Podcasts about Externalization

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!  

The online panel "Border Externalization & Migration Governance" is part of the “Who Needs a Border Wall? Borders, Walls, and Barriers: Toward a New Research Agenda” conference, organized by the Center for Geopolitical Studies of the Raoul Dandurand Chair at the Université du Québec à Montréal, in collaboration with Sidi Mohamed Ben Abdellah University in Fez.With:Amalia CAMPOS-DELGADO, Leiden University Van Vollenhoven Institute for Law, Governance and Society, LeidenCarlotta DE CUNTIS, Department of Political Science, University of Rome “La Sapienza”, RomaRachid BENHARROUSSE, The American University in Cairo, CairoModerator: Claudia Donoso, St Mary University, San Antonio

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  

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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  

How should the law govern AI? Those concerned about existential risks often push either for bans or for regulations meant to ensure that AI is developed safely - but another approach is possible. In this episode, Gabriel Weil talks about his proposal to modify tort law to enable people to sue AI companies for disasters that are "nearly catastrophic". Patreon: patreon.com/axrpodcast Ko-fi: ko-fi.com/axrpodcast   Topics we discuss, and timestamps: 0:00:35 - The basic idea 0:20:36 - Tort law vs regulation 0:29:10 - Weil's proposal vs Hanson's proposal 0:37:00 - Tort law vs Pigouvian taxation 0:41:16 - Does disagreement on AI risk make this proposal less effective? 0:49:53 - Warning shots - their prevalence and character 0:59:17 - Feasibility of big changes to liability law 1:29:17 - Interactions with other areas of law 1:38:59 - How Gabriel encountered the AI x-risk field 1:42:41 - AI x-risk and the legal field 1:47:44 - Technical research to help with this proposal 1:50:47 - Decisions this proposal could influence 1:55:34 - Following Gabriel's research   The transcript: axrp.net/episode/2024/04/17/episode-28-tort-law-for-ai-risk-gabriel-weil.html   Links for Gabriel:  - SSRN page: papers.ssrn.com/sol3/cf_dev/AbsByAuth.cfm?per_id=1648032  - Twitter/X account: twitter.com/gabriel_weil   Tort Law as a Tool for Mitigating Catastrophic Risk from Artificial Intelligence: papers.ssrn.com/sol3/papers.cfm?abstract_id=4694006   Other links:  - Foom liability: overcomingbias.com/p/foom-liability  - Punitive Damages: An Economic Analysis: law.harvard.edu/faculty/shavell/pdf/111_Harvard_Law_Rev_869.pdf  - Efficiency, Fairness, and the Externalization of Reasonable Risks: The Problem With the Learned Hand Formula: papers.ssrn.com/sol3/papers.cfm?abstract_id=4466197  - Tort Law Can Play an Important Role in Mitigating AI Risk: forum.effectivealtruism.org/posts/epKBmiyLpZWWFEYDb/tort-law-can-play-an-important-role-in-mitigating-ai-risk  - How Technical AI Safety Researchers Can Help Implement Punitive Damages to Mitigate Catastrophic AI Risk: forum.effectivealtruism.org/posts/yWKaBdBygecE42hFZ/how-technical-ai-safety-researchers-can-help-implement  - Can the courts save us from dangerous AI? [Vox]: vox.com/future-perfect/2024/2/7/24062374/ai-openai-anthropic-deepmind-legal-liability-gabriel-weil   Episode art by Hamish Doodles: hamishdoodles.com

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  

Welcome to Cuppa 37 of 40. In this episode of the 40 for Tea, host Rachel Allan invites you to a lively conversation with NNI dialogues Jonelle Naudé and Weibke Renner.   We dive straight into tea, crossing divides and removing the charge from power words.   These powerhouse women are firm believers in the power of facilitated, genuine communication and the transformative role of empathy in resolving conflicts. At the heart of their philosophy lies the knowledge that when people's voices are truly heard, a space for understanding and new solutions are created. NNI dialogue is a systems based methodology born through working in post apartheid South Africa.  Tangible change is measured through 3 specific steps. We are challenged to question the dominating focus on the "why am I right?" mindset, which often hinders progress. Instead, we are encouraged to consider that multiple truths bring resilience to a system, fear as a protector and perhaps the emotions we feel don't always belong to us. We celebrate what it is to be human, are offered valuable perspectives on how to get unstuck in relationships, teams and in life events.  As we ask the question "how do we be with complexity and move forward together?" There's also a bit of energetic plumbing!   So grab your cuppa and let's dive in together. Sign up to connect with Rachel & for the GOLD + inside info on 40 for Tea here. --------- 00:00 Intro - Podcast Cuppa explores human connection and resilience. 08:15 -  What is NNI  -  Founded in South Africa, promotes systemic dialogue. 11:29 - How it works: the measurement system: Shift in emotion, thought & behavior. 13:17 - Example in South Africa. 17.17 - Microcosm teaches us about the Macrocosom 22:59 - Update on whats happening in 40 for Tea. 25:45 - Facing suppressed feelings. 29:25 - Embracing multiple truths, creating connection through sharing. 33:12 - Diversity in voices is essential for a healthy ecosystem. 35:11 - Resilience. 39:51 - Judging words - a reframe. 44:50 - Channeling entities a real phenomena. 48:32 - The Gold The headlines:  Understanding and Expressing Emotions The role of external facilitators in helping individuals identify and express emotions. Using anonymity to express emotions without feeling personal overwhelm. Collective processing and normalization of a wide range of emotions. The impacts of suppressing emotions on personal and collective progress. 2. NNI Dialogue Methodology Aimed at crossing divides and ensuring all voices are heard. Creating empathy by speaking from the experience. Structured space for discussing complex issues including taboo subjects. Coexistence of multiple truths in dialogues. This process is like being Energetic plumbers 3. Co-creation of Meaning in Words The importance of deconstructing words to understand their relationships. Engagement with words beyond academics to comprehend diverse meanings. Removing judgments from words to maintain neutrality and observe emotions. 4. Energetic Dialogue and Healing Dialogical experiences embodying different voices to shift the awareness & system. The practical work that impacts physical, emotional, and spiritual planes. The guests as "energetic plumbers" shifting collective energies and offering aid. 5. Collective Transformation in Dialogue Settings Tracking group transformation cognitively, emotionally, and behaviorally. Case study from Bonnevale showing dialogue-induced recognition and steps towards healing. Systemic approach focusing on themes and energies instead of individual stories. 6. Reflection of Societal Systems Dialogue systems mirroring broader societal systems. Offering insight and choices to participants for pattern and behavior change. 7. Features of the 40 for Tea Podcast Emphasizing human connection and resilience through inspiring interviews. Conversations with individuals like Jonelle Naude representing NNI Dialogue. Exploring collective work for global challenges. 8. Embracing Multiple Truths and Diversity Unlocking empathy and understanding through deeper self-expression. Celebrating and accepting diverse perspectives. 9. The Value of Disconnection and Rest The necessity of disconnection and rest within systems and dialogues. Contributions of diverse voices, rest, and disconnection to a healthy ecosystem. 10. Externalization of Emotions Techniques for facilitating communication and minimizing defensiveness through externalizing emotions. 11. The Power of Words in Reality Discussion on the relational meaning of words and the impact on shaping reality. How words are negotiated and understood in relations. 12. Guest Backgrounds and the Podcast Community Geographic diversity of the guests from Berlin, Cape Town, and Ireland Encouraging the podcast community to engage, sign up for updates, and share the show. 13. Upcoming Season and Engagements Preview of the upcoming season of the podcast. Invitation for the audience to stay connected and involved with "40 for Tea."

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  

John Brisson is back after a couple of years and things have changed. He's gone from a Gnostic, Theosophist - he would say to born again Christian. This is not just one of our past guests.... seems to a slight trend. What's up with that? We chat about his YouTube cancellation, during covid, the pizzagate talk, Michael Joseph, Bailey/Blavatsky split, and who is channeling demons.   Has earth been given over to Satan? Is humanity being culled? We also into Rockefeller influence on Nag Hamadi, technomancy, his born again experience with kundalini leaving and the Holy Spirit coming in. What was Wilhelm Reich doing with kids in the basement? Is orgone just a distraction? CNP, Apostolic Fathers, the major pendulum swing happening right now all over the West, Kirwin's biblical Mandela, and the last tribe of Dan are also discussed in this first part.   In the second part we get into Darren's Atlas Shrugged world, and the herd being dangerous, when the White Lodge shows itself, who will be leading the charge in the revolution when the pendulum is back, the Mark of the Beast has to be an intentional choice - it wasn't the jab, Operation Tiberius Kirk, Operation Warp Speed, Trump, Canadian parallels, Fabian Socialism and Palantir massive health data collection.   We go deeper into the CNP. Is it also responsible for the destruction of the West? Dark Alliance? What about Turning Point? Moms for Liberty? Why is this club so secret compared to the CFR? Clinton impeachment distraction in context, the real border wall - virutal, Rex 84, Fema camps, sound of Freedom, limited hangout, Tribulation, some of the so called outsiders like Gaetz are also all discussed.   Some good quotes from John - Controlled Great Reset into a false Great Awakening, Externalization of the Hierarchy.   https://twitter.com/weve_read https://linktr.ee/weveread https://www.fixyourgut.com/author/jwbrisson/   To gain access to the second half of show and our Plus feed for audio and podcast please clink the link http://www.grimericaoutlawed.ca/support.   For second half of video (when applicable and audio) go to our Substack and Subscribe. https://grimericaoutlawed.substack.com/ or to our Locals  https://grimericaoutlawed.locals.com/   Help support the show, because we can't do it without ya. If you value this content with 0 ads, 0 sponsorships, 0 breaks, 0 portals and links to corporate websites, please assist. Many hours of unlimited content for free. Thanks for listening!!   Support the show directly: https://grimerica.ca/support-2/ Our Adultbrain Audiobook Podcast and Website: www.adultbrain.ca Our Audiobook Youtube Channel:  https://www.youtube.com/@adultbrainaudiobookpublishing/videos Grimerica Media Youtube Channel: https://www.youtube.com/@grimerica/featured Darren's book www.acanadianshame.ca Check out our next trip/conference/meetup - Contact at the Cabin www.contactatthecabin.com Other affiliated shows: www.grimerica.ca The OG Grimerica Show www.Rokfin.com/Grimerica Our channel on free speech Rokfin Join the chat / hangout with a bunch of fellow Grimericans  Https://t.me.grimerica https://www.guilded.gg/chat/b7af7266-771d-427f-978c-872a7962a6c2?messageId=c1e1c7cd-c6e9-4eaf-abc9-e6ec0be89ff3   Get your Magic Mushrooms delivered from: Champignon Magique  Mushroom Spores, Spore Syringes, Best Spore Syringes,Grow Mushrooms Spores Lab Get Psychedelics online Leave a review on iTunes and/or Stitcher: https://itunes.apple.com/ca/podcast/grimerica-outlawed http://www.stitcher.com/podcast/grimerica-outlawed Sign up for our newsletter http://www.grimerica.ca/news SPAM Graham = and send him your synchronicities, feedback, strange experiences and psychedelic trip reports!! graham@grimerica.com InstaGRAM https://www.instagram.com/the_grimerica_show_podcast/  Purchase swag, with partial proceeds donated to the show www.grimerica.ca/swag Send us a postcard or letter http://www.grimerica.ca/contact/ ART - Napolean Duheme's site http://www.lostbreadcomic.com/  MUSIC Tru Northperception, Felix's Site sirfelix.bandcamp.com

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

The Plan, QAnon, and the Externalization of the Hierarchy with John Brisson of We've Read the Documents and WR.  We've Read the Documents on Odysee: https://odysee.com/@weveread:7?sunset=lbrytv Learn more about your ad choices. Visit megaphone.fm/adchoices

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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

359: The Story of Indrani “Why can't I get close to my daughter who I love so much?” Today, we present 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! Thanks for listening! Rhonda, Jill, and David

Podcast 357: Stories from the 60s, Part 1 Today's podcast will be a little different. I had the good fortune to be alive in Palo Alto, California during the late 1960s. For me, it was a magical era of happenings, the Haight-Ashbury District in San Francisco, psychedelics, war protests, civil rights activity, cool music, learning about life, and cutting an awful lot of medical school classes! But what I learned on the streets was far more valuable in my later career as a psychiatrist, working with real people with real problems, than anything I learned in medical school. It was an era of magic, to be honest. In fact, to me, California has always had the feel of magic. And that magic is still alive and well, happening every day, at least in my life. Let me know if you like these stories. I shared them at my weekly Stanford training group, and publish the recording of that evening's training session here, with trepidation. Some of the stories are pretty far out. If you like them, and want more, I have a lot more, which I've listed below. Just let me know, and I'll gladly start babbling again. . .  IF I haven't been arrested! If you'd like to see one of the R-rated but gorgeous Larry Keenan photos taken at my “Uptightness” happening, you can see it at this link: Look for the photo called “The Kiss.” https://www.larrykeenan.com/prints Larry Keenan, a brilliant young commercial photographer at the time, attended my “uptightness” happening and took many fantastic photos that day. Larry became a famed photographer of many of the greats of the “Hippy Era,” like Bob Dylan, Neil Cassady, Lawrence Ferlinghetti, and a host of others. Sadly, Larry passed away several years ago, but I will always be grateful to him for the gorgeous and now-famous photos he created that day in the infamous but glorious 60's! Warmly, david Part 1 (in this podcast) Psychodrama / encounter David gets put down: Rob Krist's encounter group The return of tears: My first psychodrama marathon The pompous professor: False front / tragic surprise Spiritual Desert experience: Sadness as celebration Dating / Relationships / R-Rated Having fun and making a movie: "Uptightness”   Part 2 (not yet recorded: let me  know if you'd like a Part 2!) More Stanford stories not yet covered: let me know if interested! Husain Chung and the crazy teen from LA: When a stallion wants to run A frightening encounter with Vic Lovell: And a mentor's advice Threats from unwanted guests: Fighting back with paradox Bar next to the Free University Coffee House: Outrageous works, even with Hell's Angels Inside the Free University Coffee House: How I met my wife The day we bombed Cambodia: Triggering a riot at Stanford, beaten by police, motorcycle smashed to bits, handcuffed, arrest announced on the campus radio station, escaped The bearded man on the quad near the Stanford student union—Telling me to “sit with open hands” Ken Kesey and his merry pranksters in the Stanford student union—they were dressed in pajamas or clown outfits and Neil Cassady was juggling hammers) The tape recorder experiment: Bizarre week, unexpected conclusion Medical School Stanford medical school interview: Unexpected outcome The day that Gene Altman and I attended class: Totally weird Broken jaw: Anger, fear, and intense pain that suddenly vanished Getting kicked out of neuropathology class Encounter at the Medical School: Psychiatry and Psychotherapy—Are they Relevant or Obsolete? Featuring Hussain Chung Missing graduation ceremony: Didn't pick up my diploma until years later Homeless in Carmel Valley: Saved by Ramadan, Subud Re-entry: The Highland Hospital Emergency Room Dr. Allen Barbour's Medical Outpatient Clinic Hidden emotion 1: One of Stanford's first coronary artery bypass patients Hidden emotion 2: Doc, what happened? I'm not dizzy anymore! Hidden emotion 3: Help! I need emergency surgery NOW!   Here's the Stanford group feedback from group after telling stories 1 – 5 Positive Feelings about the Training   Not at all true Somewhat true Moderately true Very true Completely true N/A 1. I felt I could trust my trainer. 0 0 0 0 17 1 My trainer paid careful attention to what I said 0 0 0 0 7 11 My trainer critiqued my work in a sensitive manner. 0 0 0 0 7 11 I felt good about the training I received. 0 0 0 0 17 1 Overall, I was satisfied with my most recent training session. 0 0 0 0 17 1 Negative Feelings during Training   Not at all true Somewhat true Moderately true Very true Completely true Sometimes I felt uncomfortable during the training. 18 0 0 0 0 Sometimes I felt defensive during the training. 18 0 0 0 0 Sometimes I felt frustrated during the training. 18 0 0 0 0 Sometimes I felt anxious during the training. 18 0 0 0 0 Sometimes I felt insecure during the training. 16 2 0 0 0 Helpfulness of the Training   Not at all true Somewhat true Moderately true Very true Completely true N/A I expect to use these ideas with patients I am now treating 0 0 2 1 11 4 What I am learning seems useful in my clinical training. 0 0 1 2 13 2 My trainer and I are working together effectively. 0 0 0 2 10 6 The training was helpful to me. 0 0 0 1 16 1 I felt I was learning and growing during the training session. 0 0 0 1 16 1 Respectfulness and Safety of the Training   Not at all True Somewhat true Moderately true Very true Completely true N/A My trainer was sensitive to potentially relevant cultural, racial, religious, age, gender, or sexual identity issues that might impact the therapy. 1 0 2 0 13 2 My trainer created a safe and warm space for all identities. 1 0 1 0 14 2 Difficulties with the Questionnaire   Not at all true Somewhat true Moderately true Very true Completely true It was hard to be completely honest answering some questions. 16 1 0 0 1 My answers weren't always completely honest. 16 1 0 0 1 Sometimes I did not answer the way I really felt inside. 16 1 0 0 1   Please describe what you specifically disliked about the training? What could have been improved? Were there some things you disagreed with or did not understand? Nothing N/A Was too short na I'm starting to catch on to the fact that David has read more than 3 books... Nerd. :) It is funny coming from David and I believe he used it affectionally... most of use won't get away with the term "Chainaman" perhaps Asian American Loved the group tonight n/a Nothing I disliked. My answer of "somewhat insecure" from above was about my comments and whether they were helpful or "good enough." Please describe what you specifically liked about the training? What was the most helpful? Were there some things you learned? I really enjoyed learning from David's stories. Thank you for sharing these personal stories with us. I had been looking forward to the evening's stories but I didn't know emotional and impactful they would be. I was especially touched by David's & Cai's tears and appreciate how much they both shared. It had to be especially difficult to share over Zoom because sometimes it can sound flat. With most people muted it can be hard to hear the feedback from the audience but the connection still felt very powerful. I truly appreciate your openness and willingness to show your vulnerable side. Just like many others, I was deeply moved by your heartfelt tears as you shared stories about the woman you believed would succumb to cancer, your beautiful encounter with your wife Sara, and the journey of creating "Uptightness." You didn't have to let us into those deeply intimate and personal experiences, and for that, I am genuinely grateful. This was absolutely amazing! It couldn't have been more special. Thank you Dr Burns! You are a national treasure and gift to us all. Can't wait for the podcast so that I can re-live it exposure and being uncomfortable with adult stuff so silly but real for me I was touched by the depth of emotion David manifested in telling some of the stories, his deep compassion and humility, and the reality of celebration of sadness. I liked feeling closer to David both from his sharing deep feelings and by his telling about life events like how he met Melanie. It was cool to have stories illustrating powerful lessons and even some that illustrate the mundane (e.g. mostly not a lot happened when David spent a week disclosing every feeling). What a wonderful night. These stories brought that time period alive for me, and having not lived through that era, that was a real treat. The only thing I was surprised about, and a bit sad, was seeing that David appeared to be a little self-conscious or something. David, I hope I can reassure you that even though I was silent and didn't have any questions, you had my full attention. It was like watching a profound and entertaining movie. - Ed W I really loved hearing about the spiritual connections with others that you had, David. I also loved seeing the photos afterward and you showing us who you were talking about in your stories. What a beautiful, magical time! Some very interesting and very touching stories. Made me feel closer to the group and gave some insights into the 60s and the development of TEAM CBT That was beautiful. More and more I'm convinced therapy is art verified by science. This very human tradition of telling stories is so important to our work as therapists/people. I enjoyed this greatly. A two hour work of art I was fortunate enough to have experienced. Thank you, much love. It was mesmerizing and holy God listening to the stories now I understand how he could have come up with such an amazing Tool It was lovely to travel back in time and get snap shots of David's live in the 60s. I appreciated the tender moments of sadness and also the spiritual mystical moments. I like David even more knowing that his calling was to council people, and the journey he has taken to become a conventional healer. It is an honor to be part of this training, almost feels like a type of lineage. I mostly found it just very enjoyable and fun and salacious. But I also liked the tears and the parts about people hiding their suffering and how we all really suffer but often have a hard time showing it. That was beautiful. Fabulous! How wonderful to learn more about David, learn about his "weird" past and shadow side, and share in his authentic expression of intense feelings. He really opened up and it did make me feel closer to him! The desert story was inspirational to me, and Cai's story as well...I, too, love the book Siddartha. Interesting to learn of the origins of techniques such as Externalization of Voices and Downward Arrow. Really contextualizes it for me. Not to mention bringing the "magic" of California in the 60s back to life. Thank you! Left me yearning for more! It was a spellbinding evening, and it felt to me like we were right there with you, David, in the desert seeing the multicolored clouds with our tears flowing, or at the psychodrama marathon crying for the woman who was dying, or on in a field with you and lots of naked ladies at the "Uptightness" event. And now it makes so much sense to me how your methods like EoV and the Downward Arrow all grew out of these experiences you shared with us tonight of tapping deeply into that River of Emotions that you talk about. Thank you, David, for sharing this with us! Seeing David's tears. Love him even more. Learned so much from the stories I liked this evening very much. I felt very close to you, David, and to the others who shared, and I felt honored to be a part of it. There were so many good stories. I think your story of being in the desert and the woman suddenly giving up drinking might be an example of a powerful prayer-- I know it sounds pretty goofy and I would have thought so too when I was an atheist not long ago, but I've had some experiences that have really led me to believe some seemingly goofy things. Please describe what you learned in today's group12 responses It was such a moving & emotional evening filled with incredible stories, some of which seem too wild to be true but you certainly had the pictures to back it up! Even though I'd been working with the pictures they really came to life after hearing the context and learning more about the people in them. Thank you! It was terrific to hear the origin story of the greatest psychotherapy approach ever developed the founding go team cbt I learned it is unnecessary to be uptight except for cinematic purposes. We are all connected and affect each other on an energetic level

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

353: The Inner Scoop on “No" Practice! The “Inner” and “Outer” Dialogues— The “Inner” and “Outer” Solutions As you know, I have created many powerful communication techniques, including the Five Secrets of Effective Communication and more. One of the additional techniques is called “No” Practice, and it's designed for people who have trouble saying “no,” or setting limits with other people. Essentially, you do a role-play with a colleague or therapist who keeps pestering you with pushy demands, and you have to practice saying “No” in a polite but firm and assertive way. Sounds simple, right? But it's not! People have many reasons for not wanting to say “No.” For example, you may be afraid of hurting the other person's feelings, or letting them down, or running the risk that they may get mad at you if you don't say, “Yes.” In addition, you may feel like you'll miss out on some special activity if you say no, so you end up way over-committed. In this session, you will meet an exceptionally compassionate and highly trained young psychiatrist named Lee, who asked for help with a problem relating to some of his patients. My co-therapist is Dr. Jill Levitt, who is the Director of Clinical Training at the Feeling Good Institute in Mountain View, California. Lee explained how he struggles with saying “no” when patients make inappropriate requests, like pushing for a medication they're addicted to, and wanting premature discharge from the inpatient unit when they have unrecognized safety issues. Instead, he seems to get drawn into long explanations of his thinking and why he's declining the other person's requests, sometimes for half an hour, and ends up frustrated when the other person still doesn't “get it” and with himself for spending the time. People often think that therapy is easy, and that people just need encouragement, advice, or behavioral practice to change the way we interact with others. But as you will vividly see in this session, that is often not the case, and things that may seem simple or obvious can seem almost impossibly difficult to learn. Why does this happen? Why is it so difficult for people to learn new and seemingly simple verbal skills? Well, to find the answer, we have to go back to the teachings of the Buddha and Epictetus, who taught us that our negative feelings do NOT result from what's happening, but from our thoughts. What does this mean? Well, Lee is an incredibly intelligent and compassionate young psychiatrist, and he's clearly highly motivated, and yet he seems very slow in learning how to say “no.” Can his thoughts illuminate his apparent resistance to learning a new approach? During the session, Dr. Levitt reminded us of the fact that whenever you are involved in a conflict with someone, or any interaction for that matter, there are always two dialogues going on: the Inner and Outer Dialogues, and if you ignore either one of them, you may have difficulties triggering change. The Outer Dialogue involves what you say to the other person, and what they say next, and how you respond. For example, Patient says: “Doctor, I want to get discharged from the hospital.” Lee says: “No, I can't do that because you'd be in danger and without a place to live. You'd be living on the streets, and it wouldn't be safe for you.” Patient (who is in a state of psychosis) responds: “No doctor, I'll be okay, because I'm living with Michael Jackson.” Then Lee tries to explain his thinking again, and then the patient asks to be discharged from the hospital again. And this cycle repeats itself many times, over and over, for as much as an hour. And they both end up frustrated and a bit miffed. Why is it so hard for Lee to say no in a kindly way and then move on to some other activity? That's where the Inner Dialogue can be so important. It appears that Lee has two types of distortions that interfere with his ability / willingness to say “no.” Self-Directed Should Statements. Lee appears to believe that he “should” be able to explain his thinking to any patient. He wants to convey respect, responsiveness, and care when denying a request. This is, of course, an expression of his high standards, his compassion, and his desire to communicate clearly to his patients. But, as is so often the case, Lee takes this goal a little to far, think he should “always” be able to do this, regardless of how psychotic or confused or demanding a patient might be. Essentially, the healthy pursuit of excellence as a psychiatrist has gone a little too far and has arguably morphed into a self-defeating kind of medical perfectionism. Self-Directed Shoulds typically trigger feelings of guilt, shame, anxiety, and inadequacy. They are often accompanied by several other distortions, including All-or-Nothing Thinking, Mind-Reading, and Self-Blame, to name just a few. Other-Directed Should Statements. Lee appears to think that his patients “should” understand and acknowledge his thinking if he's being reasonable and realistic. He may also believe that if he's doing his best, then his patients “should” argue fairly and acknowledge when they understand what he tells them and “shouldn't” be manipulative, unreasonable or argumentative. Other-Directed Shoulds often trigger feelings of frustration and anger, and are often associated with All-or-Nothing Thinking, Mind-Reading, Emotional Reasoning, and Other-Blame, to name just a few. Another teaching point is that we nearly always create our own interpersonal reality, but we don't realize that because we feel like victims and see the problem as coming from outside of ourselves. Lee's urge to continue to try to “win” the arguments with patients actually forces them to keep arguing their case and trying over and over again to get their way. That's just human nature. We've all seen that people can be pretty obstinate and determined to get their way, no matter what. That's why a focus on what you can do to change will often lead to a change in other people; in contrast, repeated efforts to persuade them to change is almost never effective. By way of analogy, my wife and I have recently had a bit of a problem with our cat, SweetiePie. She was a rescue cat, and we love her to death, and do everything we can to make her happy. She loves us intensely and shows her gratitude with loud purring almost all day long when she's not asleep or out in the back yard exploring. BUT, she has been pestering us for cat candy, and has gained too much weight. Here's what happens. She jumps up on my desk, and puts her paw on my keyboard, and stands if front of the computer terminal so I can't see. So, I give her two or three pieces of cat candy on her perch next to me. She jumps up and greedily devours it. Next, she jumps back on the desk and puts her paw on the keyboard. I “explain” to her that she's eating too much candy, and try to put her back on her perch, so she swats me with her claws and draws blood if I'm not quick to pull my hand away. So, I give her a few more pieces of candy, which she devours and then goes to sleep. Similar routine with my wife. She follows her, crying like she's on the verge of death, and swatting at her ankles until she gets cat candy and / or a 30 minute lap snuggle. So, in short, we have been “forcing” her, inadvertently,  out of love, to manipulate us for cat candy. In other words, we “reward” her manipulations by giving her cat candy and love. As a result, our pour girl is gaining too much weight. Of course, the solution is simple. Melanie has agreed to give her only four pieces of cat candy per day, and I am limiting her to two pieces, just so she'll know she's still loved. And when she tries to swat me with her claws, I just explain in a kindly way that I don't like that and put her on the floor. She caught on right away and seems to have accepted the new routine. Of course, we continue to give her abundant helpings of love every day, many times a day, as the love has zero calories! So, what's the bottom line? If you're trying to learn the Five Secrets of Effective Communication, and you want to change the way you communicate with others, remember to attend to your Inner Dialogue, as well as what you are actually saying to the other person during the conflict, especially if you're getting anxious, defensive, angry, frustrated or upset. If you write down your negative thoughts, I think you'll find many similar distortions to the ones described above, and this can give you another handle on change the way you think, feel, and connect with the people you care about, as well as the ones you don't! Incidentally, the belief that we are separate from others and from our environment is the essence of evil, according to some Buddhists, and perhaps nearly all of the world's religions have had similar beliefs, though couched in different language. But what this means to me is that when we struggle with friends of loved ones, and we are locked into frustrating conflicts, we typically feel like we are “separate” from the other person who is “doing something” to us. And this perception can not only trigger anger and frustration, but sometimes even violence. As humans, we seem to have great difficulty “seeing” our own role in the conflict. And sometimes, we don't even WANT to, because the so-called “Great Death” of the self can be very painful. This is especially true when we see ourselves as morally superior to the other person who is “bad” or “to blame.” We are indebted to Lee for giving us this superb example of a problem that nearly all human beings struggle with, and also sharing his vulnerability and humanness with all of us in such an open and generous way! And we salute and thank Lee for courageously showing us the way with an intensely personal and real example. Contact info Dr. Rhonda Barovsky practices in Walnut Creek and Berkeley, California. She can be reached at rhonda@feelinggreattherapycenter.com. She is a Level 5 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. You can reach Dr. Burns at david@feelinggood.com. You can reach Jill Levitt, Ph.D. at jilllevitt@feelinggoodinstitute.com. She is the Director of Clinical Training at the Feeling Good Institute in Mountain View, California (www.feelinggoodinstitute.com) You can reach Lee at bananaquitting@gmail.com Group Feedback The following are a few of the comments in the feedback at the end of the Tuesday class. These are comments from the mental health professionals who observed the session with Lee. Please describe what you specifically disliked about the training? What could have been improved? Were there some things you disagreed with or did not understand? LOVED it! NOTHING Can't think of anything I only wish that we could have more time for this work with Lee. I kept feeling like I wanted to jump in and try some of these skills myself.   Please describe what you specifically liked about the training? What was the most helpful? Were there some things you learned? I liked the externalization of resistance and would've like to see more with that or maybe even a “rules & roles” regarding patient/doctor relationships. I really liked Lee's work. I also struggle with saying no, and I liked all of the role reversals and honest feedback from everyone involved. I found Jill's insight at the end of the session regarding the conceptualization of the problem, particularly the internal versus external solution (during the “no” practice), to be quite valuable. It was clear that Lee was facing conflicting desires - the need to act in the best interests of his clients while also seeking acceptance and approval. Taking the time to delve deeper into those internal factors may have further strengthened the effectiveness of the external solution (the “no” practice). Was helpful to see the miracle cure/goal clarified, as well as the 'acid test'. Good to see the model in action! I just enjoyed Lee's honesty , caring and professionalism. He brought up an issue that has been close to my heart as I worked with schizophrenic patients in clinic and day hospitalization settings and have experienced EXACTELY what Lee described. You feel between the devil and the deep blue sea when the medical staff conveniently toss responsibility to the less professional staff and when those in the trenches need to be there for the patients by saying NO. I LOVED David's comment about being disrespectful to patients with schizophrenia by going on and on with lofty brainy arguments while the loving thing to do is to be empathic stroking and firm. From my experience when I am real with my patients, they feel the best. Thank you, Lee, David and Jill. This was beautiful , heartwarming, and I am so touched to belong in this group. David and Jill's exquisite empathy, the Positive Reframe, and the NO practice. EVERYTHING!!! This was truly incredible! David and Jill are an unbeatable tag "TEAM!" Jill's warmth and empathy and teasing out the variables of Lee's story that were not always apparently obvious. Lee's vulnerability and seeing his depth and caring as a Psychiatrist was heartening and impressive. It helped me understand the flow of TEAM CBT and how things fit together better by seeing a live session from the beginning. I LOVED that Dr. Burns and Jill had to go down several different avenues to see what would work best. This closely reflects my own experience of therapy with my patients. Seeing them struggle a little made me feel even more sure that TEAM is the only approach that makes sense and cures people. This was a really wonderful session. I appreciate Lee volunteering, sharing with us his work challenges, and allowing us to see his kind and caring personality. I loved the masterful work of Jill and David. It seems to me that practicing responding to his patients with the use of the 5 secrets was imperative and I was amazed to see how that helped dropping down the feelings on the DML before we got to work on the Negative Thoughts. Once again, TEAM works like a charm! That this was a powerful real life issue that Lee shared. I enjoyed the empathy and how that led to sorting out conceptualization and miracle cure. David and Jill's combined efforts to go in many directions to help Lee see where he is stuck. I struggle in exactly the way Lee does in these sorts of situations, and it was so helpful and inspiring to me to see him do this work. Thank you, Lee! I was deeply moved by your deep caring for your patients and values around wanting your patients to have agency and understanding when there's so little in their world that they can control. I wish every psychiatrist had more Lee in him/her/them! I appreciate that Lee opened up himself in the group and I could observe the personal work of David and Jill, the amazing masters of TEAM-CBT. I admire Lee's compassion and warm heart toward his patients and I owed a lot to Lee who has very high standards to make things clear, just as he has done in his teaching in our Newbie group. And I think his sadness and anger might be an expression of his passion toward justice and dignity of his hospitalized patients. Appreciated Lee sharing with the group and doing personal work on a challenging problem. Liked when Jill brought up the internal versus external solution and then the session switched gears to work on the negative thoughts that made it so difficult for Lee to say no. Really enjoy the personal work, and getting to see the TEAM process unfold in skillful hands. I appreciate that you gave Lee time to explain his points, and that he was able to be truthful and disagree at times, and then you asked why and he explained further. This led to a more nuanced exploration and conceptualization of his issues and goals. I liked the focusing of a major part of the problem of "saying no" to a relationship / Five Secrets issue...resulting from internal and external shoulds. I appreciated the comparison with parent/child discipline, and not getting sucked into arguments. I also appreciate that you were able to pinpoint the problems around trying to get desperate, even schizophrenic patients, to understand one's point of view. It was great seeing the modeling of how to respond to some of these difficult patient situations. And how to clearly define the agenda when a patient is unclear about their goals. Also, so admiring of Lee. I liked how Jill and David navigated figuring out what Lee wanted to work on (when they came up with the three options). Issues that have "internal" and "external" components to them are difficult for me, and I often get confused. Seeing Jill and David work that out helps me wrap my head around how to go about it, thanks. Please describe what you learned in today's group. I appreciate Lee's vulnerability and I have so much respect for how he cares for his patients. I appreciated seeing the multiple role-playing attempts and was bummed when we ran out of time. I have so much admiration for Lee and feel for how much he's struggling. Personal work, externalization of voices, magic dial, Daily Mood Log (DML), 5 secrets, etc. How Five Secrets and No practice fit within the DML work That they could have started on the internal work of negative thoughts or the external work of "NO practice" TEAM at it's best! I observed NO practice and would like to learn more specifically about it ... Seeing the TEAM model unfold step by step in real time is always an incredibly valuable learning experience. Hearing Jill entertain potential directions to go in (i.e. crushing negative thoughts vs. No practice.) Learning challenging scenarios in context of "NO" practice was really awesome! Just magnificent overall! THANK YOU!!! Always feel so privileged to be part of this uniquely wonderful community of like-minded professionals! We are so lucky! I don't have to be smooth and have all the right answers immediately. This process is highly collaborative. How to employ the team model especially conceptualization and role play with NO practice and Five Secrets practice. How dealing with severely mentally ill pts can be so difficult. There's a sixth secret in effective communication: the willingness to use one's power in a kindly way to give the shot and get it over with. It's so helpful to me to add this secret to my armamentarium! Positive reframing and No practice, along with Externalization of Voices and Externalization of Resistance. I learned something about Lee, and about the difficulties of psychiatric hospital work for doctors! Also, seeing the process unfold skillfully, teasing out the problem to work on, Externalization of Resistance, Positive Reframing, Externalization of Voices, No/5 Secrets Practice, etc. How to be clear on agenda setting when patients are unclear on their goals. I was reminded about how to ask about a client's goal in order to guide agenda-setting. It was nice seeing the five secrets role-play / no practice. I've been inspired to start practicing daily like David said he did. Can never get enough of that!

A Second Visit to David and Jill's Tuesday TEAM Training Group at Stanford Last week, you “sat in” on our Tuesday training group at Stanford and learned about two of the four most important techniques in the treatment of perfectionism, or any other Self-Defeating Belief. (For a list of 23 common Self-Defeating Beliefs, click here.) The Cost-Benefit Analysis (CBA): You weight the advantages against the disadvantages of trying to be perfect. The Semantic Technique, to find out how to word your new belief if you decide that your perfectionism belief isn't working for you The purpose of those two techniques is to provide intellectual change. Tonight, you will join us again as we aim for emotional change at the gut level. This will be our agenda for the students in the class you will observe: 1. Please describe an example of a specific time when you felt upset due to perfectionism. What were your negative thoughts? How were you feeling? What was happening? 2. Downward Arrow Technique: Suppose you weren't perfect, or you failed or screwed up in some way. Why would that be upsetting to you? What would that mean to you. 3. Externalization of Voices (Optional: possibly we will do this, maybe just mention it, depending on time.) 4. Experimental Technique / Examine the Evidence 5. Feared Fantasy 6. Wrap-up and Teaching Points As you can see, some exercises will be performed in the large group, with everyone present and contributing, and some exercises will be in the small, breakout groups. The small groups provide more time for participants to practice. We plan on recording both of the small groups so you can observe the training techniques we use for mental health professionals. Last week our focus was motivational, so we asked: is to your advantage to aim for perfection? How will this mind set help you and how will it hurt you? Tonight, one of the key techniques will focus on TRUTH: is it TRUE that you need to aim for perfection? We will be using the Experimental Technique and / or Examine the Evidence to see if we can answer this question. In addition, we will go into an Alice-in-Wonderland Nightmare World and meet an imaginary monster who claims superiority because she or he really is perfect and really has achieved incredibly more than anyone. This can sometimes help us answer two questions: Is it possible to be or become a “more worthwhile” or “superior” human being? Would it be desirable if you could? I hope you enjoyed this new format of “dropping in” on my Tuesday training group at Stanford. Let Rhonda and me know what you think. It was just an experiment, and we want to know what you might have liked or disliked about it. Thanks! Our free weekly Tuesday and Wednesday training groups are open to therapists of all persuasions from all around the world. For information including the requirements, you can contact: Tuesday night training group with David and Jill, Contact Ed Walton: EdWalton100@gmail.com Wednesday mid-day group with Dr. Rhonda Barovsky and Richard Lam, Contact Ana Teresa Silva:  ateresasilva6@gmail.com

This week's podcast is about my visit to ByteDance, which is just a fascinating company. Lots of good lessons that I will be writing about. But here are the three things I think I was not appreciating or understanding.You can listen to this podcast here, which has the slides and graphics mentioned. Also available at iTunes and Google Podcasts.If you're interested in talking digital strategy and transformation for your business, contact us at TechMoat Consulting. ———Related articles:Can ByteDance Breach Alibaba's Infrastructure Moat and Become An Ecommerce Giant? (Tech Strategy – Podcast 82)Alibaba Takes Over Sun Art Retail. Is It Going to Take Off? Or Is It Infrastructure? (pt 1 of 2) (Asia Tech Strategy – Daily Update)Could Sun Art Grow +30% Under Alibaba? (pt 2 of 2) (Asia Tech Strategy – Daily Update)From the Concept Library, concepts for this article are:Externalization of Capabilities4 Terrains and StrategiesFrom the Company Library, companies for this article are:ByteDance -----------I write, speak and consult about how to win (and not lose) in digital strategy and transformation.I am the founder of TechMoat Consulting, a boutique consulting firm that helps retailers, brands, and technology companies exploit digital change to grow faster, innovate better and build digital moats. Get in touch here.My book series Moats and Marathons is one-of-a-kind framework for building and measuring competitive advantages in digital businesses.This content (articles, podcasts, website info) is not investment, legal or tax advice. The information and opinions from me and any guests may be incorrect. The numbers and information may be wrong. The views expressed may no longer be relevant or accurate. This is not investment advice. Investing is risky. Do your own research.Support the show

Live Therapy with Veena: Part 3 of 3 Relapse Prevention Training In the last two weeks, you heard Parts 1 and 2 of our live work with Veena, a young woman who felt devastated for fear she would be unable to conceive. One week after the work with Veena, I received a request from colleagues to have a Tuesday evening session at Stanford on Relapse Prevention Training (RPT). Jill and I decided to demonstrate the RPT techniques with Veena so we could demonstrate this technique in real time with a real situation. Prior to the role play demonstrations that you will hear, I presented the highlights of RPT with four PowerPoint slides. Here are the guidelines when working with a patient who is depressed: 1. Do RPT immediately when the patient has recovered, and before you discharge the patient. This means that the patient's scores on the Brief Mood Survey will be low and the patient is feeling terrific. If the patient's scores are still elevated, they have still not recovered completely, and need more therapy work. 2, Inform the patient that the likelihood of relapse is 100%. Relapse is defined as one minute or more of feeling upset. By that definition, most of us relapse frequently, perhaps every day. However, these relapses do not have to be a problem if you anticipate them and know how to deal with them. 3. When they relapse, they will typically experience two kinds of negative thoughts. First, the negative thoughts that had previously will return. So, in Veena's case, she will again be probably telling herself that “I cannot be happy without a kid,” “my in-laws will judge me and sideline me,” and so forth. Veena imagined having a relapse and prepared a Daily Mood Log prior to the training group. If you would like, you can review it here. 4. In addition, nearly everyone who relapses will have thoughts like these: This relapse proves that the therapy did not work. I'm a failure. I'm a hopeless case and I'll be depressed forever. When I thought I'd recovered I was just fooling myself. I've been he same worthless person the whole time. My recovery was just a fluke. It's crucial to challenge these thoughts with the Externalization of Voices technique ahead of time, BEFORE the patient relapses. That's because they can easily see the many distortions in these thoughts when they're in a good mood. But if you don't do RPT, and wait until the patient relapses, the patient may be devastated, or even suicidal, and you, the therapist, will have lost much or all of your credibility. In contrast, when I prepare the patient for relapse, I tell them that their first relapse will actually be a GOOD thing, because when they pull out of the relapse, then they'll know for sure that they have the tools they need to defeat their negative thoughts whenever they're upset for the rest of their life. And that is the crucial difference between FEELING better, which is what happens the first time they recover, and GETTTING better, which is what happens when they recover from their first relapse. I had them record their role-playing with me defeating their relapse thoughts with Externalization of Voices, and tell them to listen to that recording whenever they relapse. And that if they can't pull out of the relapse on their own, they can always come back for a session or two for a tune-up. I also tell my patients I hope they will relapse often, because if they don't ever relapse, I won't ever see them again, and this is a sad thought since I've just gotten to know them and really like them. When I was in clinical practice, relapses were rare. Only a handful of patients ever returned for a tune-up, and it was almost always one or two sessions and then they were on their way again. Of course, this was not a controlled outcome study, since I was in private practice, but  it was definitely encouraging. In summary, RPT can save you from a lot of grief when your patients relapse, and it may even save the lives of some of them. It doesn't take long, 30 minutes or so at most, but the payoffs can be tremendous. Thank you for listening today! Veena, Rhonda, Jill, and David

Live Therapy with Veena: Part 2 of 3 Last week you heard the first half of the session with Veena, a young woman who was devastated by a medical problem that may make it difficult or impossible to conceive the child she is dreaming of. Today, you will hear the inspiring and dramatic conclusion of her story, along with the feedback comments from the individuals in David and Jill's Tuesday training group who witnessed the live work. A = Assessment of Resistance Jill asked if she felt ready to roll up her sleeves and get to work on some aspect of what she'd been telling us, and she was. Jill then asked what she was hoping to get from tonight's session. If we could offer a “Miracle Cure,” what would that look like? She said, “I'd feel a lot less guilty and responsible, so I would no longer feel like the problem was my fault. I'd know that I did my best and that I can be okay even if people don't like me or judge me. Jill asked the Magic Button question, and she said that she love to see her guilt go all the way to zero, but not her many other negative feelings, like depression, anxiety, inadequacy, self-consciousness, hopelessness, upset, insecurity and self-doubt. With Positive Reframing in mind, we listed many of the positives in these negative feelings, including: Sadness. This feeling shows that I care for people and want to give them the best. It shows that I also care for my own dreams of having a baby. And it shows how much I love my mother. Anxiety, worry. This is a warning signal, reminding me to be alert and do my best, and do what the doctors require. Guilt. Shows that I'm humble and willing to be accountable and examine what I've done and look at my own mistakes. Self-Consciousness. Protects me by making me cautious so I don't just blurt out everything. Defectiveness. I see my flaws, and allows me to get closer to others, and to feel happy for the success of others. Hopelessness. When I told my husband I felt hopeless, he became SO supportive. Also, I gave myself some space so I could create an action plan. You can see the goals Veena set for each emotion on her Daily Mood Log if you click HERE. Veena with her in-laws M = Methods During the methods phase of the session, we used a variety of techniques, especially Externalization of Voices with the Acceptance Paradox, Self-Defense, and the CAT (Counterattack Technique.) We did quite a few role-reversals, which is typical, before Veena got to wins that were “huge.” There were lots of tears and laughter, and eventually Veena blew all of her negative thoughts out of the water. It was inspiring to observe this process, and to be a part of it. You can see her final Daily Mood Log if you click HERE. I think it is fair to say the Veena experienced a kind of enlightenment which was profound. Final T = Testing You can see Veena's end-of-session Brief Mood Survey and Evaluation of Therapy Session if you click HERE. You can also see her final Daily Mood LOG if you click here. Our work with Veena was some of the most inspiring work that I can recall. It was tremendously mood-uplifting, and took on a spiritual quality. You will have to listen to the session to get a feel for how majestic it was. But in my opinion, Veena did not just recover, but she achieved enlightenment, which including discovering how to love herself and her extended family as well! The following is an email I sent Veena the next morning: Hi Veena, Thanks. You were totally awesome last night, thanks so much for your contribution. I am sure the podcast will reach huge numbers of people and make a big impact on peoples' lives. I cannot remember a more exciting and loving session. We will see what the groups thinks in the feedback. I did not copy or read the chats during the session, but perhaps you or Jill did. . . We will invite you to join us on a podcast recording to get some follow-up information from you, as folks will be very interested, for the two-part podcast. Yes, I think we really were walking on holy ground last night! Thanks so much for making that happen! I am trying to recall (and will do more of this) the teaching points from last night, and a few seem important to me. They seem awfully basic and simple, but still of towering importance and have to be “seen” to be understood at a deep level. 1. In TEAM, even when a problem is “real,” it is still our thoughts that create our emotions. Our thoughts really DO create all of our feelings. 2. Those thoughts can be subtly distorted in all kinds of ways and seem determined to trick us into believing things that are not true. And even super smart people, like Veena, can be fooled. 3. We are not aiming for improvement, although that is obviously desirable, but a dramatic transformation of the human spirit and outlook. 4. Warmth, tenderness, and compassion—for others and for yourself--are important and powerful. 5. There is a strong mind-body connection, and healing your soul can often help to heal your body. 6. Good therapy can sometimes be much more than just “therapy.” Something almost magical can sometimes happen, and the change can sometimes happen rapidly. However, many people do not like hearing this, and some are even angered by this idea! This is especially true of people who have suffered and struggled for many years without success in changing the way they think and feel. 7. Recovery sometimes requires courage and trust. Just more babbling from the old guy! Apologies if it sounds ridiculous or “off.” If other teaching points come to mind, please let us know so I can add them to the list! I am betting that Jill and Veena can maybe add to this list! (and edit it as well) Warmly, david Below, you will find some excepts from the feedback that the participants provided after the session. Please describe what you specifically disliked about the training? What could have been improved? Were there some things you disagreed with or did not understand?  Nothing. It was beautiful. I wouldn't want to change anything about tonight's experience. It was so moving! Please describe what you specifically liked about the training? What was the most helpful? Were there some things you learned? I loved Veena's personal work and besides my admiration and pride of her and the gratefulness to David and Jill for sharing this wonderful work . . . I enjoy the empathy and validation as well as the trust in the process that was so beautifully demonstrated. Beautiful job by all concerned. Very impressed with Veena and how clearly she "got it" when she used the CAT (Counterattack Technique). I was very moved by Veena's story and her courage in sharing it with us. I felt as if we were witnessing a kind of history because, in the past, wives who couldn't bear children were often devalued and even rejected. Veena pushed back against that kind of thinking and instead chose to love herself. By working toward dispelling the distorted thoughts, she affirmed not only herself, but women with similar experiences now and throughout history. When she affirmed that her mother, mother-in-law, and husband would be empathetic and wouldn't actually reject her, I felt elated, thinking that the world is making progress and becoming a more compassionate place. I was also touched by the following ideas: feeling genuine sadness without distortions; locating the source of pain in distorted self-critical thoughts; painful experiences bringing loved ones closer together. The safe space that was created, the sensitivity with which the topic was handled and the respect accorded to the client. It's incredible how the trainers (Dr. Burns & Jill), set aside their ailments, and were with Veena through her journey of anticipatory loss, and her fears and apprehensions, along with her inner battle of dealing with deeply entrenched social conditionings, that are hard to face and ward off. I loved the session. Enjoyed watching the whole team model unfold. I'm so grateful to Veena for sharing this previous part of her life with all of us. It was a huge honor. I am constantly surprised by Dr Burns' and Jill's mastery of TEAM and their deep empathy skills. This was moving and exhilarating…all at once. Observing two great therapists in action. I liked how Jill and David would make notes to the class about what step they were going on to next. Veena was so amazing and brave to share her experience. As a 23 year old woman with fears of fertility issues myself due to genetics, I found the experience extremely profound and impactful on a personal level. It was awesome to go from the NEWBIE group to this session whereby a lot of the skills we were learning individually were incorporated sequentially into the session. Thank you to everyone!! I liked seeing david and jill go through the entire team model. I liked the pointing out of the Emotional Reasoning distortion and even using the straight forward technique. Excellent! I really liked seeing an entire session completed in one sitting. A very beautiful night. I really felt for Veena and what she is going through, and it was great to see her recovery. David and Jill were empathic and so knowledgeable. The humor in dark moments. the tears from time to time It was exciting to see how as Veena shed the self-blame, simultaneously she was able to see the people in her life as the caring, kind people she knows them to be--and no longer to feel afraid that they would reject her. Accepting herself allowed her to see others as accepting, and not critical. What training could be better than watching David and Jill tag TEAM thru the model! Thanks to Veena's willingness to be vulnerable and her bravery doing this personal work and inviting us all into her world and her pain. It felt like we were all a web of love and support surrounding her and a privilege to get to know her. It was extraordinarily rich and illuminating. I loved everything: the incredible empathy Jill and David demonstrated and how things were turned around for Veena. I was amazed that this was accomplished in such a short period of time; I always am when it comes to live work! I also loved knowing Veena more and seeing how wonderful of a person she is; I have so much admiration for her!!! Incredible empathy and 5 secrets from both Jill & David! So much warmth and love from the group. Seamless incorporation of the steps & methods. Please describe what you learned in today's group15 responses DML at it's best!!!! TEAM-CBT, done by skillful therapists, with open and vulnerable client, can be such a gift! I learned again how to go through the entire team-CBT process of crushing negative thoughts and helping clients to feel better. There were so many moments of subtle shifts by Jill. Each one of them were penny drop moments for me. . . Thank you both. That people have a lot of beautiful qualities. I felt I learnt anew the power of empathy and the importance of asking our clients specifically what caused the change. Thank you so much Veena. I got some therapy by proxy tonight. I felt myself take a kind of journey with you from fearful for you, and judgmental (of your aunties!) to warm and open and loving - by witnessing your transformation. A better understanding and appreciation of the entire team model and using that for a real life situation. More of the artfulness and symphony of the steps being followed with empathy being woven again and again throughout and bringing out the birth of what is really true about the self, mother, mother-in-law, and husband rather than the assumptions and self-deprecation. On how to get from T to M with E and A in the middle! I loved David's insight that this is what it means to be in a loving relationship--to hurt at times. So wonderful to get to watch Jill move through TEAM in her warm, empathic, brilliantly thoughtful way, with David interweaving his work of genius!!! So grateful to be part of this incredible community! Thanks so much! The importance of Thought Empathy and flexibility with using different techniques, as I tend to be quite rigid. For example, I love how David went right into EOV which I believe would work wonderfully with someone who knows TEAM well. It definitely did work for Veena. So very helpful to see TEAM in action in its entirety by the masters of TEAM CBT! Thank you for listening today! Veena, Rhonda, Jill, and David

The season finale of RadioEd is finally here! This week, Matt chats with Rebecca Galemba, an associate professor at the Joseph Korbel School of International Studies, who specializes the intersections of globalization, illicit markets, migration, security, and labor in Mexico, Central America, and the United States about what Title 42 is and what are its implications, both to immigrants who seek to live in the United States and as a political mechanism.Matt and Rebecca also talk about how Title 42 changed from Trump's administration to Biden's, and how the government has treated immigrants throughout the years, with policies such as Title 8, and what that could mean to future immigrants seeking asylum in the United States. Galemba also tackles the hard topic of the Externalization of Borders the United States and other countries sometimes resort to, which, according to her, can be seen as neglecting their responsibility to take in asylum seekers.Rebecca Galemba, Ph.D., is an anthropologist who studies the intersections of globalization, illicit markets, migration, security, and labor in Mexico, Central America, and the U.S.She teaches graduate and undergraduate courses on Qualitative Research Methodologies, Cultures of Development, Migration, and Illicit Markets. Through research, teaching, and community-engaged work, she draws on interdisciplinary approaches to enhance the public good and contribute to studies of social inequality in Latin America and the US. She is professionally affiliated with the American Anthropological Association, the Latin American Studies Association, the International Studies Association, the Guatemala Scholars Network, the Society for Applied Anthropology, and the Society for Economic Anthropology. More information: Laboring for Justice: The Fight Against Wage Theft in an American City: https://www.amazon.com/Laboring-Justice-Fight-Against-American/dp/1503635201Center for Immigration Policy and Research: https://cipr.du.edu/ The DU Just Wages Project: https://dujustwagesproject.wordpress.com/ Migrants Deported to Mexico Face Criminals and Predatory Officials: https://www.nytimes.com/2023/05/12/world/americas/migrants-deported-us-mexico.htmlUS authorities ‘seeing large numbers of migrants at border' before Title 42 expiration – as it happened: https://www.theguardian.com/world/live/2023/may/11/title-42-expire-republican-immigration-biden-trump-town-hall-politics-live-updates ‘The border is not open': US immediately replaces Title 42 with strict new rules: https://www.theguardian.com/us-news/2023/may/12/us-mexico-border-biden-new-immigration-rules-restrictions What is Title 42, why is it ending and what's happening now at the border: https://www.cnn.com/2023/05/09/politics/title-42-ending-whats-next-explainer-cec/index.html 

Featuring Matthew May, MD Today, Part 1. The Inner Bully Next week, Part 2. The Outer Bully There are two types of dialogues that can get us in trouble. The first is your “Inner Dialogue.” Your Inner Dialogue sometimes consists of negative thoughts and perceptions of yourself and the world, which are often dominated by the familiar cognitive distortions that trigger internal mood problems, like depression, anxiety, guilt, shame, inadequacy, loneliness, hopelessness, and more. Examples would be “I'm a failure because . . . “ or “I should be better than I am,” or “I'm really going to blow it when I give my talk, and a myriad of variations on these themes. Your Inner Dialogue often consists of mean-spirited things you say to yourself, much like the schoolyard bully who intimidates younger, weaker children. The only difference is that you are doing this to yourself, often without noticing or realizing  what that voice inside your brain is up to. When you challenge and crush these distorted perceptions, you can CHANGE the way you FEEL. Your Outer Dialogue consists of the things you say when you have with interactions with other people, and this can be especially important when you're dealing with others who are critical of you, or even threatening you with violence.  The strategies are quite different from the strategies you might use to challenge and defeat your Inner bully. Today, Rhonda, Matt and I will demonstrate various strategies for defeating the Inner Bully. Next week, in Part 2, we will demonstrate strategies for defeating the Outer Bully! Those strategies, in extreme cases, might even save your life one day, as you'll see next week. Rhonda starts the podcast by reading an awesome comment by certified TEAM-CBT therapist Dan Prine, who commented in a kindly way on podcast 334, where we interviewed Michael Yapko on hypnosis. Then we focus on multiple techniques to challenge two negative thoughts with a variety of strategies. The first negative thought is one we've seen on a number of occasions from women who had abortions as teenagers, and then experienced extreme depression and guilt later in life because of their thought, “I'm a bad person because I murdered my baby.” Using role-playing, we illustrated E = Empathy, using the Five Secrets of Effective Communication, followed by A = the Assessment of Resistance, using the Magic Button, Positive Reframing, and Magic Dial, followed by M = Methods. Methods included Examine the Evidence, the Double Standard Technique, the Externalization of Voices (with Self-Defense, the Acceptance Paradox, and the CAT, or Counter-/Attack Technique, along with the Socratic Technique, and more. Then we focused on a thought familiar to Rhonda during moments of insecurity and self-doubt: “I don't matter!” This thought has plagued Rhonda since she was a child. She recalled her father often saying, “c"Who are you? You don't matter!" She told herself, “he's saying that because I don't matter.” Even the memory causes great pain and agitation. Of course, on some level, her father's comments never had any effect on her. Only your thoughts can cause you to feel one way or another. But this was devastating to Rhonda because she believed what her father said, which is understandable, and those thoughts caused the pain. We again illustrated many approaches to challenging this thought, but one of the techniques that was most helpful was the CAT. During the Externalization of Voices, the Positive Rhonda said this to her Inner Bully: “I'm not going to listen to you anymore! I've had enough of your BS!” Thank you for listening today. Remember to tune in to the Outer Bully next week! Rhonda, Matt, and David

Mariusz and his wife, Aleksandra, who is also a psychiatrist. Personal Work with Mariusz, Part 2 Mariusz and his wondaful family. Last week, you heard Part 1 of the personal work that Rhonda and I did with Dr. Mariusz Wirga, which included initial T = Testing and E = Empathy. Today, you'll hear the conclusion of our work, including the Assessment of Resistance, Methods, final Testing and follow-up. I am repeating this darling photo Mariusz's beloved cat, with his tail strait up, showing pride and love for Mariusz! Orangina at her favorite scratching post, with tail straight in the air to show pride and love for Mariusz!  A = Assessment of Resistance Once we empathized, we issued a Straightforward Invitation, asking Mariusz if he needed more time to talk and have us listen, or was ready to focus on the problem and see what we might do to help. Mariusz wanted to get to work, and said his goal for the session was to reduce his perfectionism, but when I asked the Magic Button question, he said he would not press it, even if the Magic Button would bring about a sudden and dramatic elimination of all of his negative thoughts and feelings. So, together, we listed the many positives and advantages of his negative thoughts and feelings, including: My anxiety keeps me on my toes. My feelings of inadequacy keep me humble. My hopelessness protects me from disappointment in the session with Rhonda and David isn't effective. My hopelessness and loneliness show how much I care. My hopelessness shows how helpless I feel to free myself from the many pressures and heavy weights I have been carrying for many years. My negative thoughts and feelings show how much I care for others, including my wife and kids. My suffering with depression and anxiety increases my compassion and understanding of my patients who are suffering and frightened. My anxiety protects me from danger. My anxiety is motivating. My self-criticisms show that I have high standards. My loneliness shows that I welcome intimacy and close relationships. My sadness shows that I am realistic and willing to look at the dark side of life. As you likely know, this process is called Positive Reframing, which is looking at the positive side of things that appear to be negative. Effective Positive Reframing isn't just listing positives from a list or book, like Feeling Great,  It's suddenly “seeing” something that you hadn't previously realized, and having an “ah-ha” moment. So, I asked Mariusz if he could see any additional positives in his fairly intense feelings of sadness and depression. To help him, I primed the pump a little bit by pointing out that sadness and depression are the feelings you have when you've lost something or someone your really cared about, or when you notice that something incredibly important is missing from you life. At this point, Mariusz became tearful and said he'd been very lonely as a child. Saying this gave him a “choking pain.” But he said he always turned away from his pain, and distracted himself, with work and activities. He said “I was an obedient child, and I was an only child. Both of my parents worked. “You say something is missing. I think what is missing is life I'm too busy. I'm always distracting myself. But I'm afraid that if I slow down, I won't be able to pay my bills. I believe that 95%. Then I'll be a burden. I'll lose the respect of my family.” At the end of the Positive Reframing, he set his goals for the session, which you can see if you click on his Daily Mood Log again. As you can see, he did not seem to want to reduce his feelings to super low levels, which was surprising to me. M = Methods Rhonda suggested we could do a Feared Fantasy and asked what he thoughts others would think about him, but never dare to say, if he did slow down and they judged him. They'd think: You're unreliable. We won't include you anymore. We hate you. We reject you. We'll tell the world about you. And his worst core fear was ending up in a homeless camp. We did role reversals using the Feared Fantasy Technique until he hit the ball out of the park, and did the same using the Externalization of Voices to defeat the negative thoughts on his Daily Mood Log. When you listen to the session, you'll see that there was a lot of tenderness at this point, and we discussed our love for cats, and what we can learn from them—the joys of being average and loved and loving your life. We gave Mariusz several homework assignments: Finish your Daily Mood Log in writing, completing the Positive Thoughts and make sure you've crushed all of you negative thoughts. Experiment with being open and vulnerable with loved ones (wife and family) as well as colleagues. Practice saying no to colleagues who make requests on your time, and cut down on activities that are not cost-effective. T = End of Session Testing You can find Mariusz final Daily Mood Log if you click HERE, and his end of Session Brief Mood Survey if you click HERE, and his Patient's Report of Therapy Session if you click HERE. David, add three links when you get documents. Rhonda and I wish to thank you, Mariusz, for a brave and touching session! You gave me the chance to process some of my own perfectionism, and to express my gratitude once again for the stray cats that my wife and I have adopted who have taught me so much about love, acceptance, and the simple things in life! Follow-Up I emailed Mariusz to find out what happened when he decided to become more open and vulnerable with wife, patients, and colleagues. He wrote back: Right before the Eureka moment, there is this state of dense confusion. So I was hesitant about where to go, but there was no visible path to choose yet. It feels like your brain is not getting it. It feels dense, also in an intellectual way. Like your brain stops working. It is quite dark and heavy. And then suddenly, the tears come and things become clear and light (in the sense of brightness and lifted weight). And that you all for listening today! Last month, January, was our biggest month so far, with more than 182 thousand downloads of Feeling Good Podcasts, and this is due, in large part, to your support of our efforts and sharing the show with friends and colleagues who might benefit from it! Thanks again, Mariusz! You are shooting into orbit! I'm SO proud of you and happy for you, and grateful to have had the chance to get to know you on a deeper and more human level, and to share a little of myself with you, too! Several days later, he sent me three addition al Negative Thoughts for his Daily Mood Log. They are touching, take a look at how he challenged and smashed them! Warmly, Rhonda, Mariusz, and David

Ask David: Featuring Matt May, MD What causes anxiety? Is recovery permanent? What if the cognitive distortions aren't helpful? Do hormones cause anxiety and depression? What's the role of vitamins and nutrition? How do Exposure and Response Prevention work? And many more answers to your questions! In today's podcast, three shrinks discuss many intriguing questions about anxiety from individuals who attended one of Dr. Burns' free workshops on anxiety sponsored by PESI more than a year ago. Several of the questions were answered on the podcast, and a great many more are answered in the show notes below. But first, Rhonda opened the podcast by reading an endorsement from a listener named Rob, with a link. Here it is! Hi Dr. Burns: I'm a long-time listener/reader, first-time caller. I stumbled upon this endorsement for Feeling Good today, and I thought it was worth sharing with you. I can't think of a better endorsement for a book. I hope you enjoy it! "I've replaced my copy close to ten times, as I keep lending it to friends who never give it back." https://girlboss.com/blogs/read/feeling-good-david-burns-review Have a great day! Rob Thanks, Rob! And now, for the many excellent questions submitted by listeners like you! Many were answered in depth on the podcast, but you'll see that all questions have written answers as well. When you talk about someone recovering, is that free of panic attacks and anxiety forever, or a great decrease in symptoms but you will always be an anxious person to a certain extent? Especially for someone who has fundamentally been anxious since they were young so not episodic but continuous. David's Answer. Some people are anxiety-prone, and that is likely due to a genetic cause. I am like that, for example. Once you are 100% free of any form of anxiety, like my public speaking anxiety, you need to continue with exposure, or the old anxiety will try to come creeping back in. So, I do public speaking all the time! What if your client/patient understands the Cognitive Distortions but doesn't believe them to be true? David's Answer. It is hard for me to comprehend what you mean. But I will say this. Anxiety and depression and other negative feelings result 100% from distorted negative thoughts. And the exact moment when you stop believing the thought that's triggering your anxiety or depression, you will almost instantly feel relief. And here's the precise answer to your question. When someone says, “I understand the distortions but it doesn't help,” they still believe their negative thoughts. Resistance, too, is an issue. Nearly 100% of therapeutic failure results from jumping in and trying to help the patient without first comprehending the many reasons why the patient will fight against the therapist's efforts to “help.” Has research been done on the possible relationship in hormone levels in women and anxiety or depression? Especially during pregnancy, post pregnancy, and those going through menopause? Also, can negative thoughts also depend on the person's nutrition? Could it be that vitamins that are lacking? David's Answer.  First, I am not aware of any convincing evidence linking hormone levels with depression, anxiety, irritability, or any other negative feelings. However, we can say with certainty that whatever the cause, which is unknown, distorted thoughts will always be present and will be the trigger for the negative feelings. In or near the first chapter of my most recent book, Feeling Great, I describe case of post pregnancy depression, and you can take a look and see the mother's negative thoughts clearly. And you will also see that the moment she crushed those thoughts, her depression disappeared! People want to “biologize” emotional problems, and I started out as a “biological psychiatrist” and researcher, but found the biological explanations to be erroneous and unhelpful. Could you please give a brief overview about Exposure with Response Prevention for OCD treatment.  Thank you! David's Answer. Sure, these are tools that can be helpful, along with many other kinds of tools, in the treatment of anxiety, including OCD. They are not, for the most part, treatments. I use four models in the treatment of every anxious patient: the Motivational, Cognitive, Exposure, and Hidden Emotion Models. Exposure is facing your fears and enduring the anxiety until the anxiety subsides and disappears. Response Prevention is refusing to give in to the superstitious rituals OCD users when anxious, like counting, arranging things in a certain way, and so forth. END OF QUESTIONS DISCUSSED LIVE ON THE PODCAST The answers to the questions below were written by Dr. Burns but not discussed on the Podcast. Questions can I ask to overcome the Cognitive Distortion “jumping to conclusions”? That is the toughest for me. David's Answer. I would need a specific example. Jumping to Conclusions includes a vast array of topics and negative thoughts. Fortune Telling and Mind Reading are the most common forms of Jumping to Conclusions. Feelings of hopelessness always result from Fortune Telling. All forms of anxiety always result from Fortune Telling as well. Social Anxiety typically includes Mind-Reading, and Mind-Reading is almost universal in relationship conflicts. In addition, I never treat a distortion, an emotion, a diagnosis, or a problem. I treat human beings systematically, using the T E A M algorithm. Matt's Answer. There are many methods in TEAM that can be applied in the form of a question. These methods and how they are carried out, depends on the circumstances and the specific thoughts a person is having. Below are some examples of negative thoughts (NT's) and the types of questions that might help overcome them. (NT): ‘Something really bad is going to happen'  (Be Specific Technique): ‘Like what? What's going to happen?'  NT: ‘I'll fail my biology test'  What-If Technique: ‘What if I failed my biology test, why would I be worried about that? (write down any new thoughts) What if those things happened, too, what then? (write down any new thoughts) What's the absolute worst thing that could happen? (write this down).  Measurement: How certain am I, that these things will happen? On a scale from 0 – 100%, how likely are each of these predictions, in the form of negative thoughts, to occur?  Socratic Outcome Resistance: What do each of these negative thoughts say about my values that I can feel proud of? (write these down) What is appropriate about how I'm feeling and thinking? (write these down) What are the advantages of having these thoughts? (write these down). What would I be afraid of, if I didn't have this thought? (write these down)  Pivot Question: Given the many positive values related to worrying, the advantages of doing so, the disadvantages of a carefree existence and the many reasons why my worry is appropriate, why would I change this?  Forgetful Clone (Double-Standard Amnestic Technique for Outcome Resistance): What would you say, to a dear friend, in an identical situation, when they asked these questions: ‘I'm really worried about failing my biology test, would you be willing to help me? (if ‘yes', then continue) … Don't I need to keep worrying? Won't that protect me from failing? Don't I need to worry, so that I'm highly motivated to succeed? Don't I need to worry, so I avoid making mistakes? Don't I need to worry, to maximize my rate of learning new material? Won't I get lured into a false sense of security, if I stop worrying? Won't I jinx it, if I get too confident? What would you recommend to me? How much do you think I should worry? I am prepared to do so … would it be helpful for me to go into a sustained panic, at this time?'  Cost-Benefit Analysis: Is worrying about failure worth the price? How would you weigh the advantages of worrying about failure against the disadvantages? What are the pro's and con's? How would you divide 100 points, to reflect the power of these two arguments?  Examine the Evidence, Motivational: What evidence is there that worrying improves academic performance, concentration and learning? What evidence is there that worrying worsens academic performance, concentration and learning? Magic Dial Question: ‘‘Should I remain maximally worried, at all times, forever? (If not, keep going) 'What amount of worry is best, for me, in this moment?', ‘How about future moments? How frequently do I need to worry and for how long?'  Process Resistance for Activity Scheduling, Worry Breaks/Cognitive Flooding, Self-Monitoring/Response Prevention: ‘Would it be alright to ignore my worry most of the time and only focus on it during scheduled times? Let's say I could learn how to be extremely calm and focused most of the day, without worry … would I be willing to worry as intensely as possible, for ten minutes, three times per day, to achieve this? When my worry comes up at other times, would I be willing to observe and record that event, then return to the task on my schedule?  Socratic Questioning: Am I absolutely certain that this thought is true, that I will fail? How do I know that I will fail? What specific questions will be on the Biology test that I will get wrong? What number grade will I get? A 60? 58? 39?', ‘Would I bet money on my getting precisely that grade? Why not?'.  Examine the Evidence (cognitive): ‘What evidence is there that I will fail? What evidence is there that I will pass?  Reattribution: Let's say that I fail. Would that be entirely my fault? Are there any other factors, outside my control, that might have contributed to this outcome? My genetics, for example? Or the nature of the world, into which I was born? Did I choose my genetics? Did I choose the world into which I was born, when I was born, my parents, teachers, etc.? Could any of these factors have played any role in the outcomes in my life?  Other examples of Inquiry-based methods, using different NT's:  Negative Thought: ‘People will be angry and judge me, if I fail'  Interpersonal Downward Arrow: ‘What kind of people are they, if they judge me and look down on me, when I fail? How would I feel towards those types of people? Is it possible I feel angry? How do I express that feeling? What ‘rule' am I following, in my relationships?'  Outcome Resistance: What's good about me, for feeling anxious, rather than angry? What are the advantages of keeping my feelings inside? What would I be afraid of, if I expressed my feelings?  Process Resistance, 5-Secrets: Would I be willing to spend the time to learn the skills required to express my feelings, including anger, to people, in a way that made them feel good?  Negative Thought: ‘I'll get sick and die'  Be Specific: ‘When? What time of day will that occur? What illness is going to kill me?'  Negative Thought: ‘I'll lose my mind, crack up and go crazy'  Examine the Evidence: Has that ever happened to me? When was the last time? When you are working with clients, how do you handle it when they can challenge their thoughts very convincingly using a variety of techniques, state that they can see the logic in their restructured thought BUT they are still experiencing heightened anxiety and state that this hasn't helped them? David's Answer. They still have a strong belief in their negative thoughts. It is 100% untrue that they have “challenged them very convincingly.” Here's an example. Let's say you have an intense fear of glass elevators. You will say, “I can see that they are unsafe, but I am still terrified of going in one.” The moment you get on the elevator your belief that you are in danger will suddenly skyrocket to 100%. In other words, you still believe your negative thoughts. Of course, it is nearly always easy to overcome phobias, including an elevator phobia. As stated above, I use four models in treating every anxious patient. Simplistic formulas are just that—Simplistic! Treating humans is not like changing the oil in your car! Matt's Answer: I am hard pressed to add anything of value to David's awesome response, above. I might just reiterate that the Cognitive model, challenging the logic behind negative, anxiety-producing thoughts, is the least powerful of the approaches we have to anxiety. It is necessary, but almost always insufficient. Exposure, motivational methods and Hidden emotion are the real heavy-hitters. Until trying these, it is likely that the negative thoughts can be disproven ‘intellectually' but not at the emotional level. How do you work with clients who state they are anxious all the time, experience strong somatic symptoms (body sensations) and cannot identify specific thoughts. They don't catastrophize these somatic symptoms but really, really dislike them and want them gone! David's Answer. I just ask them to make up some negative thoughts. That works well. For example, they may have the belief that the anxiety must be avoided because it may never disappear, or may believe that they are on the verge of going crazy, and so forth. Matt's Answer, Anxiety can cause people's brains to shut down, experiencing the ‘deer in the headlights' phenomenon. Try to identify just one upsetting thought, then use the ‘what-if' technique to expand on that. You'll be off and running! How do you do techniques with a person who has active suicidal thoughts? David's Answer. I don't “do techniques.” I find out if they're actively suicidal and in danger. If I know for certain that the person is safe, I treat them like human beings, with T E A M. I'm not a formula person. Each person will be different, and will respond to different methods. My books and podcasts are chock full of examples of actively suicidal people who responded. Matt's Answer. I let them know that I don't have the skill to help them unless I know they're safe. If I'm worried for their safety, I'll be afraid to use aggressive methods that may be required for them to recover. I'd need them to convince me of their safety before agreeing to work with them. If they can do so, I offer TEAM. If not, I ask if they're willing to escalate the level of their care, e.g. to meet with me while hospitalized in a safe setting. I don't work with patients who are at risk of harming themselves because I don't believe in my ability to be helpful to them. Is it really okay to keep continuing the experimental technique when the patient does not want to continue? And, what if the therapist is not confident and something goes wrong in this situation? David's Answer. I would need a specific example, but you are right that 75% or so of therapists are afraid of exposure and will not use it, fearing that something will “go wrong!” Matt's Answer. It's important to identify the resistance before initiating the method of exposure and to talk it through. Why would they not want to continue? What are they afraid of, if they get really anxious, during exposure? Write this down. Then, surrender, acknowledging that these are some excellent reasons to avoid exposure, in which case we can't help them with their anxiety. Perhaps there's something else they want help with? If they can convince you, and themselves, that exposure is precisely what they want to do, and they're willing to keep doing it, even if it makes them very anxious, it's appropriate to push a bit, in the moment of their doing exposure, to bolster them and help them through the rough patch. That said, I always give my patients a way out, if they don't want to continue. That's their choice, I just want them to be aware of the consequences, including a worsening of their anxiety. When doing experimental method, or the exposure method for example with who has sweating issue, how do you handle the hyper-vigilance he would have with people around, especially if someone actually laughed at him? David's Answer. I would use the Feared Fantasy Technique, and Self-Disclosure. I would likely go with the patient into the real world to do these things, and have done so on hundreds of occasions. How would you work with someone who suffers from  Selective/Situational Mutism? David's Answer. I have not run into that in my clinical practice. But 100% of the time, I would want to know what the patient's agenda is. I would also want to know if there are powerful motivational factors that need to be addressed, looking at the whole person rather than the symptom. How different are Team CBT treatments for teens as compared to adults? David's Answer. My experience is limited, but I would say no difference, really. I have loved working with teens, even though my main focus was on adults. When working with little kids, I think you need to incorporate play and games, although the basic concepts are the same. For example, you can do Externalization of Voices with puppets, the “Bad, Mean Self” and the “Positive, Loving Self,” or some such. We have featured shrinks who work with kids on many times on our podcasts. Thanks for joining us today! Matt, Rhonda, and David

"Overcoming Toxic Shame" Join Dr. Jill Levitt and me  at our fabulous new workshop Sunday, February 5th, 2023 8:30am - 4:30pm PST - 7 CE units Click here for information and registration In today's podcast, David and Jill describe their new workshop on Overcoming Toxic Shame. This workshop will feature video snippets from a fantastic session with a beloved colleague named Melanie who struggled with intense feelings of anxiety and shame for more than 8 years. You will see her transformation from utter despair to joy in a single therapy session lasting roughly two hours, and you will get the chance to learn and practice the techniques that were so transformative for her. Most mental health professionals also struggle with feelings of shame because of their belief that they aren't "good enough" and from fears of being found out. You will have the chance to heal yourself while you master cool new techniques to transform the lives of your patients! In today's podcast, David and Jill do a live demonstration of a couple of the many techniques they will illustrate on February, which will include the Paradoxical Double Standardl Technique, Externalization of Voices, and the Feared Fantasy. You will not only witness a remarkable change in Melanie, as well as a sudden, severe and unexpected relapse half way through the session. David ang Jill will ask, "If you were the therapist, what would you do right now?" What follows is AMAZING! Jill practices and serves as the Director of Training at the Feeling Good Institute in Mountain View California. She is also co-leader of my Tuesday evening weekly training group at Stanford (now entirely virtual). This group is totally free and is available to mental health professional in the Bay Area and around the world. You can reach Dr. Burns at david@feelinggood.com.

How Skillful is your Shrink! Now you can find out! The Exciting Recovery Coefficient-- and the FEAR the grips the hearts of the therapists who are afraid to use it! People often wonder how skillful or effective their therapist is, but until now, there was no very valid or precise way to know. But now there is, and it has fantastic implications for psychotherapy. Today, we feature an interview with Kevin Cornelius, a therapist at the Feeling Good Institute in Mountain View, California.  Kevin Cornelius is a Licensed Marriage and Family Therapist in private practice at Feeling Good Institute, with in-person counseling for teens .Kevin is a Certified Level 4 Advanced TEAM-CBT Therapist and Trainer. I asked Kevin to write a brief description of his evolution from a career in acting to his career as a shrink. Here's what he wrote: After many years of working as an actor I was ready for a change. After some painful personal events, I saw a therapist who was quite helpful to me. She helped me see that changing to a career as a therapist could be a great thing for me. I went to school and got my Master's in Marriage and Family Therapy. Just before I began applying for internships to complete licensure, I learned that the children's theatre group I had grown up in was looking for a new supervisor to lead the group following the death of its beloved founder and leader. This was a wonderful opportunity for me to use my theatre skills and my desire to help young people in their growth and development. I was very fortunate to be hired and worked as the director of the children's theatre group for 19 years. Towards the end of my years with the children's theatre, I was ready for a change and thought it might be time for me to finish getting my therapy license. It had been 15 years since I had worked with a patient in a therapy session, so I had a lot to learn! I was so lucky to discover David Burns and his amazing TEAM-CBT. The testing element of TEAM enabled me to see right away where I needed to improve so I could focus my efforts on improving specific skills. Being able to study with David in his Tuesday group at Stanford was a golden opportunity. Here was a framework designed to make therapy as effective as possible being taught (for free!) by one of the world's greatest therapists. I'm so happy I followed David's advice to get involved at Feeling Good Institute while I was still pre-licensed. Learning TEAM while I was completing the process to earn my license as a therapist enabled me to start my career in private practice with confidence and a stable foundation. Now, I get to continue learning from mentors at Feeling Good Institute, from the wonderful Feeling Good Podcast, and the valuable lessons I get from my patients. I'll sum up my good fortune with a theatre reference and quote the Gershwins: "Who could ask for anything more?" Kevin recently made the courageous decision to find out exactly how he was doing as a therapist. And the results surprised him tremendously. Background Information for today's podcast Outcome studies with competing schools of psychotherapy in the treatment of depression have been disappointing. They all seem to come out about the same, slightly better than placebos, but not much. For example, in the British CoBalT study of 469 depressed patients treated with antidepressants vs antidepressants plus CBT, only 44% of the patients treated with antidepressants plus CBT experienced a 50% improvement in depression after six months of treatment, and the multi-year follow-up results weren't any better. This was better than the patients treated with antidepressants alone, (only 22% experienced a 50% improvement), but still—to my way of thinking—very poor. We see more improvement than that in just one day in patients using the Feeling Good App. Here are just two of many online references to that landmark study: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(15)00495-2/fulltext https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(15)00495-2.pdf Because of the disappointing results of research on the so-called "schools" of psychotherapy, the focus is switching, to some extent, to the effects of individual therapists, since even within a school of therapy, there can be huge differences in therapists' effectiveness. Some therapists seem to have the proverbial “green thumb,” with many patients improving rapidly, while others seem much less effective. Is there a way to measure this? Now there is! And do patients have a right to know how effective their shrinks are? That's what I'm proposing! For at least twenty years or more, I've been trying to sell therapists on my Brief Mood Survey with every patient at every session. That's because you can see exactly and immediately how depressed, anxious, or angry, etc. your patient was at the start and end of today's session. This allows therapists to see, for the first time, exactly how much the patient improved in various dimensions within the session, as well as how much the patient relapsed or continued to improve between sessions. Here's a simple example. To make things really clear, let's imagine that your depression test goes from 0 (not at all depressed) to 100 (the worst depression imaginable, and your patient has an 80 at the start of today's session. That would indicate a horrendously severe depression, similar to patients hospitalized with depression. And yet, your patient might be functioning effectively, and might appear reasonably happy. So, bonus #1, you can see exactly how your patient was feeling at the start of the session. You might think of the BMS as an “emotional X-ray machine.” Now, let's assume you have an excellent session, and feel like you're clicking with the patient, and the patient scores 40 on the end-of-session BMS. That would be a phenomenal 50% improvement. Of course, a score of 40 means that the patient is still moderately depressed, and has a way to go, still the goal is a score of 0 on the depression test and a huge boost in the patient's score on the happiness test on the BMS. Keep in mind that in the dozens of psychotherapy outcome studies that have been published worldwide, the very highest levels of improvement in months and months of therapy are  never higher than this. So, I call this the Recovery Coefficient (RC), and it is a very precise measure of any therapist's effectiveness in treating anything you can measure accurately. In an informal study of de-identified data of more than 10,000 therapy sessions at a local treatment center about two years ago. I discovered that the RC the first time therapists met with their patients predicted the improvement over the entire course of therapy. In addition, different therapists had vastly different initial RC scores, which can range from -100% in a single session (meaning a complete elimination of symptoms)  to +100% in a single session (meaning severe worsening.) Sadly, because all patient or therapist identifying information was removed to protect identities, I had no way of letting the therapists know their skill levels! But today, we are joined by a therapist who had the guts to calculate his RC in ten patients to see how he was doing. He was initial incredibly demoralize with his percent reductions (RC) of 45% for depression and 47% for anxiety in 50 minute sessions,  He reasoned that a 44% in a class would be a failing grade, but I pointed out that this isn't the right comparison. After all, if you had a contract to build the Brooklyn Bridge, and could complete nearly half of it in 50 minutes, you'd be doing something incredibly amazing. Kevin's Depression and Anxiety Recovery Coefficient Calculations     Depression Anxiety Empathy 1 Before 6 14 20 After 3 1   % Change -50.00% -92.86%       Depression Anxiety Empathy 2 Before 5 6 20 After 1 3   % Change -80.00% -50.00%       Depression Anxiety Empathy 3 Before 12 10 20 After 9 9   % Change -25.00% -10.00%       Depression Anxiety Empathy 4 Before 10 5 20 After 5 3   % Change -50.00% -40.00%       Depression Anxiety Empathy 5 Before 5 9 18 After 3 5   % Change -40.00% -44.44%       Depression Anxiety Empathy 6 Before 18 15 20 After 10 9   % Change -44.44% -40.00%       Depression Anxiety Empathy 7 Before 14 12 20 After 10 6   % Change -28.57% -50.00%       Depression Anxiety Empathy 8 Before 2 9 18 After 4 5   % Change 50.00% -44.44%       Depression Anxiety Empathy 9 Before 2 1 20 After 0 1   % Change -100.00% 0.00%       Depression Anxiety Empathy 10 Before 6 5 20 After 1 0   % Change -83.33% -100.00%       Depression Anxiety Empathy Recovery Coefficient   -45.13% -47.17% 19.6                     And indeed, Kevin's scores actually showed he was outperforming all the published outcome studies on depression by a factor of several hundred. Which was, I think, a well-deserved pleasant shock to his system! I've always had tremendous admiration and respect for Keven because of his obvious great skill and intelligence combined with world-class compassion and humility. In addition, patients complete the Evaluation of Therapy Session (ETS) immediately after the session, and rate the therapist on Empathy, Helpfulness, and other crucially important dimensions. Kevin's Empathy score was 19.6 (96.5%), indicating near perfect empathy ratings from his patients. This is extremely impressive, since most therapists get failing Empathy scores from nearly all of their patients when they start using the ETS scales. However, what was really cool is that Kevin brought the Daily Mood Log he prepared prior to the podcast. As you can see if you check the link, recording his intense negative feelings and self-critical thoughts when he initially completed his calculations. This helps to explain the fear that so many therapists—nearly all—feel when it comes to being accountable for the first time in the history of psychotherapy. Here's what he was telling himself: I'm not doing well enough. I'm fooling myself. I'm letting my patients down. I'm a fraud. I should be better. I should charge less. I suck! During the podcast, we used some TEAM-CBT to deal with these concerns live, in real time, using Positive Reframing, Identify the Distortions, Examine the Evidence, and Externalization of Voices to smash these thoughts. If you'd like to see the Positive Reframing Table he brought to the session, you can check here. In Kevin's case, the RC calculations, which are simple and only take a minute, gave him a huge gift—the confirmation of his immense technical therapeutic skills as well as his empathy. But what if you're not like Kevin, and you discover that your RCs are not so great, and that your Empathy ratings are in the failing range. Isn't that kind of terrible? Well, it depends on how big your ego is, and how motivated you are to improve. I've gotten plenty of horrible ratings on the ETS, and have had lots of sessions with poor outcomes, including sessions when I wrongly believed I was doing a great job. It DOES hurt. But over the years, my patients have dramatically shaped my therapy approach, and have become my greatest teachers by far. I now enjoy pretty tremendous outcomes with the vast majority of the people I treat, but could never have improved without the constant feedback. Psychotherapy skills are a lot like athletic workouts, and they say, “no pain, no gain.” This is definitely just as true for shrinks. Are you a shrink? Do you have the courage to check out your skills? Here are a couple more random comments. Over the years I've seen the scores of many therapists in training, and many established shrinks in the community. And sometimes I've been surprised that some of the big name, flashy people were actually very unskilled in real therapy situations. And I've also seen that some of the giants of our field, were humble, kindly individuals, like Kevin, who were quietly working miracles, but not even realizing it. And I also had this brainstorm. If you're a patient, and your shrink refuses to use the BMS and ETS, for whatever reason, you could take the test prior to and after each session, and calculate your therapist's Empathy Scores and Recovery Coefficient scores. Mmm. I am thinking there might be a business model in here somewhere! Like a website where you could take the tests and get all the calculations automatically. And maybe that type of information could be published... After all, wouldn't patients LOVE to have this information BEFORE going to a new shrink for treatment. And isn't that EXACTLY where our field should be moving? Accountability and transparency? I hope you enjoyed meeting the incredible Kevin Cornelius today. Thank you for listening and supporting our Feeling Good Podcasts! Warmly, david

Yikes! Do I REALLY have to share my feelings?  Last week, we featured Part 1 of a live therapy session with Keren Shemesh, PhD,  a licensed clinical psychologist who began having intense panic attacks when her mother and father visited from Israel.  Today, we feature the exciting conclusion of that session, with follow-up. If you are interested, you can listen to the follow-up with Keren and Jill who joined us st the end of today's podcast. They comment on the session as well as the details of what happened following the session. I (David) raised the question of why so many of us have trouble being honest and open with our feelings, especially anger. Jill suggested that it might be due to the false dichotomy people see, contrasting aggression with love. But you can be honest and loving at the same time, including when you express feelings of anger. Of course, we make the Five Secrets of Effective Communication sound easy, but these powerful tools actually require an enormous level of skill as well as commitment. Part 2 of the Keren session: M = Methods We began the Methods part of the session with a bit more Paradoxical Agenda Setting, and listed some really GOOD reasons NOT to open up more to her mother. I want to protect her because it may be hard and upsetting to her. I'm not used to being vulnerable with my parents. I don't want to rock the boat or change the status quo. I'm not sure I want a closer relationship with my mother. NOTE: David and Jill were thinking that we often resist intimacy because we have negative pictures in our mind of what real closeness is. For example, if you think it means something yucky and upsetting, you obviously won't want to get “close.” Jill tried to finesse around this by suggesting Keren might aim for a more “honest” relationship instead of a “closer” relationship. There are things about me that they've rejected, like the fact that I don't really want children. And I'm not so sure I want to make myself vulnerable and get rejected again! I'm afraid I'll get swallowed up and enmeshed. We asked Keren what kinds of feelings she was hiding from her mother. My feelings of nervousness and intense anxiety, and the intense somatic symptoms, like the knot in my stomach. I am scared for her future, since she is not in good health and she's not taking care of herself. I have feelings of anger and resentment about the fact that I'm not the kind of daughter they wanted. I'm sad about her health and seeing her struggle. I feel hurt when I think how I have failed them and let them down. I sometimes feel like I don't really belong. At this point, I became so absorbed in the session that I stopped taking notes, so you will have to listen carefully to the recording of the session which was fascinating. I do recall, however, that we began working on communication, using the Five Secrets of Effective Communication (LINK), as well as tips on how to proceed, taking it one step at a time and not trying to do it all at once, and role playing practice. Then we did some Externalization of Voices with the thoughts on Keren's Daily Mood Log, using several strategies: Self-Defense, the Acceptance Paradox, and the CAT, or Counter-Attack Technique. You can see the Daily Mood Log she completed after the session, based on the work we did in the session, at this LINK. Keren's end-or-session Brief Mood Survey and Evaluation of Therapy Session In addition, Keren and Jill will be with us to record the follow-up. T = End-of-Session Testing You can review Keren's BMS and EOTS (Patient's Evaluation of Therapy Session) at the end of the session at this LINK. Keren's end-or-session Brief Mood Survey and Evaluation of Therapy Session As you can see, her depression score fell to 1, indicating substantial improvement, while her suicidal thoughts and urges remained at 0. Her feelings of anxiety vanished, but her feelings of anger remained fairly elevated, falling from 7 to 4. We would not expect further improvement in this dimension until she's had the chance to share more of her feelings with her mom. Her feelings of happiness only increased from 10 to 13, again any further improvement would not be expected until she's had the chance to do her “homework” following the session. However, her satisfaction with her relationship with her mom increased from 19 to 26 out of 30, which is substantial, while still leaving some room for improvement. On the EOTs, you will see that our Empathy and Helpfulness scores were perfect, along with our scores on the Satisfaction with Session, Commitment to homework, unexpressed Negative Feelings, and honesty scales. Here's what she like “the least” about the session: “Nothing. This has been a powerful experience.” Here's what she like “the best” about the session: “This has been empowering. The hidden emotion is like a blind spot. I know it is there, but I cannot see it. I loved when David pointed to my avoidance, and I am glad we focused on the hidden emotion. Jill and David were able to see the depth in situation and I feel seen and understood.” Follow-Up We exchanged a number of emails following the session, and will also talk to Keren and Jill live on the podcast so you can catch up on what happened. But here is an excerpt from one of Keren's emails: Here is what has happened so far: On Friday morning, she made some comments about my gray hair and that the fridge gasket was not properly clean. I got really annoyed, but did not say anything. To be honest, I was too angry to use the 5 secrets and needed time to cool off. About after half an hour later, on our way to the acupuncturist, I told her that I love having her over and that it is special to me that we spend time together. She thanked me for everything that I am doing for her on this trip. Then I added: "this morning, when I came to check on you, you commented on my hair and then you told me to clean the fridge gasket..." I was going to follow up with 5 secrets, but before I was able to finish, she interrupted me and said "Gosh, I am so critical! I am sorry, I didn't mean it that way. I can see now why your sister gets upset with me. I can't believe myself." I told her that I love her honesty and while her criticism comes from a caring loving place the how and when she says things sets tone. This was a breakthrough because even though I did not finish using the 5 secrets I got through to her and felt heard. It was encouraging for me to feel that I could be understood and accepted by her.  I have clients who say that they love the 5 secrets, but like to call it the 3 secrets because they find it effective enough to use only 3. (I still encouraged them to use all 5). I can see now what they mean, I did not finish my 5 secrets spiel and got some good results. I believe that my conservation with my mother will further trickle during her stay. Perhaps because there is a lot to cover, or perhaps it's the way we communicate. In either case, I feel good about having the talks that I previously dreaded. I have not had any panic attacks since, but I don't think they have completely gone. I believe they will be there to remind me to address certain emotions that need addressing.. . . I will keep you posted and may even send this to the group. Just need to think about it a bit longer. Responses from the Tuesday Group who observed our work with Keren Here are just a few of the comments from the 35 therapists who observed the session. This is part of the feedback we get on the quality of our teaching at the end of every Tuesday training group. Please describe what you specifically disliked about the training/ Nothing. The live work was fascinating to watch. David and Jill were masterful as always! This was a truly moving and inspiring and helpful session. I can't think of anything I didn't like about it. Nothing I disliked. I think I would have liked to see Keren do more deliberate practice with the 5 secrets with grading and more roleplaying. Conceptualization was a bit hard to follow. Please describe what you specifically liked about the training. Thank you for such an authentic, moving, beautiful session. And tour-de-force demonstration of TEAM therapy. Observing David and Jill as co therapists in service of Keren was an amazing learning opportunity! The power between them was exponential and felt like they successfully addressed every angle. . .  I had not considered using EOV and loved how effective that was in crushing Keren's thoughts. I also loved how Jill finessed gently guiding her to address Hidden Emotion, having clear conviction that this was where the "action" was. I can understand what Keren said that she wants to be closer but does not want to be enmeshed. I think that it helped us in our work with immigrants and those who live away from where they were born. The discussion about the desire to be a parent or not, was another aspect of the work that I really respected. Excellent class tonight! Keren's gift to the class was priceless and David and Jill's masterful teaching was outstanding as always. Thank you!!! I got to feel closer to her and to several group members through their sharing. David touched me with the notion that opening up to one's parents is an important gift that many of them don't get to receive. Thanks for listening today! Rhonda, Keren, Jill, and David

When the Hidden Emotion isn't Hidden! Today's podcast will feature a live therapy session on September 13, 2022 with Keren Shemesh, PhD,  a licensed clinical psychologist and certified TEAM-CBT therapist. The entire session was recorded and will be presented in two consecutive podcasts. The two co-therapists are Jill Levitt, PhD, a clinical psychologist, and Director of Clinical Training at the FeelingGoodInsititute.com. Part 1 of the Keren session I will summarize the work that Dr. Jill Levitt and I did with Keren according to the familiar sequence of a TEAM-CBT Session: T = Testing, E = Empathy, A = Assessment of Resistance (formerly Paradoxical Agenda Setting), and M = Methods, with a final round of T = end-of-session Testing. In today's podcast, we will include the T, E, and A. In Part 2, we will include M = Methods and the final T = Testing. T = Testing Just before the start of the session, Keren completed the Brief Mood Survey (BMS) which you can review at this link: Keren's Pre-Session BMS As you can see, her depression score was only 3 out of 20, indicating minimal to mild depression. There were no suicidal thoughts, and her anxiety score was 10 out of 20, indicating moderate anxiety. She was also moderately angry (7 out of 20) and her happiness score was 10 out of 20, indicating very little happiness. Her relationship satisfaction level with her mother was 19 out of 30, indicating lots of room for improvement. However, she rated “degree of affection and caring” at 6 for “very satisfied,” which is the highest rating on this important item. We will ask her to take the BMS again at the end of the session, along with the Evaluation of Therapy Session, so we can see what the impact of the session was on her symptoms, as well as how empathic and helpful we were during the session. These ratings will be important, because the perceptions of therapists can be way off base, but the perceptions of our patients will nearly always be spot-on. Keren also brought a partially completed Daily Mood Log, which you can see at this link: Keren's Daily Mood Log (DML) at the start of the session As you can see, the upsetting event was her mother's visit from Israel. She had moderately to severely elevated negative feelings in nine categories, along with 17 negative thoughts, along with her rather strong beliefs in all of them. Most of her thoughts were of a self-critical nature, with lots of Hidden Should Statements as well. E = Empathy At the start of our session, which took place in front of our Tuesday evening training group at Stanford, Keren described her struggles like this: On Wednesday I woke up at 3 AM with panic attacks, one after another, and no way of getting back to sleep. I get somatic symptoms, I felt weak, nauseated, with no strength, almost paralyzed, and emotionally unstable. This was four days after my mother arrived form Israel. In the last 20 years, she and my dad visited me only once, on my graduation. I always had to visit them in Israel every year and was frustrated they none came to visit me in the Bat Area. On my last visit in May, I expressed my frustration about them not visiting me. They took it to heart and made plans to come for the Jewish high Holidays. My mom arrived first a few days ago and It's my first time alone with her. She's a Jewish mom and she stresses me out. Of course, I was really excited when she first arrived, but after four days I feel overwhelmed. This is SO MUCH WORK! I feel sad. I'm afraid I won't be able to function. I just cannot seem to enjoy my time with her. I feel fragile, but I'm hiding it. She's 73, and the signs of aging are obvious now. She needs more care, and it's tough to see her aging. Dad has always been super athletic, and he's in great shape, but she doesn't exercise or take care of herself. She's frustrated about aging and is angry with us for not accepting her as she is. I don't want to seem unhappy. I'm overwhelmed and just feel bad! David and Jill empathized, and Jill emphasized how much her parents must love her, coming from such a great distance to be with her, but also acknowledged how hard it must be for them and for Keren to be living at such a great distance. Jill pointed out that one of the issues Keren may be struggling with is the belief that their time together should be fun and conflict-free, since the time is so precious. Keren continued: My biggest problem is that I feel I cannot be me when I'm around them . . . . They want me to be a different version of myself. . . . They want me to be a mother, and they want grandchildren. But I'm in the 5% of women who don't have any interest in having children. I'm 46 years old now, and I guess I could see myself adopting, but having a family is a big job, and I've never had the passion. So, I feel like I'm a disappointment to them. But we never talk about it. I sometimes feel invisible and unseen when I'm around them. They'd be so much prouder of me if I had children they could brag about. Keren also shared her frustration and anger with her mom for not taking better care of her health. Since her mom has been in town, Keren has arranged all kinds of fun activities for them to do together, but Keren's joy is dampened by the many unspoken feelings she is constantly trying to hide, for fear of conflict and upsetting her parents. A = Assessment of Resistance Keren gave us an A+ in Empathy, so we went on to the Assessment of Resistance phase of the session, where we set the Agenda. Keren's goal was to get over her panic attacks, and we discussed three possible treatment strategies with Keren: The Hidden Emotion Technique: This technique would be based on our hunch that Keren's panic attacks are the direct result of the many feelings she is consciously, and subconscious trying to hide and sweep under the rug. Dealing with the self-critical thoughts on the Daily Mood Log she provided at the start of the session. LINK Using Forced Empathy to help her see the world through her mother's eyes, as we did in a fairly recent podcast with Zeina, another member of our Tuesday training group who was in conflict with her mother. Keren expressed considerable enthusiasm for options 2 and 3. I (David) pointed out that she appeared to be ignoring / avoiding the first option, and raised the question of whether that meant it might be the most productive, but scariest, of the three options. Keren conceded that this rang true, and wanted to start out with learning to express her feelings more openly and directly, but in a respectful and loving way. In next week's podcast, you'll find out what happened! Part 2 of the Keren session: M = Methods We began the Methods part of the session with a bit more Paradoxical Agenda Setting, and listed some really GOOD reasons NOT to open up more to her mother. I want to protect her because it may be hard and upsetting to her. I'm not used to being vulnerable with my parents. I don't want to rock the boat or change the status quo. I'm not sure I want a closer relationship with my mother. NOTE: David and Jill were thinking that we often resist intimacy because we have negative pictures in our mind of what real closeness is. For example, if you think it means something yucky and upsetting, you obviously won't want to get “close.” Jill tried to finesse around this by suggesting Keren might aim for a more “honest” relationship instead of a “closer” relationship. There are things about me that they've rejected, like the fact that I don't really want children. And I'm not so sure I want to make myself vulnerable and get rejected again! I'm afraid I'll get swallowed up and enmeshed. We asked Keren what kinds of feelings she was hiding from her mother. My feelings of nervousness and intense anxiety, and the intense somatic symptoms, like the knot in my stomach. I am scared for her future, since she is not in good health and she's not taking care of herself. I have feelings of anger and resentment about the fact that I'm not the kind of daughter they wanted. I'm sad about her health and seeing her struggle. I feel hurt when I think how I have failed them and let them down. I sometimes feel like I don't really belong. At this point, I became so absorbed in the session that I stopped taking notes, so you will have to listen carefully to the recording of the session which was fascinating. I do recall, however, that we began working on communication, using the Five Secrets of Effective Communication (LINK), as well as tips on how to proceed, taking it one step at a time and not trying to do it all at once, and role playing practice. Then we did some Externalization of Voices with the thoughts on Keren's Daily Mood Log, using several strategies: Self-Defense, the Acceptance Paradox, and the CAT, or Counter-Attack Technique. You can see the Daily Mood Log she completed after the session, based on the work we did in the session, at this LINK. Keren's end-or-session Brief Mood Survey and Evaluation of Therapy Session In addition, Keren and Jill will be with us to record the follow-up. T = End-of-Session Testing You can review Keren's BMS and EOTS (Patient's Evaluation of Therapy Session) at the end of the session at this LINK. Keren's end-or-session Brief Mood Survey and Evaluation of Therapy Session As you can see, her depression score fell to 1, indicating substantial improvement, while her suicidal thoughts and urges remained at 0. Her feelings of anxiety vanished, but her feelings of anger remained fairly elevated, falling from 7 to 4. We would not expect further improvement in this dimension until she's had the chance to share more of her feelings with her mom. Her feelings of happiness only increased from 10 to 13, again any further improvement would not be expected until she's had the chance to do her “homework” following the session. However, her satisfaction with her relationship with her mom increased from 19 to 26 out of 30, which is substantial, while still leaving some room for improvement. On the EOTs, you will see that our Empathy and Helpfulness scores were perfect, along with our scores on the Satisfaction with Session, Commitment to homework, unexpressed Negative Feelings, and honesty scales. Here's what she like “the least” about the session: “Nothing. This has been a powerful experience.” Here's what she like “the best” about the session: “This has been empowering. The hidden emotion is like a blind spot. I know it is there, but I cannot see it. I loved when David pointed to my avoidance, and I am glad we focused on the hidden emotion. Jill and David were able to see the depth in situation and I feel seen and understood.” Follow-Up We exchanged a number of emails following the session, and will also talk to Keren and Jill live on the podcast so you can catch up on what happened. But here is an excerpt from one of Keren's emails: Here is what has happened so far: On Friday morning, she made some comments about my gray hair and that the fridge gasket was not properly clean. I got really annoyed, but did not say anything. To be honest, I was too angry to use the 5 secrets and needed time to cool off. About after half an hour later, on our way to the acupuncturist, I told her that I love having her over and that it is special to me that we spend time together. She thanked me for everything that I am doing for her on this trip. Then I added: "this morning, when I came to check on you, you commented on my hair and then you told me to clean the fridge gasket..." I was going to follow up with 5 secrets, but before I was able to finish, she interrupted me and said "Gosh, I am so critical! I am sorry, I didn't mean it that way. I can see now why your sister gets upset with me. I can't believe myself." I told her that I love her honesty and while her criticism comes from a caring loving place the how and when she says things sets tone. This was a breakthrough because even though I did not finish using the 5 secrets I got through to her and felt heard. It was encouraging for me to feel that I could be understood and accepted by her.  I have clients who say that they love the 5 secrets, but like to call it the 3 secrets because they find it effective enough to use only 3. (I still encouraged them to use all 5). I can see now what they mean, I did not finish my 5 secrets spiel and got some good results. I believe that my conservation with my mother will further trickle during her stay. Perhaps because there is a lot to cover, or perhaps it's the way we communicate. In either case, I feel good about having the talks that I previously dreaded. I have not had any panic attacks since, but I don't think they have completely gone. I believe they will be there to remind me to address certain emotions that need addressing.. . . I will keep you posted and may even send this to the group. Just need to think about it a bit longer. Responses from the Tuesday Group who observed our work with Keren Here are just a few of the comments from the 35 therapists who observed the session. This is part of the feedback we get on the quality of our teaching at the end of every Tuesday training group. Please describe what you specifically disliked about the training/ Nothing. The live work was fascinating to watch. David and Jill were masterful as always! This was a truly moving and inspiring and helpful session. I can't think of anything I didn't like about it. Nothing I disliked. I think I would have liked to see Keren do more deliberate practice with the 5 secrets with grading and more roleplaying. Conceptualization was a bit hard to follow. Please describe what you specifically liked about the training. Thank you for such an authentic, moving, beautiful session. And tour-de-force demonstration of TEAM therapy. Observing David and Jill as co therapists in service of Keren was an amazing learning opportunity! The power between them was exponential and felt like they successfully addressed every angle. . .  I had not considered using EOV and loved how effective that was in crushing Keren's thoughts. I also loved how Jill finessed gently guiding her to address Hidden Emotion, having clear conviction that this was where the "action" was. I can understand what Keren said that she wants to be closer but does not want to be enmeshed. I think that it helped us in our work with immigrants and those who live away from where they were born. The discussion about the desire to be a parent or not, was another aspect of the work that I really respected. Excellent class tonight! Keren's gift to the class was priceless and David and Jill's masterful teaching was outstanding as always. Thank you!!! I got to feel closer to her and to several group members through their sharing. David touched me with the notion that opening up to one's parents is an important gift that many of them don't get to receive. Thanks for listening today! Rhonda, Keren, Jill, and David

Smashing Shyness-- Shame-Attacking and Beyond Come to our Full-Day Workshop on Sunday, October 2, 2022 For therapists and lay people alike Click here for registration and more information Today we interview our beloved Jill Levitt, PhD who will be joining me in teaching the upcoming social anxiety workshop on October 2nd. Jill is the co-leader of my weekly psychotherapy training group at Stanford, and is the co-founder and Director of Training at the Feeling Good Institute in Mountain View, California. Social anxiety was one of the most frequent problems that patients sought help for when I was in private practice in Philadelphia. Because of my own severe and persistent social anxiety since childhood, it's my favorite problem, too. Whatever you've had, I can tell you that I've had the exact same thing, too, and know how sucky it can be. I can show you the path to freedom from that affliction, and what a joy that will be! According to the DSM5, there are at least five types of social anxiety: Shyness Public Speaking Anxiety Performance Anxiety. This a broad category that can include athletic or musical performance, or any time you have to demonstrate your skills in front of people who might judge you. For example, I had a severe camera phobia since I was a child, and only got over it a couple years ago! Test Anxiety Shy Bladder / Bowel Syndrome In addition, other negative feelings typically go hand-in-hand with social anxiety, such as shame and loneliness, as well as depression and feelings of inferiority and even hopelessness. This workshop will focus on therapists looking for training. However, the general public are also included, since you will get the chance to practice and work on your own fears during the workshop. I (David) have noticed that feelings of social anxiety, especially performance anxiety, are almost universal among therapists, at least judging from those who attend our weekly TEAM-CBT training group at Stanford. So, come to heal yourself AND to learn how to heal your patients and loved ones. We will be covering not one, but four treatment models for social anxiety in the workshop: 1. The motivational model: Nearly all anxious individuals resist exposure, which is a crucial part of the treatment. Most therapists also resist exposure for a variety of reasons, thinking the patient is too fragile, or the technique will be too dangerous or upsetting for their patients. This is unfortunate, since this pretty much dooms the treatment to failure, especially if you are aiming for a “cure” rather than endless talk and hand-holding. 2. The Cognitive Model. Although usually not completely curative, the Daily Mood Log is essential to treatment, so you can find out exactly what patient are thinking and feeling at one specific moment when they were feeling anxious. I present the case of Jason, a young man feeling shy and anxious while standing in line to check his groceries one Saturday morning at the local grocery store. Many cognitive techniques are incredibly important and useful in the treatment of social anxiety, including Explain the Distortions, the three types of Downward Arrow (uncovering) Techniques, the Double Standard Technique, Externalization of Voices, the Feared Fantasy, and more. Although these methods are helpful and illuminating, they will rarely or never be quite enough for a complete cure. For that you will need: 3. The Exposure Model. In the workshop, we will be teaching: Smile and Hello Practice: In today's podcast Jill discussed the purpose of this technique, how to introduce this technique to your patients, and how to implement it. This is an example of the many techniques we will teach on October 2. David provided a dramatic example of how this humble technique changed the life of a young man from India. Flirting Training Talk Show Host Rejection Practice Feared Fantasy: We role-played how I used this humor-based technique in my work with Jason Self-Disclosure Survey Technique Shame-Attacking Exercises. We will also explain how to use several techniques crucial to the reduction of the patient's resistance: Dangling the Carrot Gentle Ultimatum Sitting with Open Hands Fallback Position However, many therapists have intense resistance to making patient accountable with these techniques that are absolutely central to TEAM-CBT, thinking they are cruel or crude or narcissistic, or some such thing. In the podcast, Jill illustrates a beautiful and gentle but firm way of introducing these techniques to patients, and emphasizes that they are actually ethical, therapeutic, and necessary for a good outcome. She also emphasizes, and I totally agree, the importance of going with the patient into the real world to do the Exposure Techniques. I have used extreme exposure techniques on hundreds of occasions when treating anxious colleagues on Sunday hikes for example, urging them to stop hikers we meet and disclose their own shyness, for example. The advantages of doing this type of thing in the real world include the ability to coach the “patient” with the best examples of how to use whatever technique you're advocating, and to be there to support the patient during and after the experience. 4. The Hidden Emotion Model. This technique is often extremely helpful in the treatment of any form of anxiety, but is perhaps less often used in the treatment of social anxiety. I can think of one example when it was extremely helpful. This was a woman whose boss kept pressuring her to give presentations about their company locally and to groups in other locations as well. She opted out because of her social anxiety. But lurking behind her symptoms were her feelings of resentment about being asked to do too much. Once she brought these feelings to conscious awareness, she decided to discuss his expectations, her feelings, and her compensation with her boss. This worked well, and her public speaking anxiety magically disappeared. Although this pattern is not common, it is always worth consideration in your treatment plan, because family and friends often pressure people with social anxiety to confront their fears, and this typically does trigger feelings of resentment and resistance. We also discussed two Self-Defeating Beliefs that are nearly universal in individuals with social anxiety: the Spotlight and Brushfire Fallacies. In the podcast, I give examples of several techniques that were life-changing for patients. Jill emphasizes that one of the underlying treatment themes is how to “wake up” from your trance so you can learn not to take yourself so seriously and begin to have fun and enjoy yourself and others way more. Improvement is not the goal of treatment. The goal of treatment is word that many mental health professionals fear and resent: CURE! In the podcast, I describe the difference between a 100% cure for any form of anxiety, and a 200% cure. Do you know the difference? I give an example of my own fear of heights when I was in high school. Of course, that's a phobia, and not a form of social anxiety, but you can also have a 200% cure for social anxiety, too! In a 100% cure your fears go to zero. You are no longer particularly anxious about talking to strangers, or public speaking, for example. In a 200% cure, you come to LOVE the very thing that terrified you in the past. Rhonda, Jill and I think this will be a powerful one day experience. We will focus on a common problem that is usually treatable fairly quickly, and often with fabulous and life-changing results. We hope you can join us! For registration information, please go to: CBTforSocialAnxiety.com Thanks! Jill, Rhonda, and David