponent of TEAM and an instructor, I'd love to know what I'm doing wrong, in presenting the model and how to get more people excited about learning it. While more research would help us see the problem more clearly, here are some factors that likely play a role: It seems humans have a hard time adopting new truths, regardless of the field being considered. I believe it was Schopenhauer who said all new truths go through three phases on the way to acceptance: People will ridicule it, violently oppose it, then say they knew it all along as self-evident! One cause of this is something called the 'primacy effect'. People preferentially retain the first version of a story they hear. If that information is corrected, later, they will continue to believe the first version they heard. Biological Factors play a role in learning, including genetics, aging, illness and toxic exposure. 'Switching gears', mentally, is more challenging in people with Schizophrenia and their first-degree relatives, for example. We know that neuroplasticity is greatest in our youth and declines over our lifespan. Hence the importance of early education and attending to our overall health, habits, nutrition and medical care. Socioeconomic and Cultural factors certainly play a role. This is well documented in the book, 'The Emperor's New Drugs', showing how marketing prevailed over science in promoting "antidepressants". Many therapists in training tell me, 'oh, they wouldn't let me use a measurement tool where I work'. Lack of 'Critical Thinking'. What people believe often has nothing to do with what is evidence-based or logical. Many people reject global warming despite the evidence and prefer to believe in conspiracy theories. We tend to preferentially believe what someone says if we feel a kinship or loyalty to that person or view them as an 'expert'. People might believe RFK Jr. when he says immunizations are dangerous, for example, because he is in their political party and in a position of power, rather than review the science for themselves. Sunk-Cost Fallacy: People who have gone through training may have a sense that they have invested too much time and money in their education to discard that model and start afresh. Even if we covered this in just a few minutes, we'd still be up against the hardest part of TEAM to learn, Agenda Setting. Lots of 'Good Reasons' NOT to have open hands, explore topics paradoxically, and reasons this is challenging, technically. So, yeah, we'll have a lot to discuss and I'm looking forward to that! Sincerely, Matt Here is David's list Taking a page out of your book, Matt, our field is filled with so-called "schools" of therapy that function much like cults, most with a narcissistic "leader" at the helm. In a cult, members are required to be absolutely loyal, and to believe in claims the guru makes that have little or no evidence to back them up. For example, most "schools" of therapy claim to know "the" cause of emotional distress, when the causes of depression and other forms of emotional disturbance are still not known. What I have been suggesting is that we get rid of all the schools of therapy and usher in a new era of science-based, data-driven therapy, which would amount to a revolution in our field. This idea, which I feel passionate about, always meets with stiff and hostel opposition / push back. People just don't want to hear it. TEAM integrates high-level empathy and compassion with firm accountability. Give Stanford story with Sunny Choi, and the statement that "Stanford graduate students and faculty cannot be held accountable for doing psychotherapy homework. The need insight-oriented therapy!" This angrily issued statement conveyed, actually, two cult-like (to my thinking) components: First, we KNOW that patients should not be asked to do psychotherapy homework between sessions. Second, we KNOW that "insight-oriented therapy" is the treatment, without ever evaluating them. TEAM focuses on the here and now, and emphasize a "fractal" approach to treatment, where the same distortions and self-defeating beliefs will be embedded in the patient's negative thoughts and feelings every time she or he is upset. So, when you change the present, you have already changed the past. Whereas most therapies have traditionally (and still) focus on the past, thinking they will find the cause of the patient's distress in some pattern or traumatic event. TEAM focuses on rapid change in the here and now, where as many (most?) therapies focus on talk therapy that unfolds slowly, over a period of months, years, or even more. This DOES provide a powerful financial incentive to do "talk therapy," since this drastically provides financial security and reduces the incredible pressure of constantly have to find new patients. TEAM is very challenging to learn. I have taught over 50,000 therapists in the past 35 years or more, through my supervision of graduate students and psychiatric residents, my weekly training group at Stanford, and my workshops, including intensive, around the US and Canada. And one lesson that has emerged is just how difficult it is to learn TEAM. It requires a high level of intelligence and aptitude, and an unusual dedication and commitment. A great many of the most important tools, like Assessment of Resistance, and Externalization of Voices with the CAT, Self-Defense, and the Acceptance Paradox, are extremely difficult to learn and master. And most give up, and drop out, in favor of some simpler and more formulaic therapy that is easy to learn. TEAM training requires constant role-playing with specific and immediate feedback on your performance, which includes bot a letter grade (A, B, C, etc.) as well as what you did that was effective, and where you fell short and might need to fine-tune your technique with frequent role reversals, always with feedback. This means lots of criticism along the way, which many (most?) therapists do not like. And although we repeatedly emphasize the philosophy of "joyous failure," and "learning through failure," most people do not buy it emotionally. We all want success and compliments! And NOT the "great death" of the self." The "great death" permeates every phase of the T E A M process. At the T = Testing, you will nearly always learn that your perceptions of your patients feel, and how they feel about you, are way off base. This is critically important, but painful for most, as it is a direct body blow to our "need" to be in the role of "expert." Unlike most other forms of therapy, we require therapists to measure patients' feelings, "in the here and now," at the start and end of every therapy session, using brief, highly reliable scales that assess feelings of depression, suicidal urges, anxiety, anger, and also happiness, as well as relationship satisfaction or discord. These scales function like an "emotional X-ray machine," allowing therapists for the first time to see exactly how effective or ineffective you were in every therapy session. Can you take it? On the positive side, this information will allow you to fine tune the therapy and learn from all of your patients every day. On the negative side, you may not want to have to "see" your failures before your eyes at every session with every patient. David: Tell the story of Tuesday group patient who proudly showed me her depression (and other scores) over the previous year with one of her patients. . . But there was absolutely no improvement in any scale. This was shocking and it made me very sad. My goal is to get dramatic changes within a single session. This "great death" continues during the E phase. TEAM therapists are required to ask "What's my grade on empathy" during the session, and also patients fill out the Empathy Scale and other scales on the "Patient's Evaluation of Therapy Session" right after the session. These scales are set up to make therapist failure common, almost universal at first. A warm and curious dialogue about where the therapist went wrong can revolutionize the therapy and deepen the relationship—quickly. But at what cost to the fragile ego of the insecure shrink? The "great death" continues with A = Paradoxical Agenda Setting. You give up your role as the "expert:" or "helper" or "rescuer," which many therapist refuse to do, and instead "become" the patient's subconscious resistance, arguing, with compassion and logic, that there are many GOOD reasons NOT to change. This freaks therapists out! The "great death" continues with the M = Methods phase of the session. I have developed roughly 140 methods to help people challenge distorted negative thoughts and self-defeating beliefs, and have always taught that no one method will work for everyone who's depressed and anxious. So you will have to try many methods, using the Recovery Circle, to find the one that works for each patient. But these methods are challenging to learn, and most therapists don't seem to have the intelligence, aptitude, or commitment to learning how to use them. Many of the methods and insights of TEAM or subtle nuances that many therapists do not "get" or perhaps do not want to "get." Example, the ACT training group, where someone held up the Feeling Good book and said, "We do not want THIS!" They falsely believed that "leaning into" your feelings is always the answer, and wrong believed that TEAM tried to make people happy all the time—called Toxic Positivity—whereas nothing could be further from the truth. In fact, I mentioned healthy negative feelings as early as, I think, Chapter 3 in Feeling Good, "Sadness is Not Depression," where I told the story of an elderly man who died on the Stanford inpatient medical service one evening when I was a medical student. Much of what I teach is shocking and at odds with what people are taught in graduate school. For example, the idea that most people with depression and anxiety—NOT everybody!—can be effectively treated in a single, extended therapy session. Curses! That sounds horrible! And even worse-sounding is the idea that change typically happens suddenly, at the very moment patients stop believing their distorted thoughts. Of course, since most therapists have not seen these phenomena, due perhaps to not having the skill, they insist instead that David is some type of fool, liar, or con artis. Okee Dokee! People—therapists and patients alike—do not "get" a great many of the key ideas in TEAM. For example, let's say the socially anxious patient totally believes the thought, "I shouldn't be so screwed up!" the necessary and sufficient conditions for emotional change. The necessary condition: The Positive Thought (PT) must be 100% true. Rationalizations and half-truths have never helped anybody. The sufficient condition: The PT must drastically reduce your belief in the negative thought. And that's when your negative thoughts will suddenly change. There is even more of what I teach is shocking and at odds with what people believe. For example, 2,000 years ago Epictetus stated they key premise of all the cognitive therapies: "People are disturbed, not by things, or events, but by the views they have of them". And recently, our research team has provided proof of this for the first time, in a study of nearly 7,000 users of our Feeling Great app, using sophisticated statistical modeling techniques. So, the three tenants of cognitive therapies, including TEAM, are: First, you FEEL the way you THINK. In other words, all of your positive and negative feelings result from your thoughts in the here-and-now. Second, depression and anxiety are the world's oldest cons. In other words, your negative thoughts, like "I'm not as good as I should be," or "I'm a hopeless case,"—will be loaded with many of the ten cognitive distortions and are extremely misleading—but you don't realize this when you're upset. You will believe these thoughts with all your heart and feel CERTAIN that they are 100% true. Third, you can CHANGE the way you FEEL. But lots of people will won't have it. They keep insisting on theories that simply aren't true—that emotions cause thoughts, for example—and on methods that may have little or no "punch" above and beyond the placebo effect. Story of Tuesday group student who was scolded in her graduate school counseling program for using the words "thought" or cognition during a therapy session. She was told ONLY to focus on feelings. Many people—therapists and patients alike—strongly believe that therapist empathy is THE key to healing. I have developed many powerful empathy tracking and training methods, but our clinical experience and research has shown, over and over, that therapist empathy is NOT the key to healing. They keys involve using TEAM systematically, and the rapid healing happens during the A and M for the most part. But those are the hard parts! Other problems include the idea that we can convert normal human emotional distress into a series of "mental disorders" that are listed in the DSM, the "bible" of the American Psychiatric Association. In TEAM, we consider each patient's patterns of suffering at the start of therapy, quickly and easily screened by the EASY Diagnostic System, but monitor therapy and patient progress with simple tools that measure feelings, like depression, anxiety, anger, and more. But this is an argument for another day. There's a lot more issues, too. Have I, David, contributed to the resistance to TEAM? Absolutely I have. I plead guilty as accused, and I'm proud of it. I'm totally aware that people—maybe even you— get turned off by criticism, and naturally recoil to protect your "in group," as Matt so clearly pointed out, and maintain loyalty to your "leader," whether it's Freud, Jung, Beck, Hayes, Rogers, or whoever. People are more emotional than rational, and people can be intentionally cruel and deceptive, too, all in the name of what they believe. We see that in our politics these days too. People believe things that are totally false, and wildly implausible, because the group or leader says it's true, it's the way things are. I'm a strong believer that science and truth will win out in the long run. Is this inevitable? I'm not totally confident, and have my doubts, but I am also filled with hope, and look to a future with more therapists like our beloved Matt May, MD and others who have dared to venture in a radically new direction, much like the early astronomers like Galileo and Copernicus who dared to challenge the superstitious teachings of the Catholic church. Those brave and brilliant early souls said, "things are NOT the way you think!" And they used data and mathematical modeling to prove their points. But there were a hundreds years of intimidation and suffering until people finally began to catch on to the then-ridiculous and outrageous ideas that the sun does NOT actually revolve around the earth, and that the earth is NOT the center of the universe. Those NOTS changed history. Can it happen again in the fields of psychiatry and psychotherapy? I hope so, and I've been giving my all, in my teaching, research, clinical work and writing, to make this happen. Sadly, I've fallen far short of my dream, but I'm thankful every day for what I've got, and the wonderful colleagues I'm privileged to know and love. Warmly, David, Matt and Rhonda
As long as our shame is hidden, there is nothing we can do about it. “The only way out is through.” "Embracing our shame involves pain. Pain is what we try to avoid. In fact, most of our neurotic behavior is due to the avoidance of legitimate pain. We try to find an easier way. This is perfectly reasonable. In the case of shame, the more we avoid it, the worse it gets. We cannot change our “internalized” shame until we “externalize” it. Externalization methods include:1. Coming out of hiding by social contact, which means honestly sharing our feelings with significant others. 2. Seeing ourselves mirrored and echoed in the eyes of at least one non-shaming person. Reestablishing an “interpersonal bridge.” 3. Working a Twelve Step program. 4. Doing shame-reduction work by “legitimizing” our abandonment trauma. We do this by writing and talking about it (debriefing). Writing especially helps to externalize past shaming experiences. We can then externalize our feelings about the abandonment. We can express them, grieve them, clarify them and connect with them. 5. Externalizing our lost Inner Child. We do this by making conscious contact with the vulnerable child part of ourselves. 6. Learning to recognize various split-off parts of ourselves. As we make these parts conscious (externalize them), we can embrace and integrate them. 7. Making new decisions to accept all parts of ourselves with unconditional positive regard. Learning to say, “I love myself for . . .” Learning to externalize our needs and wants by becoming more self-assertive. 8. Externalizing unconscious memories from the past, which form collages of shame scenes, and learning how to heal them. 9. Externalizing the voices in our heads. These voices keep our shame spirals in operation. Doing exercises to stop our shaming voices and learning to replace them with new, nurturing and positive voices. 10. Learning to be aware of certain interpersonal situations most likely to trigger shame spirals. 11. Learning how to deal with critical and shaming people by practicing assertive techniques and creating an externalization shame anchor. 12. Learning how to handle our mistakes and having the courage to be imperfect. 13. Finally, learning through prayer and meditation to create an inner place of silence wherein we are centered and grounded in a personally valued Higher Power. 14. Discovering our life's purpose and spiritual destiny.All of these externalization methods have been adapted from the major schools of therapy. Most therapies attempt to make that which is covert and unconscious into something overt and conscious.These techniques can only be mastered by practice. You must do them, then reinforce them by doing them again. They will work if you will work." JOHN BRADSHAW - Healing the Shame that Binds You John Bradshaw's website.Buy the book, Healing the Shame that Binds You Read the TOXIC SHAME article from Very Well Mind.Read Julie's Medium Blog.Support JULIE (and the show!)Support + get some bonus stuff over on PATREON.Get an occasional personal email from me: www.makeyourdamnbedpodcast.comTune in on INSTAGRAM AND YOUTUBE or TIKTOK.Info on War Tax Resistance.Donate to the Palestinian Children's Relief Fund and the Sudan Relief FundThe opinions expressed by Julie Merica and Make Your Damn Bed Podcast are intended for entertainment purposes only. Make Your Damn Bed podcast is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Support this show http://supporter.acast.com/make-your-damn-bed. Hosted on Acast. See acast.com/privacy for more information.
Meet Richard Lam-- Master TEAM CBT Teacher and Therapist! Today we chat with Richard Lam. Richard is a licensed Marriage and Family Therapist in private practice in Mountain View, California. He is a graduate of Palo Alto University. He currently provides short-term therapy for anxiety, OCD, habits/addictions, depression, and relationship concerns using Cognitive Behavioral Therapy. Richard also trains other therapists in David Burn's model of CBT called TEAM-CBT Therapy. He is a certified Level 5 Master Therapist and Trainer in TEAM-CBT Therapy. And today, Richard has gifts for you! They are fantastic! See below! I began by asking Richard how he got interested in teaching. When he was first learning, he was tutored by Dr. Angela Krumm, an advanced TEAM CBT practitioner and one of the three founders of the Feeling Good Institute. He was loving the training, but one day she said, "That's all I can teach you. Now you have to start teaching!" And that started the wagon rolling down the hill. Richard is particularly interested in developing free self-help tools for patients, but also runs a special training class for TEAM CBT therapists who themselves want to become trainers. It meets in-person at the FGI office on Mondays from 12 to 2 PM. If interested, contact Richard (contact information is at bottom of show notes.) Richard is one of our most articulate TEAM CBT teachers, and is renown for some of his live demonstrations of specific techniques, like Forced Empathy. He has created a series of multi-page interactive teaching guides for a variety of techniques, so you can learn exactly how to do the Double Standard Technique, or the Externalization of Voices in a simple, clear, step-ty-step manner. Here are links to several examples. Check them out and feel free to share them with your patients if you are a TEAM therapist. These links are all kick ass! Check them out and do the exercises. You'll be glad you did! Link to Double Standard Technique Link to Externalization of Voices Link to Externalization of Resistance Link to I Feel Statements, Part 1 Link to I Feel Statements, Part 2 Link to Feared Fantasy Link to Forced Empathy Link to Forced Empathy Handout Link to Future Projection, for Habits Link to Paradoxical Ultimatum Richard tells us that mental health works a lot like physical health. When we don't regularly care for our bodies, things start to deteriorate and the same is true for our minds. These tools give you a way to keep nurturing your mental health so you can maintain a strong, healthy mind. Richard and I also discussed Acceptance--one of the most difficult concepts for patients and therapists alike to "get." I was delighted to learn he has a five-point plan to help people grasp this concept. Richard's Five Steps to Acceptance 1. The Win-Win Principle: How can I see this loss as a win? In high school, Richard had a patient whose heart was set on making the varsity basketball team, and was heartbroken when he only made the junior varsity team. But then he got to thinking that it would be fun to be the start on the JV team because his best friend is also going to be in JV. He relaxed and started to enjoy his practices with the team. And He was promptly promoted to the varsity team! 2. Remember the butterfly effect! Richard described getting angry and frustrated when he was late for an important appointment, and the car in front of him was moving slowly and caused a delay at a red light. His first impulse was to get angry and insist it SHOULDN'T have happened. But then, in reflection, he thought: "Wait a minute. This delay will change the entire trajectory of the rest of my life. And who knows, this could have save my life from some future tragedy if the trajectory of my life had been on time." 3, Growth mindset I have always thought of this important idea in simple terms. There is really no such "thing," from a Buddhist perspective, as "success" or "failure." These are just experiences. But often things do not turn out as one hoped. Instead of caving in, giving up, or feeling depressed or frustrated, although those are perfectly reasonable human experiences, you can accept your failure and view it as an opportunity for growth and learning. Our 9 month old grandson has reminded me that when we are learning to walk, we "fail" constantly, falling over, etc. But these are steps in learning that eventually culminates in the ability to walk--which is a miracle! 4. The spiritual view Acceptance can be thought of as letting go of judgement. Richard treated a woman who was angry at God because she could not have children, and she had always dreamed of having a big family. But from a medical perspective, her anger and constant agitation were actually the main reason she couldn't get pregnant. Shen she began working on reducing her anger using TEAM CBT, she was able to relax, and accept her fate with greater in peace. And then she suddenly got pregnant! I, David, have seen this on many occasions. Check out Podcast #7f9, one of our most popular podcasts ever, with Daisy: "What is the Secret of a Meaningful Life?" Or Podcasts 268 - 269, featuring live work with our beloved Dr. Carly Zankman. Or #349: "What if my family rejects me?" All of these podcasts were amazing, and resulted in rapid pregnancies! 5. Empathy vs anger Richard described getting VERY angry when someone broke into his car and stole a bunch of stuff, but then asked himself why they did it. He realized that they were probably struggling and desperate for money--for drugs, for food, for family. Understanding someone's story can help lower the anger that you feel. Richard, Rhonda, and David
Live Work with Madeleine I'm Helpless! Part 3 of 3 Today, we are pleased to present the live and unedited follow-up session with Madeleine, a loving mother who became terrified when she realized that her oldest beloved daughter might be in mortal danger during her hear abroad while in college. Part 3 of 3 We were a bit rushed near the end of M = Methods in Part 2 because of a mistake that I (David) made. I forgot that we had extended this webinar by 30 minutes, so we wouldn't be rushed at the end, so I wrongly concluded we were running out of time when we weren't! In order to complete our work, we scheduled Part 3 several weeks later to do the following critical pieces of the work with Madeleine. Additional work with the Externalization of Voices to make sure she could knock all of her self-critical thoughts out of the park. Cognitive Flooding, using the magazine article she was triggered by to prompt the anxiety. The idea is to make yourself as anxious as possible for as long as possible, until the anxiety and panic eventually loses its punch and becomes boring. This will be one of the first times we have illustrated this technique live in a video-recorded session. Any other loose ends that may have emerged since our first session with the wonderful Madeleine! We did some cognitive flooding, urging Madeleine to close her eyes and describe her most terrifying fantasy involving her daughter's abduction by a sociopathy. We encourage her to make herself as anxious as possible, and within minutes she was at 100% and sobbing. Then we did some "memory" rescripting as we had promised her at the start, and part way through there was an unexpected surge of anger, that seemed to come from out of the blue, although the circumstances of the fantasy were clearly more than enough to trigger rage. Using the technique called "Affect Bridging," I asker her whether the anger she was now feeling might trace back to some earlier traumatic event in her life, perhaps when she was young, and this was confirmed. She described a profoundly troubling indecent involve her mother and dad shortly before they got divorced. There was a tremendous amount of emotion packed into today's follow-up session, almost non-stop, in fact. We look forward to seeing Madeleine's end-of-session Brief Mood Survey and Evaluation of Therapy Session. Jill and David assigned follow-up homework for her, including 15 minutes per day reading the terrifying article from People Magazine that had initially triggered her in the beauty salon. We want to thank you, Madeleine for your courage in being so open and real, and for giving us all a unique opportunity for some incredible learning, and also the chance to get to know you at a deep a genuine level! Thanks for listening to these three podcasts. We hope you enjoyed them and learned something useful and helpful, especially if you've also been struggling with feelings of depression and anxiety, or if you're a mental health professional wanting to take a deeper dive in to how TEAM CBT can sometimes produce extremely rapid healing, even from severe feelings of depression, anxiety, and despair. Madeleine, Jill, Rhonda, and David Following the session, Madeleine sent us the following feedback on the session via email: Hi Jill and David, Completed after session yesterday, but in my state of emotional fatigue, forgot to hit send! Brief Mood Survey after session: Depression: 3 / 20 (minimal) Suicidal urges: 0 / 12 (none) Anxiety: 8 / 20 (mildly elevated) Anger: 9 / 20 (mild/moderately elevated) Happiness: 12 / 20 (low) Relationship Satisfaction: 29 / 30 (nearly perfect) Evaluation of Therapy Session Empathy: 20 / 20 (perfect score) Helpfulness: 20 / 20 (perfect score) Satisfaction: 8 / 8 (perfect score) Commitment: 8 /8 (perfect score) Neg feelings: 4 (high, range = 0- 4) Difficulties with Q: 2 (medium, range = 0- 4) What did you like the Least: exposure was pain. It feels very heavy and exhausting. And i understand, necessary to healing. What did you like the Most: David's "bridging" my affect states to discover my rage source. Jill's keeping us on track and making connection from my present worry about daughter's safety to past feelings of betrayal, losing trust, and resulting anger in my dad, a trusted figure. You both hit the nail on the head so many times in the session to uncover the deeper, ugly, messy, dark pools that lie within me i choose to keep safely sealed tight and out of the light. Postscript: I just completed day 1 of exposure in re reading the awful article. All the anxiety and fear resurfaced along with new feelings of revenge, determination, appreciation for the authors who are perhaps trying to help the family by publishing this. Ick. Best Regards, Madeleine Again, a big thanks to you Madeleine, and we will watch closely as you continue your courageous daily exposure work, and look forward to the day when you have won this battle! Warmly, david
Live Work with Madeleine I'm Helpless! Part 2 of 3 Today, we are pleased to present the exciting conclusion of our work with Madeleine, a loving mother who fears that her eldest daughter might be in mortal danger during her year abroad. Last week, you heard about the T = Testing and E = Empathy phase of the live work with Madeleine, a mother feeling intense panic and helplessness and inadequacy because she fears that her daughter could be in grave danger of abduction and worse. This week, we will focus on A = Paradoxical Agenda Setting, using the Miracle Cure Question, Magic Button, Positive Reframing, and Magic Dial to see if we can melt away her resistance to change. You can see the Emotions table of the Daily Mood Log Madeleine during the Magic Dial portion of the session if you Click Here As you can see, she wanted to reduce her negative feelings somewhat, but thought she still wanted to keep them fairly elevated, since she still sensed that her daughter might be in real danger, and clearly did not want to abandon her. This is one of the significant refinements in TEAM CBT. First, we want to bring the patient's resistance to full conscious awareness. Second, we want patients to full grasp that their negative thoughts and feelings do NOT result from some "defect" or "mental disorder," but rather from what is most beautiful and awesome about them as human beings. After the Magic Button, David and Jill went on to the final, M = Methods portion of the TEAM session, using tools such as Identify and Explain the Distortions, the Double Standard Technique, and the Externalization of Voices, with the Acceptance Paradox, the Self-Defense Paradigm, and the CAT (Counter-Attack Technique). We will, of course, do numerous role reversals to see if we can get Madeleine to a "huge" victory over her many distorted thoughts. You can see the Daily Mood Log Madeleine prepared at the end of the session if you Click Here As you can see, the reductions in negative feelings were dramatic, but in several areas (anxiety, inadequacy, frustration and anger), Madeleine's negative feelings were still minimally elevated. That is one of the reasons we decided to schedule an additional session together several weeks later to see if we could intensify Madeleine's responses to her negative thoughts, and hopefully due some Cognitive Flooding to complete her "treatment." At the end of these show notes, you will find an email from Madeleine after the session that includes her end-of-session scores on the BMS and EOTS. You will also see comments submitted by many participants who attended the webinar live. This email below from Madeleine following the session shows her end of session scores on the Brief Mood Survey as well as the Evaluation of Therapy Session at the end of her session with Jill and David. Hi David, Yes, here are my BMS & ETS score totals after the extended session. Please let me know if you have any questions. A relapse prevention session would be nice; however, I hesitate to accept your offer as you all are so busy. Please know that I am practicing the PTs and keeping the NTs in check for now. Thank you again a million times over
Live Work with Madeleine I'm Helpless! Part 1 of 3 Today, we are pleased to present one of our favorite podcast topics—live work with a real human being who is suffering. We will be working with Madeleine, a woman who read a disturbing article while at the hairdresser and freaked out, sensing that one of her daughters might be in mortal danger. This live and unedited session was first presented as part of a free webinar on September 11, 2025. There was no preparation or role-playing—everything was absolutely real and spontaneous, exactly as it evolved in real time. We present Part 1 as our final Feeling Good Podcast for our 2025 season. This is our most powerful and popular type of podcast, and we hope you enjoy it. We also give a big thanks to our courageous "patient," Madeleine. My co-therapist will be Dr. Jill Levitt, a clinical psychologist and Director of Training at the Feeling Good Institute in Mountain View, California. Jill and I greatly enjoy working together as co-therapists when we teach and we typically see our "patient" for an extended, two-hour session. We find that this is the most effective format for teaching, and that way, we can frequently complete a course of therapy in a single session. However, you do not need more than one therapist to do effective TEAM CBT, and you can do it in conventional 50 minute sessions as well. But often, you can do vastly more in a double session. We will not be engaged in an ongoing therapeutic relationship with Madeleine. When we work with therapists, they are doing personal work as a part of their training. We feel that this experience is vital for every therapist who hopes to do world-class TEAM CBT with their own patients / clients. More than 2,000 individuals registered for this workshop. Although the workshop was open to everyone, only 13% of the participants identified as general public, while 87% identified as mental health professionals. In Part 1, which we present today, we focused on T = Testing and E = Empathy phases of the TEAM session. In Part 2, which you will hear next week, we will focus on A = Paradoxical Agenda Setting and M = Methods. We will also show you the changes in her scores on the Daily Mood Log (DML) and Brief Mood Survey (BMS) from the start to the end of the session, as well as Madeleine's scores on the Evaluation of Therapy Session (EOTS) at the end, including what she liked the most and least about the session. That way, we can see clearly how much improvement there was (or wasn't) during the session, and how Jill and I did in terms of empathy, helpfulness, and other scales that evaluate the patient's view of the session. In Part 3, which you will hear in two weeks, we did more Externalization of Voices along with Cognitive Exposure, since we had some loose ends we wanted to tie up before completing our work with Madeleine. This follow-up session occurred many weeks after the initial session at the workshop, and will also serve as a follow-up to see how Madeleine did in the days following the live work. Part 1 of 3 Our "patient," Madeleine, is a courageous woman who experienced sheer panic after being triggered at the hair salon while reading an article about a young woman who was abducted. Since Madeleine's oldest daughter's is away at college, taking a year abroad, Madeleine realized she could not protect her from predators and freaked out, thinking about all the horrible things that could happen to her. In addition, Madeleine had many self-critical thoughts about ways she thought she had failed her daughter when her daughter was growing up, and worried about her daughter's judgement: She hasn't always made the best decisions about guys she's gone out with, and she's shared everything with me. She says, 'Don't worry mom. I've learned from this.'" At the start of the session, we reviewed Madeleine's scores on the Brief Mood Survey (BMS). This indicated only minimal depression (5/20), with no suicidal urges or anger, but her anxiety was still extremely elevated (18/20). In addition, her Positive Feelings score was only 20 out of 40, with 0 meaning no positive feelings at all, and 40 being the highest possible feelings. However, her Relationship Satisfaction score with her husband was 25 out of 30, which indicates strong satisfaction, with just a little room for improvement. We will ask Madeleine to complete the BMS again, along with the EOTS, so we can see precisely what changed, and by how much, during the session. Our goal, of course, with TEAM CBT, is nearly always to cause a near-complete, or complete, elimination of symptoms during a single, extended therapy session. In addition, we want every patient to have a crystal clear understanding of how and why they got upset, along with how to use the tools that were the most helpful to them in the session. That way, they'll be armed to deal with future relapses, which are inevitable for all human beings. And here's the big point. Our goal in sharing this session with you is so you can feel inspired, and see that rapid recovery really IS possible. And if you're a therapist, we hope that you will feel motivated to learn TEAM CBT so you can significantly improve your outcomes with your own patients. You can see the Daily Mood Log Madeleine prepared just prior to the session if you Click Here The upsetting situation was reading the article about the young abducted woman in the hair salon. On the Emotions table she indicated that she was feeling sad, down, and unhappy (85%), anxious, frightened and panicky (100%), inadequate (100%), frustrated (90%), and angry and upset (100%). These extremely high ratings tells us that Madeleine's negative feelings were about as intense as a human being can experience. Although your life is undoubtedly very different from Madeleine's, perhaps you, too, have felt panic and helplessness when you thought the life of a loved one might be in danger. Madeleine generated several additional negative Thoughts during the empathy phase of the session, including, I'm totally responsible for how she's turned out. 95% I was not present enough for her. 95% She may not trust that I'm there for her. 60% She's anxious and insecure and a people-pleasure, and she's also perfectionistic, and it's all my fault. 75% I should have been more sensitive when she was growing up. I expected too much. 100% Again, if you're a parent, you may have had similar negative thoughts about your own parenting. I know that I have! During the Empathy phase, Madeleine described her horrors when reading the article at the hairdresser's, with thoughts of Natalie Hollaway's brutal murder as well as other women who were abducted and murdered. Madeleine explained that she and her husband both married late, and felt somewhat insecure as parents: "It wasn't easy having children late in life. . . . When our first baby was born, the milk was not coming down. My daughter would look deep into my eyes, and I had the thought, 'I'm letting my daughter down.'" She said she had a rough time when she was growing up and her parents got divorced: "My heart was broken, and I had to learn to be strong. I had to learn not to let so much emotion through. I had to learn how to keep guys at arm's length. I had to protect myself from getting hurt." She said that wanted her daughters to grow up being strong and independent, but as she reflects back, she thinks she may have failed them and not provided enough warmth and support. Our goal during E = Empathy is not to help or even try change anything, but simply to go with our patients to the gates of hell, so they can vent, cry, and express their deepest and most private feelings. At the end of the Empathy portion of the session, we asked Madeleine to grade us on the three key elements of empathy, using letter grades: How accurately did we understand how you were thinking? How accurately did we understand how you were feeling inside? To what extent did we convey the spirit of trust, warmth, and acceptance? She gave us 3 A's, indicating it was time to move on to A = Paradoxical Agenda Setting, which you will hear next week. We will want to find out what Madeleine might want help with. We will also try to melt away her resistance to change using the Miracle Cure Question, the Magic Button, Positive Reframing, and the Magic Dial. Why would we anticipate resistance? After all, Madeleine is asking for help. But remember, the desire for change cannot always be take for granted in anyone. Nearly all of us have mixed feelings about change. After all, a loving and concerned mother might NOT want to stop worrying about a beloved daughter who seems to be in grave danger! But if you deal with this resistance in a compassionate way, you may open the door to the possibility of rapid healing when you come to the M = Methods portion of the session. We can check it out at the exciting conclusion of the work with Madeleine next week!
Welcome to the Leading Edge in Emotionally Focused Therapy, hosted by Drs. James Hawkins, Ph.D., LPC, and Ryan Rana, Ph.D., LMFT, LPC—Renowned ICEEFT Therapists, Supervisors, and Trainers. We're thrilled to have you with us. We believe this podcast, a valuable resource, will empower you to push the boundaries in your work, helping individuals and couples connect more deeply with themselves and each other. Step into a heartfelt conversation where Dr. James Hawkins and Nicola Hawkins explore the art of externalization in emotion-focused therapy. This episode delves into how therapists can gently guide clients into their most vulnerable spaces without overwhelming them—using creative, compassionate externalization techniques. Listeners will find practical strategies, authentic reflections, and moments of inspiration that underscore the importance of safety, attunement, and reintegration throughout the therapeutic journey. It's a compassionate guide for every EFT therapist looking to expand their “toolkit” for helping clients move courageously into their own healing. Top Points from the Episode: - Upcoming training opportunities in EFT and gratitude for the therapy community, especially during challenging times. - The concept of externalization as a gentle intervention to help clients face vulnerability when direct approaches would overwhelm. - Creative metaphors and analogies—for example, “letting clients breathe but not leave”—to describe how to stay connected and supportive in tough moments. - Techniques for externalization: using third-person references, prototypes, past versions of self, and broader narratives to create safety. - The crucial process of reintegrating externalized parts to support clients' healing and growth. - Reflection on the therapist's role in providing validation, understanding, and new perspectives. - Practical adaptations for different cultural and client contexts, ensuring inclusivity and relevance. - Emphasis on co-creating meaning—from reframing past experiences to fostering autonomy and choice within sessions. - Encouragement for therapists to remain flexible, observant, and compassionate when clients hit emotional blocks. - Inspiring reminders about the transformative power of working on the client's “leading edge”—where real change happens. We aim to equip therapists with practical tools and encouragement for addressing relational distress. We're also excited to be part of the team behind Success in Vulnerability (SV)—your premier online education platform. SV offers innovative instruction to enhance your therapeutic effectiveness through exclusive modules and in-depth clinical examples. Stay connected with us: Facebook: Follow our page @pushtheleadingedge Ryan: Follow @ryanranaprofessionaltraining on Facebook and visit his website James: Follow @dochawklpc on Facebook and Instagram, or visit his website at dochawklpc.com George Faller: Visit georgefaller.com If you like the concepts discussed on this podcast you can explore our online training program, Success in Vulnerability (SV). Thank you for being part of our community. Let's push the leading edge together!
Unlock the secret to overcoming anger in Episode 179 of the DYL Podcast! Join host Adam Gragg as he dives headfirst into those fiery moments we all face, and turns them into opportunities for growth. Ever felt your blood boil over a holiday drama or at the office? You're not alone! Discover why anger really shows up, what's hiding beneath it, and the three powerful actions you can take today to reclaim control.From wild tales of flying pen holders and kitchen knives, to honest confessions about facing fear, this episode is packed with relatable stories, laugh-out-loud insights, and practical tools to help you cool the flames before they burn bridges. Learn how externalizing your anger, digging into your hidden fears, and leaning on your “monkeys", those trusted friends, can set you free.Ready to transform your frustration into confidence, gratitude, and lasting change? Listen now and start living the legacy you want to be remembered for. Don't miss out—your courage upgrade begins here!Click Here ➡️ Shatterproof Yourself Light CourseTop 5 Most Relatable Blogs:3 Foolproof Ways To Motivate Your Team: 3 Areas to Focus on as a Leader7 Benefits of Being Courageous4 Ways You're Demotivating Your Team: And What You Can Do About Each One10 Ways to Encourage People: How to Break The Invalidation TendencyHow to Make Good Decisions: 14 Tools for Making Tough Life Choices00:00 "Managing Anger and Expectations"03:35 "Accepting the Uncontrollable"08:20 "Unpacking and Addressing Fears"10:23 "Overcoming Fear and Anger"15:30 "Perspective on Wealth and Life"18:01 "Fighting for Gratitude"20:34 "Overcoming Anger and Legacy"Don't forget to subscribe, leave a review, and share this episode with anyone who could use help managing anger!Live the life today that you want to be remembered for 10 years after you're gone—you decide your legacy! Be sure to check out Escape Artists Travel and tell them Decide Your Legacy sent you!
Relapse and Relapse Prevention for Overeating Featuring Dr. Angela Krumm On today's podcast, we proudly feature an old friend, Dr. Angela Krumm, on the topic of relapse prevention for habits and addictions. This is certainly a top of incredible importance, since all treatments for all habits and addictions seem to have extremely high relapse rates. Anything we could do to reduce that would be a major contribution. Angela was on our Feeling Good Podcast #270 on Nov 29, 2021 describing some TEAM CBT methods she'd developed to deal with her own weight gain. In podcast #270 she taught listeners how to set process goals, instead of outcome focused goals. She then taught about the Triple Paradox, Habit Addiction Log, Devil's Advocate technique, and the Problem-Solution log. In that first episode she explained that this was a difficult time in her life: her father had died, and she'd also experienced a traumatic fall which caused a concussion. So she fell off being careful about her diet, and one day was shocked that she could not recognize herself—due to weight gain--in a photo, and was on the fast track to Type II Diabetes. As a result, she utilized many of the TEAM CBT techniques and slowly, but surely, lost weight and kept it off for multiple years. She explains that she was "solid for a long time, but have to confess, with shame, that I eventually relapsed because I got over-confident. I'd been tracking what I ate, which was an important key for me, and stopped keeping up with it consistently, thinking I didn't really need to anymore." We reviewed the kinds of tempting thoughts she'd had (and still has, of course, at times), when she feels tempted by her favorites: things like delicious brownies, red wine, and other sweet treats. She has tempting thoughts such as: I deserve to take a break from tracking what I eat. I deserve a treat—I've had a hard day. It's silly to be so rigid. I deserve to eat whatever I want. Spontaneity is one of my core values! During the podcast, we illustrated the Devil's Advocate Technique (DAT), which is powerful and a lot of fun, but sometimes trickier than it looks. When Angela gave a "good" but not "huge" response to one of these tempting thoughts, I automatically suggested a role-reversal. Rhonda immediately and rightly reminded us that we never do role-reversals when people are stuck during the Devil's Advocate. Instead, we paradox the person and sit with open hands. Rhonda modeled this beautifully and it worked like a charm. Angela had a sudden about face and blew the tempting thought out of the water immediately. We made three teaching points on DAT. Don't give in to the urge to "help." This will have the opposite effect of keeping the patient stuck. Realize that if you're a therapist, and your patient cannot convincingly defeat all the temping thoughts in the office, the likelihood that they can defeat them when they're at home is 0%. So, the DAT is both a powerful technique to boost motivation with tools you can use when tempted, but it is also a powerful test of motivation. Remember to Sit with Open Hands if your patients cannot convincingly defeat their tempting thoughts. Angela shared that she now realizes that the main reason for her relapse was that she had skipped relapse prevention. This is the danger of being your own therapist, sometimes you make the mistake of cutting corners or getting overly confident. She asked to return to the podcast today to talk about that important mistake and help others prevent that mistake in the future. She wants us to emphasize the important of Relapse Prevention for all habits and addictions. When Angela mentioned that she'd relapsed in her eating to a therapist who was just learning TEAM-CBT, the therapist seemed shocked and asked, "Oh, does this mean that the techniques we're learning don't actually work?" This is such a great (but naïve and common) question, because we always emphasize that all patients—in fact all human beings—will relapse after recovery from depression, anxiety, a relationship conflict, or a habit / addiction. That's why it's so important to tell patients about relapse before discharge from therapy, and do a brief but intensive relapse prevention intervention. We reviewed several of the Relapse Prevention techniques, including the Problem Solution List and the Relapse Prevention Daily Mood Log, using and recording the Externalization of Voices. When you do this step with a patient, ask them to imagine the future moment in time when they have relapsed. It's important to capture the thoughts that will lead them to give up and quit using the techniques. Often, these are hopeless thoughts about the usefulness of the techniques or their ability to remain in recovery. If these thoughts are left unchecked, they will spiral the person into a deeper and more lengthy relapse. If they can predict the thoughts ahead of time and generate powerful rebuttals to use in that moment, then their first moment of relapse can be turned around quickly! We listed several of Angela's predicted negative thoughts during her relapse: I should not have let this happen. 100% I'm not strong enough. 60% It's just too hard to start tracking and logging what I eat again. 65% It will be too painful to have to track and see what I've eaten. 60% This isn't fair. It should be so hard to be healthy! 70% Screw it. I should just accept this and give up! 40% Podcast listeners will judge me because I have gained weight again. 10% We practiced challenging those thoughts with the Externalization of Voices, and Rhonda summarize several of the strategies that can be the most helpful: Self-Defense The Acceptance Paradox. The Counter-Attack Technique A combination of two or three Angela summarized three important take home messages from today's podcast. Always prepare a Relapse Daily Mood Log ahead of time, anticipating what you will be telling yourself when you relapse Challenge those thoughts with EOV and record that role-play so you can listen to it in the future when tempted. After you have lost sufficient weight, make a plan to continue your healthier eating after the acute phase. Do NOT make the common mistake of thinking, "Oh, I've achieved my goal of losing 30 pounds (or whatever), so now I'm done, and can go back to my normal eating habits and patterns again." Thank you for listening today! Angela, Rhonda, and David
COMING UP IN JANUARY: Fast Track to LEVEL 3 TEAM CBT Certification Howdy! If you're a therapist looking to strengthen your TEAM CBT skills and earn continuing education credit, here's an exceptional opportunity coming up in January 2026. Feeling Good Institute's Fast Track to Level 3 TEAM CBT Certification Starts January 16, 2026 • 25 weeks • 46 CEs Special Offer for Podcast Listeners: Use discount code FRIEND50 for a course price of $595.* Enroll Now at FastTrackCBT.com. This hybrid course combines: • Live weekly practice groups • Self-paced video training featuring Dr. David Burns & Dr. Jill Levitt • Deliberate Practice exercises such as Externalization of Voices and the Double Standard Technique • FREE Therapist Toolkit ($199 value) • Certification exam fees included *Early-Career Clinicians: If you're an Associate or Postdoc in the USA or Canada, use code EarlyCareer2026 and get the course for just $195 plus exam fee. Enroll Now at FastTrackCBT.com. If you want to level up your therapy skills for the rest of your career, this may be the ideal time.
Ask David Are You Getting Old and Cranky Now? TEAM CBT and Spirituality The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question. Jenn asks: Are you getting old and cranky now? Jenn also asks: How did you get involved with / develop the spiritual and enlightenment aspect of TEAM? Dear Dr. Burns, Let me start by saying thank you for all of your hard work and diligence in creating a method which is so user friendly. Completing the book, When Panic Attacks, changed my life and helped me reach enlightenment. My Ask David question is inspired by the last few podcasts, the live session with Rhonda and the live session with Madelaine which David just did with Jill. David has clearly worked so hard to create TEAM and has dedicated so much time to perfect it. I was lucky enough to have been introduced to the podcast when it first started. Some of my favorite episodes to listen to are the live therapy sessions. I've gained insight and felt heard through many of these such as when David told Lee how lonely enlightenment can be because I agree with that! Recently I have noticed that David's demeanor has changed and was hoping to ask about it. I can imagine David might feel lonely in his expertise sometimes. I might be on the wrong track here too but I wonder if David might be feeling frustrated with the lack of understanding from people around him. He has been dedicating his life to this and still people do not understand certain aspects of his research and teaching. On recent podcasts, David had mentioned that he gets more irritated with teaching now too and it has seemed like he is irritated with Rhonda at points. He has mentioned that he feels disappointed if he doesn't see change in 2 hour sessions. Recently I watched a live session with Madelaine and some of the techniques (for example, calling her negative self sociopath during counter attack) did not seem to land or resonate with her and that wasn't addressed with David's usual love and tenderness and warmth with empathy. It seemed rushed and not necessarily focused on the patient outcome but the timeline. I did not find it to be David's usual work of patience and warmth. I could be completely off the rails but I am wondering if this is resonating with David and if he could share more about what it's been like for him recently. I also am wondering if it is difficult to navigate being seen as "a great leader" in a field. Do people see you as "David" simply a dedicated expert in your field or do people treat you like a "God" that has all the answers? I can imagine people would want help from you 24/7 and if you could speak to that. I am hoping David can look at some of those thoughts and comments he's made on the podcasts and become the client for us listeners! I would love for David to show us how to experience TEAM from the client's perspective for all to hear. I have used TEAM-CBT for 10 years and recently started the Fast Track Program which I am very excited for! Thank you again for this truly amazing process! Jenn David's reply Thanks, Jenn, You are right, I DO feel quite a bit of irritation with our field and can identify a bit with Martin Luther, who nailed his treatise / ideas on someone's door hundreds of years ago, and also Jesus who angrily threw the money changers out of the temple a couple thousand years ago. I know that sounds narcissistic, but that's how I feel sometimes. My frustration has several dimensions: The field, to my way of thinking, is incredibly screwed up and anti-scientific, divided into irrational cults called "schools" of therapy. Nobody seems to notice this "elephant" in our room! Hey, are you all sleeping? Did you learn critical thinking in college? When challenged by research that seriously questions the validity and effectiveness of current psychotherapies for depression and anxiety, for example, no one seems to care or notice. It seems like wrong theories die hard. People do not like being criticized and got angry when I criticize the field of psychotherapy. So, there is a kind of a "let's be politically correct" and be super "nice" to everyone, so as not to stir them up or hurt their feelings. There is a potential for massive change and improvements in psychotherapy and psychiatric treatment, but it would require a revolution and the acceptance of totally new approaches which would threaten many therapists' thinking and survival at a very basic level. Are you or others interested in my thinking? Let me know. If so, more later, maybe on a podcast or two with Jill and Matt, and of course, Rhonda. And here are the answers to some of your other questions. You say, "He has mentioned that he feels disappointed if he doesn't see change in 2 hour sessions." We're not on the same page here. I nearly always see dramatic change in 2 hour sessions, and I'm dramatic that I have created a therapeutic approach that makes this possible. When I was a young man, a psychiatric resident, I use to dream about that, and wondered if it was even possible, since I almost never saw meaningful change, much less recovery and joy, in any of my patients using the methods I was talk (supportive listening and antidepressants.) You also wrote: I also am wondering if it is difficult to navigate being seen as "a great leader" in a field. Do people see you as "David" simply a dedicated expert in your field or do people treat you like a "God" that has all the answers? Cool question. I think many people see me as a dedicated expert, but I think a few, particular from some of the Asian countries, to like to see people as "gurus" or something on that level. Sometimes I may even encourage that, as I am a strong believer that therapy, at its deepest level, does become spiritual. So, questions about spirituality and enlightenment do interest me greatly, and many of the techniques I've created are designed to facilitate rapid improvement, in minutes, vs. years of meditation. The Externalization of Voices would be an example, and it was actually the first CBT technique I created, around or even prior to 1975. You say, Recently I watched a live session with Madelaine and some of the techniques (for example, calling her negative self sociopath during counter attack) did not seem to land or resonate with her and that wasn't addressed with David's usual love and tenderness and warmth with empathy. It seemed rushed and not necessarily focused on the patient outcome but the timeline. You are partially correct and perhaps somewhat "off." Where you are right is that I miscalculated the time for the webinar, and thought we had to stop at 12:30. I later figured out we had until 1 PM, and we could have spent more time on EOV. Where you're perhaps wrong is that sometimes a confrontation can "jar" a patient into enlightenment. Few therapists use confrontation, but I have always used it, ever since my days in psychodrama as a medical student. Madeleine commented in her follow up evaluation on the things most helpful to her during the session, and that was one of them. Research has consistently proven that the observers of therapy cannot accurately assess the quality of the therapeutic alliance, as reported by the patient, or the effectiveness of what's happening during a session. I sometimes wish therapist observers had a bit more humility about the accuracy of their observations, based on research that's been replicated over and over! But there I am, whining again so I will stop! At any rate, Jenn, thanks for the wonderfully informative critical thinking, and great questions! Warmly, david Jenn's response to David Hi Dr. Burns, Thank you so much for your fast response. I am really honored that you took the time to reply to me! Thank you for your honesty too and I can imagine it's super frustrating! I do not think that sounds narcissistic, I think you are right. I find it extremely frustrating too and I am just a user and learner of TEAM. I think I "see it" sometimes since I've done some personal work. I'm still human with many flaws as I am sure you caught on to a few in my email. I completely agree with all of your points. I genuinely do not understand how TEAM-CBT is not the go-to. It is finally a scientific method that is proven to be effective. It truly leaves me speechless and I could ramble about TEAM for hours to be honest! I am a registered nurse and I have a difficult time seeing my patients being "thrown" anti-depressants etc. The biological theory was the go-to in mental health and about 10 years ago as I was finishing my nursing degree I read When Panic Attacks. It was mind blowing to me. At the time I was working on a Stroke Rehab unit and the psychologist would recommend our depressed and anxious patients be put on medication. When I asked if she had heard about your work she scoffed at it and it made me so mad! I wanted to scream at her to read your work but she was resistant to even listening and perhaps that will not surprise you based on your points (and also how I incorrectly tried to sell it to her!). I would see so many of my patients put on antidepressants and left alone afterwards as if that would solve everything. Even recently during my labour and delivery training we had a psychologist speak to us about post partum mood "disorders" and she specifically mentioned her patients "yes-butting" her and made a joke about how resistant they are to change and I just had this thought HELLOOOOO has agenda setting not been around for years????? Do people not search out solutions and try to be better? I could Google "my patient is yes-butting me" and your work would come up and it is not easy but it is spelled-out and so accessible to learn. Anyway, I could rant forever. I'm on the same page with you, Dr. Burns! Thank you for the follow-up email as well. You are right on this one for sure- my therapist observer totally was inaccurate! And I was thinking "I wonder what her EOV is here and if that was effective". I had asked that question in the chat after the webinar but it was at the end and we did not get to it So next time I will ask that as a question in my email instead. I had not seen confrontation used like that and it did seem off-putting and that just shows how well-versed you are in its use and how I am a learner. Thank you for the feedback. This is making me laugh because I am in the Fast-Track course and I really strive on feedback, and I like getting errors over with. In my nursing career I always had "med error" as the thing I never wanted to do and it felt so good when I finally made one (and it also helps the patient was fine haha). So, I had this thought about learning TEAM and how I know that the therapists are never accurate and how I never want to be the therapist that assumes their thinking. So, I am very happy to have done it already and I have not even started the course really. I want to comment and ask about the spiritual aspect of TEAM. Did you find the spirituality came after personal work or did you see the spiritual aspect before or just as you were developing the whole process? Externalization of voices and a daily mood log is what got me to enlightenment, but it is hard to put into words. I had blips of the euphoria enlightenment over the years but about 5 years ago I had this "big one" and it was not euphoric. It was nothing (but everything) and it was like I became an observer and absolutely none of my thoughts had emotional attachments. It was instant relief of human suffering for sure. Sorry if this is bizarre and I am not sure if this resonates or if I sound like a crazy person. In your podcast with Lee you mentioned that enlightenment is lonely and so I thought maybe you have been here. When it first happened it was an overwhelm of being just matter and being everything and nothing all at once. I could see humanity from an outside perspective almost. I was raised catholic and everything that I learned made sense but in a very different way than I was taught - it was like I understood what Buddha and you and the bible talks about but the deeper meaning if that makes sense. And I sat in the observer role for a couple of days and it was fine because I had no emotional attachment. Actually, as a test I looked at my husband when he got home from work the day it happened and I recognized him of course but I just felt the baseline contentment or a peace overall. The nothingness and the everythingness all at once. When I looked at him I had no emotions or gut reactions or anything and when I thought "that is my husband" I had no emotional ties but I could recognize that my human self loves him but even that love was all created from nothing and everything. This sounds so bizarre! Day 3 or 4 I went to a house party and again I was just an observer and recognized that my human ego is very tied to wanting others to like me, when I attempted humor it would be to serve my ego, before I'd try to make people laugh for me rather for them and a lot of our actions are tied to our egos. After this party, maybe the next day or something I also saw that as I was observing that although I had no emotional ties that also means…I had no emotional ties! It came to me that to live a human life I cannot be in this enlightenment stage. It was lonely even though that did not bother me at the time and seeing humans from this outside perspective is incredibly hard to describe and was overwhelming. So in my enlightenment it was almost like I had to decide to step back into trying to be human so I could carry on with life and try and find these emotional ties and what to do with this awareness of my flaws and what even my personality is. It has rocked me a bit! I have decided to just follow things that I find fun or challenging or have become an interest and the flaws quickly followed! Have you heard of anyone having a bit of fear in reaching enlightenment again? Although the initial hit was so awesome and a huge relief of suffering, I experienced truly what it is like to not have flaws and not have any emotional ties to thoughts. I do have some interesting anxious thoughts about going "back there" and this was the perfect example of "everything in moderation". I must love my flaws haha. Thanks for your time, Dr. Burns! I thought I had heard you mention during a podcast that you feel disappointed if you don't see change in a 2 hour session maybe while you were empathizing with another therapist so I apologize that I was wrong there. I am most likely remembering it incorrectly or I presented the context incorrectly -it's a common flaw of mine haha usually I need to write things down. Looking forward to hearing back, Jenn David's response to Jenn Thanks, Jenn. Awesome email. In the context of my empathizing with another therapist, I could well have said something like that for sure! You are dipping into enlightenment. Way to go. Very exciting, and now YOU will be the expert. When I lived in Philadelphia, I was lucky to audit a class by James Arbukcle at Temple University on structural equation modeling. It was unbelievably exciting for me, and even though I was in private practice, I went once a week for the three hour seminar and did 20 hours of homework every week. I could not believe my good fortune, as he made everything super simple and clear. It was a wow experience every week. For quite a while, I would ask him question when I got stuck or puzzled analyzing my data with his AMOS program, and he seemed to know everything. Which was also cool. Then, one day, he started answer my questions by saying, "Actually, I don't know the answer to that." Like, the first time this happened I asked him the cause of Heywood cases. That where you get a seemingly impossible result, like a correlation greater than one. But then, an odd thing happened. I found that if I worked at it, I could figure these things out for myself. And often, the answers would come to me in a dream, in the middle of the night. So, like James, I probably can't answer all your questions anymore, although hopefully I can still answer a few of them! By the way, James Arbuckle was one of the most amazing teachers I've ever had, and I will forever be grateful for his generosity in letting me audit his class--I was not even a student at Temple--two years in a row for free. And what I learned forever changed my career and my life, especially my way of thinking about research and statistical analyses. Warmly, david Thanks for listening today! Rhonda, Matt, and David
TEAM Trauma Treatment-- How Does It Work? And Why? Featuring Dr. Jill Levitt Today's podcast features one of our favorite guests, Dr. Jill Levitt, who is one of the greatest psychology teachers on planet earth. We explore trauma, and how it is treated. We focus in particular on the unique features of trauma treatment using TEAM CBT. Jill is currently the Director of Training at the Feeling Good Institute in Mountain View, California, but she has had intensive training in trauma treatment beginning during her psychology internship at the Cornell Medical Center (? is this correct) in 200? (dates please Jill) and continuing until (date please.) She worked with adults survivors of childhood physical and sexual abuse, as well as victims of the 2011 tragedy at the world trade center, which happened when she was working in New York. She got extra training from several outstanding experts in the treatment of trauma and anxiety, including the renown Dr. Edna Foa, from Temple University in Philadelphia, as well as (please list if you like, Jill!) Rhonda also has extensive experience in the treatment of trauma since she worked for (x years, please fill in) at th San Francisco Rape and Trauma Clinical. Rhonda emphasized the importance of shame and toxic but high irrational self-blame so often seen in trauma patients of all ages, including, of course, children. Jill and Rhonda emphasized the importance of the selective use of exposure techniques with trauma patients, and the unfortunate fear that many, and perhaps most, therapists have of these techniques, wrongly fearing that the patient will decompensate and that the therapist, too, will become overwhelmed when hearing the patient recount their horrific experiences in detail. I, David, will add that I've never had a negative experience with the use of exposure techniques, like cognitive flooding, memory rescripting, and many more with any trauma patients. However, I always do E = Empathy first, as well as A = Paradoxical Agenda Setting, to guarantee that the patient and I will be working together as a collaborative team. Rhonda asked us to talk a bit about "vicarious trauma" that the therapist might experience when working with trauma patients. Both Jill and David said they've never experienced this, and that only our thoughts, and not the experiences our patients describe, can upset us. We believe the concept of "vicarious trauma" is highly (but not intentionally) misleading and needlessly frightening to those working with trauma patients. Of course, if a therapist does become triggered when working with any patient, including a trauma patient, that is grist for the mill for the therapist to work out with their own therapist, using perhaps the Daily Mood Log to explore and challenge the therapist's upsetting negative thoughts. Perhaps the most important theme today focused on the treatment of trauma patients--as well as non-trauma patients--individually, using TEAM to pinpoint one moment the patient was upset, and exploring their negative thoughts and feelings with the help of the Daily Mood Log, as well as the other vitally important components of T E A M. I (David) do not place much stock in treating patients with "formulas" based on their "diagnosis" or problem. I did 20 or more two day trauma workshops around the US and Canada several years back, and treated a volunteer from the audience at each workshop on the evening of day 1, using a two-hour TEAM CBT session. In all or nearly all of these sessions, the individuals experienced a triumphant and blow-away elimination of all their negative feelings by the end of the demonstration. But here's the interesting thing: although I occasionally included cognitive exposure, it was perhaps the technique I used the least often with these individuals. Far more powerful for most were techniques like Explain the Distortions, the Paradoxical Double Standard Technique, and the Externalization of Voices. Sometime, an interpersonal technique, including the Five Secrets of Effective Communication, was helpful, even life-changing. If you are interested, you can read about those sessions in Chapter X in my most recent book, Feeling Great, as well as illustrations of the data from all the patients, showing the dramatic changes in negative and positive feelings from the start to the end of the sessions. Why did these individuals recover so dramatically and quickly--within a single session? I believe it was because I focused on what was upsetting THEM, and developing an agenda and selecting methods to focus on what they wanted. This, to my way of thinking, is different, even radically different, from imposing a pre-set agenda on patients simply because we think they have some type of trauma diagnosis. David described the three elements of an "abuse contract" between the abuser and the victim: I get to hurt or exploit you for my own pleasure. The Blame will be 100% on you. I am a blameless, superior god. We must keep this as a secret, even between us. If you violate this, I will hurt you very badly. Thanks for listening today! Jill, Rhonda, and David
What if the endless search for hidden knowledge—from JFK to 2025—wasn't leading you to truth at all, but trapping you in the serpent's oldest deception?Conspiracy culture has been growing since the JFK assassination, and today it has come full circle. From endless rabbit holes to the promise of hidden knowledge, many get caught in a cycle of searching but never finding—a trap Scripture warns of as the serpent's age-old deception.In this episode, I explore how the ouroboros, the serpent eating its own tail, mirrors the matrix of illusion that keeps so many trapped. I examine Alice Bailey's “Externalization of the Hierarchy” and her vision of 2025 as a turning point for a global spiritual shift, while tracing the occult influence of Helena Blavatsky and Aleister Crowley. I also look at real-world 2025 examples, from UN spiritual initiatives to AI as a false savior and the push for one-world unity. I share my personal testimony of being caught in this cycle, and how Christ is the only true way out. The serpent promises hidden wisdom, immortality, and godhood—but these are counterfeits. True freedom from the ouroboros and the matrix - comes through a relationship with the Creator.Amy is a Christian counselor - book an appointment:https://www.biblicalguidancecounseling.com/appointmentsAmy's online Bible studies:https://rumble.com/c/BibleStudywithEyesontheright?e9s=src_v1_cmd
The episode is about how true peace of mind comes from discovering and practicing a personal process—the “how”—that aligns with who you are, rather than chasing external categories or “what” you do.Support the showBecome a premium member to gain access to premium content, including the Techniques and Mindsets Videos, visual concept summaries of each episode, community forum, episode summary notes, episode transcripts, q&a/ama sessions, episode search, watch history, watch progress and support.Join Now at nontrivialpodcast.com or patreon.com/8431143/join
Hopelessness: A New Approach Featuring Mike Christensen Often, therapists are drawn to become specialists in the very area where they once suffered and felt most vulnerable. In Mike's case, he describes his own feelings of failure, betrayal, bitterness and hopelessness in his early career, and how he found his way to become a star in the TEAM therapy firmament. Today, he describes a breakthrough approach in the treatment of hopelessness as well, based on the A = Assessment of Resistance portion of TEAM. Mike began by saying that treating hopelessness is always a challenge. . . in fact, I can vividly remember when I felt hopeless! And of course, part of the challenge is the fear that hopeless patients may try to take their own lives. This is the “dark side” of clinical practice, and it is not often talked about because of the terror it strikes in the hearts of mental health professionals. Mike started out with a bit of his traumatic personal history. He explained that he once owned and ran a bicycle shop in Canada when he was in his mid- to late-twenties. “There was a fellow businessman in my town who was a bit older than me and somebody I really looked up to. He was successful, had a beautiful family, was well respected in the community and had some wonderful friends. One day I got a phone call from my wife and she said to me: ‘Did you hear what happened to John? She went on to tell me that it was shocking and terrible because he was somebody who enjoyed hunting. One day he went out to the family cabin and took his shotgun and took his own life. Mike said that at his funeral, “I can remember it like it was yesterday hearing his daughter's voice when she spoke and those words that she said. “Daddy, why were you so sad?” “A number of years later we had moved on, sold the business and our home and moved to another town to work in an organization supporting people. I had done my degree in theology with focus on youth and counseling and was working with young families. Unfortunately there were some real difficulties in the situation and it did not turn out very well after a little over a year. He felt betrayed, and ended up with no job. He was now in his mid to late-30s, and got a job in a hardware store. “I was really struggling with the sense of confusion, frustration, depression and hopelessness. Even though I had a supportive family, and had been successful in many areas of my life. He recounts, “One day I looked in the mirror and as I was having those thoughts of hopelessness I was reminded of John, my business colleague who had taken his own life 10 years earlier and I thought about my 2 young daughters. I could hear John's daughter's voice: “Daddy why were you so sad” in my head and I thought I have to get some help” “My wife is a nurse and has a very wise family physician, Dr Mariette deBruin, who is incredibly skilled at empathy. Fortunately, she had been at a mental health conference earlier that year and heard this brilliant psychiatrist share a powerful approach to treating depression without medication. That psychiatrist was Dr David Burns. She suggested I get a hold of the book, Feeling Good, and that was the start of my recovery in 2006. I went back to grad school to do my Masters in Counseling Psychology and then attended my first workshop with Dr. Burns in 2009.” Looking back, I realized that hopelessness was actually my best friend. I was in a tremendous amount of pain. Here were some of the positives I discovered in my feelings of hopelessness: In my previous work, I'd been hurt badly, stabbed in the back. My hopelessness was my way of punishing the people who'd hurt me. I was saying, “Look at me. I'm a broken shell.” I felt like this gave me some value. . . as well as a sense of revenge.” I had placed a lot of value in my success in my life, three beautiful kids, and a great athletic career (biking), and my hopelessness protected me from the disappointment of dashed dreams in my new career. I felt I was being realistic. Hopelessness validated how severe my problems were. Hope trivialized it. When I'm working with practicum students or interns that are early in their counseling or therapy career, one of the greatest fears that they have is that one of their clients or patients will take their own life. Sadly, when you go into this line of work the reality is that at some point, someone we work with in some capacity will experience that level of hopelessness and so I have to inform them that “suicide is not if, but when.” This is why it's so critical for us to know how to work with it. He explained that “Hopelessness validated how I felt. People were all trying to cheer me up. That's the WORST thing you can do. “My TEAM training was pointing me in the opposite direction. Validating it and acknowledging it took the pressure off of it and began the process of bringing about tremendous relief.” We discussed the power and value of Positive Reframing, even with the hopeless patient, as well as the value of empathy. He said the Positive Reframing shows that “you totally get what this is like for me.” The positive reframe serves as our most profound empathy tool. By enabling us to perceive the world through the eyes of our clients or patients, it eliminates their sense of isolation. The hopelessness shows something beautiful and awesome about you. He recalls his early training in TEAM, and the immense value of the Externalization of Voices and Feared Fantasy work he did with David to challenge his negative thoughts, including: I really AM a failure. David must be thinking that I'm an embarrassment to him. David is also thinking, “I can't believe I let you on this podcast.” We illustrated the Externalization of Voices and Feared Fantasy live on the podcast, including the blow-away Acceptance Paradox. Because of that training, “I am no longer afraid of failure!” Thanks so much for joining us today! Mike, David and Rhonda
Crystal Readings & The Great Summer of Purification – Ra Castaldo Returns | TSP #2122 Bio / Intro: Ra Castaldo, visionary mystic, author, and ancient knowledge keeper, returns to the Typical Skeptic Podcast for a powerful night of crystal readings and deep esoteric wisdom. Known for his profound insights into prophecy, ancient texts, and spiritual cycles, Ra weaves together timelines from the Rig Veda, the channeled works of Oahspe, Alice Bailey, and Rudolf Steiner, revealing how humanity's current shift is part of a greater cosmic plan. With March 21, 2025 marking the end of the Kali Yuga, Ra explains how we are now entering the Great Summer of Purification—a 300-year transformation period where humanity will experience intense spiritual cleansing, awakening, and global change. He'll also explore the historical 1879 planetary cycle shift and what it means for our present moment. As tonight also marks the beginning of the Lion's Gate and the Externalization of the Hierarchy, Ra's channelings and crystal guidance will help viewers align with the incoming energies. This is a must-watch for seekers of truth, prophecy, and spiritual empowerment. Website: TheMysticalSpiral.com Store: TheMysticalSpiralStore.com YouTube: Exploring the Ka with Ra Description: Join us for a high-energy episode as Ra Castaldo returns to the Typical Skeptic Podcast for an evening of live crystal readings and multidimensional prophecy. We'll dive into: How March 21, 2025 marked the end of the Kali Yuga and the start of the Great Summer of Purification (next 300 years) Insights from the Rig Veda and the 1879 planetary cycle shift Channeled wisdom from Oahspe, Alice Bailey, and Rudolf Steiner The opening of the Lion's Gate Portal & Externalization of the Hierarchy Using crystals to connect with higher frequencies during this time of great change If you're ready for guidance, prophecy, and esoteric knowledge, this is an episode you won't want to miss.
Part 2 of Our Personal Work with Rhonda The Surprising Conclusion of Rhonda's Session with Matt and David Last week, you heard Part 1 of our personal work--a single two hour therapy session--with Rhonda, focusing on her recent shocking diagnosis of a cancerous and potentially fatal lymphatic tumor in her neck. We did initial T = Testing and E = Empathy. Today we do the A = Assessment of Resistance and the M = Methods, and of course, the final assessment of symptoms and teaching points. A = Assessment of Resistance How DO you help someone facing a terrifying diagnosis of cancer? What's the best method to use? How do you cheer them up, or is it impossible to do so and foolish to try? Or is there no correct answer to these questions? Well, there IS a "correct" answer, at least according to the gospel of TEAM. You ASK the person if they want help, or if listening is enough. And if they want help, you ask them what they want help with. This personalizes the treatment and brings it alive for the patient. Rhonda said she had difficulties accepting help, and extreme fears of being a burden on others. She specifically wanted to stop comparing herself to her friend, Jack, who has so far survived for four years after a severe diagnosis of disseminated cancer requiring whole body radiation. She also wanted help feeling less guilty about her anger and her complaint about pain and side effects. Because we didn't want the session to run overly long, we did some streamlined Positive Reframing, listing 11 positives embbeded in her negative thoughts and feelings, such as "I have no right to complain." What does each negative thought and feeling show about her that's positive and awesome? And what were some benefits of them? The we asked Rhonda about her goals for each negative feeling on her DML, which you can see if you CLICK HERE As you can see, her desired reductions for most of her negative feelings were only modest, perhaps indicating some acceptance of her situation and the negative feelings that seemed inevitable. However, this can sometimes indicate some residual resistance that has not been addressed. We'll have to wait and see what happens next to find out! M = Methods We worked with Rhonda using several methods, especially the Externalization of Voices with frequent role reversal until she got to huge. My memory of the session is that the Counter-Attack Technique compared with the Acceptance Paradox got her to HUGE wins. You can see Rhonda's ratings for each negative feeling at the end of the session if you CLICK HERE And were these rating genuine? Or was she just being "helpful" to us for the sake of the podcast? At the end, Rhonda estimate her gratitude was 1,000,000%! Thank you, Rhonda. We all love you for your incredibly important gift to all of us today, teaching us how to love, and to laugh, when we all have to face our inevitable fate of letting go and experiencing the "true Great Death" of the "self." And we are 1,000,000% grateful to your wonderful doctors at Stanford that this cancer will NOT get the last word! Teaching Points The first take home message is that you can't effectively treat anyone with any kind of emotional problem without asking them to write down their negative thoughts. If you do this, you can find out exactly what's going on, and you'll know the only real cause of all the negative feelings that person is struggling with. That's why you can't treat depression with “tips” or advice, like “spend time in nature,” or “spend time with friends.” That's just junk and cheap advice and it will not work, above and beyond a possible placebo effect. Second we don't treat problems, like “cancer” or "depression" or any “mental disorder” with packages developed for just that problem. We treat people who are struggling, and find out what their negative thoughts are! You CANNOT know what someone is thinking without asking them. Everyone's thoughts are different and unique. That's why packages, including ALL the so-called "schools" of therapy, will ALWAYS fall short. There are, of course, common themes, like “I'm not good enough,” but we all put our own unique spins on these themes when we're hurting. And third, measure what you're trying to treat, with brief accurate scales worded in the hear and now at the start and end of each session. That's the ONLY way to know if you've been effective. And finally, events no matter how traumatic, do NOT cause feelings. Only your thoughts can have impact on how you feel about yourself, other people, and the world. That statement is not intended to blame you for how you feel, but to liberate you from the traps you've fallen into. Thanks for listening today! Matt, Rhonda, and David
Excusing BPD Behavior is Codependent ExternalizationExcusing BPD behavior is what so many people with Codependency do and it is a function of Codependent Externalization and need for taking more personal responsibility for yourself - not how anyone with BPD treated you terribly. It is important to get into a healing and recovery journey in therapy to break the trauma bond, learn to focus more on yourself, and to stop externalizing out your needs that can't be met by a person with BPD. Codependent needs that you need to learn how to meet internally for yourself.https://ajmahari.ca - Sessions - Contact - Bloghttps://ajmahari.com - Online Store - Ebooks & morehttps://survivingbpdrelationshipbreakup.com - Podcasts This podcast is ranked in the Top 100 Relationships Podcasts on feedspot.com at:100 Best Relationship Podcasts You Must Follow in 2025
All of this week's episodes of It Could Happen Here put together in one large file. - A Medical Perspective On Protest Safety - Dividing the World, Pt. 1 feat. Andrew - Dividing the World, Pt. 2: Externalization feat. Andrew - Zohran Mamdani Wins NYC Dem. Primary - Executive Disorder: White House Weekly #22 You can now listen to all Cool Zone Media shows, 100% ad-free through the Cooler Zone Media subscription, available exclusively on Apple Podcasts. So, open your Apple Podcasts app, search for “Cooler Zone Media” and subscribe today! http://apple.co/coolerzone Sources/Links: A Medical Perspective On Protest Safety https://lapdonlinestrgeacc.blob.core.usgovcloudapi.net/lapdonlinemedia/2021/12/Directive_17.1_40mm_Less_Lethal_Launcher_Oct-.pdf https://www.iheart.com/podcast/1310-live-like-the-world-is-dy-85677729/ Dividing the World, Pt. 1 feat. Andrew Rome: https://europe.factsanddetails.com/article/entry-1087.html China: Rome, China, and the Barbarians Ethnographic Traditions and the Transformation of Empires by Randolph B. Ford European Colonialism: https://www.jstor.org/stable/j.ctt1mf71b8.7?seq=1 Edward Said - Orientalism Benedict Anderson - Imagined Communities John Lewis Gaddis - The Cold War: A New History Samuel Huntington - Clash of Civilisations Immanuel Wallerstein - The Modern World System https://theanarchistlibrary.org/library/elia-j-ayoub-the-periphery-has-no-time-for-binaries Dividing the World, Pt. 2: Externalization feat. Andrew David Graeber - Debt: The First 5000 Years Karl Polanyi - The Great Transformation Immanuel Wallerstein - The Modern World System Zohran Mamdani Wins NYC Dem. Primary https://www.youtube.com/watch?v=yxyXXVoi514 https://www.nytimes.com/live/2025/06/24/nyregion/nyc-democratic-primary-election-mayor https://www.nytimes.com/interactive/2025/06/24/us/elections/nyc-mayor-primary-results-precinct-map.html https://www.instagram.com/reel/DKvdChiOFLv/ https://gothamist.com/news/nearly-a-quarter-of-nycs-early-voters-hadnt-voted-in-a-democratic-primary-since-2012 Executive Disorder: White House Weekly #22See omnystudio.com/listener for privacy information.
The latest episode of The Courtenay Turner Radio Hour delves into the extraordinary convergence of spiritual prophecy, global governance, and technological transformation centered on the year 2025. Turner explores the legacy of Alice Bailey and the Lucis Trust, whose esoteric teachings—rooted in the concept of the “Externalization of the Hierarchy”—envision 2025 as a pivotal moment for humanity, marked by a centennial conclave that may set the stage for profound spiritual and social change. This year is described as “The Stage of the Forerunner,” a preparatory and revelatory period ahead of the anticipated “Reappearance of the Christ,” with major spiritual observances like the Seven Rays Conference and World Invocation Day scheduled for June, coinciding with the Gemini Full Moon. Turner highlights the alignment of these spiritual activities with a packed agenda of global governance meetings, including the Bilderberg Group's June gathering in Stockholm, the G7 Summit in Canada, and key United Nations assembliesaddressing labor, disaster risk, and human rights. The episode examines how organizations like Lucis Trust seek to influence these secular forums through their “Cycle of Conferences,” aiming to ground international policy in spiritual ideals of unity, justice, and the “will-to-good”. The discussion expands to the intersection of technology and spirituality, addressing the rise of transhumanism, AI ethics, and the Game B movement, which advocates for cooperative, group-oriented solutions to global challenges—mirroring the Aquarian ideals promoted by Bailey's followers. Turner critically assesses how these converging narratives—spiritual, political, and technological—could reshape governance, individual autonomy, and global society, raising urgent questions about democracy, sovereignty, and the future of human consciousness in an era of rapid transformation. Ultimately, the episode offers listeners a comprehensive analysis of the forces shaping 2025, inviting reflection on the complex interplay between prophecy, power, and the quest for a new civilization. Listen weekly as Courtenay broadcasts deeper dives into truth, globally via the WWCR airwaves. Catch the Courtenay Turner Show, LIVE every Monday at 3pm CST. Tune in LIVE via Shortwave Radio on 9.350mHz, or via MP3 stream at: https://bit.ly/CourtenayTurnerShow ★Article Referenced: The 2025 Centennial Conclave: Unmasking Lucis Trust's Century-Long Agenda for Global TransformationCOURTENAY TURNER·JUN 8Read full story __________________________________________________________________ This Show Is Only Possible With The Support Of Viewers Like You! Courtenay's Substack is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber. __________________________________________________________________ ▶ GET On-Demand Access for Courtenay's Cognitive Liberty Conference Cognitive liberty Conference ----------------------------------------- ▶ Follow & Connect with Courtenay: CourtenayTurner.com Linktree ▶ Support my work & Affiliate links: Buy Me A Coffee GiveSendGo Venmo Cash APP RNC Store Vitamin B-17! Far Infrared Saunas...Promo: COURTZ Red Light Therapy...Promo: COURTZ Stem Cell Activation Gold Gate Capital Free Satellite Phone...Promo: COURTZ MagicDichol Goldbacks=Real Currency! Promo:COURTZ Honey Colony Health&More...Promo:COURTZ ▶ Follow Courtenay on Social Media: Twitter TruthSocial Instagram Telegram Facebook Apple Podcasts Spotify Amazon Music Rumble YouTube —————————————————▶ Disclaimer: this is intended to be inspiration & entertainment. We aim to inform, inspire & empower. Guest opinions/ statements are not a reflection of the host or podcast. Please note these are conversational dialogues. All statements and opinions are not necessarily meant to be taken as fact. Please do your own research. Thanks for watching!—————————————————©2025 All Rights Reserved Share Courtenay's Substack Learn more about your ad choices. Visit megaphone.fm/adchoices
What's the Latest on The Feeling Great App? Featuring Jason Meno and Adam Holman Adam Holman and his loving cat! The featured photo is Jason Meno, also a cat lover! Today we focus on a number of exciting updates in the Feeling Great app, and are delighted to be joined by our esteemed colleagues, Jason Meno and Adam Holman who have recently created and launched to new V2 version of the Feeling Great chatbot, which includes greatly increased horsepower, in terms of rapid and dramatic reductions in 7 negative feelings, including feelings of depression, anxiety, guilt / shame, inadequacy, loneliness, hopelessness / discouragement, and anger. The latest data indicates reductions of more than 60% in all of these feelings within the first 90 minutes of chatbot use in most new users, and more than 70% reductions in repeat uses in the same amount of time. This is absolutely phenomenal and far surpasses my expectations 50 years ago when I first imagined and visualized this app. In addition, the new version of the app also causes fairly dramatic increases in seven positive feelings at the same time--a highly desirable feature that was lacking in most previous versions of the app. Jason and Adam also described a number of exciting, user-friendly features like two-way verbal communication with the app so you no longer have to type your dialogues (although you can if you prefer that mode.) Another new feature is long term memory, so the bot will remember you and be able to summarize your previous sessions, and more. In addition, to illustrate exactly HOW the app works, we did a live demonstration with Jason, who has been struggling with several of his negative thoughts, like "This app might not reach the hundred of millions of people around the world who need it." His belief in this thought was 80%, and the thought triggered strong feelings of hopelessness, sadness, guilt, anxiety, frustration, anger, and inadequacy. This is a valid concern since we must rapidly boost sales if we hope to break even and stay in business, We tried a number of methods that weren't effective, following the app's philosophy of 'failing as fast as we can," including Positive Reframing and Paradoxical Magnification, that did not help at all. In fact, Positive Reframing simply triggered increased resistance. Then we tried a method that has been really helpful for Jason in the past, Externalization of Resistance, and he was able to successfully challenge all the really GOOD reasons to cling to his negative thoughts. At the end, his belief in the thought was reduced from 80% to 20%, which was satisfactory to Jason as he said that some worrying is realistic and keeps him on his toes continually adding amazing new features to the app. If you've been struggling with low self-esteem or negative feelings or low self-esteem, you might want to check the latest version of the Feeling Great app. You can take a free ride and check it out. You've got absolutely nothing to lose but a couple hours of your time, and a life of greater joy and happiness to gain. Rhonda, Jason, Adam, and I appreciate all of you, and thank you for joining us today!
Episode 438 The TEAM Approach to Habits and Addictions Powerful New, Radically Different Approaches that Can Help! Today, Dr. Jill Levitt joins David and Rhonda to discuss and illustrate the TEAM CBT approach to habits and addictions and give a little promo for their upcoming online workshop on Habits and Addictions on March 28, 2025. You can sign up for the workshop here: cbt-workshop.com Although the workshop is for mental health professionals, participants will have the chance to work on their own habits and addictions during the workshop in order to gain a more in-depth understanding of the new treatment methods for: Overeating / binging / restricting Drugs Alcohol Procrastination Doomscrolling Excessive cell phone use Internet addiction Excessive use of social media Shop-a-Holic Biting fingernails Video games Gambling And more David emphasized that nearly all current treatment methods frequently fall short because they focus on control of symptoms using behavior modification rather than the cause. He describes a research study at the Stanford inpatient unit that indicated that 50 common DSM Diagnoses (such as mood disorders, anxiety disorders, personality disorders, and more) were not significantly correlated with any of the DSM addictive / misuse disorders including drugs, alcohol, eating disorders, and gambling, which was not really consistent with the beliefs of many that emotional factors play a central causal role in addictions. In fact, the only significant correlation he noted was between depression and overeating, but the correlation was in the negative direction—in other words, higher levels of depression were associated with weight loss, not weight gain. And, in addition, the magnitude of the correlation was extremely small, indicating that other factors play a far more important role. So, what is the explanation for this puzzling and anti-intuitive finding? David described a 5-item survey he developed which asks about temptations in use or give in to your habit / addiction in the past week. This tool, in contrast to all of the DSM diagnoses, was very strongly correlated with all the addictions. This suggests that we give in to our habits and addictions for one simple reason--they make us feel great! At least in the short term! 150 years ago, they didn't have an epidemic of obesity in America. Why not? Life was likely just as stressful as it is now, maybe even more so! But what they didn't have was all the fast food restaurants and all the gooey, tasty foods that are abundantly available today, and they didn't have the resources to purchase them, either. This doesn't mean that behavioral models or diets or other tools have no value. But the TEAM CBT model focuses first on assessing the patient's motivation for and resistance to treatment using a variety of powerful and innovative new techniques, including: The Triple Paradox The Ten Positive Distortions The Habits and Addictions Log (HAL) The Devil's Advocate Technique The Five-Minute Rule The “I Stubbornly Refused” Technique The Anti-Procrastination Sheet Relapse Prevention Techniques utilizing The Externalization of Voices The Acceptance Paradox Stimulus Control And more They emphasized that these are methods, but not in the ordinary sense, because they rely heavily on the use of paradox, which is unfamiliar to many therapists, and require a great deal of skill. Jill and David first discussed the nature of tempting thoughts and how positive distortions work. Then, they illustrated the Devil's Advocate Technique with Rhonda who volunteered to work on her temptation to overeat chocolate, and especially chocolate chip cookies with peanut butter, and listed several of her tempting thoughts, including: 1. A little chocolate chip cookie can't hurt. 2. I have to keep them in the house because my husband loves them. 3. Just one cookie. It will taste SOOOO Gooood! 4. I can always work out a little more. 5. That cookie smells Sooo Good! I just CAN'T resist. Jill and David played the tempting part of Rhonda's brain, and she played the part that resisted the temptations. She started strong, but her conviction seemed to weaken on the third thought, and she didn't win “huge.” Instead of doing a role reversal to “help” or “save” her, David said that perhaps that wasn't really something she was willing to give up, and perhaps we could work on something else instead. She INSTANTLY did a complete turnaround and won “huge” when they gave her another chance to defeat the tempting voice. David and Jill emphasized that paradox nearly always wins, and “helping” nearly always fails. But this is why these methods are so challenging—because the therapist's well-intentioned attempts to help nearly always backfire, and yet are extremely difficult to resist. Jill and David emphasize that prior to doing this type of role-playing method, it is crucial to find out if this is something the patient really wants help with, and Jill emphasized that we rarely or never impose an agenda on any patient. We do not have any belief that there is a “correct” way for people to be. Rhonda—or any patient--will first have to convince us that this is something she really wants help with. And that will be one of the many take home messages for the therapists who attend on March 28th. Thanks for listening today, and be sure to tune in again next week! Jill, Rhonda, and David
On this week's radio hour Courtenay Turner explores Occult High Priestess Alice Bailey's predictions for the year 2025 and Lord Maitreya. Will AI bring the Antichrist in the form of a CyberSatan? Listen weekly as Courtenay broadcasts deeper dives into truth, globally via the WWCR airwaves. Catch the Courtenay Turner Show, LIVE every Monday at 3pm CST. Tune in LIVE via Shortwave Radio on 9.350mHz, or via MP3 stream at: https://bit.ly/CourtenayTurnerShow ____________________________________________________________________ ▶ GET On-Demand Access for Courtenay's Cognitive Liberty Conference: https://cognitivelibertyconference.com ----------------------------------------- ▶ Follow & Connect with Courtenay: https://www.courtenayturner.com ✩ Linktree ▶ Support my work & Affiliate links: ✩Buy Me A Coffee! ✩GiveSendGo ✩Venmo ✩Cash App ✩ Richardson Nutritional Center: (B-17!) ✩ Relax Far Infrared Saunas: (Warm Up!) Discount Code: COURTZ ✩ LifeWave Stem Cell Activation Patches: (Activate your master cells!) ✩ Gold Gate Capital (Secure Your Wealth!) ✩ SatPhone123 (Claim Your Free Satellite Phone!) Promo Code: COURTZ ✩Discover The Magic of MagicDichol: ✩Defy The Grid With Real Currency.....Goldbacks!: Promo Code: COURTZ ✩Honey Colony "Where The Hive Decides What's Healthy": Promo Code: COURTZ ▶ Follow Courtenay on Social Media: ✩Twitter ✩TruthSocial ✩Instagram ✩Telegram ————————————————— ▶ Disclaimer: this is intended to be inspiration & entertainment. We aim to inform, inspire & empower. Guest opinions/ statements are not a reflection of the host or podcast. Please note these are conversational dialogues. All statements and opinions are not necessarily meant to be taken as fact. Please do your own research. Thanks for watching! ————————————————— ©2025 All Rights Reserved Learn more about your ad choices. Visit megaphone.fm/adchoices
Swimming in an Ocean of Gold-- The Unique Magic of TEAM-CBT!
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Live work with Joshua-- The Secret of Self-Esteem I was recently a guest on the “Philosophical Weightlifting” podcast with host Joshua Gibson (link). At the end of the interview, he asked if I could give an example of some of the techniques in TEAM-CBT, so I decided to jump right into a live demonstration, in real time, which we are publishing on today's podcast. I am very grateful to Joshua and hope you enjoy the session as much as we did! The session covers a number of topics that just about everyone can relate to, including a couple extremely common Self-Defeating Beliefs: The Achievement Addiction The Love Addiction The Inadequacy Schema (“I'm not good enough.”) It also covers some familiar territory, including the question, “Am I good enough?” It also provides an answer to the questions: “What is the secret of self-esteem,” and “what is the secret of sex appeal?” To kick things off, Joshua shares an upsetting event along with some of his negative thoughts and feelings. The upsetting event was feeling attracted to a young woman who waited on him in a restaurant, and then going to his car and wishing he'd asked for her personal information for a date. Then he courageously went back and did just that, but got shot down. Paired with this experience, his overwhelming thoughts and how strongly he believes each one are: I won't be successful. 85% I won't get to live the life I want to live. 70% I won't find love. 90% I'm not attractive. 100% This is a list of Joshua's negative feelings, and how strong each one was at the start of the session: Feeling % Now % Goal % End Anxious 95% Sad 90% Guilty 85% Inadequate 90% Lonely 90% Embarrassed 90% Hopeless 85% Frustrated 70% Angry (with self) 75% Two things stand out when you examine this list. First, Joshua is an attractive, friendly, and personable young man hosting a popular podcast. If we didn't have these estimates of his feelings, you would have NO WAY of knowing how he felt inside. These feelings are all very severe. So many people we greet in our daily lives are similar—looking terrific on the outside, but dying of loneliness and unhappiness within. Second, he is experiencing nine different types of similarly elevated negative feelings, and not just one negative feeling. This confirms statistical modeling I've done with data from the Feeling Great App. There appears to be an unknown “Common Cause” in the human psyche that activates numerous feelings simultaneously. This is like the “dark matter” of the human psyche. We can prove its existence, but don't yet know precisely what it is! However, our goal today will be to see if we can help Joshua change the way he's feeling, regardless of what's causing his pain. Positive Reframing Tool Feeling Positives Frustration It has motivated me to work hard It shows I have not given up Anxiety Keeps me from putting myself at risk It has inspired me to face my fears and grow Sadness Shows how much I care about others Helps me understand others who are suffering, like my mom Shows I have high standards and high expectations Guilt Shows that I want to live up to my expectations Shows that I have a strong moral compass Inadequacy Shows I'm honest about my flaws and eager to improve Show I'm humble Makes me approachable Loneliness Has helped my develop independence and autonomy Has motivated me to reach out to close community and to create my own Embarrassment Makes me behave in socially desirable ways Hopelessness This serves as a driving force Shows that I'm a critical and realistic thinker Protects me from disappointment Anger (at self) Shows that I have high expectations for myself and hold myself to a nigh standard You can see Joshua's goals for each negative feeling after we used the Magic Dial. The whole idea was to lower his negative feelings, not all the way to zero, since that would also wipe out all these positives, but lower them enough so that he would suffer less and still preserve all the many positives we listed, and more. Feelings Table with Goal column filled in Feeling % Now % Goal % End Anxious 95% 20% Sad 90% 10-15% Guilty 85-90% 15% Inadequate 90% 10% Lonely 90% 20% Embarrassed 90% 10-15% Hopeless 85% 20% Frustrated 70% 20% Angry (with self) 75% 5% As you can see, he decided to lower all of his negative feelings if possible. Now, we're ready for the M = Methods of TEAM-CBT. Joshua said he wanted to work on, “I'm not attractive” first. I asked Joshua how and why he came to this conclusion, since he is clearly a large and attractive guy. He confessed he had severe acne when he was an adolescent, and now has scarring that makes him look “disfigured”. Although he probably does have some scars, I asked Joshua if he thought this thought might contain some cognitive distortions. He immediately mentioned All-or-Nothing Thinking (AON). I asked Joshua to “Explain this Distortion.” Specifically, I wanted him to imagine that I was a fourth grade student, and to explain to me in simple terms WHY this thought is an example of AON, why the AON in this case is unrealistic and misleading, and why it is also unfair. He did a great job, and this reduced his belief in the thought to 50%. As an exercise, can you think of some additional distortions in this thought? Briefly stop this recording so you can write them down on a piece of paper, and then you can look at the answers at the end of the show notes. “Explain the Distortions” was an excellent first step, but it was not enough, so we went on to the Paradoxical Double Standard Technique. I played the role of a long lost identical twin or best friend who was just like Joshua. I explained that I thought I was not attractive, and asked him what he thought. He did a tremendous job, and argued that this was not really valid, and I asked if he was being honest or just trying to cheer me up. He said he was being completely honest. Then we switched into high gear, using a much more aggressive technique, the Externalization of Voices, including Self-Defense, the Acceptance Paradox, and the Counter-Attack Technique, with perhaps a couple additional techniques thrown in. He got some strong momentum and blew all four negative thoughts out of the water. We were out of time, but did take the time to rate how he felt at the end, which you can see below. Feelings Table at the End of Session Feeling % Now % Goal % End Anxious 95% 20% 0% Sad 90% 10-15% 0% Guilty 85-90% 15% 0% Inadequate 90% 10% 0% Lonely 90% 20% 0% Embarrassed 90% 10-15% 0% Hopeless 85% 20% 0% Frustrated 70% 20% 0% Angry (with self) 75% 5% 0% Answer to the quiz question above: The thought, “I'm not attractive contained many distortions in addition to AON, including: OG = Overgeneralization MF = Mental Filtering DP = Discounting the Positive MR = Mind-Reading Mag/Min = Magnification and Minimization ER = Emotional Reasoning LAB = Labeling SH = Hidden Should Statement SB = Self-Blame I was extremely grateful and honored to be a guest on Joshua's wonderful podcast, Philosophical Weightlifting, and invited him to join our Tuesday psychotherapy training class at Stanford because of his work in coaching. If you are a mental health professional, including a therapist or coach, contact me and let me know! The classes are two hours weekly and free of charge, although some course materials are required. Thank you so much, Joshua, for sharing your “inner self” with me and all of your and our podcast fans! And thank you, all of you, for listening or watching today! Rhonda, Joshua and David The following is an awesome email I received from Jason Meno right after he listened to the Joshua session. Hey there! I just finished listening to the last hour segment of David's "Philosophical Weightlifting" podcast episode with Joshua Gibson (it starts at about 1:13:52). It was fun to see a 45-minute TEAM session in action. I thought the Externalization of Voices (EoV) that was done here that seemed to work really well, really fast. It also highlighted a lot of complex dynamics that I see David use a lot. Here's my analysis of what went down and what I think we can learn from it: Joshua's attack: Joshua's negative thought was "I'm not attractive", but when it came time for him to attack, he said, "You know Joshua, you are disfigured and because of that you're unlovable and that's an unavoidable thing you're going to have to deal with." This attack is a lot more powerful than just the thought "You're not attractive." It digs into hurtful labels, hopelessness, and frustration. When you are in the position of roleplaying as the negative voice, there's often new and subtle dimensions that come out of it. Right now we are making it easy for the user to attack the AI by just printing out their negative thoughts, but I think letting the attack be more dynamic would be a lot better. David uses Be Specific: "Can you tell me in what way I'm disfigured?" I REALLY like Be Specific. It sets things up very well. I'd love to do this as part of the EoV formula. Joshua answers: "Yes, so you had acne growing up and now you have scars as a result and that makes you look different from everyone else." David uses Paradoxical Acceptance / Humorous Magnification: "Well, thank you, wise guru. I'm enlightened now and see that I'm some kind of ugly monster who's going to scare all the women in the United States. But what you're saying is a lot of horseshit, and you know it." David's sarcastic tone belittles the negative voice's criticism, which also lightens up the absurd magnification that follows. He then quickly rejects the absurd and flows into healthy acceptance following this. David uses Straightforward Acceptance: "But it's true I'm not perfect, and I did have acne, and I do have scars, and there there's plenty of Hollywood movie stars who have some kind of fantastic looks." There's something very powerful about going from the absurd magnification into this healthy acceptance. It's kind of like framing the horrifying absurd with the moderately painful truth makes the truth a lot easier to accept. David uses Defense: "I have a lot about me that's attractive that I can be proud of, including my love, my humility. I've built a tremendous body that 99% of men would be the envy of, and 100% of women would love to touch and fondle." The self-compassion and focusing on specific strengths and pride in accomplishments seems to a very effective defense. There's also a little magnification and humor going on here too that works well. This is a lot stronger than a lot of defenses I see where people just say the thought is being distorted or unfair. David sets up the Counter-Attack Technique: "But there is one thing that's very, very unattractive about me that you didn't mention." Joshua asks: "What's that?" David uses the CAT: "That's that effing crappy voice in my head belittling me and constantly putting me down. And when I'm not listening to you, I'm feeling pretty damn happy. So, to quote the Buddha and Jesus alike, shut the f up." One of the things that seems to make the CAT really effective is when you can take the negative voice's criticism and throw it right back at the negative voice itself. In this case, the negative voice is the real unattractive quality. Awesome work David, and I'd love try out this EoV framework in the app. Best, Jason Roughly one week after the session with Joshua, Rhonda and David interviewed him for his reflections on the session and an update on how he's doing now. He said: I've reflected a lot on this, and what has changed for me. There were many things that impacted me, but positive reframing was a game-changer. For example, if I get anxious, I welcome the feeling, and tell myself, "This anxiety will help me with this project." I was getting a tattoo, and it hurt, so I told myself, "I'm glad it hurts. This pain protects my body." And, of course, people with leprosy lose the ability to feel pain, and the consequences are disastrous and tragic. He continued, I have become more accepting, and talk openly about my appearance. I've had the courage to face that fear. The theme of my life has been, "I'm not good enough." But now I remind myself that I've done all kinds of cool stuff. For example, I coached several people into the top five in the United States in power lifting. I'm way less self-critical now. I visited, and loved, the Tuesday group at Stanford. I didn't judge myself but just jumped in and did what I could do! We concluded the session with some Relapse Prevention Training, using Externalization of Voices to challenging his previous negative thoughts, including the thoughts he will have when he relapses. such as I'm not good enough. I'm a hopeless case. The therapy didn't work on me because I'm different. I'm a hopeless case. We used Externalization of Voices with role-reversals, and Joshua won "huge!" His final response was, "There's pain and joy in life. I'll feel joy and love!" Thank you for listening today. We hope you enjoy the intensely personal work with Joshua. Let us know what you think, and if it touched you if you've ever felt like you weren't "good enough!" Warmly, Joshua, Rhonda, and David
Sep 1, 2024 From the Truth is stranger than fiction... Will's work is stunningly visual in nature. Please go watch his videos on YouTube or Odysee ~~~ Timestamps: 0:00 - "Cosmic week" clip from Limits to Growth 01:55 - "Birth of the Robot" Intro 05:55 - Oh... Fortuna!! 10:45 - The picture that changed our worldview... 16:46 - Star child and the globe 22:20 - the Planned Deception... 30:45 - Externalization of the Rainbow... 38:15 - Club of Rome & technocracy 42:05 - Fertility rate lowest in a century 42:55 - Lex tells Elon about his ayahuasca space journey 44:49 - the progress of pantheism... 50:18 - Neil Armstrong declares Age of Aquarius to congress 53:09 - "Be Thou My Vision" Jac Marino Chen 57:18 - Philippians chapter 3 / outro ~~~ Sep 1, 2024A PLANNED DECEPTION by Constance Cumbey (audiobook by Magical Mystery Church) - • PLANNED DECEPTION Limits to Growth 1973 full documentary - • Club of Rome 1973 Documentary A New World Religion – Constance Cumbey - • A New World Religion - Constance Cumby Discovering the “New Age” Movement – Constance Cumbey - • Discovering the "New Age" Movement / ... Lex Fridman reflects on ayahuasca trip with Elon Musk - • Lex Fridman reflects on Ayahuasca tri... Neil Armstrong talks about the Age of Aquarius to joint session of congress - • Apollo 11 Address Joint Session of Co... ~~~ Music: “Room full of strangers” – The Bright Dark - • Room Full of Strangers “Be Thou My Vision” – Jac Marino Chen - • Be Thou My Vision “We are not motions adrift” - Halfway Line - • Halfway Line - S/T [EP] (2024) ~~~ Please also be sure subscribe to Will's backup channel on Odysee ~~~ Will's Links: Will's Blog (throughaglassdarkly) Eschaton Designs (graphics) If you feel led to help support Will's work: Patreon PayPal Email ~~~~~~~ From Me: Be Good Broadcast I just rebroadcast those spreading the Word. If this blessed you, please just share it with someone who may need to hear it. Please rate or review on Spotify, Apple or wherever good podcasts are found. --- Support this podcast: https://podcasters.spotify.com/pod/show/begoodbroadcast/support
418 The Fear of Driving Featuring Werner Spitzfaden, LCSW and Rhonda Barovsky, PsyD Today, we feature Werner Spitzfaden, LCSW, a Level 3 certified TEAM-CBT therapist who recently treated Rhonda, who's driving phobia returned during the pandemic because she did very little driving at that time. After you overcome any fear or phobia, it has a way of returning if you don't continue confronting your fear. Werner describes his skillful and compassionate work with Rhonda! Werner is a dear colleague and friend with over 35 plus years of clinical experience treating phobias, such as the fear of flying, claustrophobia (the fear of being trapped in small places), and driving (especially over bridges and overpasses). He also treats depression, panic and other forms of anxiety, and works in corporate environments to improve communication and teamwork. Let's dive right in, Please take a look at Rhonda's completed Daily Mood Log, As you can see, the upsetting event was thinking about driving over an overpass, and she rated her initial anxiety cluster at 100%, indicating extreme anxiety. She was also 90% ashamed, and 80% Inferior, worthless, inadequate, defective, and incompetent. She was also feeling 99% embarrassed, foolish, humiliated, and self-conscious, and 85% hopeless, despairing, frustrated, stuck, angry, annoyed, irritated, upset, and devastated. Her sadness was only modestly elevated at 25%. There are several teaching points. First, most of Rhonda's negative feelings were severely to extremely elevated. Second, although she is asking for help with a phobia, anxiety often goes hand-in-hand with a wide variety of negative feelings, including shame and inadequacy. This is because anxious individuals often feel like there's something terribly and shamefully wrong with them. Rhonda's feelings of shame are not unusual. Shame is a central feature of anxiety, whereas a loss of self-esteem is a central feature of depression. Werner added that the fear of driving often goes along with the fear of heights as well as claustrophobia. Rhonda admitted to engaging in many “safety behaviors” which typically make anxiety temporarily better but worse in the long run. Rhonda's "safety behaviors" included going out of her way when driving to avoid scary overpasses as well as asking her husband to drive her many place. As you can see, these totally understandable “safety behaviors” relieve your anxiety in the here-and-now because they are forms of avoidance, but that's why they makes anxiety worse in the long run. The urge to avoid of the thing(s) you fear is universal among individuals struggling with all forms of anxiety. Werner emphasized the importance of empathy in the initial phase of treatment, and throughout the treatment, since trust and the courage to face your fears is so central in the treatment of all forms of anxiety and, of course, depression as well. Rhonda invited Werner and another TEAM-CBT colleague, Lee Flowers, to stay with her in Berkeley during the recent TEAM intensive that David and Jill Levitt directed at the South SF Conference Center near the airport. She drove the group to and from the workshop to face her fears and get some motivation and support at the same time. You can see many of her negative thoughts about driving on Rhonda's completed Daily Mood Log, including these: The bridge will collapse. 95% Other cars will make the bridge unstable. 100% I'll have a heart attack. 95% I'm so dumb for not driving on this overpass. 1005 I'm an ass. 100% I can't do this. 100% I'll die. 100% Lee and Werner will see me at my worst. 100% I need to study the exact route before I start. 100% I'll get into an accident. 100% As you can see, the list includes a mixture of fear-inducing thoughts as well as self-critical thoughts and shame-inducing thoughts, like "Lee and Werner will see me at my worst." Whenever you are working with anyone with anxiety, you have to emphasize first, to create trust, warmth, and understanding. This won't cure anyone of anything, but will give your patients the courage to face their fears when you get to the M - Methods portion of your TEAM session. After you get your A in empathy, you can move on to A = Paradoxical Agenda Setting. That where you bring Outcome and Process Resistance to conscious awareness. Then you melt them away using a variety of TEAM-CBT techniques. Outcome Resistance means that Rhonda may have mixed feelings about a “cure” for her driving phobia. In other words, although she WANTS to get rid of this fear, she may subconsciously NOT want to get rid of it. Can you think of why? Take a moment to think about it, and make a guess. You'll find the answer at the end of the show notes. Process Resistance means she may WANT a cure for her driving phobia, but may not be willing to do what it takes to defeat this fear. What will she have to do? Take a moment to think about it, and make a guess. You'll find the answer at the end of the show notes. Werner and Rhonda described a number of TEAM-CBT M = Methods that they used to reduce Outcome Resistance, including The Miracle Cure Question The Magic Button Positive Reframing The Pivot Question The Magic Dial. To put this phase in a nutshell, Werner highlighted how Rhonda's intensely negative feelings helped her and revealed many positive things about her core values as a therapist and human being. This is a shame-reducing technique and you can use the Magic Dial to ask your patient what they would like to dial each negative feeling down to, without reducing them all the way to zero. You can see Ronda's goals on Rhonda's completed Daily Mood Log in the Emotions Table Next, Werner worked on Process Resistance, bringing the work on Paradoxical Agenda Setting to closure. At the start of the M = Methods portion of their work, Rhonda identified the distortions in two of her thoughts (“I'm dumb,” and “I can't do this.”). See how many distortions you can find. Wrote them down on a piece of paper and when you're done you can see the answers at the end of the show notes. Werner pointed out that Rhonda's anger, directed against herself, had become a springboard for agitation which intensified her anxiety. Werner and Rhonda challenged some of her negative thoughts with Examine the Evidence, Externalization of Voices (illustrated live during the podcast),Double Standard Technique and the Paradoxical Double Standard Technique as well as a Fear Hierarchy, which you can see if you click here. The also did Cognitive Flooding (also called Imaginal Exposure) three times, and by the third time Rhonda could only increase her negative feelings into the mild range, whereas they had started out in the extremely elevated range. They also used breathing exercise plus getting into the here-and-now to calm herself while driving over overpasses. All of this was background work for actually driving during the intensive, and the highlight was driving home in the dark on the third evening of the intensive. For Rhonda, this was the most fearful thing of all! She said at the start her anxiety was "greater than 100%," but she felt triumphant when she arrived home. Werner gave her specific homework, like driving over a specific overpass four times, and also encouraged Michael, Rhonda's husband, not to give in to her requests to do the driving on a planned trip to visit friends in Sacramento. I am deeply grateful to Rhonda for giving us such a raw and real glimpse into her courageous and victorious win over her intense driving phobia, and a big thanks also to Werner for being such a kind and powerful TEAM-CBT therapist, teacher!, and beloved friend! Thanks for listening today, Rhonda, Werner, and David Solution to puzzles above Outcome Resistance: If she's “cured,” she'll have to start driving much more, and that will include driving over overpasses and bridges. This concept will freak her out now, because she's still afraid something horrible might happen if she stops avoiding them. Process Resistance: To overcome her fears, she'll have to face them and experience some fairly intense fear along the way. Werner can support her, and drive with her, as he did, but she will still freak out at first when driving on overpasses and bridges. The distortions in those two negative thoughts included All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Mind-Reading, Magnification and Minimization, Emotional Reasoning, Hidden Shoulds, Labeling, and Self-Blame.
Podcast 417 Bullying Featuring Manuel Sierra, MD (pictured above) Today, we welcome an old friend, Manuel Sierra, MD, who practices pediatric psychiatry in Idaho, and Dr. Matt May, a familiar and beloved colleague, to discuss bullying. Below you'll find a great list of questions Dr. Matt May submitted just prior to today's podcast, along with some links you may wish to explore for more information. We addressed some of the questions, but certainly not all, during the podcast! Manuel described bullying, and said the ¼ of children and adults have experienced bullying. The consequences can be severe, including suicidal urges or completed suicides, along with shame and a severe loss of self-esteem, and more. He pointed out that bullies are good at zeroing in on aspects of ourselves that we feel insecure about, including how we look, our ethnicity, our aptitudes, and more. He provided links to resources on bullying. The bully picks on someone who is weak, so there is a power imbalance, and does the bullying to gain popularity and power, at the expense of the victim. David and Manuel emphasized that the bullying per se cannot cause the depression, shame, and so forth, but rather the victim must buy into the bully's mean-spirited statements, like “you're weak,” or “you have an ugly zit on your nose,” “your mother is a dirty whore,” and more. Then, the inner dialogue of the victim often goes like this: I must be a terrible and horrible person to get bullied like this. I'm worthless. All the kids are looking down on me. Everybody hates me! Everyone is laughing at me. I'm just a loser. And that, of course, is the voice of the “inner bully” who does all the emotional damage. Manuel and David both emphasized that the goal of treatment is to help the victim see that the “badness” is not with them, but rather with the kid (or adult) who's doing the bullying. Because the victims nearly always feel ashamed, they will often suffer in silence, keeping the bullying a secret. David described what he calls the “abuse contract” that many, and perhaps most, humans buy into when being hurt or exploited. It's really a contract between the abuser and the abused, and there are there parts to the agreement. I get to hurt you for my own pleasure. This might include sexual, physical, financial, or psychological torture or abuse. You, the victim are entirely to blame for this. You are the bad one. I am superior and totally innocent. You deserve what's happening to you. We have to keep this a secret, even from ourselves. You cannot even hint that I am doing something wrong. If you try that, I will REALLY hurt you. David emphasized that the tendency to “accept” this type of horrible contract is not limited to children, but includes adults as well. He emphasized that sometimes the child who is being bullied will tell parents, who then tell the teacher or school officials, who will tell the bully to stop. This is rarely effective, and often makes the situation worse, since the bully tells the victim that they are a snitch and now they will REALLY get what they “deserve.” Matt described many types of bullying, including physical, psychological, and cyber bullying. Manuel described some of the signs to look for if you suspect a problem with your child, including: Not wanting to go to school. Saying things like “everyone thinks I'm terrible.” Changes in sleep, eating habits, and energy. Somatic symptoms such as stomach aches and headaches. Manuel emphasized that the goal is not to eliminate negative feelings entirely, but rather to reduce the time you spend feeling anxious, humiliated and upset after being bullied. He also emphasized that ongoing practice talking back to your own negative thoughts is an important key to change, in exactly the same way that athletes must commit to ongoing daily practice to boost their physical skills and stamina. Manuel emphasized the importance of empathy and support, as well as asking victims if they'd want some help combatting their automatic negative thoughts and feelings. He shared that he endured considerable bullying as a kid, and was bullied because he was poor, of Mexican heritage, short, wearing glasses (“four eyes”), and young, and sometimes called “a fag” and other hurtful things. He said that reattribution is one useful strategy, among many, for combatting automatic thoughts and negative feelings. Instead of automatically blaming yourself for the bullying, you can ask questions like this: “What is it in their life that makes them want to do things like this.?” And “They are trying to hurt and embarrass me. Why are they doing that.” The goal is to help the victim see that the “badness” and shame really reside within the bully, and not with them. The bully is trying to tear you down. Ask yourself why? The bully thinks that this is the best way for them to gain popularity, power, and importance. Toward the end of the podcast, I, David, again emphasized that the Outer Bully can hurt us physically, by hitting for example, but only the Inner Bully can make us suffer emotionally. And if you've used the Externalization of Voices to crush the inner bully, and you no longer feel intimidated or ashamed when some tries to bully you, it becomes infinitely easier to respond effectively to the Outer Bully, using the Five Secrets, including Disarming and Stroking, as well as humor. To demonstrate this, I invited the other guests to try to bully me as an old person (I'm about to turn 82), and urged them to say the cruelest things they could think of. This is called the Feared Fantasy Technique. I was surprised and pleased at how incredibly easy it was to get “the edge on them. “ I hope you enjoy that aspect of the podcast. We will likely approach this topic again, with a focus on cyber bullying, and will restrict our focus to children and teens. How to Help! Matt once worked with a child who encountered their own 'inner bully' in the form of negative thoughts that would occur when they were unable to assemble LEGO's. The child could express certain thoughts, but was too young to write, so Matt wrote these down: I'll never be able to do it It's impossible I'm not good at anything There is something wrong with me Matt asked the child if they would like to learn a trick for how to feel better and the child agreed. Matt wrote down some new thoughts for the child to choose from to describe the situation that was upsetting to them. Multiple Choice Positive Thoughts: I really, really want to do this! It's ok if I can't do it, yet Some things take lots and lots of practice I may be able to do it later I can do lots of things really well already I can probably get better with practice People love me and like to help Nobody's good at everything all the time Everybody messes up sometimes It might help to take a break I can always choose to like myself The child said they really liked #11 and felt better right away and during future 'relapses'! Thanks, Matt Thanks for listening today. Below you'll find the email Matt sent prior to the show. Manuel, Rhonda, Matt, and David Matt wrote: Just to stir up trouble and make you all sweat, I'm sending a few questions we might address: What is bullying? How are we defining this term? Is it Liberal Propaganda? How dare I say that? What's the difference between bullying and micro-aggressions / gaslighting? Am I crazy, if I think I'm being gaslighted? If I avoid bullying, in-person, including physical, emotional and verbal abuse...am I safe, on the Internet, at least? Is there such a thing as 'Safety'? Isn't that the thing we need, the most? Whose job is it, to make me feel safe? Why do some people think that safety doesn't exist? What is the significance of bullying? Does it matter or have any tangible effects on individuals or society? Link: https://www.ncbi.nlm.nih.gov/books/NBK390414/ What are some common misconceptions when it comes to bullying? Here are some that Matt has seen on DML's: It was all my fault / I deserved it / This happened because I am (insert label: bad/weak/defective, etc.) Bullying is normal, nothing can be done about it. Everyone gets bullied. It builds character. I should just get over it. I shouldn't *still* feel upset. That was a long time ago and I've done a lot of therapy. I can't speak up or talk about it, it's just too disturbing and upsetting. People would judge me and reject me, if they knew what happened to me All conflict is dangerous and must be avoided, at all costs I'm just a loser, a born victim, worthless in every way. This will always happen to me and people who believe #2 are correct I should be more accepting of bullies, they're people, too. Bullies shouldn't be bullies and should be hunted to the ends of the earth, and destroyed. What is the *cause* of bullying behaviors? Why would anyone choose to be cruel, manipulative and selfish? What is the 'Dark Triad'? Which feature of the 'Dark Triad' is most closely associated with bullying? Link: https://en.wikipedia.org/wiki/Bullying What can be done about bullying? How can TEAM therapy help someone who is being bullied? Can TEAM therapy help a bully? What can parents do, if their child is being bullied? Can TEAM help? What can parents do, if their child is bullying? Can TEAM help? What can society do? Other Questions: What is the “Internal Bully”? How does the “Internal Bully” relate to depression? What is the greatest predictor of bullying behavior and thinking? Who's to blame, anyway, here?
Feeling Down? Try the Feeling Great App for Free! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com! What's a Give-Get Imbalance? What's the Best Treatment for Anxiety and Dysthymia? Can you do Externalization of Voices on Your Own? The show notes for today's podcast were largely written prior to the show. Tune in to the podcast to hear the discussion of these questions by Rhonda, Matt, and David. And keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks! Suzanna asks: What's a “Give-Get” imbalance? And how can you get over it? Martin asks: What's the best treatment for anxiety and dysthymia? Eoghan (pronounced Owen) asks: Can you do Externalization of Voices on your own? 1. Suzanna asks: What's a “Give-Get” imbalance? And how can you get over it? Description of Suzanna's problem. Suzanna is a woman with a grown daughter with severe brain damage due to a severe brain infection (viral encephalitis) when she was an infant. Suzanna was constantly giving of herself and catering to her daughter. She explains that her daughter can be very demanding and throws tantrums to get her way, and kind of controls the entire home in this way. She can only talk a little and has the vocabulary of about a two-and-a-half-year-old. She can mostly express the things she wants or doesn`t want on a very basic level. She mostly understands what I want from her, but mostly does not want to do what I ask her to do. She can be very stubborn. And I cannot reason with her because she has her own logic and, in her eyes, only her logic is valid. Maybe all a little bit like a two-and-a-half-year-old. Suzanna struggles with negative feelings including guilt, anxiety and depression, because she is constantly giving, giving, giving and feeling exhausted and resentful. And she tells herself, “I should be a better mum.” Can you spot any distortions in this thought? Put your ideas in the text box, or jot them down on a piece of paper, and then I'll share my thinking with you! What are the distortions in the thought, “I should be a better mum”? There are many distortions in this thought, including All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Magnification and Minimization, Emotional Reasoning, Self-Directed Should Statements, and Self-Blame. There may be one or two more, too! The first step in change nearly always includes dealing with motivation and resistance. Suzanna decided to do a Cost-Benefit Analysis, as you can see below, and a revision of her Self-Defeating Belief, as you can see below. Another helpful step might include “No Practice,” which simply means saying “no” so you don't constantly get trapped by “giving,” as well as “giving in.” A third critically important strategy involves the mom and dad making the decision to work together as a loving team in the management of a troubled child, rather than fighting and arguing with each other, as we've discussed on previous podcasts. However, in many, or possibly most cases, the parents are not willing to do this. They are more concerned about being "right" and so they continue to do battle with each other, as well as the child who needs a more loving structure. David Cost-Benefit Analysis Self-Defeating Belief: I should be a better mum to my daughter Advantages of this belief(How does believing this help me?) Disadvantages of this belief(How does believing this hurt me?) This thought motivates me to: Put myself out. Push myself to give what I have. Find ways to advance her development. Find ways to involve her in everyday life. Invest myself into her and her life as much as I can, physically, emotionally and time wise. Try to find ways that my daughter can have a fulfilling life. Try hard to connect to her, her pain, her needs, her sadness and her frustration. Try to make her life as easy as possible. Try my hardest to see her world through her eyes and gain deeper understanding of how she feels. Try to understand what is upsetting her when she throws a tantrum. Stay healthy and fit to have energy for her. Try to make her life rewarding and meaningful. Fulfill my duty as a mum to my daughter who needs my support. I can feel good about myself. I satisfy other people's expectations of me. Protects me from criticisms from my husband I am a prisoner to my daughter. No matter how hard I try I don`t seem to make a meaningful difference to her life and to her development. I am a “Siamese Twin” to her. I cannot move or do anything if she doesn`t want to. I reason with my emotions instead of thinking rational at times. I let my daughter get away with “murder”. I find excuses for her behaviour. I find excuses for her why she cannot behave differently. I beat up on myself when I feel I failed her. I take all responsibilities away from My daughter and make them my own. I blame myself when I cannot motivate her to do something. I blame myself when she is bored and unhappy. I feel guilty doing my own things. I feel guilty when I do not involve her in my activities. I feel guilty when I expect her to do entertain herself for a while. I cannot live my own life. I cannot be myself at times. She rules my life, and she lives my life. I feel trapped and frustrated. I feel I need to constantly entertain her. I feel responsible for her happiness. I feel responsible when My daughter is sad and frustrated. I feel exhausted and overwhelmed at times. I feel unhappy and unfulfilled. Advantages: 20 Disadvantages: 80 Semantic Method: Re write your personal value I want to be a mum to My daughter and help her along and invest myself into her. But I also want to treat myself the way I treat her. She has a “right” to live a happy and fulfilling life, but so do I. Our needs and desires are equally important and deserve the same attention and care. I can only continue to look after My daughter well if I look after myself too and take myself and my needs and desires as seriously as I do hers. There needs to be a give-get balance so that both of us can be healthy and happy and stay healthy and happy. I want to help her to slowly take new steps into independence and support her lovingly along the way. 2. What's the best treatment for anxiety and dysthymia? Hello Dr. Burns, What method of treatment would you suggest for GAD and dysthymia? 3rd wave CBT, ACT? What is best based on science? Can you recommend some books please? thank you Martin David's Reply My books are listed on my website, FeelingGood.com. They all describe my approach, which is a bit like CBT on steroids. But every patient is treated individually and uniquely, following a structured and systematic approach that facilitates rapid and dramatic change. I don't recommend “methods of treatment” or “schools of therapy” based on so-called “diagnoses,” but treat the individual with TEAM. Every session with every patient is an experiment, with precise measures at the start and end of every session. The new Feeling Great App, now available, gets a mean of 50% or more reductions in seven negative feelings, such as depression, anxiety, and more, in 72 minutes of starting to use the bot. You can check it out for free! Anxiety and depression often co-exist, and the app targets both. My book, When Panic Attacks, describes my approach to anxiety, based on four models of treatment: the Motivational, Cognitive, Exposure, and Hidden Emotion Models. If you use the search function, you can find podcasts describing those models. Also, there's a free anxiety class on this website. Thanks, Martín, for your excellent question! Best, david 3. Can you do Externalization of Voices on your own? Hi David, Long time listener of your great podcast and huge fan of your book Feeling Great. I've often heard you mention that “externalization of voices” is one of, if not the most powerful CBT techniques. I am just wondering if it is still almost as effective when done solo without a therapist i.e. the person takes on both the roles of positive and negative by recording themselves talking or similar? Also, have you any data comparing the efficacy of TEAM CBT work carried out solo using Feeling Great/your podcast as a guide vs. TEAM CBT performed with a trained TEAM therapist? I am very much looking forward to the Feeling Great app launch in the UK as hopefully that will be a much more effective way to do personal work without a therapist. Many thanks, Eoghan (pronounced Owen) David's reply Thank you, Eoghan! Appreciate your support and thoughtful question. I don't have any data on the use of EOV on your own. One could use a recording device, like your cell phone, and record your negative thoughts in second person, “you,” and try to defeat them when you play them back, one at a time. But in my experience, people nearly always need an experienced role player to do role reversals to show them how to get to a “huge” win. People almost never get a huge win when doing it for the first time, because the therapist (in the role of positive self) can model unfamiliar strategies for the patient. Generally, a hugely successful response involves a combination of self-defense, self-acceptance, and the CAT, or counter-attack technique. And sometimes other methods as well, like Be Specific, for example Radical new learning is definitely the key to success with EOV. Now, thanks to the app, everyone can practice, since we've trained our Obie Bot to role-play with users, do role reversals, give feedback, and so forth. Great question that I will include in the next Ask David if that's okay! We are also exploring the combination of the Feeling Great App plus a trained TEAM therapist from the Feeling Good Institute in Mountain View, California. We are hoping that 1 + 1 may equal 3. Wouldn't that be awesome? What I've found when doing research is that the results are virtually always wildly unexpected! Somethings come out great, and some things come out dismally. I always tell myself that “the Lord giveth, and the Lord taketh away!” Seems to be the rule in research! Especially when you're wanting to be guided by the truth, and not so much by your hopes and expectations. Best, David
Special Announcement #1 The Legendary Summer Intensive Starts on Thursday of this week! Featuring Drs. David Burns and Jill Levitt August 8 - 11, 2024 Click for registration / more information! This workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Podcast #408-- Does God exist? We started today's podcast with a beautiful testimonial and a shout out for the intensive from August 8 to 11, 2024 at the South San Francisco Intensive in person or virtually if you prefer. To learn more, contact www.CBTintensive.com. Act fast because the intensive is on Thursday of this week when today's podcast will be published. Today, we tackle another popular and intensely debated philosophical / religious puzzle: Does God exist? People have very heated views, one way or the other. I (David) will start with a brief explanation of a Wittgenstein answer to this question, and then for the most part, we will focus instead on the question of how we all incorporate spirituality into TEAM-CBT. Wittgenstein emphasized that philosophical problem exist when we debate about the meanings of words or terms that are vague, or poorly defined. Traditionally, we think there are three positions one could take: Theism: You believe that God exists. Atheism: You do not believe in God. Agnosticism: You say that you do no know whether or not God exists. My own thinking, which is strongly influenced by Wittgenstein, would be that I don't understand any of those three stances because I have no idea what you mean by your use of the word, “God.” What is it, exactly, that I'm supposed to believe in, or not believe in? To me, the question, “Do you believe in God,” is nonsensical, so I simply do not deal with it. All of the three positions listed above are based on the idea that the word, “God,” has some kind of clear meaning that we can all agree upon. But it clearly does not. You might define “God” as the “creator of the universe.” Well, there is certainly something magical and mysterious about the existence and creation of the universe (assuming it did begin with some kind of “big bang.”) Some questions might include “Where did all the energy come from all of a sudden?” Or “Are there many universes?” These are valid questions, and physicists are pursuing the answers, which is very exciting and fantastic. But they are generally not invoking the concept of a “God,” although some undoubtedly would say that they do “believe in Gad.” Regardless, I cheer them on and find every new discovery about the nature of the universe, and how the universe works, endlessly fascinating! For today, we will ask a much simpler question of whether and how we include some kind of spiritual dimension into our work as shrinks. This is a topic that is equally exciting, and definitely meaningful. Rhonda got us started by explain that she sees the belief in God as a matter of faith, and is not something that can be tested empirically, which is certainly true. She says she does believe in God, or some “higher power,” but does not believe in a God who “rules over things.” She was raised in the Jewish religion, and says that many Jews believe that God exists in everyone . This sounds a little like Hinduism, which traces back at least 2500 years ago, and possibly as early as 5000 years ago. I believe that the Hindus believe that God exists in everything. The practical impact of the belief that God exists in all of us, is that we will treat each other with love and respect, since we are all an expression of God. She also said that we can “create God among us as a community.” Matt said that he was raised as a Christian and that when he was growing up he had heard about miracles, like Jesus raising Lazarus from the dead in the New Testament on the Gospel according to John. He said that he views our work with individuals who are severely depressed as a kind of spiritual healing, even though we are working with purely secular methods. This is especially true when we are working with individuals who appear to be paralyzed by depression, claiming they are unable even to get out of bed, people who bombard themselves with harsh criticisms, and feel hopeless and ashamed. Matt said that self-acceptance (accepting ourselves exactly as we are) is one of the many tools we use, and that he (Matt) loves to think about the ripple effects of our work, which not only transforms the lives of individuals who awaken from their depressive trance, but this also has enormous positive effects on their friends and family as well. He asks, “How do we achieve this?” I (David) loved hearing from Rhonda and Matt on spirituality in TEAM, and pointed out many areas of overlap between TEAM and the Christian theology I was raised on, since my dad was a Lutheran minister. For example, The TEAM concept that you do not, and cannot, earn genuine feelings of worthwhileness or self-esteem through achievement. In other words, your worth is not your work, but something you give yourself unconditionally. In Christianity, we are sometimes taught that you cannot get to “heaven” through your good works. Enlightenment is a gift, a decision, and not something you have to earn. We also teach that humans are not purely good, but have a mixture of positive and negative motives, and that many people suffer because of guilt and regret about past errors or sins. When we are teaching the Acceptance Paradox, we are teaching a “letting go” of the inner abuse we endure from that relentless, critical voice in our brains, labeling us and telling us that we aren't good enough, we're “bad,” we're “losers,” and so forth, using powerful tools like the Externalization of Voices. In Christianity, this message is delivered in my ritualized ways, including the act of communion, confessing your sins and accepting the blood and body of Christ who “died for your sins.” This is just another way of sending the message that it is okay to accept the fact that you are flawed and fallen, and yet still worthy of God's love—and your own love! In the interpersonal TEAM model for troubled relationships, the entire emphasis on pinpointing your own role in a problem with a friend, colleague, loved one, or stranger, instead of casting blame on the other person and feeling angry and morally superior. My Relationship Journal is a tool designed to facilitate this process very rapidly. In Christianity there are many messages about taking out the moat in your own eye, as well as the idea that when you blame others, and cast judgment, you condemn yourself. There is a strong emphasis on humility and accountability in TEAM-CBT. This often comes up during positive reframing; we talk about how the patient's self-criticisms are often an expression of high standards, honesty, and humility, and that these are beautiful qualities that are real, important, and powerful. And this similar, it seems to me, to the Sermon on the Mount, where Jesus talked about “blessed are the meek, for they shall be called the Children of God.” There are many, many additional areas of overlap, and many books have been written on this subject. During the podcast I provided examples of how the spiritual and psychological realms can meet and reinforce each other at the moment the patient recovers and discovers their own enlightenment. I am proud to have developed TEAM-CBT, and it is clearly infused with many spiritual dimensions, even though it is entirely secular. I mentioned that I was born on a Sunday morning, and my dad said it was the only time he was unable to preach his sermon. He was too excited, especially since my parents had become reconciled to the notion that they could not have children. He called me David Dean Burns, and hoped that someday I would become D.D. Burns, D.D. DD is an honorary degree in theology, and he (and everyone) assumed that I would one day be a minister, like was. He was L.C. Burns, DD. (Lyle Charles Burns) I went in a different direction, but have kind of returned to my original calling, though threw an unexpected route, and hope you have all enjoyed our “sermons” this morning. I would add that I would never impose my beliefs or spiritual orientation on any patient, and only ask about the integration of their successful recovery with their own religious beliefs AFTER they have recovered, so as to add a deeper level of meaning to the work and transformation that they experienced. We only emphasized the Jewish and Christian approaches to spirituality because that was our upbringing, but the spiritual “discoveries” during TEAM treatment are actually compatible with nearly all, if not all, religions and spiritual paths. Warmly, Rhonda, Matt, and David
Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Podcast Practical Philosophy Month Part 2, Do Humans have “Selves”? This is our second podcast in our Practical Philosophy Month. Last week, in our first episode, we focused on the “free will” question. As humans, we all feel like we have “free will,” but is it just an illusion, especially if all our actions are the result of the physical processes in our brains and the laws of the universe? The Bible certainly dealt with this in the book of Genesis, where we learn that the first humans, Adam and Eve, were given a wonderful Garden of Eden to live in, but they had to choose whether or not to obey God's rule NOT to eat the forbidden fruit from the tree of knowledge of good and evil. They chose to eat the fruit, implying that humans have free choice. But the philosophical arguments rage on. In today's podcast, we are joined by two beloved and brilliant colleagues, Drs. Matthew May and Fabrice Nye, as we explore the question of whether or not the “self” exists. We all feel like we have a “self,” but is this real or just an illusion? When you try to define your “self,” you may run into problems. For example, you might think that the “self” has to be the part of us that does not change from moment to moment, and is always ‘the same.” For example, I might think back on my childhood and feel convinced that I was the “same David Burns” then that I am now. And, if you are religious, you might also be comforted by the idea that your “self” is the same as your “soul,” and that you will therefore live on after you die. This concept of a “soul” is a core belief in many religions. But are we fooling ourselves? And what was the Buddha thinking about 2,500 years ago when we talked about enlightenment as resulting from the “Great Death” of the “self.” He seemed to be hinting that something wonderful can happen when you give up the idea that you have a “self.” In the original draft of my book, Feeling Great, I had a chapter on entitled, “Do you need a “self?” Join the Grateful Dead.” I tried to persuade readers that the existence of a “self” is nonsense, based on the philosophy of Ludwig Wittgenstein in his famous book, Philosophical Investigations. But readers found the chapter so upsetting that I decided, on their urging, to delete it from the manuscript, which I did. My goal is not to disturb people, but to provide a path to joy and to loving connections with others. But to this day, I still get emails from people asking me to offer that chapter, or to deal more deeply with this concept of the “self” vs “no self” in a podcast. So, here is my attempt today. I will start with my own take, and then summarize some of the views about the self that were expressed by Fabrice, Matt, and Rhonda during the show. Here's my thinking. There are many key questions you could ask about the concept of the “self?” including: Do we have a “self?” And if so, what is it? Does the first question even make sense? I'm sure you would agree that if a question doesn't make sense, then it isn't a “real” question, and there really isn't anything to talk about. Then we can just stop feeling frustrated and perplexed, and move on with our lives. That is the precise position that the late Wittgenstein would probably have taken. He stated that words have no ultimate or “true” meaning outside of the various contexts in which we use them in daily life. Most words have many meanings, because they are used in different ways, and you can find most of the meanings in any dictionary. So, if you think of the word, “game,” you will quickly realize that it does not have one “true” or essential meaning. It can mean a sports competition, with two teams competing against each, like soccer. But you can have two teams competing in some way other than a sport. And you don't even need two teams to have a “game.” For example, some games are played by one individual, like solitaire with a deck of cards. Or you can think about the “dating game,” or refer to “game birds,” or a “game boxer.” In short, there is not some single “correct” meaning to the word, “game.” Some uses have overlapping meanings, and some uses do not overlap at all with other uses. So, there is no point in trying to figure out if “games exist,” or what the ultimate or essential meaning is of the word, “game.” Now, how do we use the word, “self,” and what does it mean in each context? You might tell your child to behave themself. This simply means that they are misbehaving and will be punished if they don't behave more politely. You do not have to tell the child that their “self” also has to behave better, because that would be meaningless. We already told the child to change their behavior. You could ask friends, as I did this morning, if they are planning to join me on the Sunday hike. Two of them confirmed and said that “they” would join me today on our hike. I did have to ask them if they would be bringing their “selves,” because I just do not know what that would mean! They already told me they're coming to the hike. (They did come and we had a lot of fun.) In my extremely challenging freshman English class at Amherst College, we had to write two or three papers per week on odd topics. The teachers were relentlessly critical in their feedback, and would nearly always point out that we sounded incredibly phony and need to find our true voices, which came from our real selves, as opposed to the false fronts we often used to try to impress people. Almost every student got dumped on constantly! The professors weren't referring to some metaphysical “true selves.” They were just referring to the fact that our writing didn't sound natural, compelling, or vulnerable, and so forth. Our writing was, for the most part, an enormous turn-off. Most of us never could figure out quite what that class was all about, but it was useful as I became more sensitive to the “tone” or “voice” in any writing. I would have to concede that it was a sobering but helpful class. But they were not referring to some mystical “true self” we had to find. They just wanted us to stop writing in such a sucky way! So here is my point, which you might “not get.” When you keep the word, “self,” in the context of everyday life, it is obvious what it means, and it never refers to some metaphysical “thing” that we could “have” or “not have.” It is just a vague, abstract concept that is devoid of meaning when it's all by itself. A “self,” just like “free will,” is not some “thing” that we might, or might not, have. The question, “Does the self exist,” according to Wittgenstein (or his big fan David) has no meaning and so we can just ignore it. It's not a real question. It is, as Wittgenstein was fond of saying, “language that's out of gear.” Now, does this discussion have anything to do with emotional problems, or TEAM therapy? It absolutely does. That's because nearly all depression results from some version of “I'm not good enough,” including: I'm inferior. I'm a loser. I'm a “hopeless case.” I'm a failure. I'm unlovable. I'm a bad parent. I'm defective. And so forth. If you buy into these “self” condemning proclamations, thinking that they mean something, you'll probably feel depressed, ashamed, inadequate, hopeless, and more. As you can probably see, all these self-critical thoughts contain tons of cognitive distortions, like All-or-Nothing Thinking, Overgeneralization, Labeling, Mental Filtering, Emotional Reasoning, Self-Blame, Hidden Shoulds, and more And to put it in a nutshell, they ALL involve the belief that you have a “self” that's broken, or simply not “good enough.” And all of those statements are meaningless. My goal in therapy is NOT to persuade you that you ARE worthwhile, or “a winner,” or a “good” parent, but rather to show you how to let go of these meaningless but painful ways of belittling yourself. I might use techniques like Empathy, Positive Reframing, Explain the Distortions, Let's Define Terms, Be Specific, the Double Standard Technique, the Externalization of Voices, the Downward Arrow, and many more. That's because the VERY moment you suddenly “see” that these kinds of statements are both untrue and unfair, and you stop believing them, your feelings will instantly change. So, you could say that TEAM really IS a “Wittgensteinian” therapy. And when people ask me how to develop better self-esteem, I would not try to get them to discover how to have some magical and wonderful “thing” called self-esteem, because that concept is just as nonsensical as the concept of a “self.” You might say that “self-esteem,” if you want to use the term, is more about what you DO. And there are two things you can do if you want to change the way you feel. First, you can stop beating up on yourself with hostile criticisms like the bulleted statements listed above, and talk to yourself in the same encouraging way you might talk to a dear friend or loved one who was hurting. And second, you can treat yourself in a loving way, in just the same way you might treat your best friend who was coming for a visit. In other words, you can do nice things for yourself. The day my first book, “Feeling Good,” was finally published, my editor called me with some bad news. She told me that the publisher, William Morrow and Company, loses money on 9 out of 10 of the books they publish, so they decide which ones are most likely to sell, and those are the only ones they'll promote. The rest of the books go on a “loser list,” and the company does little or nothing to promote them. She said my book was #1 on their “loser list,” since the president of the company felt it had no commercial potential, and that very few people would be interest in a long book on depression. She added that the one thing they did do was to send my book to ten popular magazines for first serial rights. That means they get to publish an excerpt from your book as an article, so that stirs up some media interest in your book. Sadly, she said that all ten had turned them down. She said that I'd have to be in charge of any further marketing of my book, so I asked what I should do. She said to call all ten magazines right away and persuade them to change their minds. In a panic, I called them all, including Ladies' Home Journal, Reader's Digest, and on and on. Every magazine said the same thing—they did not want my book, had turned it down, had zero interest in it, and to please top calling since authors shouldn't call them and they considered it a form of phone harassment since they'd already made a decision. Yikes! No fun! When I jogged home from the train station that night, I shouted, “You're a loser, you're a failure.” That didn't sound so good so then I shouted, “No, you're not! You'll figure out how to make it happen! Just keep plugging away.” That sounded a lot more loving, so when I got home, I told my wife that the book at just been published and that I'd been turned down by all ten magazines for serial rights, and the publisher decided not to spend any money on marketing or advertising, so we needed to go out and celebrate. She why we would celebrate? I said, “You don't need to celebrate when you win, because you already feel great. But when you lose, that's when you need to celebrate, because you're feeling down. So, tonight we'll celebrate!” We went out for a fancy dinner and celebrated and had fun. And the rest, they say, is history. I just kept trying and getting turned down by newspapers, radio stations, television programs, and more. But eventually, the tide started to turn. To date, Feeling Good has sold more than 5 million copies and it achieved best-seller status. And the reason was that researchers discovered that the book actually had antidepressant properties, so excitement about it spread by word of mouth. I am hopeful that the new Feeling Great App will help even more people. Fabrice made some interesting and wise comments on the notion of the “self.” He said that the idea that we have a “self” is a sense that we nearly all have. Some people feel like the “self” that is located somewhere behind the eyes or in the middle of the head. But, he emphasizes, there is no such “thing” as a “self.” He has quoted someone who has “said it all,” but the statement only makes sense IF you “get it!” Here's the quote: “No Self? No Problem!” This is actually the title of a book by Chris Niebauer, PhD, and the subtitle is How Neuropsychology Is Catching Up to Buddhism. If you want to check it out, here's a link to it on Amazon: https://www.amazon.com/No-Self-Problem-Neuropsychology-Catching/dp/1938289978 Fabrice emphasized that the concept of “self” is “nebulous.” He asked, “Is there a ‘David'?” He explained: You wouldn't be able to prove this in court. Well, you could show ID, but that would not be proof. Where does the information on the ID come from? Birth certificate? Who wrote the information on the birth certificate? Probably some doctor back in 1942. And where did he get that information from? Probably some caregiver said “Write ‘David' here.” Was that from a credible source? Not at all. That info was made up on the spot! Now, you can say that there's a “sense” of a David going around, and that there are some patterns that show signs of “David-ness,” but there is no “David.” Matt added that your body is not your “self.” When you break your arm, you don't say that you have broken a part of your “self.” You just say, “I broke my arm.” Rhonda raised the question of whether the “self” is just the same as “consciousness” or “awareness.” Someone in our group added that the “self” is what we DO, and not what we ARE. And, of course, what we are doing is constantly changing from moment to moment. My understanding of all of this is that once you let go of the notion that you have a “self,” you will no longer worry about whether or not you are “good enough” or “special,” or whoever. You can focus instead on living your life and solving the problems of daily living and appreciating the world around you. If you screw up, you can focus on what specific error you made, rather than obsessing about your inferior or defective “self.” You can actually welcome failure as just another teacher, so you can grow and learn, and simply accept your screw ups, or both. In fact, two of the most popular TEAM techniques for challenging the distorted thoughts in bullets above are called “Let's Define Terms” and “Be Specific.” These techniques are right out of Wittgenstein's playbook, and they are prominently featured in the “Learn” section of the new Feeling Great App. If you're feeling depressed, and thinking of yourself as a “loser” or as being “inferior” or even “worthless,” the goal is NOT to “become a ‘winner,” or more ‘worthwhile,' but rather to give up these notions as nonsensical. But once again, many people cannot “get it,” or “see it,” and that's where a caring and skillful therapist can help. Some people wrongly think that letting go of the notion that you could be “worthwhile” would mean a huge loss of something precious. Many people who don't yet “see” what we're trying to say are terrified of the “Great Death” because they think that giving up the notion that you have a “self” means giving up all hope for improvement, for joy, for intimacy, and so forth. But to my way of thinking, the truth is just the opposite. When your “self” dies, you and your world suddenly wake up and come to life. When you accept yourself and your world, exactly as they are right now, everything suddenly changes. Of course, that's a paradox. I believe that leading our patients to the “Great Death” of the “self” is like giving them the understanding and courage they need to throw some garbage in the trash instead of carrying the garbage around with them all the time! I hope some of this makes a little sense, but if not, don't worry about. Sometimes, it takes a little time before you suddenly “see it!” Thanks for listening today. We love all of you! Rhonda, Fabrice, Matt, and David
Ask David Unfairness Worthwhileness Erasing Depression with Lasers TEAM in the UK What's the Most Powerful Technique? We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes. We love your questions. Remember to send them to David@feelinggood.com. Special Announcement Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. But there's some good news, too! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out! Today's Questions Kiernan asks about “unfairness” and the connection between worthwhileness and achievement. Brittany asks: Can you “erase” feelings of sadness and depression by shining lasers in the patient's eyes? James asks about the use of TEAM methods in the NHS in the UK Brian asks: Is positive reframing the most successful technique you have used with your patients? 1. Kieran asks (slightly edited for clarity): How would you talk back to negative thoughts like this one: “It's not fair that I can't afford quality food when there are millionaires that will have access to better food and a healthier lifestyle which has an effect on overall health and longevity'”? Or what if you feel like it's unfair that you should have to pay a lot of money for an expensive dental treatment that you can't afford? Kieran also asks (slightly edited by david): What if worthwhileness is not based on achievement but there are still things you would like to have and enjoy? They would buy and own things that they happen to like and not to impress others. Hi David and Ronda, and if Matt is on I have been listening to your wonderful podcast for about the last 3 years as I drive to work. It has really opened my eyes about how your thoughts create your interpersonal reality. Loved the podcasts on jealousy addiction, perfectionism, achievement addiction and many more. My questions would be: What about if someone wants to achieve more but it isn't based on worthwhileness? They would buy and own things that they happen to like and not to impress others. Let's say they wanted to be able to afford a nice house, healthier higher quality food and water. As the quality does have an effect on health especially in the US as the regulations are not the greatest. However, the fact that they couldn't afford to buy these upsets them? Thoughts: 'It's not fair that I can't afford quality food but there are millionaires that will have access to better food, lifestyle which has an effect on overall health and longevity' Or if someone has to pay for unexpected expensive dental treatment. Thoughts: 'It's not fair that I have to pay £14,000 for this treatment'. 'It should be more affordable to lower income households, as it is essential to have functional teeth' I hope I have explained this well, I would love to hear your thoughts. Keep doing what you are doing and all the best. Kieran David's response Sure Kieran, if you like I will make this an Ask David question for a podcast. LMK if that's okay, and if it is okay to use your first name. Great question, and has to do with the theme of acceptance: should I or shouldn't I? Here are the quick versions, but we can discuss in more detail on the live podcast. First, I do not find it useful to base my worthwhileness on my achievements or on my failures. I do work hard and like creating things that are helpful to people, and I enjoy earning money to support my family. I can be motivated to work hard to get things we want or need, but I don't base anyone's worthwhileness on how much money they have, or anything, to be honest. In fact, I could also easily accept wanting to buy something really cool, not just because I like it, but because it might impress others, or because they might find it fascinating, too! I don't try to regulate my life with a lot of shoulds and shouldn'ts, and find that I am happier and more peaceful without lots of shoulds. In the Feeling Great App I have created a class called “Your PhD in Shoulds.” You might enjoy it! Second, you can say that it is unfair that some people have more money and resources than other people if you like. And you have every right to feel angry if that's what you want, as well. Acceptance is more of a decision than a technique. Take the fact that lions kill deer when they are hungry. You can say, “they should not do that. It's unfair!” But that won't stop a hungry lion. You don't have to LIKE seeing a lion kill an innocent deer, but you can accept it. Again, that's a choice. The behavior of a lion is dominated by millions of years of evolution. Humans are no different. One thing that sometimes helps is to make a list all the REALLY GOOD reasons NOT to accept the “unfairness” in the world. I'll bet you could come up with at least ten to fifteen strong reasons. Then you can ask yourself, “Given all those good reason NOT to accept the fact that some people have more and some people have fewer resources, maybe I should just stay good and angry! Why in the world would I want to change?” Also, when you find an injustice, you can use your energy being good and angry, and complain about it, or you can use your energy to do something about it. Or, you can also work to change yourself, instead of complaining about the world. I also have a new class on acceptance. It's called, “Accept this shit? Hell NO!” You might like it as well. I am babbling so will stop. Warmly, david 2. Brittany asks: Can you “erase” feelings of sadness and depression by shining lasers in the patient's eyes? Hi David, My husband's boss was telling him she's going to be doing some laser therapy to “cure” her depression. She had to undergo 9 hours of testing to see if she'd be a candidate. Apparently, they plan to shine lasers in her eyes to “erase” her sadness. Obviously, I assume this is a load of garbage. But have you ever heard of such a thing? Is this just hypnosis? Best, Brittany David's Reply Hi Brittany, Probably. As they say, follow the money! There is a placebo effect if you believe something will help, so tons of garbage gets served up as costly gourmet food. You can read up on this on the internet I suspect. Let me know what you learn! Best, david Brittany responds to David Love your answer! I was looking into it and read they use a cold laser in the eyes which allegedly releases endorphins. I already know from you that just like with exercise and that study about the endorphin blockers, it made no difference. People just feel better because they think they are doing something good for their body by exercising. They also allege that the lasers aid damaged neurological tissue. They claim it has helped many patients but there is no data backing it up that I see. They really lost me when I read that lack of activity, stress, and maternal deprivation cause depression in the first place. Thanks! Brittany David adds As it turns out, I know two laser experts who are regulars on my Sunday hikes. Dr. Alexander Makowski is a brilliant scientist who is involved in the research and development of lasers and their marketing. Here is his email, along with some terrific links to articles about the hype of “low light lasers.” Hope you enjoy the email and links from Alex: Hi David, I'll chime in too! From a different angle. Zak knows some great doctors who are doing real work, but the general field of low-level laser/ light therapy (LLLT) for medical issues has been fraught with charlatans for some years. (David note: Zak is a laser expert at the Stanford Medical School and is currently preparing a blog on the topic of LLLT. I will include a link to her blog when it is published, likely in a couple weeks. She is awesome and also often joins our Sunday hikes!) Dr, Alex Makowsy continues Good work by Tiina Kaaru (https://www.spiedigitallibrary.org/profile/Tiina.Karu-8010) and Juanita Anders (https://www.usuhs.edu/profile/juanita-anders-ms-phd) on mechanisms behind using light to stimulate our mitochondria or deactivate infectious bacteria are well documents However, the good work done by the few was overshadowed and worse, was perverted for many years into crackpot devices using bad stats and poorly designed studies. Or sometimes just straight preying on vulnerable people. It is the great shame of the laser industry. Worse yet, some of these devices were actual lasers that led to people getting hurt. I can't recommend in good conscience that lasers be shone into eyes at any time other than diagnostic devices meant to diagnose the eye itself. It may be that some day soon a good scientific body of evidence changes my stance but not yet... The story starts in the origin of my journey into light and lasers. I got involved in this field in 2005 while taking an elective class on optics and lasers when I got a call from my mom that she was seeking a laser therapy for her fibromyalgia. My mother's desire to get her fibromyalgia treated with a "cold laser" pulled me into this field since I was taking a class with a professor who later became my doctoral mentor. A full semester of my free time disappeared as I tried to source out of print articles and do a deep dive on whether this was real or garbage. A research term paper and a conference visit later I could finally see the same trends you saw with medication. I talked her out of the potentially dangerous unproven device usage. [As you may have suspected, In fact my mom was having significant issues in her marriage and life and a very good doctor set her straight. My mom divorced and is now happily remarried, about 95 pounds lighter, no fibromyalgia or serious insomnia. If only we had known you back then she would have recovered in a session or two rather than 3 years] However, in the process, I dug into some of the real research that small doses of light can affect our bodies in ways we don't understand fully due to lack of research. Fast forward several decades and some of the best researchers survived the public scandal of LLLT and found a scientific mechanism (cytochrome c oxidase activation) to explain observed changes in mitochondrial activity. However, the scientists don't claim to cure everything or anything. Then they published this mitochondrial activation and suddenly: This, of course, proves that blogablum does in fact exist and now the truth about the panacea is available for all!! David note: “blogablum” is a fake nonsense word I made up that refers to nothing meaningful. Now continuing with the Alex email: This is a good review of the history and current evidence about it : https://www.mcgill.ca/oss/article/medical-critical-thinking/hype-around-photobiomodulation But if you want the real goods, the hard truth about cold lasers has been out there for over 15 years: Introducing the New Low Level Laser Treatment! youtu.be The following search on YouTube will reveal the secrets of the universe: "cold laser before:2009" Warmly, Alexander J Makowski, Ph.D. Dr. Matt May's reply Hi David, Thank you for forwarding this question to me. I am very concerned and wonder if this may fall under the category of 'malpractice'. For one, I am unaware of any FDA approved treatment for depression that involves shining lasers into people's eyes to erase their sad memories. For a list of FDA approved treatments for depression, you could refer to: https://www.ncbi.nlm.nih.gov/books/NBK559078/ It's possible that there is new evidence I'm not aware of, but I searched online for studies of light in treatment of depression and was unable to find any placebo-controlled trials. This is a problem because placebo responses can be so high in the case of depression and anxiety. There were some studies on light therapy, but nothing fitting the description of 'shining lasers into eyes to erase sad memories'. Other concerns I have relate to the high cost of such an extensive “evaluation”, as well as possible risk of shining lasers into someone's eyes. In the absence of evidence supporting the treatment, it seems like a high cost, and potential risk, to the patient, hence my concern for malpractice. It's pretty common for people with depression to feel a sense of desperation, especially after many failed efforts to address their symptoms. This group of individuals are likely to be extremely susceptible to scams and purveyors of 'snake oil' (sham treatments). It's also concerning to me because the theory behind the idea of shining light into people's eyes to erase sadness doesn't make logical sense to me. It's a potentially-testable hypothesis, but it's such an absurd hypothesis that I don't see it as worth testing or entertaining. If we are defining depression as some combination of worthless, hopeless, ashamed and guilty feelings, then the hypothesis that such feelings could be meaningfully addressed by such a crude instrument as a laser or a pill or an electrical impulse is absurd. This is because our feelings arise from our thoughts/perceptions. I've never met a single person or patient who was suffering from depression but had healthy positive thoughts about themselves. I've also never met someone who had patterns of negative thinking, but felt fine, up-beat and positive. The idea that a pill, a laser, a magnetic pulsation or electrical current could selectively alter the specific thoughts that cause depression doesn't make sense with what we know about the brain and thoughts and feelings. How could a pill, for example, which crosses the blood-brain barrier and impacts every neuron in the brain, selectively target only the neurons that give rise to depressed thinking? It's like imagining that we could carpet-bomb a city but only kill the murderers and rapists. I'd encourage all potential clients who are receiving treatment for depression or other conditions to ask their providers for literature that documents the effectiveness of the treatment and to get a second opinion if they are unsure. These are my 2-cents on the topic and I could be completely wrong about it all. Hoping to hear from others what they think. Also, David, I saw several other people included in the invitation to respond to this question but I didn't see them cc'd. Perhaps they were bcc'd? Wishing you the best, fondly, Matt David's reply to Matt Thanks, yes, I have a fantastic response already in the show notes from Dr. Alex Makowski who does research and development of lasers with valid medical applications. His thrust is similar to yours. Our field is littered with junk “scientism” intended to fool and exploit people, similar to the snake oil salespeople who use to go from town to town in America selling magical “elixirs” that “cured” just about everything! But people are endlessly gullible, and con artists are still in endless abundance these days, it seems! Best, david Will add your kind and thoughtful comment to the show notes! 3. James asks about the use of TEAM methods in the NHS in the UK. Hi Rhonda, I hope you are well. I had a couple of questions for an 'ask David' on the podcast if that's okay. A bit of background.... I am Level 1 Team and have attended David's training in Atlanta. I live in the UK and have recently changed career to work in the NHS delivering CBT interventions for patients because David's work inspired me so much. The NHS uses specific interventions for particular diagnoses and because I am in training I have to try and stick to this. I do use the TEAM materials and approach when I can and have already seen some great results. The NHS uses 'Behavioural Activation' for certain patients with Depression and I just wondered what David thought about the effectiveness of this (perhaps compared to Cognitive Restructuring). I believe Beck introduced this into the CBT model as he thought it was useful. Another question was regarding treatment of GAD and whether dividing worries between hypothetical and practical, and then using a certain time to actually worry rather than letting the worries dominate throughout the day was something he thought was useful or had heard about. Thanks so much for all the great work you are all doing and inspiring people all over the world! Kind Regards James Bibby. David's response Hi James, Thanks for the great questions. In today's recording of an upcoming Ask David podcast, we can address: The history of “Behavioral Activation,” including the pros and cons of this approach. The history and pros and cons of “Worry Breaks.” The idea of matching a “technique” to a “diagnosis,” as opposed to learning to treat the whole patient with TEAM. The results of our latest research with the Feeling Great App, and whether it might have some value for patients struggling with depression and anxiety disorders in the UK. Best, David Matt's Thots: Great question! I'm looking forward to discussing. There are certainly some techniques that are more effective, than others, for addressing specific negative thoughts. Meanwhile there are a number of problems that come up when we are, as clinicians, throwing solutions at diagnoses, rather than treating the human being who is suffering. Studies on the treatment of PTSD at the VA, for example, showed veterans often got worse after this approach, in which their diagnosis was matched with a method, ‘prolonged exposure', without any agenda-setting. This just retraumatized lots of veteran! Similarly, if someone is secretly blaming, and haven't experienced the ‘death of the blaming self', they might be assigned ‘communication skills training', only to see this backfire, because their intent is still to try to change someone, rather than accept them. You might tell a patient with depression that they should go exercise, only to cause them to resist you, ‘you don't understand, I can't even get out of bed!'. In short, most therapy fails or even makes patients worse because it doesn't consider the good reasons to continue to blame, give up, criticize ourselves, etc. 4. Brian asks: Is positive reframing the most successful technique you have used with your patients? I can see how it would cure someone in 2 hours! Feel free to use my question and do and use my name if you wish. I'd be honored. Best, Brian David's reply Hi Brian, Thanks. Great question! It's one of the latest powerful techniques, but Ext of Voices might still be the “champion.” Using them in the T, E, A, M sequence is especially powerful. Positive Reframing often gets them closer, but not quite all the way to enlightenment. Externalization of voices (EOV) often gets them over the finish line, especially if you know how to use it skillfully, incorporating Self-Defense with the Acceptance Paradox and Counter-Attack Technique! In fact, you can incorporate many of my > 100 techniques when using EOV, such as Be Specific, Semantic Technique, Examine the Evidence, and a host of other. Best, david Matt's comments I agree, Positive Reframing and Externalization of Voices are incredibly powerful and it's often what we're doing when we see recoveries. What works for a given individual, however, is quite hard to predict, in advance and there's a ‘process' to therapy, such that we can't really skip steps, except in some unusual circumstances. Some other super-powerful methods include Externalization of Resistance, Double Standard, Flooding, Feared Fantasy, and the Hidden Emotion Technique. I'm probably forgetting some. Thanks for listening today! Matt, Rhonda and David
Premiered May 3, 2024 Christopher Knowles, aka Secret Sun Speaks, is the owner of the Secret Sun Blog, and the author of Our Heroes Wear Spandex, Endless American Midnight, He Will Live Up in the Sky, The Spandex Files, The Secret Sun Synchromystic Handbook, and The Secret History of Rock 'n' Roll Topics: - His Background in the Church - Pagan Symbolism All Around Us - Lucifer, Mithras, and Perseus - The Meaning of a Church Sanctuary - Why Strong Men Are a Threat To the Empire - Watcher Worship and the Ruling Elites - Human Misery in the Collapse of Civilization - The Happy Ending of the Book of Revelation [00:00:00] Intro [00:04:46] Christopher's Background in the Church [00:07:25] Pagan Symbolism All Around Us [00:11:54] Lucifer, Mithras, and Perseus [00:39:38] The Meaning of a Church Sanctuary [00:52:04] Strong Men Are A Threat To the Empire [01:03:36] Watcher Worship and the Ruling Elites [02:25:18] Human Misery in the Collapse of Civilization [02:54:57] The Happy Ending of Revelation ~~~ Christopher Knowles: The Secret Sun Blog Secret Sun on X Patreon LinkTree ~~~ MENTIONED IN THIS PODCAST "Endless American Midnight" - Christopher Knowles "Our Gods Wear Spandex" - Christopher Knowles "Adam and Eve and the Serpent" - Elaine Pagels "The Externalization of the Hierarchy" - Alice Bailey Bloomberg's London Mithraeum The Mithras Liturgy ~~~ 12 RULES FOR CHASTITY - FREE GUIDE! https://renofmen.gumroad.com/l/12rules SPONSORS https://ReformationCoffee.com Use the code SUBFREE to get one free bag of coffee with subscription. https://obrienfitnesslifestyle.com Use code RENOFMEN to get 10% off any online training package. ~~~ The Renaissance of Men: Connect on X Instagram YouTube LinkTree ~~~~~~~ From Me: Be Good Broadcast Many thanks to Will and Chris for their permission to broadcast this episode. Two legends who deserver your undivided attention. I just rebroadcast those spreading The Word. Propagate it. Share it. Contact Me Please Rate or Review onSpotify or Apple. This and all works are protected by CC BY-NC-ND 4.0 DEED Attribution-NonCommercial-NoDerivs 4.0 International License --- Send in a voice message: https://podcasters.spotify.com/pod/show/begoodbroadcast/message Support this podcast: https://podcasters.spotify.com/pod/show/begoodbroadcast/support
Incredible Voices from the Past! Plus: David's Amazing Summer Intensive Returns August 8 - 11, 2024 Today, David and Rhonda are joined by Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mountain View, California, and two incredible voices from the past: Dr. Karen Radella, a clinical psychologist who volunteered to do personal work at the 2013 summer intensive at the South San Francisco Conference Center, and Jacqueline Ong, LCSW, who volunteered to do personal work at the 2019 summer intensive. That was the last summer intensive, due primarily to the Covid pandemic. Karen Radella, PhD But here's some fantastic news. The intensive returns again this summer, from August 8 to 11, 2024, at the same location. And Karen and Jacqueline give testimonial today, along with Rhonda, to the magic of the intensive, by describing the phenomenal impact of the personal work they did years ago, and the tremendous impact that work has had on their personal and professional lives. Both Karen and Jacqueline had been suffering from the devastating emotional impact of severe personal trauma for many years. Nine years earlier, when Karen's daughter was 12, she asked Karen if she could go out to play after dinner. She'd done this for years, but Karen had the thought that it was late and cold outside, but gave in and let her daughter go out to play. Minutes later, some neighborhood boys snuck up on her and shot her in the mouth with a high-powered pellet rifle that blew out one of her teeth and did considerable damage to her mouth which triggered PTSD and required many dental surgeries to correct. Both Karen and her daughter had been suffering emotionally for the nine years since that incident. Karen was telling herself that she was a bad mom, that she “shouldn't have” let her go out to play on that particular night, and that her daughter's horrific trauma was her fault. She was also convinced that other people, including the 100+ in the audience that evening, would be judging her as harshly as she was judging herself, and her feelings of fear and despair were palpable at the start of her live work. Karen described the techniques that were so helpful to her in her fantastic recovery that evening during her two hour session with Jill and David, including the Survey Technique, which she said was the “coolest experience of my entire life.” She was also helped by other techniques, including Explain the Distortions, the Double Standard Technique, and the Externalization of Voices. Jacqueline had suffered a different but equally severe traumatic event of a personal nature, but also disclosed it and worked it through with great courage in front of an audience of the same size in 2019. Like Karen, she experienced a complete elimination of her symptoms in the 2 hour session with Jill and David. She describe the keys to her suffering and recovery involved perfectionism (the need to be flawless) and perceived perfectionism (a term David coined that refers to the belief that others expect us to be perfect in order to be loved and respected.) Jacqueline emphasized that “failing as fast as you can” is one of the keys to the rapid recovery we so often see in TEAM. Instead of meeting once a week for an hour, which sets you up for very slow progress with relapses between sessions, you use technique after technique in one session until you find the one that works. Of course, following “recovery,” your negative thoughts will return over and over throughout your life, because no one is entitled to be—or would even want to be—happy all the time. But once you've experienced your own enlightenment, you know the tools that work for you, so you get better and better at heading off the relapses at the pass. Jacqueline and Karen both said they'd heard that the personal work at an intensive can be life-changing, but they “wouldn't have believed it” until they experienced it. Rhonda said, “I saw both live demonstrations. My first intensive was also the 2013 intensive when Karen did her personal work and saw Jackie's work at the 2019 intensive. I cried my eyes out with both of you at those intensives. After watching David and Jill's personal work with Karen at the 2013 intensive, I decided that TEAM was the therapeutic method I wanted to learn, and that's why I've dedicated my life to learning, practicing and teaching TEAM.” David, Jill and Rhonda hope YOU can attend the magical intensive this year. To learn more, you can just go to www.CBTintensive.com. This year you can attend in person OR online, since the program will be live-streamed. In the past, David has done all the teaching, but this year, David and Jill will do their dynamic “tag team” teaching made famous by their weekly free training group at Stanford. It is now online and is free for therapists around the world. It is Tuesdays from 5 to 7 PM west coast time. If you are interested in joining, contact Ed Walton, edwalton100@gmail.com. You could also join Rhonda's Wednesday TEAM training group that meets over zoom from 9-11:00 am. The timing of this group is more convenient for therapists from many parts of the globe. If you are interested in the Wednesday group, please contact Ana Teresa Silva, ateresasilva6@gmail.com. We hope to see you on August 8 at the South San Francisco Conference Center. But move fast if you want to attend in person, since seating will be strictly limited for those who wish to attend in person. Click here for further Summer Intensive information Best, rhonda, jill and david Thanks for listening today!
393 Marina Dyck on TEAM for Insomnia Today we feature Marina Dyck, a TEAM-Certified Clinical Counselor in private practices in Swift Current, Saskatchewan, Canada. She works with individuals and families struggling with trauma, anxiety, depression, and relationship issues. She combines the latest research in neuroscience, powered by TEAM-CBT, and what she calls the "whole person" approach. Marina describes her innovative TEAM-CBT treatment for patients with trouble sleeping. Many of them toss and turn at night, unable to turn off their anxious and agitated brains, so they ruminate over and over about problems that are bugging them. Sound familiar? Here's David's quick, step by step overview of Marina's treatment approach, which is based on the steps of TEAM and the Daily Mood Log. Step 1. Let's imagine you're the patient (or the shrink), so you start with a brief description of the Upsetting Event at the top of the Daily Mood Log. It could be something as simple as ”Lying in bed for several hours, unable to get to sleep because I keep ruminating about a report I have not finished for work,” or some other problem. Step 2. Identify your negative feelings and estimate how intense each one is on a scale from 0 (not at all) to 100 (the worst.) For example, you may be feeling: Sad, down: 80% Anxious, panicky: 95% Guilty, ashamed: 70% Inadequate, incompetent, inferior: 90% Alone: 100% Discouraged: 80% Frustrated: 95% Angry, annoyed: 100% Step 3: Record your negative thoughts and how strongly you believe each one from 0% to 100%. For example, you may be telling yourself: I have to get to sleep! 100% If I don't get to sleep, I'll never be able to function tomorrow. 90% I should have completed my report for my boss today. 100% I should get out of bed and work on it. 90% There must be something wrong with me. 100% etc. etc. Step 4. Identify the distortions in these thoughts, like All-or-Nothing Thinking, Fortune-Telling, Should Statements, Emotional Reasoning, Magnification, and more. Now, if you're a shrink, after you've empathized, do the A = Paradoxical Agenda Setting or Assessment of Resistance. If you're a general citizen, you can do Positive Reframing. In other words, instead of trying to make your negative thoughts and feeling disappear entirely by pushing the Magic Button, you can ask two questions about each negative thought (NT) or feeling: How might this NT or feeling be helping me? What does this NT or feeling show about me and my core values that's positive and awesome? Example. In the current example you are 95% anxious and panicky about your report for work as well as the fact that you can't relax and fall asleep. Could there be some positives in your anxiety and panic? For example, these feelings might show Your intense commitment to your work. They may be a reflection of your high standards. Your anxiety, while uncomfortable, has probably motivated you to work hard and achieve a great deal. Your anxiety may protect you from danger and keep you focused on what you have to do to succeed and survive. Your anxiety could be an expression of your respect for your boss and for the company you're working for. Your desire to do a good job is probably a reflection of one of your core values as a human being. You could make similar lists for other feelings as well, like feeling down, guilty, discouraged, angry, and so forth. At that point, you can set your goals for every negative feeling. For example, you might decide that 15% or 20% might be enough anxiety and panic, and that 15% shame would be enough, and so forth. You can record your goals for each negative feeling in the goal column of your Daily Mood Log. This is much easier than if you try to reduce them all to zero by pressing the Magic Button. And even if you could, then all of the positives you listed would go down the drain, right along with your negative thoughts and feelings. Instead, you can aim to reduce them to some lower level that would allow you to relax while still maintaining your core personal values. Now we're ready for the M = Methods portion of the TEAM session. You will enjoy this portion of the podcast. Marina led Rhonda in three classic TEAM methods: The Paradoxical Double Standard Technique, the Externalization of Voices, and something Marina calls Distraction Training, which is actually a mix of Image Substitution, self-hypnosis, and relaxation training. Essentially, you focus on something positive and relaxing, as opposed to ruminating about all you have to do. This approach will come to life when you listen to the podcast, and I think you will agree that it IS innovative and significantly different and from 99% of what is currently sold as “insomnia treatment!” Marina emphasizes that you, the client, will have to agree to spend 15 to 20 minutes per day doing written work with the Daily Mood Log, or all bets are off. In addition, I would like to add that you and your shrink (or you and your patient) will have to find effective ways to combat each patient's ruminations and negative thoughts, because we're all quite different and our problems will usually be unique. In fact, that's why I (David) have created way more than 100 methods for challenging distorted thoughts. But here's the basic idea: When you learn to CHANGE the way you THINK, you can CHANGE the way you FEEL as well as the way you SLEEP! Thanks so much for listening today, and happy dreams! Marina, Rhonda and David
392 The Empty Nest Cure Featuring Jill Levitt, PhD Plus BIG NEWS! The Magical Annual Intensive Returns this Summer at the South San Francisco Conference Center August 9 -13, 2024 You can Review the Exciting Details Below Or click this link! Today we are proud to feature our beloved Dr. Jill Levitt. Jill is the Director of Clinical Training at the Feeling Good Institute in Mountain View, California, and co-leader of my Tuesday evening psychotherapy training group at Stanford. She is a dear friend, and one of the world's top psychotherapists and psychotherapy teachers. Today, Jill joins us to discuss the so-called “Empty Nest” syndrome. According to Wikipedia, this is the “feeling of grief and loneliness parents may feel when their children move out of the family home, such as to live on their own or to pursue a higher education.“ Jill emailed Rhonda and me to explain why she thought a podcast on this topic might be of some value. She wrote, Recently, I was working with two different women around the same age who were having similar feelings of guilt and shame about the choices they made around parenting versus working. Jane is a 60 year old high level executive with two boys who was super successful and is now retired. She is telling herself, “ I did not do enough for my boys. I should have worked less. I should have spent more time with them. I was selfish, and worked because I enjoyed it. I should have done more for them. I'm a terrible mother. Stephanie, in contrast, is a 60 year old stay-at-home mom of four adult kids, and now that her last kid has left for college, she is telling herself: I should have had a career. I have done nothing with my life. I am a smart woman so I should have done more. I am inferior compared to other women who have contributed to society in some way. Jane and Stephanie both struggled with feelings of guilt, shame, sadness and inferiority, and they were both telling themselves that they should have made different choices. I'm sure your life is very different from their lives, but you may have also looked in to the past and beaten up on yourself for what you should or shouldn't have done. Or, you may be beating up on yourself right now with shoulds, telling yourself that you should be better, or smarter or more successful or popular than you are. In fact, according to the late Dr. Albert Ellis, these “Should Statements” are responsible for most of the suffering in the world, and there are several different types, including: Self-Directed Shoulds, like “I shouldn't be so klutzy and shy in social situations. These self-directed shoulds trigger feelings of depression, anxiety, inadequacy, inferiority, guilt, shame and loneliness, to name just a few. Other-Directed Shoulds, like “So and so shouldn't be such a jerk!” Or, “You have no right to feel the way you do!” These other-directed shoulds trigger feelings of anger, blame, resentment, irritation, and rage, and can easily escalate into violence, and even war. I'm sure you can see that both women were struggling with Self-Directed Shoulds. What can you do about these shoulds and the unhappiness they trigger? Jill explains how both women experienced rapid recovery when she used simple TEAM methods systematically, including empathy and Positive Reframing as well as other basic techniques like the Double Standard Technique and the Externalization of Voices, and more. I, David, then described a woman he treated who fell into a depression when her two daughters went off to college. And she was perplexed, because she'd always had a super loving relationship with them, just as she'd had with her own mother when she was growing up. When I explored this with her, a Hidden Emotion suddenly emerged, as you'll hear on the podcast, and that also led to a complete recovery in just two sessions. Then Jill had a sudden “eureka” moment and realized that the Hidden emotion phenomenon was also central to the anxiety that one of her two patients was experiencing. One of the neat things I (David) really like about TEAM is that we don't treat people with formulas for “disorders” or “syndromes.” These three woman all had the same “Empty Nest Syndrome,” but the causes and the cures for all of them were unique, as you'll understand when you listen to this podcast. Our 400th podcast is coming up soon, and we want to thank all of you in advance for your support and encouragement over the past several years, which we all DEEPLY appreciate! We'll be joined by a number of our podcast stars from the past 100 shows, as well as our beloved founder, Dr. Fabrice Nye! And we have one VERY special event coming up this summer that might interest you if you're a shrink. I (David) have done very few workshops over the past five years because of the pandemic as well as the intensive demands of developing our Feeling Great App which will be available soon. The most fantastic work of the year was always the summer intensive at the South San Francisco Conference Center. Well, guess what! We're bringing it back this year. The dates will be August DATES, and it will have the same magic it has always had, but with some cool innovations. It will be Thursday to Sunday noon, 3 ½ days instead of four, but it will include two fantastic evening sessions, so you will get a MASSIVE amount of teaching. It will be sponsored by the Feeling Good Institute in Mountain View for the first time, Jill and I will teach together, just as we do in the Tuesday group. Of course, Rhonda will be hosting the event as well! There will be many expert helpers from the FGI to assist you in the small group exercises throughout, so you will LEARN from actual practice with immediate expert mentoring and feedback. There will be a live demonstration with an audience volunteer, as in earlier years, plus your chance to do live work in small groups on the evening of the third day. This is always the top rated event during the intensive. You can attend in person if you move fast (seating will be limited to around 100 or so) or online (for half price or so.) That will give people from around the world the chance to attend without the extra cost and time to come in person. The online people will have leaders guiding you in the same exercises we will do with the in-person group. You'll get intensive TEAM training in the high-speed treatment of depression and anxiety, so you can really “get it” all at once and see how all the pieces of this amazing approach fit together. You'll also have the chance to do your own personal work and healing, which is arguably the most important dimension of professional training. There's a whole lot more but I'm running out of steam. For more information, click this link! Here are the details: High-Speed CBT for Depression and Anxiety— An Intensive Workshop for Therapists with Dr. David Burns and Dr. Jill Levitt Join in person or online! Dates (3 ½ days) Thursday, August 8: 8:30am-8:30pm Friday August 9: 8:30am-4:30pm Saturday August 10: 8:30am-9:00pm Sunday, August 11 8:30am-12:00pm PT Location South San Francisco Conference Center (10 minutes from SF Airport) Cost In Person $895* Early Bird Price (only 100 seats) Online $495* Early Bird Price To receive the online price, you must enter the discount code: OnlineOnly when purchasing The $100 price increase for live and online starts on 6/3/24 Rhonda, Jill, and I hope to see you there! And thanks for listening today!
Evolution of TEAM from CBT Porn Compulsive Liars Angry Patients Who Resist Where's the App? and More! Note: The answers below were written by David prior to the podcast, just to give some structure to the discussion. Keep in mind that the actual live discussion by Rhonda, Matt and David will often go in different directions with different information and opinions. So, please listen to the podcast for the more complete answers! Today's live discussion was especially fun and lively, so make sure you listen to the actual live podcast. Questions for this Ask David Podcast Stan asks if any of my early methods have been abandoned by newer and more effective methods as CBT evolved into TEAM. Stan asks if mild porn is harmful or helpful. Rima ask how you can deal with compulsive liars. Pretika asks what to do with patients who angrily resist positive reframing. Anonymous asks several questions about the Feeling Great App. 1. Stan asks about new approaches in TEAM for habits and addictions, as well the evolution of TEAM, as compared with the much earlier classical CBT. 2. Stan also asks if mild porno is helpful or harmful. Hi David. I read in the eBook (I think it was) that you have radically changed your approach and have many new methods for Habits and Addictions. I actually have many of your books such as: Feeling Good Feeling Good Handbook When Panic Attacks Intimate Connections Feeling Good together Feeling Great eBook I wonder if you could please tell us in one of your Ask David podcasts which methods described in your earlier books you no longer recommend, because they have been superseded by more effective ones described in Feeling Great for example. I am sure there must be a lot of material that is still valid in those earlier books and which is not mentioned in Feeling Great. It would be great to know which ones you no longer recommend for the general public. I also want to ask you about Porn Addiction. Do you think occasional mild porn use is harmful or beneficial? I read in a BBC article that porn probably isn't harmful for most men, and can even be positive for couples. For example, some couples start to engage in oral sex after seeing it on the internet. Porn seems a bit like alcohol, if you abuse it it will be bad for your health but if you don't go for the strong stuff and don't over use it, it could be OK. I think some people might misinterpret your references to porn addiction as being any kind and intensity of porn use. Maybe these people feel anxious and shameful for using it as a result. I would welcome your clarification on this issue. Finally, even though I know you have heard it thousands, or hundreds of thousands of times, your work is having a really positive effect on my life. I am truly grateful for all that you do. Thank you, David. Warm regards Stan David's Reply Hi Stan, I can turn this into a couple Ask David questions for the podcast if you like. There have been many upgrades of the therapy ideas and techniques over the years, as we develop greater understanding of how people change, and what works and what tends not to work. In addition, I would say that we develop new methods and ideas on a weekly basis. The TEAM models lends itself very nicely to evolution, perhaps one of the strong points. I can speak in more detail on the podcast, but here are two ideas. First, I have come to appreciate more and more that all change in emotions comes from a reduction in belief in the negative thoughts that trigger negative feelings with few, if any, exceptions. In addition, any reduction in belief in negative thoughts will case an immediate reduction in the negative feelings that thought causes. This insight angers many people who don't really “get” it, so I don't push it. I find that people sometimes do not take kindly to statements that challenge their sacred beliefs. A simple example would be jogging, or aerobic exercise. Some people believe on faith or personal experience that exercise has a mood elevating effect due to release of endogenous “endorphins” in the brain, and many even claim that exercise is the most effective antidepressant known. While some people do experience a mood lift after strenuous exercise, I believe this is due to the change in their thoughts, telling themselves and believing that this is going to be good for the health and outlook. So that thought can have potent effects on mood. I can describe some experiments on exercise and mood. Second, I have tilted much further in the direction of appreciating the existence and power of resistance in all emotional and behavioral problems, and the often magical power of the new resistance-melting techniques I've developed in opening the door to the possibility of rapid and dramatic change. I'm also very aware of the therapy wars, predicated on the belief that our group as THE answer and your group consists of fools! And typically, one or both of those who are arguing have never measured anything in their patients on a session by session basis to see if things are working or not. This is just the tip of the iceberg, however! You can find a free offer of two free chapters on Habits and Addictions on every page of my website in the right-hand panel. You will find a strong emphasis on powerful new techniques that focus on motivation, such as the Triple Paradox, the Decision-Making Tool, the Devil's Advocate Technique, and more. Most of the techniques I developed in the early days of CBT still have a lot of power and I use almost all of them, sometimes with various modifications and upgrades. For example, I have added the CAT to the Acceptance Paradox and Self-Defense Paradigm in the Externalization of Voices (EOV), and now there are two versions of the CAT, one of them created just last week! On the porno question, I am not an expert in sociology research, so I don't know, and I try to avoid giving expert answers on things I don't have expertise in. My goal is not to proclaim what people should or shouldn't do, but rather to help people who come to me asking for help. It is tempting to assume your own views are straight from God, but I find that my own narcissism just gets me into trouble most of the time! I do like your thinking, though, that much of the time there are no absolute answers, rather personal preferences, and the impact will often depend on how things are used. As you say, a glass of wine could add to your meal. A bottle of wine daily might get you into trouble with your health and habits! Warmly, david 3. Rima asks about compulsive liars How do you deal with people who are compulsive liars? I found that even when using the five secrets, they either get really angry and start on the offensive or completely deny no matter what you say. If you have a client or someone in your personal life that you have deal with that lies a lot even when faced with facts and proof, what is the best way to handle it? On another point, I know that we all tell lies to a certain extent but I'm wondering whether you can impart some wisdom on why some people are compulsive liars. David response: I have a policy of NEVER answering general questions. If you want help with a relationship problem, please fill out the first four steps of a Relationship Journal. That way, we can see what the other person said, and what you said next. Otherwise, you might frame it as wanting help figuring out how to “handle” this other person who is “to blame,” or behaving badly, and so forth, without pinpointing your own role in the problem, which is the whole key to interpersonal therapy. Then we will have some dynamite to play with, as opposed to bullshit which tends to be too gooey in my experience! Certainly, people who lie compulsively can be challenging and irritating for sure, but let's take a look at the whole picture so we can also answer this question: Are you responding in a way that reduces the likelihood that they'll be honest? I'd LOVE to answer this question again once you send an RJ partially filled out. Thanks! 4. Preetika Chandna asks about patients who angrily resist Positive Reframing My client was offended by the positive reframe questions (any benefits and values for anxiety). She was unable to 'see' any benefits to her anxiety despite 'priming the pump' and gathered evidence from friends to emphasize her point. She ultimately dropped out of therapy. I'm wondering if we can move forward without positive reframing and circle back later, or is an open hands with empathy the best option when a client refuses to reframe and is actually offended by the suggestion? David's Take Sometimes you can do effective work without the A = Paradoxical Agenda Setting step in a highly motivated patient. However, I suspect a more fundamental problem is occurring here. Whenever you're stuck with an angry patient, immediately go to E = Empathy, and don't use any methods until you get an A, and have really re-established a warm, trusting relationship with the patient. I have emphasized the importance of using the BMS and EOTS with every patient at every session. Have you been doing this, and have you been getting a perfect score on the Empathy and Helpfulness Scales? This seems unlikely to me. Often anxious patients feel shame, especially if they have social anxiety, but this is also common with panic attacks and some other forms of anxiety. If she's ashamed of her anxiety, it would make sense that he might get defensive when asked to positively reframe it. At this point, I can only speculate, since I don't know the details of this case. Sometimes, it makes sense to pay a colleague for a couple consultation sessions to get “unstuck.” These are always extremely productive learning sessions. Positive Reframing, or Assessment of Resistance, is an art form, and sometimes you just can't “see” the reasons for the resistance at first. You might recall, or want to listen to, our live session with Sunny, who developed a sudden relapse of intense anxiety when he decided to change his approach to work, or non-work. (see podcast # X). The traditional positive reframing was not effective, but then when we started on methods, I suddenly “saw” something none of us had seen before during the session. His “anxiety” was actually a sign that something wonderful was happening! You can always start with M = Methods, and then when you run into resistance, you can revisit resistance with a Paradoxical CBA, or Externalization of Resistance, or some other approach. But the crucial thing is to get on the same page, and stay on the same page, with your patient. David 5. From a therapist who wishes to be anonymous I have a question, I think that habits and addiction (including the online additional chapters) are very important. I wonder if they will ever get their own book and app? David's take: Eventually we hope to include that dimension in our Feeling Great App. The Feeling Great book is designed for self-help. I wonder if you have suggestions regarding using the different role-playing techniques (such as externalization of voices) for patients or individuals that works on their own? David's take: Yes, we use these role-playing techniques in the Feeling Great App. When are we expecting the app? David's take: First quarter of 2024. Thank you ! Thanks for listening today!
Featured Photo is Dr. Amy Huberman The Amy Story, Part 2: The Joys of Doing the Laundry! Amy and her exuberant son, Sasha, and wife, Alena Last week you heard Part 1 of the Amy session, which included T = Testing, E = Empathy, and A = Assessment of Resistance. Today, you will hear Part 2 of Amy's exciting journey from perfectionism to JOY. M = Methods We used a variety of Methods to help Amy challenge her negative thoughts, starting with the first, “I'm failing my patients.” We started with Identify and Explain the Distortions, then went to the Double Standard Technique, and ended up with the Externalization of Voices. As a reminder, you can see Amy's Daily Mood Log at the start of her session here.. As an exercise, see how many distortions, or thinking errors, you can find in her first Negative Thought, “I'm failing my patients,“ using the list of cognitive distortions on the bottom of her Daily Mood Log. You'll find the list of the ten cognitive distortions if you click here. After you've identified each distortion, see if you can explain two things about it: Why is this distortion in Amy's thought unrealistic and misleading? Why might it be incredibly unfair and hurtful? You'll find my list of the distortions in this thought at the end of the show notes. But don't look until you've made your list! These techniques we used were effective , as you'll hear on the podcast, especially the Externalization of Voices. You'll hear us doing role-reversals with Amy, and the method that “won the day” was the CAT, or Counter-Attack Technique, combined with the Acceptance Paradox. The Acceptance Paradox involves finding truth in a negative thought with a sense of peace or even humor. The CAT involves confronting the hostile voice in your head and tell it to go fly a kite, or other gentle but firm message You'll enjoy seeing some striking changes in Amy, as her tears and feelings of intense self-doubt are suddenly transformed into joy and laughter. Those changes created strong feelings of joy for Jill and me as well. We both have incredibly fondness and admiration for Amy, and feel great joy as well when she feels joy. Here are Amy's final scores at the end of the session. Emotions % Now % Goal % After Sad, blue, depressed, down, unhappy 80 25 0 Anxious, worried, panicky, nervous, frightened 80 20 0 Guilty, remorseful, bad, ashamed 90 5 0 Worthless, inadequate, defective, incompetent 100 15 5 Lonely, unloved, unwanted, rejected, alone Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing 90 5 0 Frustrated, stuck, thwarted, defeated 80 5 5 Angry, mad, resentful, annoyed, irritated, upset, furious Other The Joyous Dr. Amy! Sudden and dramatic change is pretty trippy, but it isn't much good if it doesn't last. And it won't! Negative thoughts and feelings will always return, because no one can be happy all the time. That's why some relapse prevention training and ongoing practice and refinement of what you've learned can be vitally important. In our follow-up session with Amy one week later she said she'd felt way better during the week, but did, in fact, have some relapses and had to challenge her negative thoughts again. She'd been helped a lot by the idea that it was okay to fail, to seek consultation, and learn, and that failing with patients gave us endless opportunities to learn and grow as therapists. And it was also okay not to have to listen so intently to the attempts of the negative self to put her down. In fact, our misery almost never results from our failures, but from telling ourselves that we “shouldn't” ever fail, and from punishing ourselves mercilessly when we do. One of her most exciting statements in our follow-up session was that she discovered that even something as humble as putting the dirty clothes into the washing machine could be a joyous experience without that negative voice in her brain constantly hollering at her that she wasn't good enough! Teaching points It was hard, at first, for Amy to “see” how distorted and unfair her negative thoughts were. She is an extremely intelligent, accomplished, and beloved colleague, and yet most of us cannot “see” or really “grasp” that we can be pretty mean to when we're feeling down and anxious. I have often said that feeling anxious and depressed is a lot like being in a deep hypnotic trance, telling yourself and believing things that just aren't true. For example, Amy is doing beautiful work with the great majority of her patients, and is doing the exact same thing with the patients who are responding beautifully as she is with the two who are stuck. So, when she tells herself she's a failure, she's clearly involved in All-or-Nothing Thinking. In other words, she's thinking that if she's not perfect, she's a complete failure and a fraud. She also seems to have many Hidden Shoulds (e.g. I SHOULD be able to help every single patient quickly) and Mental Filtering (focusing only on the negatives) and Discounting the Positive (ignoring the positives, as if they didn't count.) The techniques that were the most helpful for Amy were Positive Reframing: that's where we pointed out the positive aspects of Amy's Negative Thoughts and feelings. The Externalization of Voices with Self-Defense, the Acceptance Paradox, and the CAT. Be Specific: Amy was Labeling herself as a “fraud” and a “failure,” and she was Overgeneralizing from two patients to her entire self and career. Jill emphasized Be Specific. In other words, focus on and accept what's real. What's real is that Amy has been valiantly struggling to help two patients who are stuck. She can just accept that, and get some consultation and guidance from a colleague, which would probably help her get unstuck. So, instead of labelling yourself as “a failure” and “a fraud,” which are just mean, vague words, you can tell yourself that you have a specific problem—in Amy's case, getting stuck with two very anxious patients. Then you can focus on getting some help in solving that specific problem—for example, by seeking consultation from a colleague. Jill said that's what she does when she gets stuck. I used to do that every week, especially when I was first learning cognitive therapy. Getting stuck, then, can simply be an opportunity for growth and learning cool new tools. If we never got stuck, we'd never learn anything new! The very moment Amy stopped believing her negative thoughts, her feelings instantly and dramatically changed. That change happened suddenly, over the course of about 30 seconds, and you can SEE it in her face and hear it in her voice. But it won't last forever! Jill pointed out that the belief at the root of Amy's problem was Perfectionism, and the idea that “I should know exactly what to do with all of my patients.” That may be a pleasant fantasy, and it might even motivate us to work hard and achieve, but it's also a recipe for misery! Follow-up Rapid recovery is great, but will it stick? You will hear excerpts from our brief follow-up session one week later for Relapse Prevention Training. The idea is that none of us can feel happy forever, and negative thoughts will creep back into our minds sooner or later. However, you can anticipate this and prepare for it by challenging your negative thoughts with the same techniques that helped you the first time you improved. That's because the details will usually be different every time you're upset, but the pattern of self-critical negative thoughts will usually be the same. And this DID happen to Amy, just as it will happen to you. But this was an opportunity for her to deepen her understanding of perfectionism and to refine and enhance her ability to respond to her negative thoughts. During the weeks following the recording of this podcast, Amy found that she experienced some resistance to using the counterattack technique. She began to feel like she was relating to her perfectionism as an enemy and attacking it—and in doing so, was discounting all the good in it, including the values that came shining through during the Positive Reframing. She found that a better fit for her, instead of the counterattack, was to disarm her perfectionistic thoughts by seeing the truth in them. In fact, you could view this as yet another form of acceptance. When she did this, the perfectionistic voice in her head naturally backed down and gave her the space to do what matters to her unencumbered by self-criticism. I thought it was cool when she described experiencing waves of joy while doing the laundry—an activity that had always felt like a chore to her before, when it was accompanied by thoughts like “I should have finished this laundry days ago.” She discovered that without beating up on herself, something as humble as doing the laundry could be incredibly rewarding! After our follow-up meeting, I got a lovely email from Amy about the joys of giving up the need for perfection, and sent this follow-up reply to Amy: Thank you, Amy, you are the BEST! I did a four-day intensive in San Antonio years ago with a small group of about 25 therapists. As you know, I always BS and say “As the Buddha so often said . . . “ followed by something goofy or quasi-mystical or whatever, and most people seem to kind of like that and see it as fun or humorous or whatever. Well, I was doing that at the workshop, and at one of the breaks a woman approached me and said she was interested in my Buddhist remarks because she had been raised as a Buddhist in an Asian country where Buddhism is prominent. I panicked and thought I'd been found out and exposed as a fraud. She went on to say that their family gave up Buddhism, however, and she was sad. I asked why they gave up Buddhism, and she explained that her mother suffered from severe depression, and the Buddhists taught that's because you think you “need” things, and if you're a good Buddhist you won't think that way and you won't ever suffer. Since she suffered, she felt like a failure as a Buddhist, so the family gave up Buddhism. I told her that she might not be aware that there are actually two schools of Buddhism. There's low-level Buddhism and high-level Buddhism. In low-level Buddhism, you're not allowed to want or need anything, and you're not allowed to suffer. That's sounds like that was the school of Buddhism your family was raised in. But there's another type of high-level Buddhism. In high level Buddhism you're allowed to suffer and struggle, and screw up, and fail, and all sorts of stuff. She got animated and said, “I didn't know that. Thank you so much. You've restored my faith in Buddhism, and I can't wait to tell my mother!” Aside from my being elderly and half-demented, I hope that makes some sense in light of our work together with Jill! So, if you need any translation or explanation, Amy, I'm inviting you to join the high-level Buddhist therapist group where you're allowed to screw up with some of your patients, or even many! Warmly, david Subsequent Follow-Up I forgot to tell you what happened to Amy's two “stuck patients.” Well, she got some consultation about why these patients might be stuck, which is nearly always an Agenda Setting problem—the therapist is working harder than the patient due to the need to “help,” and this plays into the patient's ambivalence. This struck a chord, and Amy was very excited to see her patients again, and both suddenly got “unstuck,” although in somewhat different ways. And that is why I call it the Acceptance Paradox. The moment YOU change, and accept yourself, your world will also change! Or, to put it differently. We often see the world as “different” or as “other,” thinking we are separated. The Buddhists see the world as “one,” and that is certainly true in therapy as well. Answers to the Quiz Question David's list of Distortions in Amy's Negative Thought: “I'm failing my patients.” 1. All-or-Nothing Thinking. This is not realistic because Amy is not stuck with all of her patients. And even though she's still far short of her hopes for these two patients, they may feel they are getting lots of TLC and support from Amy. 2. Overgeneralization. This is misleading because she's overgeneralizing from her two failures to her “self,” and labeling herself as “a fraud and a failure.” She also overgeneralizing to the future, thinking things will never change or improve so she should get a new career. 3. Mental Filtering. She only focusing on the two patients who are stuck. 4. Discounting the Positive. She's overlooking the fact that she's going excellent work with a great many people, and has tremendous integrity, skill, and commitment to her patients. 5. Magnification and Minimization. She's kind of blowing things out of proportion, although it's always good to focus on patients who aren't yes improving. 6. Emotional Reasoning, She FEELS like a failure so thinks she IS a failure. 7. Hidden Should Statement. She thinks she SHOULD be perfect! 8. Labeling. Same as Overgeneralization. See above. 9. Self-Blame. She's blaming herself instead of loving herself and focusing on getting she help she needs and deserves! Thanks for listening today! Rhonda, Amy, and David
Personal Work with Dr. Tom Gedman-- Overcoming Performance Anxiety The Triumphant Conclusion Last week you heard Part 2 of our personal work with Dr. Tom Gedman, which included T = Testing and E = Empathy. This week you will hear the dramatic and inspiring conclusion of the session, including A = Assessment of Resistance and M = Methods. Dr. Tom's beloved pal Start of Part 2 A = Assessment of Resistance We began with the Invitation Step, asking Dr. Gedman what he hoped to accomplish in today's session. His list included: Develop some clarity on the direction of my business. Become more authentic in my video recordings promoting my clinical work. Increase in self-confidence. Feel accepted by David and Rhonda. My ability to push ahead during recordings instead of stopping and backing down because it isn't “good enough.” Dr. Gedman said that he'd gladly push the Magic Button to make his negative thoughts and feelings instantly disappear, but agreed to look at some of the positives in them first by asking these types of questions of each negative thought or feeling. Is there some truth in this negative thought? Could this negative thought or feeling be appropriate or even healthy, given my circumstances? How might this negative thought or feeling be helping me? What does this negative thought or feeling show about me and my core values that's positive and awesome? Could there be some negative consequences of giving up this negative thought or feeling? The Positives in My Negatives Negative thought: “I can't be authentic on videos. I look like such s smug phony.” I want to be other-centered, and focused on how I might be able to relieve the emotional struggles and health problems of my patients. I value being authentic and genuine. I want to help people who resonate with my message. I don't want to hide. I want to be open with my flaws. I value honesty and integrity. I value humility. I value compassion. Negative feeling: sadness I care a great deal about my dream. I don't want to fail and let my family down. Negative feeling: shame Motivates me to work harder Shows my love for my family. I'm aware that I'm letting down the very people I want to help. Negative feeling: inferior, inadequate Show that I respect and admire the many people who have superior skills at talking live in front of a camera. Shows that I'm aware of what others have accomplished. Shows I don't feel superior to others. The idea behind the Positive Reframing is to help the patients see that their negative thoughts and feelings are not the expression of what's “wrong” with them, but what's right with them. This paradoxically reduces the resistance to change and opens the door to the possibility of rapid recovery. You can see Dr. Gedman's goals for each of the negative feelings on his Daily Mood Log if you click here. As you can see, instead of trying to eliminate his negative thoughts and feelings by pushing the Magic Button, he has decided to dial them down to lower levels with the Magic Dial. Of course, these are only goals. We will need methods to challenge and smash his negative thoughts so we can reduce his negative feelings. M = Methods Rhonda, Tom, and David used a variety of methods to work on several negative thoughts Tom wanted to work on first, including numbers 1, 2, and 4 from Tom's Daily Mood Log.. I can't be authentic. I look like a smug phony. 100% I waste so much time on my videos. I should be quicker. This should be easier. 100% David and Rhonda will judge me for what I'm doing. 80% We used several methods including Explain the Distortions, Survey Technique, Externalization of Voices (with Self-Defense, Acceptance Paradox, Counter-Attack Technique,) and more You can see Dr. Gedman's end-of-session scores on his nine negative feelings on his Daily Mood Log if you click here. As you can see, eight of the feelings fell all the way to zero, and his feelings of inadequacy fell from 100 all the way to 5. Toward the end of the session, we discussed Tom's medical and psychological philosophy, which might appeal to some of our podcast fans, especially if you live in England. First, he uses TEAM-CBT in individual two-hour sessions to help help people who are struggling with feelings of depression and anxiety. He finds this work thrilling because you can often see amazing changes within a single session, just like we saw in Tom's work today. Dr. Gedman also hopes to develop TEAM-CBT groups as well. This can be difficult because you need many referrals, but in my experience, TEAM groups can be incredibly effective, and cost-effective as well. In addition, Tom also has a Functional Medical Practice which focuses on developing healthy nutritional and eating habits, consistent exercise, limiting the intake of toxins, developing loving relationships via the Five Secrets of Effective Communication, and enhancing spirituality. If you would like to contact Dr. Gedman and learn more about his clinical practice, he can be reached at www.DrTomGedman.com. Toward the beginning of these show notes, I reminded everyone of how anxious and insecure our beloved Rhonda felt at the start of our work together, when she took over for Fabrice. And now, she seems to be the poster child for charm, warmth, humor, and charisma. That doesn't usually happen automatically. Rhonda, like Tom, did her hard personal work, using the Daily Mood Log and several TEAM-CBT methods. But one thing that has been especially helpful to her, after initially “beating” her insecurity, has been the constant exposure work, with hours of weekly podcast recordings. I, too, have had the chance to do constant, ongoing exposure for my own extreme feelings of inadequacy in front of live audiences or cameras, since I teach every week at my Stanford psychotherapy training class, as well as frequent workshops, In addition, I have recorded almost daily for the Feeling Great App, which should be released in the first quarter of 2024. This exposure work has helped me cement and extend my gains in overcoming my own performance anxiety. I plan to contact Tom to recommend the same. Perhaps in England they have program similar to Toastmasters, where you can have the chance to speak in public frequently and get valuable feedback from peers and colleagues. I want to give a big hug and thanks to you, Tom, for sharing your intensely personal and real personal work with all of us today, and thanks, too, for reminding us of our own humanity and the magic of humility and the “Great Death” of the “Self.” Thanks for listening today! Tom, Rhonda, and David
Personal Work with Dr. Tom Gedman-- Overcoming Performance Anxiety Have you ever struggled with Performance Anxiety? That can include public speaking anxiety, as well as anxiety when having to perform in an athletic or musical event, or speak on the radio, TV, or internet , etc. This is one of the most common forms of anxiety that we see in mental health professionals, as well, of course, in general citizens, including children, teens and adults. Today you will hear Part 1 of the live work with Dr. Tom Gedman, a British physician struggling with intense performance anxiety, including the initial T = Testing and E = Empathy. Next week, you'll hear Part 2 of the session as David and Rhonda do the A = Assessment of Resistance and M = Methods portions of the work with Dr. Gedman. You may recall Dr. Gedman from our previous podcast (# 348). Recently, Dr. Gedman has wanted to promote his new programs on health and mental health in brief videos he plans to publish on social media sites, but finds himself crippled by negative thoughts that make him freeze up in front of the camera, like these: I'm not good at this. 100% I can't be authentic. 100$ I'll look like a robot! 100% Tom practices in England as a family practice doctor, but has decided to work part time for the national health service while he establishes his clinical practice because he is only permitted to spend 10 minutes with each patient. He has developed a love affair and expertise with TEAM-CBT, and wants the freedom to practices in the way he wants, offering two-hour individual and group sessions, where he emphasizes the integration of physical with mental health. But this means having to advertise his clinical practice to solicit patients, and this is a bit of a treadmill because of the rapid changes he sees in so many of his patients. Hence, his urgent need to overcome his public speaking / performance anxiety. I have a soft spot in my heart for anyone who's struggle with these types of anxious thoughts and feelings, because I have encountered them on many occasions in my professional career when I had to present my work in conferences, or even when attending receptions that included other mental health professionals. In fact, I am the “voice” on the Feeling Great App that I've been developing over the past several years, and it took me some time to get comfortable with the recordings, since I told myself that I “had to sound natural, spontaneous, and inspiring.” Of course those internal and external demands caused the exact opposite—feelings of tension, insecurity, pressure, and intense self-doubt, resulting in “robotness” as opposed to spontaneity! Yikes! It was a dreadful battle for a while! So, I KNOW how Tom has been feeling. And our beloved Rhonda has been there, too, especially when she took over from Dr. Fabrice Nye as host of the Feeling Good Podcast that you're listening to right now. If you recall, she was feeling pretty darn insecure! (See Podcasts # 142 and 143.) Perhaps you've also struggled with social or public speaking anxiety, and felt insecure, panicky, frustrated, or ashamed? Have you? Even in our weekly training group at Stanford for mental health professionals, these feelings are rampant and nearly universal. Part 1 of the work with Tom T = Testing Tom brought a partially completed Daily Mood Log to today's session. You can review it if you CLICK HERE. As you can see, he was feeling nine different categories of negative feelings, all intensely, with estimates ranging from 70 to 100. This is why T = Testing is necessary for all mental health professionals, regardless of your so-called “school” of therapy. People, like Tom, may look attractive and filled with enthusiasm and joy on the outside, and still be experiencing EXTREME levels of distress inside. The T = Testing vasty improves your accuracy in understanding how your patients are feeling. It also makes you accountable, which can be sobering, because we will again ask Tom how he's feeling at the end of the session. The improvement, or lack of improvement, will tell us EXACTLY how effective, or ineffective, we were today in our work with Tom. This is a great bonus for therapists who are courageous enough to use my Brief Mood Survey at the stat and end of every session, with every patient, because your patients become your best teachers, by far. But it's also a threat, because the numbers don't lie, and you'll also be confronted by your ineffectiveness with many of your patients / clients. Sadly, a great many therapists would prefer not knowing the truth! E = Empathy Although Tom had previously defeated these anxiety-provoking thoughts and reached a state of relative enlightenment and joy, the thoughts have come creeping back into his psyche. That's one of the things about anxiety. Once you've beaten it, you have to keep up the assault with frequent, ongoing exposure, or the anxiety will once again invade your brain and body. But the good news is that the methods that helped you initially are very likely to help you again, and if you continue using exposure after your first recovery, you can greatly reduce the probability of relapse. These are the methods that helped Tom in the past: Positive Reframing of his negative thoughts and feelings following the initial E = Empathy phase of his session. Externalization of Voices Survey Technique Self-Disclosure (vs hiding) of his negative feelings of insecurity Tom said, Those techniques worked like magic when David and Mike Christensen did a live demonstration with me several months ago at a TEAM-CBT conference in England. I opened up about how I was feeling inside, and sobbed for several minutes during the session. Then I developed amazing relationships with colleagues at that conference. I was on a high for several months. The TEAM-CBT session was life-changing. It gave me my life back. But now I've lost my way again. Can those methods help Tom again today? You will get the chance to look behind closed doors as Rhonda and David do some personal TEAM-CBT work with Tom. Tom continued to explain his situation as Rhonda and David empathized. I'm very passionate about the work I want to do, but when I try to convey my message, I tighten up. . . I did 18 takes on a brief message to promote my new practice, but I just wasn't authentic. I felt enormous pressure to entertain. If I don't get over this, people will think I'm a quack. I'll get criticized. The work I do with patients behind closed doors has been amazing. personal The last couple patients I saw got their mood scores down all the way to zero. Those sessions were intensely exciting! But how can I get the word out to the many people who need help with feelings of depression and anxiety, as well as poor habits of exercise and eating? I'm just not earning much money now. My wife is working long hours to support our family while I'm trying to guild up my clinical practice. I feel so guilty. I take care of our three-year old son. On Monday, I felt so frustrated and discouraged that I felt like I was on the verge of a breakdown. I feel sad and worried that things won't pan out. It's high stakes. . . I've always been a perfectionist. It's helped me, but it's also held me back. I'm just angry at myself for not getting myself out of this desperate situation. Rhonda and David paraphrased Tom's words and acknowledged his intensely negative feelings as he spoke, without trying to be helpful, and without making interpretations or trying to cheer him up. Then we asked Tom to give us a grade on empathy, thinking of these three aspects of effective: How well did we understand how Tom was thinking? How well did we understand how he was feeling inside? Did we create a sense of warmth, connection and acceptance? Tom gave us an A. Next week, you'll hear the dramatic conclusion of our session with Tom, including the A = Assessment of Resistance and the M = Methods, and, of course, the final T = Testing to find out if the session was helpful! End of Part 1 Thanks for listening today! Tom, Rhonda, and David
Jessica Malvicino Live Work With Jessica-- Living with Regrets Rhonda and I recently did live work at a TEAM-CBT intensive in Mexico City. Our “patient” was a 40 year old mental health professional named Jessica with many years of unhappiness because of a decision she made when she was just 17. Perhaps you've also looked back on your life and thought, “If only I would have . . . “ done something I didn't do,” as well as, “I wish I hadn't done X, when I was young.” Last week you heard the initial Testing and Empathy portions of the session with Jessica. Today you'll hear the Assessment of Resistance, Methods, and final Testing.. Part 2 of the Jessica Session A = Assessment of Resistance Jessica said her goal for the session was learning to accept life and move on, and not have such constant feelings of emptiness, with so many “I should have” thoughts running through her brain. Although Jessica, like most people, said she'd press the Magic Button to make all of her negative thoughts and feelings disappear, we decided to do some Positive Reframing first, to see if there were some positives hiding in her negative feelings. We asked the following questions about a number of her negative feelings and thoughts: Why might this thought or feeling be appropriate and healthy? Why might this thought or feeling be helpful to you? Why does this thought or feeling show about you and your core values that's positive and awesome. ? As you probably know, the goal of there are two goals for this paradoxical exercise: First, we want to bring the patient's subconscious resistance to conscious awareness. Second, we want her to see that her struggling and suffering is NOT the result of what's WRONG with her, but rather, what's RIGHT with her. The moment that people really “see” and “get” this, there's often a sharp and sudden reduction in feelings of shame, and a strong burst of motivation to crush the negative thoughts at the heart of her misery. Here are some of the Positives we listed: SADNESS My sadness shows my passion and love of dancing. It shows my dedication to the idea of having a fulfilling career. It shows that I'm a very loving person. ANXIETY, WORRY, NERVOUSNESS These feelings show that I'm responsible motivate me to complete tasks help me avoid procrastination make me vigilant and protect me from danger SHAME These feeling show that I'm concerned about others I'm human I want to please others with my career I admire my mom and want to make her proud I want her to admire me I'm humble I want to feel close to others ANGER These feelings show that I'm a caring and passionate person I have character I have a moral compass I'm feisty and strong I'm accountable My anger also empowers me After listing these and other positives, Jessica decided to use the Magic Dial to reduce her negative feelings to lower levels, but not necessarily all the way to zero, as you can see in the goal column on her emotions table: Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, depressed, unhappy 90 20 Foolish 100 0 Anxious, worried, nervous 90 10 Discouraged 97 5 Bad, ashamed 95 0 Frustrated, stuck, defeated 100 5 Inadequate 90 0 Angry, mad, resentful, annoyed 95 10 Lonely 92 5 Other Then we went on to M = Methods These were some of the negative thoughts that Jessica wanted to challenge, along with the percent she initially believed each of them: I'm a failure. 90% My mom is to blame for not understanding the career path that I wanted. 90% I was an idiot for not following my dreams. 100% Nothing will truly fulfill my professional career. 100% I have to “settle” for my professional career now.100% She had many others ad well. We used a variety of techniques to challenge and crush these thoughts, including the Externalization of Voices with Self-Defense, the Acceptance Paradox, and the CAT (Counter-Attack Technique), and used frequent role reversals to help Jessica get to “huge” wins when she was in the role of her positive thoughts. Here you can see Jessica's scores in the “% After” column. As you can see, her scores were extraordinarily low, which is terrific. Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, depressed, unhappy 90 20 0 Foolish 100 0 3 Anxious, worried, nervous 90 10 0 Discouraged 97 5 0 Bad, ashamed 95 0 0 Frustrated, stuck, defeated 100 5 10 Inadequate 90 0 0 Angry, mad, resentful, annoyed 95 10 5 Lonely 92 5 0 Other Typically, such drastic and sudden reductions in negative feelings not only indicate “recovery,” but the experience of feelings of joy and enlightenment. At the end we asked Jessica two questions: Are the scores valid, or is she just trying to please us? If they are valid, what were the most healing and helpful aspects of the session? As you listen to the end of the live session, you'll find out what she said! Rhonda and I hope you enjoyed the session with Jessica. We believe that live work with real people, and not role players who are pretending to be in therapy, is invaluable, and one of the best—and only—ways to learn many of the subtleties of rapid and effective treatment. And if you are a general citizen, and not a therapist, I hope your found our work with the brave and wonderful Jessica to be inspirational and educational, especially if you have also sometimes felt depressed, anxious, or ashamed, and if you have found that regrets about the past can put a real damper on your capacity to live and enjoy your precious present moments! Our best teaching is usually through live work, and so we give you, Jessica, a warm thanks and salute for the great teaching YOU have done today! Thanks for listening, everybody! Jessica, Rhonda and David
Why Therapy Fails One of the most common reasons patients contact me is to find out why the therapy isn't working. They may be TEAM-CBT patients or patients of therapists using other approaches. Therapists also ask for consultations on the same problem--why am I stuck with this or that patient who isn't making progress? In the Feeling Good App, my colleagues and I have been looking into this as well. Most app users report excellent and often rapid results, but some get stuck, in just the same way they might get stuck in treatment with a therapist. I have tried to organize my thinking on this topic, because if you can diagnose the cause of therapeutic failure, you can nearly always find a solution. Of course, the app is not a treatment device, but a wellness device, but the same principles apply. So today, Rhonda, Matt and I discuss a couple reasons why therapists and patients alike sometimes get stuck. Matt described a patient who was misdiagnosed with a psychotic disorder who turned out to have sleep apnea. When the proposer diagnosis was made and treated, the patent suddenly recovered. Rhonda described a patient who jumped from topic to topic and always brought up a new problem before completing work on the previous problem. This problem was solved when Rhonda explained the importance of sticking to one problem for several sessions, until the problem was resolved. The patient then began to make progress. David described a depressed woman from Florida who was stuck in treatment, and not making progress, and then the therapist said "I just can't help you," This hurt and confused the patient who wrote to me. There were essentially two problems--the patients depression what brought her to therapy in the first place, and her unresolved hurt feelings when the therapist "gave up" on her. This problem reflected many failed relationships is the patient's life. This was resolved when the patient took the initiative to schedule a session to talk about the conflict more openly with excellent results. In addition, the patient had heard that she "should" accept herself, but didn't know how to accept her constant self-critical troughs and intensely negative feelings. I suggested she make a list of the benefits of her negative thoughts and feelings, as well as the many positive things they showed about her and her core values as a human being. She came up with an extremely impressive and long list! For example, her criticisms showed her high standards, her humility, her dedication to her work, her accountability, and much more. In addition, she'd achieved a great deal because of her relentless self-criticisms. I asked her why in the world she'd want to accept herself, given all those positive characteristics She decided NOT to accept herself, and was delighted with her decision. She said she felt profound relief! An unusual, but awesome, path to acceptance! In other words, she ACCEPTED her "non-acceptance." I hope you find today's podcast interesting and helpful. Of course, ultimately therapy is part science and part human relationship art. That's why Rhonda and I offer free weekly training groups for therapists who wish to develop their therapeutic skills. The groups are on zoom so therapists from around the world are welcome. Matt offers a consultation group (free to Stanford psychiatric residents) every other Tuesday for therapists who want help with difficult, challenging cases. To learn more, you'll find details and contact information at the end of the show notes. When Therapy Doesn't Work-- And How to Get Unstuck (for Therapists and Patients) By David Burns, MD Here's are some of the most common reasons why therapy might fail or appear to be stuck / without progress. Some of them will be of interest primarily to clinicians, while others will be of interest to clinicians and patients alike. And many of these reasons will also apply to individuals using the Feeling Good App who are stuck in their attempts to change the way they think and feel. But what does “stuck” actually mean? The definition, of course, is subjective. I believe that a substantial or complete elimination of depression and anxiety can typically be achieved in five sessions with a skilled TEAM therapist. I use two-hour sessions, and can usually see dramatic change in a single session, although follow-ups may be needed for Relapse Prevention Training or other problems the patients might want help with. In my experience, the treatment of relationship problems and habits and addictions usually takes much longer than the treatment of anxiety or depression. The techniques to treat relationship problems and habits and addictions actually work just as fast as the techniques to treat depression and anxiety, but the resistance can be far more intense. For example, someone may be ambivalent about leaving a troubled relationship or giving up a favored habit for many months or years before making a decision to move in a new direction. And, of course, the treatment of biological problems like schizophrenia and bipolar I disorder will nearly always require a long term therapeutic relationship, often requiring medications in addition to therapy. The problems and errors I've listed below are mostly correctable. And although there are many traps that therapists and patients fall into, the vast majority of therapeutic failure the patient's hidden 'resistance' to change and the therapist's lack of skill addressing it. This is true in clinical practice and in psychotherapy outcome studies, as well. On the one hand, a great many patients will feel ambivalent about change. For example, a patient with low self-esteem may not want to stop being self-critical and accept themselves, as-is, but to have a better version of themselves, first. Or they may want to overcome their fears without facing them. Or they might want a better relationship but would want the other person to do the changing. Unfortunately, most therapists lack the skills to address resistance and, in fact, often make it worse by trying to motivate the patient to change, rather than understand their hesitation to change and discuss it with them. This is one area where TEAM training has a great deal to offer, including over 30 skills therapists can learn to address motivation and resistance. The following list of 37 reasons why therapy fails follows the structure of T, E, A, M. Errors at or before the initial evaluation Patient is just window shopping Patient does not buy into the cognitive model Incorrect conceptualization of type of problem, so you end up using the wrong techniques. To simplify things, I think of four conceptualizations: Individual mood problem (depression or anxiety) Relationship Problem Habit / Addictions “Non-problem”: healthy negative feelings such as the grief you might feel when a love one dies Patient is not in treatment out of choice. For example, a teenager might be brought in by parents to be “fixed,” like bringing in your car to the local garage for a tune up, and you don't have an agenda with your patient. Or a parent might be court-ordered to go to therapy if he wants to have custody of his children. Failure to ask patients to complete the Concept of Self-Help Memo, the How to Make Therapy Rewarding and Successful memo, and the Administrative Memo prior to the start of therapy. These memos fix a great many therapeutic problems that are likely to emerge later on, like homework non-compliance, premature termination, and policies about confidentiality, last minute cancelling of sessions, conflicts of interest (eg patient is seeking disability) and more. Most therapists ignore the use of these memos, only to pay a steep price later on. Failure to mention the requirement for homework and similar issues the at initial contact with the patient. Failure to explore the patient's motivation for treatment. T = Testing Diagnostic errors: not recognizing additional problems which patient may have in addition to the initial complaint, such as drug or substance abuse, psychosis, intense social anxiety, past trauma or abuse, or hidden problems the patient is ashamed to disclose. This is easily solvable by the use of my EASY Diagnostic System prior to your initial evaluation. It screens for 50 of the most common DSM “diagnoses” and only takes ten minutes or so out of a therapy session to review and assign the “Symptom Cluster Diagnoses.” Failure to use Brief Mood Survey before and after each session. This error makes the therapist blind to the severity or nature and severity of the patient's feelings, which cannot be accurately identified by a patient interview or therapy session. As a result, the therapist's understanding will not be accurate, and the therapist will not be to pinpoint the degree of change (or failure to change) during and between therapy sessions. E = Empathy Failure to ask patients to complete the Evaluation of Therapy Session after each session. As a result, it will not be possible for therapists to understand their level of empathy, helpfulness, and several other relationship dimensions critical to good therapy. Failure to use the “What's My Grade” technique while empathizing with the patient. Failure to receive training in the Five Secrets of Effective Communication and the three advanced communication techniques. These techniques are difficult to learn, requiring lots of practice and commitment, but can be invaluable in therapy and in the therapist's personal life. A = Assessment of Resistance (also called Paradoxical Agenda Setting) Failure to recognize and deal with Outcome Resistance: There are four distinct types, corresponding to depression, anxiety, relationship problems, and habits and addictions. Failure to recognize and with Process Resistance: There are four distinct types, corresponding to depression, anxiety, relationship problems, and habits and addictions. The “because” factor: I won't let go of my depression until “I've lost weight,” or “I've found a loving partner,” or “I've achieved something special,” or “I've found a better job / career,” or “I've achieved my goals at X.” This is another type of Outcome Resistance. M = Methods--errors using the Daily Mood Log Patient “cannot” identify any Negative Thoughts The way you worded your Negative Thought. The common errors include thoughts describing events or feelings, rhetorical questions, long rambling thoughts, or thoughts consisting of a few words or phrases, like “worthless.” No Recovery Circle / many need many techniques combined with the philosophy of “failing as fast as you can.” This allows you to individualize the treatment for each patient. It is simply not true that there is one school of therapy or method (like meditation, mindfulness or daily exercise, etc.) that will be helpful, much less “the answer,” for all patients! The way you did the technique / incorrect use of technique. Many of the most powerful techniques, like Interpersonal Exposure, Externalization of Voices, Paradoxical Double Standard, Feared Fantasy, and many more require considerable sophistication and training. They can be fantastic when used skillfully, but they aren't easy to learn! Trying to challenge your negative thoughts in your head / vs on paper or computer. This is associated with Process Resistance for depression—refusing to do the written homework, and it is exceptionally common. Trying to challenge the negative thoughts of someone else or encouraging them to think more positively: won't work! In my first book, Feeling Good, I spelled out the warning that cognitive techniques are for you, and NOT for you to use on other people, including friends, family, and so forth. It is my impression that many people ignore this warning. When they discover that the person they are trying to “help” does take kindly to identify the cognitive distortions in their thoughts, both end up frustrated. Failure to “get” the Acceptance Paradox / using too much self-defense in your positive thoughts, especially Technique when doing Externalization of Voices Using the Acceptance Paradox in a defeatist, self-effacing way Failure to include the Counter-Attack Technique when doing Externalization of Voices. This techniques is not always necessary, but can sometimes be the knock out blow for the patient's endless inner criticisms. Not understanding the necessary and sufficient conditions for emotional change when challenging distorted thoughts. Too much focus on cognitive / rational techniques when far more dynamic techniques are needed, such as the Experimental Technique (e.g. exposure) in treating anxiety or the Externalization of Voices or Hidden Emotion Techniques Not recognizing that the patient's negative thoughts might be valid (I think that my partner is cheating on me) and trying to get your patient to challenge the “distortions” in the thoughts Other therapist errors Codependency: addiction to trying to “help” / cheer up the patient / solve some problem the patient has Need to be “nice” and refusal to hold patients accountable Narcissism: unwilling to be criticized, unwilling to fail, needing to stay in the expert role Difficulties “getting” the patient's inner feelings, due to lack of skill with Five Secrets and the failure to use Empathy Scale Difficulties forming a warm and vibrant therapeutic relationship, which can sometimes result from strong (and nearly always unexpressed) dislike of the patient Commitment to a favored “school” of therapy / thinking you are superior to colleagues and have the one “correct” approach Failure to use assessment tools with every patient at every session Failure to make patients accountable for homework Four types of reverse hypnosis: this is where the patient hypnotizes the therapist into believing things that simply aren't true. Depression: the patient may really be hopeless or worthless Anxiety: the patient is too fragile for exposure Relationship problems: the patient is too fragile for / not yet ready for exposure Habits / addictions: not making the patient accountable or assuming patient isn't yet “ready” to give up the addiction, or the patient needs to have emotional / relationship problems fixed first Unrecognize, unaddressed conflicts with therapist that need to be addressed with Changing the Focus. This error often results from the therapist's fear of conflict or patient anger, and is usually accompanied by a failure to use the Evaluation of Therapy Session, which would send a loud signal to the therapist that something is wrong. Failure to do Relapse Prevention Training prior to discharge. Conceptualization errors. Failure to use or select the most effective therapeutic approach and techniques for the patient's problem. For example, the Daily Mood Log and Recovery Circle are great for depression and anxiety, although there will be some important differences in the choice of methods for depression vs. anxiety. For example, Exposure and the Hidden Emotion Technique are great for anxiety, but rarely useful for depression. The DML has only a secondary role in the treatment of relationship problems (the Relationship Journal is more direct and useful) or habits and addictions (the Triple Paradox and Habit and Addiction Log (HAL) are far more useful. The therapist may be committed to a school of therapy, like Rogerian listening, without addressing resistance or using methods. Or therapist may believe that psychodynamic or psychoanalytic therapy, or ACT, or traditional Beckian cognitive therapy, will be the “answer” for everybody. The schools of therapy function much like cults, causing feelings of competitiveness (our guru is better than your guru) and sharply limiting the critical thinking and narrowing the consciousness of the faithful “followers.” Conflicts of interest. The therapist may subconsciously want to keep the patient in a long-term “talking” relationship due to emotional or financial needs. The therapist may have been taught that therapeutic change is inherently slow, requiring many years or more. This belief will always function as a self-fulfilling prophecy. Thanks for listening! Matt, Rhonda, and David
Menopause-- The End? . . . or the Beginning? Rhonda starts today's podcast, as usual, with a warm endorsement from Sally, a podcast fan who really liked Podcast 355 on the topic of “Relationship Problems: Be Gone!” She said the role-play demonstrations were “incredible” and especially helpful. We'll keep that in mind and see if we can do some more role-playing demonstrations in future podcasts, along with instructions so you can practice at home, as well. This can be extremely helpful if you want to master the techniques we describe. They may sound simple, but they're not! In our recent podcast on free practice groups (put LINK), you can find many virtual practice groups you can join from home to practice many of the techniques in TEAM-CBT with like-minded colleagues and become part of the growing TEAM-CBT community. We now have many excellent and free practice groups for the general public as well as and training groups for shrinks. Today, Mina returns to the show with a new problem—pre-menopausal symptoms that are scaring her and casting a shadow on her future as well as her marriage with her husband, Maurice. Menopause is a topic that freaks many people out, due to feelings of anxiety and shame which can sometimes be intense. Today, menopause will be out in the open and front and center. However, Meina is confused because so many problems and feelings are swirling around in her head, and she doesn't quite know where to start. At the start of the session, Mina's Brief Mood Survey indicated mild depression, severe anxiety, moderate to severe anger, and greatly diminished feelings of happiness and relationship satisfaction, thinking of her husband, Maurice.f If you review Mina's Daily Mood Log. you can see that the Upsetting Event is irregular periods due to menopause. You can also see that Mina is struggling with fairly feelings of depression, anxiety, shame, inadequacy, loneliness, embarrassment, hopelessness, frustration and anger, and she's giving herself some intensely negative messages, like “My body is falling apart,” and “My husband will leave me,” and “I'll get osteoporosis and die in pain like my grandmother,” and more. During the initial Empathy phase of the session, Mina described quite a lot of personal and professional concerns, as well as somatic complaints of various kinds. Sometimes, in the past, Mina has developed numerous somatic complaints that terrify her, because she has interpreted them as possible serious diseases, like multiple sclerosis. However, excellent physical evaluations rarely or never provide any medical evidence or explanation for her symptoms. This pattern of obsessing about somatic symptoms is actually quite common. Many general practice doctors report that as many as a third of their patients complaining of pain, dizziness, and so forth do not have any medical disease that could possibly explain the symptoms. In fact, in his classic book, Caring for Patients, the late Dr. Allen Barbour from Stanford reported that about half of these types of patients experience a disappearance of their somatic symptoms when they identify some conflict or problem that they've been avoiding, and then take steps to express their feelings or solve the repressed problem. Pretty much every time, this has been true of Mina, too. It often turns out that she is upset about something she is sweeping under the rug, and the Hidden Emotion Technique has proved extremely helpful in pinpointing the hidden feeling or conflict. Then, as soon as she acts on this information, and expresses her feelings, the somatic problems immediately disappear. So, our first task in today's session was to see if the same thing was happening. It turned out that she was quite upset with her husband, Maurice, so we did a Relationship Journal to see if we could get a better understanding of what was going on. Her complaint was that Maurice did not want to talk about “difficult feelings.” Instead, he suggests they go for a nature walk or watch a movie. So, she felt sad, anxious, rejected, hurt, frustrated, and alone. But, as is the case nearly 100% of the time, when we examined a brief interaction between them—what did he say and what did she say next—it became clear that she was actually pushing him away and putting him down. This was understandably painful for Mina to see, and a bit embarrassing, but she was super brave, and saw how she could use the Five Secrets to respond to Maurice in a radically different and more inviting manner. As an aside, the person who seeks treatment for a relationship problem will nearly always discover that they have actually be causing the very problem they're complaining about. If Mina's husband had come to us for help, he would have made the exact same shocking discovery—that HE was causing the problem he was complaining about. I call this strange but fascinating phenomenon the “theory of interpersonal relativity.” Mina feared abandonment, but discovered that her real problem was that she was rejecting her husband, and forcing him to reject her! Although this type of sudden insight can be tremendously painful, it is also liberating at the same time. That's because people discover that they have far more power than they thought. Mina felt helpless, but was actually pulling the strings. Once you “see” this, you have the option of moving in a radically new and more rewarding direction. Mina promised to send a follow up once she's had the chance to try a new approach during her interactions with Maurice. We have our fingers crossed! In addition, we worked with Mina's negative thoughts and feelings on her Daily Mood Log, starting with Positive Reframing, which she found helpful. What did her negative thoughts and feelings show about her that was positive and awesome, and how were they helping her? Then we did several rounds of Externalization of Voices and she was quickly able to knock her negative thoughts out of the park, with incredible results that you can see if you examine the emotions goal and outcome columns on her emotions table HERE. As you can see, there was an immediate and dramatic reduction in all of her negative feelings. We publish these TEAM-CBT sessions because we believe that the vast majority of mental health professionals do not know how to trigger rapid and extreme changes in how people think, feel, and interact with others. It is our hope that these podcast live therapy sessions, in conjunction with our weekly training groups, will make mental health professionals aware of what's now possible, and how TEAM-CBT actually works. We try to make it look simple, but it requires tremendous training, practice, and commitment. Rhonda and I have strong, tender feelings toward our dear colleague, Mina, and we are deeply indebted to her for making herself vulnerable in a public forum so that we can all learn and feel much closer to one another. Personal work is one of our finest teaching tools. In addition, feelings of respect, love, and connection are so often missing in our embattled and hostile political and world environment these days. We cannot change the world, but we can definitely make our own small ripples in the pond, and work on changing ourselves. If you'd like, you can take a look at Mina's Brief Mood Survey and Evaluation of Therapy Session at the end of the session. Thanks so much for listening today! Rhonda, Mina, and David
360: The Story of Indrani “Why can't I get close to my daughter who I love so much?” Today, we present Part 2 of the awe-inspiring work that David and Jill did with Indrani in the Tuesday group at Stanford. Indrani was a mother with a heart-breaking but all-too-common story of a conflict with her daughter. Sometimes, we love someone tremendously, but every time we try to get close, they seem to push us away. The story should ring true and be helpful to so many people, as nearly everyone runs into conflicts at times with our family members, including our parents, siblings and children. And, as usual, the solution often involves attending to your “inner” dialogue, which is the conversation you're having with yourself about the conflict, and the “outer” dialogue, which is what happens when you try to get close to the person you love. And today's session illustrates not one, but two forms of enlightenment. The changes in the inner dialogue involves challenging and crushing the negative messages you've been giving yourself about h problem with the person you love so much. You can see Indrani's Daily Mood Log if you click HERE. As you can see, she's been telling herself that her daughter has shut her out of her life, and that she'll die alone/ That's incredibly sad! And she's also telling herself that all of her friends have wonderful relationships with their daughters “and I don't” and she's blaming herself for the problem: “I deserve this treatment,” and “nothing I do pleases her.” You can also see the intensity of Indrani's negative feelings, including sadness, anxiety, inadequacy, loneliness, embarrassment, discouragement, irritation, and more. You can also see a typical exchange with her daughter if you look at her Relationship Journal (RJ). As you may know, the whole theme of my interpersonal model in TEAM-CBT is that we create our own interpersonal reality at every moment of every day. In other words, we unknowingly create and cause the exact relationship problems that we complain about, but just don't realize this, so we think there's something wrong with the other person. But how can this be? If you look at Step 2 of Indrani's RJ, her response to her daughter seems innocent enough! But stayed tuned, because Indrani makes a shocking and mind-blowing discovery during the session, and that discovery requires the exceedingly painful “death” of the “self.” But this “Great Death” is instantly followed by a “Great Rebirth.!” At the end of the session, a Tuesday group members named Keren, said this to Indrani: “You wowed me!” One of the men, Ed, could barely speak because he was sobbing. You may also be sobbing for joy when you listen to this heart-warming story. In part 1, today's podcast, you'll hear the initial T = Testing and E = Empathy. In part 2, in next week's podcast, you'll hear the M = Methods, including Jill and David's incredible work with Indrani on her R and her rather sudden discovery, in Step 4, of exactly how and why she'd been driving her daughter away—and how to stop doing that and begin to communicate in a way with a far greater chance of enhancing closeness and love. The Jill and David turn to Imani's Daily Mood Log so she can smash her distorted negative thoughts with the Externalization of Voices, and several role reversals illustrating the integration of Self-Defense, the Acceptance Paradox, and the CAT (Counter-Attack Technique.) You can see Imani's initial and final Brief Mood Surveys plus her Evaluation of Therapy Session, We are extremely grateful to Indrani for giving us this very intimate glimpse into her inner life in a way that will illuminate and inspire every person with the good fortune to listen to Indrani's amazing Journey this evening! PS I emailed Indrani this morning to see how she's doing, and recevied this wonderful reply: I'm still feeling great…very light and hopeful. I've listened to the audio. I sound goofy at times but loved re-living the moment when the truth dawned on me and how I felt immediately afterwards. My daughter Soni ( like the Japanese electronic company :) is coming on Thursday. I would've been filled with intense anticipatory anxiety but now I can't wait to give her a big hug and use what I've learnt to connect with her. I'm looking forward to watching the video with Soni. Thank you so much Dr. Burns and Jill! Thanks for listening! Rhonda, Jill, and David
On today's episode of the Occult Symbolism and Pop Culture with Isaac Weishaupt podcast we are joined by John Brisson for an absolute jaw dropping banger! This could be one of the most controversial shows I've ever done because we're going to take a critical look at some "Heroes" and question a lot of religious, political and conspiracy beliefs. We'll hear about John's spiritual journey as a truther from being a New Age white nationalist Gnostic to a born again Christian! We'll learn about the controversy behind the Sound of Freedom film about Tim Ballard from Operation Underground Railroad as we explore some major conspiracy topics: Gnostic duality of light vs dark and Q Anon good vs evil false paradigms, The Finders, human trafficking, child abuse, Alice Bailey, the UN, LDS Mormons, the Right's Council for National Policy (CNP), Externalization of the Hierarchy and a DEBUNK of adrenochrome!!We'll answer the question: Should you go see Sound of Freedom??..."Cursed is the man who puts his hope in man, and who will strengthen the flesh of his arm in him, and withdraws in his heart from the Lord." -Jeremiah 17:1NOW UP AD-FREE ON SUPPORTER FEEDS! Free feed gets it Monday!Links:Follow John Brisson everywhere!LINK TREE TO ALL HIS CHANNELS AND SOCIALS: https://linktr.ee/wevereadHis video on Sound of Freedom: https://odysee.com/@weveread:7/sound-of-freedom:5Billy Ray Valentine's FreeWorld.FM: https://freeworld.fmFree World NYC event tickets: https://www.eventbrite.com/e/free-world-nyc-tickets-667727369537Show sponsors- Get discounts while you support the show and do a little self improvement! 1. Diversify your retirement portfolio with GOLD! Set your 401K up to a precious metals account with Augusta Precious Metals! Text I-S-A-A-C to 68592! Or go to AugustaPreciousMetals.com to learn more! 2. HelloFresh.com/OSPC50 and use code OSPC50 for 50% off plus free shipping! 3. ATTENTION CRYPTO NERDS!!! CopyMyCrypto.com/Isaac is where you can copy James McMahon's crypto holdings- listeners get access for just $14. BetterHelp: This episode is brought to you by BetterHelp. Give online therapy a try and get 10% off at betterhelp.com/illuminatiwatcher and get on your way to being your best self. 5. *Want to advertise/sponsor our show? Email Isaac at IlluminatiWatcher@gmail.com (*business inquiries only please- I'm a one man operation)GRIFTER ALLEY- get bonus content AND go commercial free + other perks:* APPLE PREMIUM: If you're on the Apple Podcasts app- just click the Premium button and you're in! *NO more ads *Early Access *EVERY BONUS EPISODE* PATREON: ad free, all the bonus shows, early access AND TWO OF MY BOOKS! (The Dark Path and Kubrick's Code); you can join the conversations with hundreds of other show supporters here: Patreon.com/IlluminatiWatcher * VIP: Due to the threat of censorship, I set up a Patreon-type system through MY OWN website! IIt's even setup the same: FREE ebooks, Kubrick's Code video! Sign up at: https://illuminatiwatcher.com/members-section/ * *****Want to check out the list of all 160+ bonus shows that are only available on Patreon and IlluminatiWatcher.com VIP Section?… I keep an index right here: https://www.patreon.com/posts/2941405More from Isaac- links and special offers:1. Check out another free podcast I make with my wife called the BREAKING SOCIAL NORMS podcast- it's all about the truther (me) lovingly debating conspiracies with a normie (my wife)! Go to BreakingSocialNorms.com You can get it free wherever you listen to podcasts (e.g. Apple: https://podcasts.apple.com/us/podcast/breaking-social-norms/id1557527024?uo=4). You can get the Uncensored and commercial-free option at Patreon.com/BreakingSocialNorms2. Index of EVERY episode of OSAPC Podcast going back to 2014! https://illuminatiwatcher.com/index-of-every-podcast-episode-of-occult-symbolism-and-pop-culture/3. Signed paperbacks, shirts, & other merch: f4. FREE BOOK: https://illuminatiwatcher.com/how-to-get-free-books/5. Isaac's books for Amazon and narrated for Audible: https://www.amazon.com/author/isaacweishaupt6. Subscribe to my NEW YouTube channel (*with most of the episodes in video form): https://www.youtube.com/@occultsymbolism7. *STATEMENT: This show is full of Isaac's useless opinions and presented for entertainment purposes. Audio clips used in Fair Use and taken from YouTube videos.*ALL Social Media, merch and other links:https://allmylinks.com/isaacwThis show is part of the Spreaker Prime Network, if you are interested in advertising on this podcast, contact us at https://www.spreaker.com/show/3200989/advertisement