Podcasts about feeling good podcast

Secrets of Superb Interviewing-- How to Be Everyone's Number 1 Choice! Today we feature our beloved Kyle Jones, Ph.D, a clinical psychologist who suggested we might do a really cool podcast on the interviewing skills featured in Chapter 16 of my Feeling Good Handbook. Rhonda and I are absolutely delighted to welcome Kyle for his third appearance on to the Feeling Good Podcast. (Rhonda had to excuse herself after introducing this episode because she was not feeling well) In that chapter on interviewing skills, I listed the five basic principles of successfully interviewing for a job, for admissions to a school, or really almost any type of interview at all. I have to warn you that these ideas may be unfamiliar, and will definitely be quite different from what you've been taught about winning interviews. #1: Be personable and friendly. Don't try to impress the person who's interviewing you! #2 Make them sell themselves to you. #3 Be honest, but present yourself in a positive light. #4 Don't get defensive. #5 Punt when you don't know the answer to the question. To illustrate the first idea, I told a story from Dale Carnegie's book on How to Win Friends and Influence People, in which he describes his interview with a wealth and powerful man in the hopes of soliciting a donation  for the Boy Scouts of America. This was back in the era many years ago when the Scouts were still very popular. The receptionist who made the appointment warned Dale Carnegie that he would have only 15 minutes, and emphasized that her boss was 100% meticulous about time. He started exactly on time, and ended exactly on time, whether or not you were done, so he better talk fast once the interview started. When the time came, and Dale Carnegie entered the office, the receptionist again reminded him that he'd be kicked out after 15 minutes no matter what! As he walked in, Dale Carnegie spotted a trophy fish proudly displayed on the wall above the rich man's desk, and asked, if the wealthy man he'd caught it. himself, The rich man said he had caught it in lake so and so. Dale Carnegie got excited and said, "I fish there too. Where, exactly, were you fishing on the lake when you caught this fish?" The man told him where his favorite fishing hole was, and they become engrossed in a vibrant conversation about the joys of fishing. Suddenly, the office door opened, and the receptionist appeared and said the time was up. On the way out, the wealthy man said, "Oh, I forgot to ask you what the purpose of the interview was." Dale Carnegie said, "Oh, I'm sorry, I forgot to mention that I am trying to raise money to support the Boy Scouts of America." The man replied, "You'll receive a check in the mail tomorrow for a million dollars." And those were the days when that was an enormous amount of money. What's the moral of the story? Relate to the person who's interviewing you as a person, and show an interest in them, instead of pitching your talking points and trying to impress them. People usually make decisions influenced greatly by how much they like the person they are talking to. Don't try to be impressive. Aim for friendly, real and human. How do you do this? Well, let's say that you have an interview with a law firm, hoping to get hired, and you're just out of law school. I used to be the shrink for the University of Pennsylvania Law School, and at the time there were too many law school  graduates looking for too few job openings, and almost no one was hiring. They referred despondent and panicky students to me who'd had a string of rejections. At the time, the top firms had at least 50 to 100 top notch candidates for every position. Was there any hope of starting their careers? I told them to do some research on the person who was going to interview them, or on their firm. Find something interesting about them. Then, at the start of the interview you can say something like this: "I'm so excited to meet you because I've been following your work for some time. I was amazed and blown away by your strategy in the X, Y, and Z case, and I was wondering if you're still using that approach in litigation and how it's been working out? I'd love to hear more about your work, and how you came up with the approach you're using, and what you like the best about this firm." This will get them to talking about themselves. DON'T try to impress them with how great you are . That will just bore them, or turn them off, and it will certainly put you under pressure to perform. This pressure will probably make you anxious, and your  anxiety and insecurity will show. Instead, impress them with how great THEY are. They'll love you! I trained the students in this doing role-playing of imaginary job interviews. Every student I trained in this approach became the #1 choice at every firm they interviewed at! This approach is not just for law students, it's for every type of job, as well as interviews for college, graduate school, and more. Here's the underlying idea. People don't really care much about you. They care about themselves. This is true of all of us. So, use this to your advantage, and you'll suddenly be super happy and glad you were OTHER centered and not SELF centered! Does this mean you should hide your own skills and accomplishments? Of course now. You can answer questions about what you offer with humility and integrity. But that alone will rarely be enough. #2 Make them sell themselves to you. Let's say you're applying for graduate school, and it's very competitive. Again, they have 100 brilliant candidates for every position. Suppose the interview says something challenging, like "As you know, all the top candidates in the Unites States apply to us here at Harvard. Most of them were #1 in the their college classes and several have already been nominated for Nobel Prizes. Why should we be interested in you?" This, of course, is absurd, but I'm taking the worst imaginable question in an interview. Yikes! This sounds impossible, right? How in the world could you respond? Actually, it's easy. You can just say, "Gosh, I don't know if I'd be a good fit here. That's what I'm hoping to learn today. Maybe you can tell me what you're looking for in a top notch candidate. What kinds of candidates have gone on to be stars, and what types have been disappointments? Then I can give you a better answer on whether or not I might be a good fit. Although I love your company, and I'm so impressed with your own career, I wouldn't want to accept a job unless I was convinced I could really contribute to your firm." Is this realistic, or just some David fantasy? During my senior year in college, I was planning to go to graduate school in clinical psychology, since I'd majored in philosophy and psychology seemed like a way more practical career.  However, my college adviser said that medical school would be a far better choice because medications were becoming more and more important in treating mental illnesses, and only psychiatrists could prescribe drugs. I told him that I'd never had any interest in being a medical doctor, and wasn't even a premed student, so there was no way I could get into medical school. I hadn't even had a single biology class in college. He said "That won't be a problem I don't think. You've got the gift of gab, and they probably won't even notice." So, I applied to a number of medical schools and landed an interview at Stanford, and several others. My interview was with someone in the Anatomy Department which was located in the basement of the museum on campus. I went down the stairs and into a room where I met the man who was interviewing me. I said, "It's a bit dark down here. Is this where the medical students dissect their cadavers?" He said, "Absolutely. But it's actually pretty awesome down here. In fact, my laboratory his just down the hall. I said, "Oh, could I see your laboratory? I'd love to take a look and find out what kind of research you do." He seemed excited and as we walked into his lab I noticed all kinds of fancy equipment and read the name on one of them, so kind of photometer or something. I had no idea what it was, but said, "Oh, I see you have an X, Y Z photometer. (or whatever it was). Do you use this in your research?" He said, "Oh, absolutely, it's extremely important in my research." I asked him about the research he did. He excitedly started explaining it, and for the most part I had no idea what he was talking about, but kept expressing interest and asking him for more and more information. I was terrified that he'd ask me questions about my undergraduate work and my research, which of course did not exist. I'd never done any research! Just philosophy classes and such. Well, we had quite the conversation, but after a while he suddenly looked at his watch and said, "Oh, my goodness. We were only supposed to talk for 15 minutes, and we've been talking for nearly two hours. I have to rush over to the medical school quad for an important meeting I'm almost late for. Why don't we walk over in that direction together?" As we were walking out of the basement, he said, "Oh, my goodness, I forgot to ask you who you are and where you're from." I said, "Oh, I'm David Burns from Amherst College." He said, "Well, David Burns, I want you to know that you're the kind of young man we need at the Stanford Medical School.!" I said, "It's really kind of you to say that, but I'm afraid I won't be able to come to the Stanford for medical school." He said, "That's nonsense? Of course you can come! Do you think Harvard is going to make you a better offer? We'll top anything they offer." I said, "Oh no, sir, that's not it. You see, my father is a minister, and we don't have much money, and I've heard that attending medical school would cost more than one hundred thousand dollars. And he believes that borrowing money is a sin." He said, "David Burns, I'm the head of the admissions committee, and that's where I'm headed right now. And I'm going to tell them that you're the #1 choice for admission this year. And you won't have to pay a thing. We'll pay for tuition, room, board, books, expenses, everything. It won't cost you one cent to go to Sanford medical school." I said, "Oh, thank you so much! That's an offer I can't refuse!" I got my acceptance letter two days later and the rest, as they say, is history. But to spell it out. Why was I accepted to a top-flight, highly competitive program when I had absolutely NO credentials? Because I expressed an interest in him, and I was friendly, and I believe that meant a great deal to him. And I'll always be grateful for his help. My wife and I returned to Stanford almost 30 years ago, where I've served on the voluntary (unpaid) faculty at the medical school, teaching  and doing research and continuing to develop TEAM CBT. I turned out to be a terrible medical student, and dropped out for a full year on two different times because I just wasn't the "medical" type. I had very little aptitude or interest in medicine. But I did end up as a psychiatrist, and came to love medicine and healing people who were suffering, and doing research. And my voluntary work is my way of trying to repay my tremendous debt to Stanford! And I'll never forget the kind gentleman who interviewed me. Kyle and I jammed on all five examples, including many additional stories to bring these ideas to life. Kyle used this strategy when interview for his internship in psychology, and it worked like a charm. I would say that I've taught many people how to use these ideas, including family members, students, and colleagues. The impact has been nothing short of incredible. That probably sounds over the top, and I "get it." But the stories are true, and the ideas can change your life. Remember what the Buddha said, 2500 years ago: "Selling yourself sucks! So, Stop it, and do what works!" Warmly, Rhonda, Kyle, and David Contact information Kyle is a superb TEAM CBT therapist who practices virtually throughout California. Here's his contact information:  Dr. Kyle Jones

David, Matt, and Rhonda Answer Your Questions! What's the One-Minute Drill work? How does it work? What's Memory Rescripting? How does it work? How can I endure boring and irrelevant college work? Aaron asks: How do you do the One Minute Drill? Aaron asks how and why Memory Rescripting helped a college student overcome her fears of public transportation (e.g. agoraphobia). Gray asks: How can I endure having to do boring work in college and beyond? Two questions from Aaron W. C. who is a Licensed Master Social Worker in Idaho, and said, “I look forward to the podcast.” 1. Hi Dr. Burns, Can you share how you do the one-minute drill? In When Panic Attacks, you only mentioned the name but not how it works. Thank you, Aaron W. California David's reply We'll explain and demonstrate it on the podcast. It's a partially helpful tool for troubled couples who argue and fail to listen. 2. Hi Dr. Burns, I completed rereading When Panic Attacks yesterday night. I have a question about one of the case examples you mentioned. In the book, you mention a patient that has a phobia of taking public transportation. She did the reimagination exercise of picturing herself castrating the men that harmed her roommate and branded the man that hurt her as a child. If remember right, the book does not link using the "reimagination exercise" to overcoming her fear of taking public transportation. How did the reimagination exercise help her overcome the fear of taking public transportation? I have reread the book two times this year! Thank you, Aaron W. California---LMSW (Idaho) David's reply I am happy to include your question on an upcoming Feeling Good Podcast. Can I use your first name? Thanks! I can answer two of your questions, and can even demonstrate the one-minute drill, and discuss its uses and limitations. Best, david 3. Gray asks about feeling better about post-secondary education Hi David, I struggle with intense anger, frustration, and depression while doing college coursework, with recurring thoughts like, “This is pointless,” “This work is for nobody, ” "I'm just working to work," "I'm being hazed," and “I profoundly don't care!” I'm interested in law school because I'd love being a lawyer, but I worry that I won't be mentally healthy in that environment. Many lawyers say 80+% of law school is irrelevant and doesn't adequately prepare you to practice law or even to pass the Bar, so I expect similar frustrations would resurface. I've looked into this very carefully and I'm convinced that the basic substance of my thoughts has bulletproof empirical grounding (outside of STEM, for sure). How could I manage these distortions when I'm in the midst of law school homework? P.S. I'm quite hostile to appeals about how I would actually learn important things in class or about developing resilience for its own sake, so I'd prefer to avoid that line of thinking unless it's really important. Thank you, Gray David's reply Can you give me an example of one of your negative thoughts. They always contain some truth, by the way. Perhaps you're trapped in a Hidden Should Statement. Are you wanting to feel happy about having to do boring homework, or are you wanting not to have to do boring homework? What's your goal, in other words. All therapeutic failure, just about, is due to a failure of agenda setting. In other words, reducing resistance is the key prior to crushing distortions. Warmly, david There is certainly a great deal of irrelevant stuff one has to plow through to get a college or graduate degree, for sure. So there seems to be a lot of wisdom in your negative thoughts and feelings. I guess my question would be, what type of help, if any, are you looking for? Best, david Gray responds Subject: Re: Feeling better about post-secondary education My hidden should statements are something like "I shouldn't have to do this." and" I should be able to prove myself by doing real work instead". I am hoping to be able to do lots of boring/irrelevant homework and be okay about it, not even necessarily happy. Then I could go to law school and be in passable mental health. Thanks again! Gray David Replies Well, you're right on all counts, including “I shouldn't have to do this.” In fact, you DON'T “have to” do it. And if you do stick with it, there's no rule that says you have to stop whining and complaining! I made the choice of going to medical school and hated it. Worst medical student they had. But I had to complete medical school and psychiatric residency in order to become a psychiatrist. Don't think I learned much of anything in medical school or psychiatric residency that ever really helped any of my patients at that time. But now I have a life I really enjoy, although there are still negatives I have to put up with. Warmly, david One last thing to add. The boring, trivial work does not upset you. Only your distorted thoughts can upset you. The truth in your thoughts is real but does not upset you. You are saying that you SHOULD NOT have to do trivial boring work. Where did you get that idea. Did you think you were entitled to a universe that conforms to your demands? Why should the world be the way you want it to be? There's an irritating voice in your brain that keeps telling you that you should have to do this and you shouldn't have to do that. That voice is your enemy, your source of angst, and not the actual work. So, your first step is to make a decision, perhaps two Cost-Benefit Analyses. The first might be the Advantages and Disadvantages of loudly protesting and insisting it SHOULDN'T be this way. There will be many advantages and a few disadvantages as well. Now balance the Adv against the Dis on a 100 point scale at the bottom, putting the higher number under the column that feels the more desirable or impactful. For example, if the ADV are a lot greater, your two numbers might be 70-30. Then you might do a second CBS listing the Advantages and Disadvantages of ACCEPTING the fact that school often sucks. There may be some advantages and a few disadvantages as well. Now balance the Adv against the Dis on a 100 point scale at the bottom, putting the higher number under the column that feels the more desirable or impactful. For example, if the DIS of acceptance are a lot greater, your two numbers might be 25-75. Send me your two analyses when you're done! If you come to the unlikely decision that acceptance is preferably to shoulding on yourself, there are lots of strategies that might help. But I'd need to know where you stand first, or the methods would be a waste of time. Anger, unlike most negative feelings, is highly addictive, and most people don't want to let go of it. You could also do Positive Reframing of your anger and negative thoughts, which is super powerful, but this is getting a bit long. Best, david David follow-up for podcast audience: As far as I can tell, Gray didn't respond to my email. Sad!

Dr. David Burns, clinical psychiatrist, Adjunct Clinical Professor Emeritus at Stanford Medical School, bestselling author of numerous books, an award-winning researcher and teacher, and podcast host joins me on this episode. David graduated magna cum laude from Amherst College, received his M.D. from Stanford University School of Medicine, and completed his psychiatry residency at the University of Pennsylvania School of Medicine. Articles about him have been featured in notable media outlets including The New York Times and Reader's Digest, and he's been interviewed on more than 1,000 radio and TV shows. Topics we cover include David's journey into psychiatry, experiences that shaped his groundbreaking work in cognitive behavioral therapy, what's behind our feelings, cognitive distortions, why we resist change, TEAM CBT, and more. Get connected with David: Website: https://feelinggood.com/ Facebook: https://www.facebook.com/DavidBurnsMD/ Twitter: https://x.com/daviddburnsmd LinkedIn: https://www.linkedin.com/in/david-burns-86178657/ Purchase a copy of Feeling Great: https://www.amazon.com/Feeling-Great-Revolutionary-Treatment-Depression/dp/1962305392 Try the Feeling Great app: https://www.feelinggreat.com/ Listen to the Feeling Good Podcast: https://podcasts.apple.com/us/podcast/feeling-good-podcast-team-cbt-the-new-mood-therapy/id1171155453 Leave a 5-star review with a comment on Apple Podcasts: https://podcasts.apple.com/us/podcast/business-minds-coffee-chat/id1539014324  Subscribe to my Business Builder Newsletter: https://bit.ly/32y0YxJ  Want to learn how you can work with me to gain more clarity, build a rock-solid foundation for your business, and achieve the results and success you deserve? Visit http://jayscherrbusinessconsulting.com/ and schedule a 1:1 discovery coaching call. Enjoy, thanks for listening, and please share with a friend! To your success, Jay

Ask David: Getting Off Benzos How Does Music Stir Our Emotions? Combatting Negative Thoughts about the World Treating Schizophrenia with TEAM The Four Feared Fantasy Techniques and more! Questions for today: Mamunur asks: What's the best way to withdraw from benzodiazepines? Gray asks: How does music evoke such powerful emotional reactions? Josh thanks David for techniques that have helped in his personal and professional life. Harold asks: How do you respond to negative thoughts about the world, as opposed to self-criticisms? For example, “The world is filled with so little joy and so much suffering.” Moritz asks: How do you help people with bipolar, schizophrenia, etc.? John expresses gratitude for our answer to his question on Positive Reframing, which triggered an “ah ha moment.” Rhonda asks: What are the four Feared Fantasy Techniques? The answers below were written prior to the podcast. Listen to the podcast for the dialogue among Rhonda, Matt, and David, as much more emerges from the discussions! Mamunur asks: What's the best way to withdraw from benzodiazepines? Ask David, Bangladesh question Dear Sir, I am writing to you from Bangladesh. Your book Feeling Good is a phenomenal work, and it has greatly helped in promoting the development of a healthy mind through logic and reason. Sir, I have a question regarding benzodiazepine withdrawal, which is often prescribed for mental health disorders. Is there a specific CBT (Cognitive Behavioral Therapy) approach that can help in withdrawing from benzodiazepines? Your guidance on this would be invaluable, as many people have been taking it for years, either knowingly or unknowingly, without being fully aware of its severe withdrawal effects. Thank you, sir, for your kind contributions to humanity. Sincerely, Mamunur Rahman Senior Lecturer David's reply Dear Mamunur, Thank you for your important question! I am so glad you like my book, Feeling Good, and appreciate your kind comments! As a general rule, slow taper off of benzodiazepines is recommended. This might involve slowly decreasing the dose over a period of several weeks. When I was younger I used to take 0.25 mg of Xanax for sleep, because it was initially promoted as being non-addictive, which was wrong. It is highly addictive. The dose I used was the smallest dose. When I realized that I was “hooked,” I tapered off of it over about a week, and simply put up with the side effects of withdrawal, primarily an increase of anxiety and difficulty sleeping. These disappeared after several weeks. Abrupt withdrawal from high doses of any benzodiazepine can trigger seizures, as I'm sure you know. That is the biggest danger, perhaps. I do recall a published study from years ago conducted at Harvard, I believe at McClean Hospital. The divided two groups of people hooked on Xanax into two groups. Both groups were switched to Klonopin which has a longer “half-life” in the blood and is supposedly a bit easier to withdraw from than Xanax, which goes out of the blood rapidly, causing more sudden and intense withdrawal effects. After this initial phase, both groups continued with slowly tapering off the Klonopin under the guidance of medical experts. However, one of the groups also attended weekly cognitive therapy groups, learning about how to combat the distorted thoughts that trigger negative feelings like anxiety and depression. My memory of the study is that the group receiving cognitive therapy plus drug management did much better. As I recall, 80% of them were able to withdraw successfully. However, the group receiving drug management alone did poorly, with only about 20% achieving withdrawal. My memory of the details may be somewhat faulty, but the main conclusion was clear that the support of the group cognitive therapy greatly enhanced the success of withdrawal from benzodiazepines. I decided early in my career not to prescribe benzodiazepines like Ativan, Valium, Librium, Xanax, and Klonopin for depression or anxiety, because the drug-free methods I and others have developed are very powerful, and the use of benzos can actually make the outcomes worse. Years back, a research colleague from Canada, Henny Westra, PhD, reviewed the world literature on treatment of anxiety with CBT plus benzos and concluded that the benzos did not enhance outcomes. Here is the link: https://pubmed.ncbi.nlm.nih.gov/12214810/. I hope this information is useful and I will include this in a future Feeling Good Podcast.   Gray asks: How does music evoke such powerful emotional reactions? Subject: Re: Podcast question: love songs Hi David, That's a really tough question. Music has a unique way of cutting straight to emotions for me, and it makes it especially hard to identify the thoughts behind them. My best way of explaining is with these two thoughts, which have to be viewed as a pair to get that emotional reaction: My life would be perfect if I had that I'm so far away from that These thoughts don't resonate quite right for me, but it's something like that, going from imagining bliss to crashing to hopelessness within the space of a moment. Thank you so much for your response. Gray David's reply You're right. Music can be so beautiful, especially of course, the songs we love, that it is magical and emotional to listen to! It seems more like a sensory experience, than something mediated by thoughts, but we certainly have perceptions of beauty, etc. Similar with some incredibly delicious food. Creates incredible delight and satisfaction, and no words are necessary other than “delicious!” Sorry I can't give you a better answer to your outstanding question! Best, david   Josh thanks David for techniques that have helped in his personal and professional life. Dear Dr. Burns, I am sure you are swamped with substantive emails and fan mail, but I just wanted to express appreciation to you for all I have gained from your publicly available content. I have learned so much that I have applied in my personal life. I have also benefited tremendously in my work with clients. So much of what you say about anxiety, and especially the hidden emotion technique, has allowed clients to have in almost every session an aha moment. I have not yet been able to see a complete removal of symptoms in one session yet, but as a therapist, I too have many skills yet to improve and much work to do. So, in short, thank you so much for making your experience and wisdom available for free, and thank you for doing it in such an engaging manner. Sincerely, Josh Farkas   David's Reply Thanks, Josh. You are welcome to join our weekly virtual free training group I offer as part of my volunteer work for Stanford, if interested. For more complete change within sessions, a double session (two hours) in my experience is vastly more effective. Is it okay to read your kind note on a podcast? Warmly, david   Harold asks: How do you respond to negative thoughts about the world, as opposed to self-criticisms? For example, “The world is filled with so little joy and so much suffering.” Dear Dr. Burns, First of all, I would like to thank you for all your work and your outreach. Your books have profoundly influenced my thinking and value system. I really admire how you exemplify both scientific rigor and human warmth. Finally, I want to thank you for promoting the idea of “Rejection Practice! I haven't had a breakthrough yet, but some unexpected, very encouraging experiences. I first came across Feeling Good 12 years ago when I developed moderate depression in the context of living with my ex-partner, who probably had borderline personality disorder. I tried the techniques in Feeling Good and also psychotherapy, but unfortunately without much success. I only started feeling a lot better when I began to rebuild my social life and leisure time activities (ballroom dancing, getting involved with a church, ...). Several months later, I also broke up with my ex-girlfriend. Since then, I've had ongoing mild depression. I recently tried the techniques in Feeling Great but wanted to ask you for your opinion on a couple of negative thoughts I'm particularly stuck with. My issue is that I'm normally not attacking myself, but life in general. I keep on telling myself things like "Life is just one crisis after the other," "Life is for the lucky ones," "Really good things just don't want to happen," "Life is so much suffering and so little joy," and the depression itself makes these statements all the more convincing. (Triggering events can be rainy holidays, romantic rejections, grant interview rejections, etc.) I think it could be helpful if in a podcast you could give more examples on resolving negative thoughts attacking life / the world rather than oneself. I also have many more questions for podcasts if you are interested. Thank you for reading this, and thank you so much again for all your work! With very best wishes, Harold   David's Reply Happy to address this on an Ask David, and it would help if you could let me know what negative feelings you have, and how strong they are. I will be answer in a general way, and not engaging you in therapy, which cannot be done in this context. Is that okay? I'm attaching a Daily Mood Log to help organize your thoughts and feelings. Send it back if you can with the Event, Negative Feelings and % Now columns filled out (0-100), and Negative thoughts and belief in each (0-100). You can also fill in the distortion column using abbreviations, like AON for All-or-Nothing, SH for Should Statement or Hidden Should, MF for Mental filtering, DP for Discounting the Positives, and so forth. Thanks! If you were in a session with me, or if we were just friends talking, I would reply to your complaints with the Disarming Technique, Thought and Feeling Empathy, “I Feel” Statements, Stroking, and Inquiry, like this: Harold: “Life is so much suffering and so little joy." David: “I'm sad to hear you say that, but you're right. There's an enormous amount of suffering in the world, like the horrible wars in Ukraine and in the Mid-East. (I feel; Disarming Technique) It makes sense that you'd be upset, and have all kinds of feelings, even anger since there's so much cruelty, too. (Feeling Empathy) And even people who appear positive and joyful often have inner sadness and loneliness that they are hiding. (Disarming Technique) Your comment tells me a great deal about your core values on honesty and compassion for others. (Stroking) Can you tell me more about the suffering that you've seen that has saddened you the most, and how you feel inside? (Inquiry) But I'm mainly interested in you right now. Can you tell me more about YOUR suffering, and especially if there's some problem you might want some help with? (Inquiry; Changing the Focus) I would continue this strategy until you gave me an A on Empathy, and then I would go on to the A of TEAM (Assessing Resistance), and ask what kind of help, if any, you'd be look for in today's session. I might also use a paradox, like the Acid Test. If you wanted to reduce some of your negative feelings, I might try a variety of techniques, such as “How Many Minutes?” I'd also think about the Hidden Emotion Technique. Is there some problem in your life right now that you're not dealing with, so you instead obsess about the problems in the world to distract yourself? I would continue this strategy until you gave me an A on Empathy, and then I would go on to the A of TEAM (Assessing Resistance), and ask what kind of help, if any, you'd be look for in today's session. I might also use a paradox, like the Acid Test. If you wanted to reduce some of your negative feelings, I might try a variety of techniques, such as “How Many Minutes?” I'd also think about the Hidden Emotion Technique. Is there some problem in your life right now that you're not dealing with, so you instead obsess about the problems in the world to distract yourself? I ask this because your negative thoughts are very general, but I always focus only on specifics, specific problems and moments. What's has been going on with your parents or in the past or present that you are distressed about? I've found that when I (or my patients) solve one specific problem that's bugging me, everything seems to suddenly brighten up. For example, you wrote : “I asked someone out I like; she surprisingly said yes. After 10 days of not hearing from her, I messaged her, . . . “ I wrote a book about dating, Intimate Connections, because I was a nurd and had a lot to learn about dating. One idea is that waiting 10 days might not be a good idea to arrange the specifics of the date, as that might make her feel uneasy. There's a lot to learn about dating, for example. A tool like the Pleasure Predicting Sheet can sometimes help, too. And finally, a good therapist can also often speed things up. Sometimes two heads are better than one. You seem extremely smart and willing to work hard, so there's all kinds of room for growth, learning, and greater joy. The Feeling Great App is NOT therapy, but the tools there might also be helpful, especially since you are willing to work hard a do a lot. That's super important. Can I use this email in my reply in the show notes if we discuss your excellent questions? And should I change your name to Harold? Warmly, david Best, david     Moritz asks: How do you help people with bipolar, schizophrenia, etc.? Hi David, You have mentioned a few times that there are only a handful of "real" psychological disorders with known causes, as opposed to just a collection of symptoms. Could you please tell a bit about how you would go about helping somebody with one of the "real" disorders (like Schizophrenia or Bipolar) using TEAM therapy? Most of the episodes with personal work seem to fall into the other category (anxiety, depression, compulsive behavior), so I'd be really curious about some examples. Best regards, Moritz Lenz   David's Reply Hi Moritz, Thanks! Good question, and happy to address this on an Ask David. Here's the answer in a nutshell. When working with someone with schizophrenia, the goal is to help them develop greater happiness and interpersonal functioning, exactly the same as with anyone else, using TEAM. The goal is not to cure schizophrenia, because we still do not know the cause and there is no cure. But we can help individuals with schizophrenia with problems that they are having. Bipolar: in the manic phase, usually strong meds are indicated, and often at least one hospitalization. For the rest of their lives, including depression, TEAM works great. Can add more in the podcast. Best, david   John expresses gratitude for answer his question on Positive Reframing, which triggered an “ah ha moment.” Hi David and Rhonda! I have listened to Episode 415 and your response to my positive reframing question! I had a bit of a aha moment! I think I had been approaching it in the cheerleading sense and trying to encourage myself with these positive qualities rather than attaching the positives to the negative thoughts and feelings themselves! This has created a much stronger emotional response during the positive reframing section! The building up of the negative thoughts and feelings is a gamechanger! Thanks so much for the time and attention given to it during the podcast. Thanks so much again, I appreciate you folks way more than you could know! John David's Reply Thanks, Rhonda and John. Yes, you've pointed out a huge error many people make when trying to grasp positive reframing. If it is okay, we can include your comment in a future podcast. Warmly, david   Rhonda asks about the four Feared Fantasy Techniques: David's Reply Here are the four Feared Fantasy Techniques Approval Addiction / Perceived Perfectionism: “I judge you.” Achievement Addiction: “High School Reunion.” Love Addiction: Rejection Feared Fantasy Submissiveness: No Practice There are quite a number of additional role plays, too, as you know. Maybe a question about all the role plays, bc we all have: Self-Critical Thoughts: Paradoxical and Straightforward Double Standard Externalization of Voices Uncovering Techniques Man from Mars Tempting Thoughts Devil's Advocate Technique Tic-Tok Technique Resistance Externalization of Resistance How Many Minutes? Five Secrets / Relationship Conflict Intimacy Exercise One Minute-Drill I'll bet you can think of more, too! This is one of the unique features of TEAM, but for whatever reason it seems like few therapists use them. As you know, on average they tend to be way more potent and emotional, and of course fast impact. Warmly, david

Meet Tahn Palmetto Theravada Buddhism--the Thai Forest Tradition Our dear colleague, Jason Meno, generously invited five high-profile Buddhist monks / teachers, to appear on our Feeling Good Podcast, hoping we could feature one every week during our "Enlightenment Month."  He included his dear friend and ordained Buddhist monk, Tahn Palmetto. Happily, Tahn accepted Jason's invitation, and we are thrilled to chat with him today about his feelings of depression as a young man in the army to his search for happiness and peace through meditation. Tahn began his journey when we was young, 20 or 21 years old. After he enlisted in the army, he was lying on the floor, staring at the ceiling and realized he was depressed. He also realized that he didn't actually want to go to war, and saw that the best of good intentions often lead to pretty terrible outcomes. Jason and David described the basis of cognitive therapy, confirmed in Jason's recent research on meditation, that the degree of upset from any negative thought depends on how strongly you believe it to be true. Tahn said he also realized that his negative feelings did not depend so much on what he was doing, but how much he believed his thoughts. He got out of the army and searched for spiritual teachers, and eventually settled on Theravada Buddhism, also known as the Thai Forest Tradition. He said, “I found that you can have a lifestyle that triggers feelings of unhappiness, and committed my life to achieving happiness and peace.” He said that some people who come to the monastery discover that they don't want to commit themselves to the monastic life, and some commit to it but do it poorly. He said that your commitment will depend on how strongly you want to feel happy and enlightened. Believing that this is possible requires a paradigm switch. It is possible to have a mind that is clear, but even on a clear day, there will be clouds. The clouds, however, are only temporary. Our suffering comes and goes. If you twist your knee, it may hurt for life. But if you have a cold, you can recover completely. Even in a monastery, people have their squabbles. Within the Buddhist practice, Than explained that it is important to try to identify the disease and only then prescribe the effective treatment. Jason mentioned that some people come to the monastery but leave feeling hopeless. Others stay and are successful. Tahn explained that in Asia it is common for someone to enter the monastic life for a brief period, for example when they are experiencing grief. He said that if you grieve over the loss of a loved one, time alone will heal your grief, and once the suffering is relieved, they leave the monastic life. Rhonda asked if mindfulness meditation could be harmful to some people. Tahn explained that mindfulness does not cause negative feelings, but often reveals the presence of negative feelings. If you have a condition that prevents you from experiencing enlightenment, the condition is getting in the way. Sometimes the practice will give you the stability and the peace of mind to deal with it. If you come to the practice of mindfulness or the study of Buddhism for the wrong reasons, you might stay for the right reasons. If it does not work or help, you can always seek some other type of treatment. Tahn explained that mindfulness or Buddhism addresses unhappiness caused by mental or physical pain, and that people are often surprised by how it helps them. He believes that mindfulness meditation is “the thing” that treats someone's stress. It treats the “dukka,” which is a fundamental Buddhist teaching that refers to (according to the internet) the “suffering” or “unhappiness” of life. It is one of the first “noble truths” of Buddhism; namely, that suffering cannot be avoided. Apparently dukka comes in three flavors: Physical and emotional pain and discomfort Suffering from the inability to accept change The profound dissatisfaction of existence. Tahn said that you develop greater resources when you meditate. Then you may have extra resources to help others: You learn to deal with everybody's stuff. You learn to be aware of your body. This is your perspective for everything you do. It makes me happy to think about my eyeballs. When I meditate on this, it becomes funny, and I laugh. Tahn suggested that when you meditate, you learn to be aware of your body, because that is the center point of your world. This is your perspective on everything that is going on in the world. When you become aware of your body and what it is doing, you know the context of everything in your life. What does his day look like? Tahn said: I answer emails, I troubleshoot problems. Lately we've had a problem with scorpions. But we don't try to kill them. Tahn talked about how Buddhism defines Truth as reality, and that the definition of happiness is “non-suffering.” There are three patterns that lead to unhappiness: Attachment, which he defined as greed and desire, especially when you seek some external object(s). An extreme example would be disregarding the needs of others or even endangering others to get the object of your desires, or an attitude of only wanting or caring for things that you like or want. Aversion which refers to feelings of aggression, anger, and hatred. Aversion's opposite is loving kindness. When we experience Aversion, we push away (usually aggressively) the things that we dislike. If we allow our ignorance to take over, we can conjure up hatred for the things that we dislike and the people we see as blocking our desires. We saw from the meditation experiment that Jason described last week, how meditating on loving kindness brought about a reduction in people's negative thoughts. Ignorance refers to delusion, confusion and dullness. Ignorance defuses understanding serving to confuse you and prevent you from doing something functional. This can be experienced as an inability to see the truth or reality of ourselves or the world around us. Asking questions like “Am I real” is the basis of the first two in this list. Tahn also discussed how the mind precedes the thoughts. Then we talked about the concept of the Self, in that we think that we exist. However, there is no stable “I.” All we find are temporary phenomena. For example, you don't need to have a “self” to drive to a picnic. All you need is a car and a tank of gas. The group discussed the Buddhist concept of “laughing enlightenment.” Thank you for listening today! Tahn, Jason, Rhonda, and David

This was the most meaningful podcast that I've recorded to date, as I was joined by the legend Dr. David Burns.  David is a psychiatrist and author known for his contributions to cognitive behavioral therapy. His book "Feeling Good: The New Mood Therapy" explores the philosophical underpinnings of how our thoughts influence our emotions and behaviors. As a professor emeritus at Stanford University, Burns continues to examine the intersection of psychology and philosophy, particularly in how individuals can rationally approach and overcome psychological challenges. His books have transformed millions of lives, while his "Feeling Good Podcast" reaches countless listeners worldwide.In this episode, we discuss the underpinnings of TEAM-CBT, how David is incorporating this model into an app (Feeling Great), and we role play a therapy session.Enjoy.David's website:https://feelinggood.com/The Feeling Great app:https://www.feelinggreat.com/Feeling Good podcast:https://pod.link/1171155453David's other books!https://feelinggood.com/books/Follow me:https://www.instagram.com/josh_philwl/

#400! Yippee! Today, Rhonda has prepared a special celebration for our 400th podcast, and still going strong! She has invited a number of our favorite people and podcast guests to celebrate with us, starting with our beloved friend and frequent Ask David contributor, Matt May, MD, who officially joined us in early 2000. Matt's presence on the show had meant a great deal, personally and professionally, because I supervised Matt when he was a Stanford psychiatric resident, and had been missing our weekly chats! Our reunion via the Feeling Good Podcast has been special for that reason, but also because of Matt's kindly but scholarly answers to the many questions all of you submit. Keep them coming, and send them directly to Rhonda or David. We love reading and answering them! Next, we were joined by two more extraordinary psychiatrists and human beings, Drs. Heather Clague and Brandon Vance, who song their rendition (with guitar accompaniment) of “Help Dr. Burns!” (Based on Beetles' Help, I need somebody!” With their kind permission, here are the brilliant lyrics! Help! I need a podcast! Help! Not just any podcast! Help! Pushing the Magic Button for .... Help! When I was younger, 8 years younger than today I thought I could help everybody; help them in every way. I got so grandiose; I was so self-assured. I'd push my brilliant techniques, but my patients were never cured. So, Help me not to Help oh Dr. Burns Will they like me if they have to do the work? If I set an ultimatum, am I a jerk?! Won't you please, please stop me?! So many times, I tried to help, but then got stuck I didn't know but my patients were also thinking what the #?@! Your podcast said to test at the start and after every session. And then my eyes they opened wide Boy, was that a lesson! Oh Help me not to help, oh Dr. Burns! Help me unlearn the bad habits I have learned I'll do homework when my urge to help returns Won't you please, please help me?! Now I explore my patients' reasons not to change. I learned to sit with open hands if they choose to stay the same. Only when they fight for change and want to do the work, That's when I offer tools, and know the changes will endure. You've helped me not to help, oh Dr. Burns ‘Til my patients show me that they really yearn To do the work and ask me really firmly Won't you please, please help me? Your podcasts helped ME! Oooooooh! Much warmth to each of you! Heather and Brendan Our next guest was the brilliant and beloved Dr. Jill Levitt who joined my weekly Stanford training group when she and her husband, Brian, and two boys moved to the Bay Area from New York in 2007. Jill has moved up in the ranks and now co-leads the Tuesday group with me, and also joins me as co-therapists in a great many live sessions we have published as two consecutive podcasts. The idea is to document exactly how TEAM-CBT works, and how we can nearly always get such blow-away results in a single, extended session. That was my dream as a young man, since the methods I was taught as a psychiatric resident almost never got rapid results, or even any noticeable changes in my patients. Now that dream has become a reality, and a great many people in our TEAM-CBT community have contributed to that evolution. Next we were joined by our beloved Dr. Amy Huberman. Her riveting personal work on perfectionism was published recently on two consecutive Feeling Good Podcasts. Amy was glowing and filled with joy, which gave us great feelings of joy as well! And then we were graced by a visit from Mina, who has starred in many Feeling Good Podcasts on a number of personal issues. I will be seeing Mina and her beloved husband in a few minutes for our Sunday morning hike and dim sum feast afterwards. It is always a highlight of my week! Next was another Amy Berner who reported on her recent and wildly successful Intimate Connections Book Club with yet another psychiatrist, Dr. Leigh Harrington. Amy did some personal work with me on dating and sex appeal three years ago, when we discussed the Queen Bee phenomenon. Apparently, it was successful, because she brought her fantastic husband, Randy Kolin, as proof of the effectiveness of the many dating strategies and tips in that book. Randy is also a mental health professional who works with stressed-out scientists working on nuclear fusion at the Lawrence Livermore Laboratories. We wish him all the best since the work of those scientists is well on the road to creating commercially viable nuclear fusion, which will transform life as we know it on the surface of the earth by supplying unlimited, clean, low-cost energy. Their visit was followed by Zane Pierce, whom I hadn't had the chance to chat with much for a number of years. He led a recent “delight” and “gratitude” hike that we published on podcast # 361entitled “Finding Joy in Everyday Life,” with Dr. Angela Krumm from the Feeling Good Institute in Mountain View, California. We have done previous podcasts with Zane, and his lovely wife, Daisy, including one of our most popular podcasts ever on “What's the Secret of a Meaningful Life,” Episode 079. And then came the magnificent colleague and friend, Indrani Mookerjee.  Indrani joined our community after attending the 2019 intensive, and recently did one of the most explosive and jaw-dropping podcasts, Episodes 359 & 360, “You Wowed Me, A Mother-Daughter Conflict,” featuring her personal work on her relationship with her daughter. Indrani had struggled, unsuccessfully, to get close to her daughter, whom she loved greatly. She made a mind-blowing discovery of why during her personal work, and instantly achieved what I call “interpersonal enlightenment.) She now provides the joyous follow up on how her relationship with her daughter has blossomed and evolved since that momentous moment. Next, we were joined by Mike Christensen, who is our top TEAM therapist in Canada. Mike became familiar with my work when he read Feeling Good in 2006 and then heard a keynote speech I gave at a conference in 2009. Since that time, he attended many of my two-day workshops in Canada, and now is a leading TEAM-CBT therapist and teacher. He's been a featured guest on seven Feeling Good Podcasts or episodes of Facebook Live, when I was doing televised work on Facebook every Sunday afternoon. Mike describes himself as “joyously average,” a idea that really resonates with me. It is a form of “invisible enlightenment” which nearly everyone fears, but you cannot understand the incredible liberation of this “Great Death” of the “self” until you've experienced. We recollected a Feared Fantasy exercise we once did together while hiking one evening following a workshop in Canada. We also got updated on his beautiful and brilliant daughter, Katlin, who is now studying psychology in college and hopefully heading for her own career doing TEAM-CBT. And finally, one my most favorite people in the, our brilliant, wonderful, and funny Sara Shane, whose life-changing enlightenment has been a fantastic source of joy and inspiration to me and to many. Sara came from humble roots, as a Mexican immigrant picking fruit with her parents for survival in the US, and is now living in the Central Valley and attending not one, but two weekly TEAM-CBT training groups. She specializes in brief intensive treatments for the patients she treats. You may recall her from podcast #162, High Speed Cure for OCD, where she described her single-session treatment for 20 years of OCD / contamination phobia. She also did a lot of personal work to achieve liberation from her fairly severe social phobia and feelings of inferiority that were embedded from early childhood. We love you and so much appreciate you, Sara! That's about it for today, but than you all for listening. Next week, we will likely have two consecutive Ask David podcasts with Dr. Matt May, followed by two consecutive podcasts called “Raw Emotion: Personal work with Chris,” featuring the work that Jill and I did with a young man with social fears and an almost unbelievably traumatic childhood, growing up in Palo Alto. The sound quality is not always top-notch, sadly, but the unbelievable quality and impact of this session easily makes up for that, so we have decided to publish it anyway, and hope you find it as amazing as we did. David, Rhonda, and the whole gang! 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 long 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. Hey, another special announcement! The long-awaited Feeling Great App is finally available in the Apple and Google stores. Check it out! You can try it for free!      

Have you ever wondered if it's possible to give speech back to those who've lost it using advanced brain technology? Dear Listeners, welcome to episode #82 of our “Neurocareers: Doing the Impossible!” podcast, where we're diving deep into the world of speech neuroprostheses and exploring how brain-computer interfaces (BCIs) are unlocking new ways to communicate. Speech-decoding BCIs are gaining ground rapidly. They promise a new way to communicate for those who cannot speak by tapping directly into brain activity. The secret to making these devices work is understanding how speech is produced in the brain, from the timing to the specific brain regions involved. Interestingly, it looks like even deeper brain areas, including the insula, hippocampus, and thalamus are involved in this process. I am your podcast host Dr. Milena Korostenskaja or simply Dr. K. and joining us today is Maxime Verwoert, a researcher with the long-term goal of developing speech neuroprostheses. After her studies in Psychology and Neuroscience at Utrecht University, Maxime is now a PhD candidate at Maastricht University in Netherlands focusing on decoding speech signals in real-time with stereo-EEG. This technology is less invasive than other methods, such as ECoG, offering hope for long-term use in BCIs. Maxime's recent work, published in Nature's Scientific Data, involved collecting a rich dataset from participants reading aloud while their brain activity was meticulously recorded. This dataset covers a broad spectrum of brain regions and offers deep insights into how we produce speech. In our chat, Maxime explains how this cutting-edge technology is developed, the hurdles of interpreting complex brain signals into speech, and what the future holds for people needing speech neuroprostheses. Maxime will also share her advice for those who are planning to get into the field of neurotechnologies. Whether you're a tech enthusiast, a healthcare professional, or just curious about how neuroscience changes lives, this conversation promises to bring unique knowledge and inspiration. So tune in, and get ready to be amazed by how close we are to turning thoughts into words! About the Podcast Guest: Get in touch with Maxime Verwoert via LinkedIn: https://www.linkedin.com/in/maxime-verwoert-756966105/ Lab:  https://neuralinterfacinglab.github.io/ Dataset: https://osf.io/nrgx6/ https://www.nature.com/articles/s41597-022-01542-9 Articles: https://doi.org/10.3389/fnins.2020.00123 (sEEG for BCIs) https://ieeexplore.ieee.org/document/10394550 (sEEG semantics) https://www.nature.com/articles/s42003-021-02578-0 (sEEG speech BCI proof-of-concept) https://doi.org/10.1007/s13311-022-01190-2 (speech BCI review)  Courses: https://www.codecademy.com/ https://www.codecademy.com/ https://www.coursera.org/ https://scikit-learn.org/stable/  https://neuromatch.io/ Mental Health: “Feeling Great” Book (https://www.amazon.com/stores/page/E0B7C5D5-CD14-405B-BD0A-253F8D94A3B4?channel=db-website) “Feeling Good” Podcast (https://feelinggood.com/subscribe/)   About the Podcast Host: The Neurocareers podcast is brought to you by The Institute of Neuroapproaches (https://www.neuroapproaches.org/) and its founder, Milena Korostenskaja, Ph.D. (Dr. K), a neuroscience educator, research consultant, and career coach for people in neuroscience and neurotechnologies. As a professional coach with a background in the field, Dr. K understands the unique challenges and opportunities job applicants face in this field and can provide personalized coaching and support to help you succeed. Here's what you'll get with one-on-one coaching sessions from Dr. K: Identification and pursuit of career goals Guidance on job search strategies, resume, and cover letter development Neurotech / neuroscience job interview preparation and practice Networking strategies to connect with professionals in the field of neuroscience and neurotechnologies Ongoing support and guidance to help you stay on track and achieve your goals You can always schedule a free neurocareer consultation/coaching session with Dr. K at https://neuroapproaches.as.me/free-neurocareer-consultation Subscribe to our Nerocareers Newsletter to stay on top of all our cool neurocareers news at updates https://www.neuroapproaches.org/neurocareers-news   

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

Rhonda Describes the GRIP Program and Interviews GRIP Graduate, Shakur Ross The Guiding Rage Into Power (GRIP) Training Institute serves incarcerated men and women in California.  Their mission is to create personal and systemic change to turn violence and suffering into opportunities for learning and healing. I (Rhonda) was introduced to the GRIP program when two of my dearest friends, Steve Zimmerman and Vicki Peet, invited me to a yearly celebration of the GRIP Training institute.  I was blown away by who I met and what I learned that I wanted to share it with the Feeling Good Podcast listeners.  Thank you, David, for letting me deviate from our typical subjects. The GRIP program is a different subject for the Feeling Good Podcast, because it is not about TEAM-CBT.  What the GRIP Program and TEAM-CBT have in common is that they are both evidence-based programs that incorporate CBT theory and methods into their treatment methodology.  But the main thing they have in common is that people who engage in these two therapies experience profound, enlightening changes in their lives. From their program: “The GRIP program is an evidence-based methodology developed over 25 years of work with 1000's of incarcerated people and many victim/survivors. Rooted in Restorative Justice principles, the program's trauma informed model integrates cutting-edge neuroscience research.  Students engage in a yearlong, in-depth journey to comprehend the origins of their violence and develop skills to track and manage strong impulses rather than acting out in harmful ways.  They transform destructive beliefs and behaviors into an attitude of emotional intelligence that prevents revictimization.” The GRIP Training Institute was started in 2011.  As of October 2020, nine years after running its first group, 915 students have graduated.  Of the 915 graduates, 369 were released from prison.  Only 1 graduate in nine years returned to prison, which is a recidivism rate of 0.3%, which is very impressive considering the recidivism rate for California is between 44-46%.  Many, if not all of the graduates, say that GRIP saved their lives.  Something many people who have benefitted from TEAM-CBT echo. At the GRIP celebration, I was standing in line waiting for the buffet.  A man got in line behind me.  It was confusing where the line ended, which was not directly behind me. In another circumstance I might have mentioned to him that the line ended somewhere else, but he was kind of scary looking, big, buff with obvious prison tattoos on his neck so I didn't say anything.  But the line moved slowly and I was curious so I asked him what his connection to GRIP was.  He told me he was a graduate of the program and then politely asked me the same question. It has been my experience that often people love to talk about themselves more than they are interested in other people so I was immediately impressed that he was as interested in me as I was in him.  When I told him I was a therapist, he asked me what kind of therapy I practiced.  I explained TEAM-CBT, and he was super interested! He told me he loved CBT, and had learned a lot about himself through that kind of therapy because GRIP incorporated it in their program.  I asked him about his experience in GRIP and his tough exterior transformed right in front of me as he talked about how GRIP saved his life. I talked to several other men (so far only men have graduated from the GRIP program because the services have only recently been brought to a women's prison), and had the same experience.  I met our guest on this podcast, Shakur Ross, who kindly agreed to share his journey of transformation with us. GRIP graduates continue to do the work and live as Peacemakers.  Shakur works for GRIP and returns to San Quentin and other prisons to provide the same lessons that he received. The podcast starts with an interview with Kim Moore, the Executive Director of the GRIP Training Institute, who explains some of the key concepts of the program. Thanks for listening today! Rhonda  

At Last! An Outcome Study!  One of the wonderful things about TEAM-CBT is the dramatic and rapid changes we see in so many of our patients. But we've had a huge problem-no published outcome studies. And that has definitely limited the general acceptance and recognition of TEAM-CBT. Today, that era has come to an end, thanks to Dr. Elise Munoz, who joins our beloved Feeling Good Podcast to discuss a remarkable outcome study conducted at her Feeling Good Psychotherapy clinic in New York City. She wanted to evaluate the effectiveness of TEAM-CBT with teens and young adults. Dr. Munoz is the Founder and Lead Therapist at Feeling Good Psychotherapy and Adjunct Assistant Professor at New York University. She is also a Level 4 Certified TEAM-CBT Therapist & Trainer, and specializes in the treatment of anxiety, depression and life transitions. Elise conducted a “naturalistic” study of data from 116 teenagers and young adults aged 13 -24 years of age who were treated by 15 therapists between 2017 and 2022. In a “naturalistic” study, you simply analyze all the data from your patients to evaluate the effectiveness of  the treatment. This is in contrast to a “controlled outcome study” where patients are randomly assigned to two treatments to see which treatment delivers the best results. Elise conducted the research study as part of her work for a Doctorate in Clinical Social Work at the University of Pennsylvania in Philadelphia. "The results," she says, "were encouraging." That's perhaps a humble description of her findings. David and Rhonda might say that the results were pretty awesome! Elise told us that although the average number of treatment sessions was 27, most of the patients made maximal gains after just 10 weeks (2.5 months) of treatment, and many achieved maximal improvement by the 5th session.  Specifically, by the tenth session. 80% of the patients scored in the "subclinical" range on the depression scale of my Brief Mood Survey (with scores of 0 to 4) and 87% scored in the subclinical range on the anxiety scale (scores from 0 to 4) . These scales range from 0 (no symptoms) to 20 (extremely severe.) Prior to the study, only 30% were in the subclinical range. According to Elise, the rapid improvement suggested that most patients will not need long-term treatment, although some will need more time to incorporate their gains following their initial improvement, and many will want to remain in treatment to deal with other problems, such as relationship issues that are so important in this (or any) age range. Prior to the study, Elise trained the therapists in a weekend TEAM-CBT "boot camp," along with two hours per week of group training and 1 hour per week of individual consultation/supervision. My own view (David) is that learning TEAM-CBT is very challenging, requiring a minimum of one to two years of intensive training. However, the fact that therapists can get excellent results with a relatively small amount of training is encouraging. One of the key components of TEAM is T = Testing. We test every patient at the start and end of every therapy session, asking, "How are you feeling right now?" This provides the therapist with a kind of emotional X-ray machine that allows you to see the precise degree of improvement, or lack of improvement, at every session in multiple dimensions. Therapists can use the information to fine-tune the treatment on an ongoing basis. Many other research studies have demonstrated that session by session monitoring of symptoms, consisting of measurement and feedback, significantly improves outcomes in mental health treatment. (please contact Elise for a list of research studies you can look up online). Research indicates that roughly half of adolescents and young adults will suffer from some mental health problem. Therefore, it is essential to provide accessible, effective treatments to prevent the development of long-term mental health problems. We salute Elise for going the extra mile to evaluate the effectiveness of the treatment and to identify the therapists who get the best results. This requires courage and also allows our field to move forward based on real data rather than subjective impressions. Dr. Munoz's fascinating work adds to the body of evidence supporting the effectiveness of TEAM-CBT. and also sets a commendable example of dedication to improving mental health outcomes through research and ongoing professional development in a private practice environment. The famous and idealistic “Boulder Model” of the “scientist / practitioner” is highly touted in graduate school graining programs for mental health practitioners, but is rarely practiced in real life. Dr. Munoz shows that the integration of science with clinical treatment in community settings is not only possible, but extremely important. Dr. Munoz's research also indicates that the TEAM model offers an exciting path to improved mental health for teens and young adults!

Shoulds and More with our Beloved Fabrice! Three little words that will make your life miserable are “shoulds,” “wants,” and “needs,” says Dr. Fabrice Nye, the father / creator of the Feeling Good Podcast several years ago. But for the purpose of this episode, we'll add a fourth word, “Musts,” which was popularized by Dr. Albert Ellis, who referred to it as “Musterbation.” Fabrice says that, “Shoulds are a trap. . . . There's no such thing as a should, except for the laws of nature. For example, if I drop my pen, it “should” fall to the floor because of the effects of gravity. And sure enough, it does! “But when I say, ‘I should get an A on my upcoming exam,' i may just be setting myself up for frustration. That's because there's no laws of the universe saying that people will always get As on their exams. "Similarly, if I say it SHOULDN'T be raining today, I'm involved in fiction, not reality. The clouds don't obey our whims, they are just obeying the laws that govern the weather.” Fabrice explained that when you apply shoulds to some past event, telling yourself that your shouldn't have made some mistake, you just make yourself guilty because it sounds like you're scolding yourself. Again, you're living in some fictitious reality where things are always the way you want them to be, because it's impossible to change the past Fabrice reminded us that the Anglo-Saxon origin of the word, “should,” is “scolde.” So when you “should” on yourself, you're actually scolding yourself. Fabrice also explained that the concept of “needs” can also get us into emotional hot water, since we sometimes tell us that we “need” things that we may want but don't really “need.” So, if you tell yourself that someone “needs” to do something for you, you are simply applying pressure to the situation. For example, you might want or prefer for the person to be on time for appointments or planned activities, but you don't “need” them to be on time. Similarly, you might want to find someone to love, or someone to love you, but you don't “need” love, according to Fabrice. . . . and David agrees! It has been shown in research studies that infants and young children need love to grow and develop in a healthy way, but love is not an adult human need. According to the Buddhists, “needs” are not real. They're just cravings, or intense desires that we've elevated to some godly state. Of course, there ARE things that we really do “need.” For example, we “need” to breathe to stay alive, and we “need” to have gas in the car if we want to drive to San Francisco. Those things are needed to fulfill a particular goal. So the key to an actual need is adding the phrase, “...in order to...” Fabrice also described some “want” traps. For example, you may sit at your computer cruising the internet or playing digital games, all the while telling yourself “I really want to get to work on my paper,” or taxes, or whatever. But in point of fact, you DON'T want to get to work on the thing you're putting off. You WANT to be doing exactly what you are doing. Fabrice explains that we “trick ourselves into thinking we want something (like doing our taxes) when we really want to be doing something else (watching TV, playing computer games.) So, once again, we are telling ourselves stories that don't map onto reality." Our real “wants” are the result of an unconscious cost-benefit analysis we make in our head, where the choice that comes out on top is our real want. It's only when I really start doing my taxes that I'll know this is what I want to be doing (probably because the urgency of the matter made the cost-benefit analysis tip in that direction). David was trying to see if this concept of “wants” can be helpful in therapy but had trouble seeing how this might help someone who's procrastinating. Fabrice explained it like this: First, we need to realize that we are doing what we want in the moment; so, it's a choice. Next, we can make our cost-benefit analysis conscious and see that we're only considering short-term factors (e.g., it's a lot more comfortable right now to be watching TV than doing taxes). Finally, we can develop some empathy for our future self (the one who will be pulling an all-nighter three weeks from now, or who will have to pay late fees) to reevaluate our cost-benefit analysis with more complete data. Fabrice also explained that procrastination can sometimes be difficult to treat because it's an addiction. Rhonda also commented on the use of these concepts in therapy. Fabrice concluded the podcast by saying that he watches out for those three little words in his own thinking: “should, need, or want.” Thanks for listening today. Fabrice, Rhonda, and David  

Are the "physical" symptoms of depression specific or non-specific? How do you treat schizophrenia with TEAM? Why don't more shrinks help themselves? Healthy vs unhealthy negative feelings-- what's the difference? Questions answered in this podcast: 1. Laura asks: Why don't you include the physical symptoms of depression in your assessment tests? 2. Fred asks: How would you use TEAM-CBT to treat individuals with schizophrenia? 3. Author not known: Why don't the therapists you treat with TEAM treat themselves using self-help techniques? 4. Zach: How does David understand the difference between healthy and unhealthy emotions? Is there any overlap between EFT (Emotionally Focused Therapy) and David's TEAM-CBT?   The following are David's written responses to these questions. However, in the podcast, Rhonda and David discuss them, and their answers together may differ or enlarge on the material below. Also, in some cases, the written answers contain additional information not included in the live podcast. 1. Laura asks: Why don't you include the physical symptoms of depression in your assessment tests? Author: Laura asks a question about post #248: “David and Rhonda Answer Your Questions about Exercise, Empathy, Euphoria, Exposure, Psychodynamic Therapy, and more!” Comment: Fabulous, David. Bless you. Have you done a show on assessments? I'll be honest about my confusion. Some of the measures that you have developed almost seem too simple to be accurate. For example, the depression test isn't sensitive to any of the physical manifestations of the illness. Anyway, I was just curious about that. David's Reply Thanks, Laura! Good questions! First, the so-called physical symptoms of depression are non-specific and not uniquely associated with depression. Only the core emotional symptoms are good indicators of depression: feeling down, hopeless, worthless, unmotivated, and not enjoying life. If you want to measure physical symptoms, they won't give you much information about depression, but at least they need to be worded correctly, which they aren't in most assessment tols. For example, you can measure weight gain, OR weight loss, in single and separate items, but not in the same item. But if you go to a mall and ask how many people have had weight gain, you'll probably find that more than 50% report weight gain, but this is rarely due to depression, rather it is due to overeating! Similarly, a significant fraction will say yes to a question about weight loss, and in the vast majority of cases this will be due to dieting, not depression. Similarly with the other poorly thought out physical symptoms, like trouble sleeping. The reliability of my depression measures has typically been .95 or better, as compared with measures like the Beck or PHQ9 that have only .78 to .80 reliability coefficients (called “coefficient alpha.”) I have observed a phenomenal lack of critical thinking behind most current psychological tests for depression, anxiety, and other variables of interest to clinicians and researchers. You also asked about apps for anxiety, like OCD, as opposed to depression. The Feeling Good App causes rapid and significant reductions in, not one, but seven categories of negative feelings, including feelings of depression, anxiety, guilty/shame, inadequacy, loneliness, hopelessness and anger. Thanks so much! Finally, I have to confess my bias toward trying hard to make things simple, so we can all understand what we're talking about! When things are overly complicated or hard to “get,” I usually feel fairly suspicious about the person who is trying to “teach.” In college I always had the policy that if I can't understand what the teacher is trying to say, the teacher has a problem! My thinking today is pretty similar! I've always appreciated teachers who keep things simple for us mere mortals who appreciate having things explained clearly and in everyday words. Best, david 2. Fred asks: How would you use TEAM-CBT to treat individuals with schizophrenia? Hi David, Do you have any schizophrenia thought experiments? Most of my clients struggle with voices. I tell them there is always a good voice, which I believe is the Holy Spirit woven into every person at birth. I also tell them to welcome the voices and listen for what they need, because the voices need to be welcomed back into the body - the "family" - of the person, according to Internal Family Systems. I welcome your thoughts. I am not a therapist so anything I say or do needs to fit my role as a recovery coach. Fred South Bend, Indiana David's Reply. Thanks, Fred, great question. I have treated many individuals with schizophrenia, but they have rarely or never asked for help with the voices they hear. I like to set the agenda for each patient, finding out what they specifically want help with. And individuals with schizophrenia respond very well to TEM-CBT, both the individual treatment model for depression and anxiety, as well as the interpersonal model for relationship problems. An experience early in my career highlighted the folly of trying to challenge the delusions of individuals with schizophrenia. A young man, a new patient, seemed uncomfortable and when I inquired, he explained that the receptionist, Lucretia, was listening in because she could “hear” our thoughts and our conversation. I explained that Lucretia did not have much money, and that if he wanted we could do an experiment to test his belief. I put a $20 bill on the desk and said that if Lucretia knocked and came into the office, she could have the money. So I did that and Lucretia did not knock on the door or appear in the office. I asked the young man what he concluded from our “experiment.” He said that she “knew” it was an experiment since she could “hear” our thoughts, and didn't come in because she didn't want us to know she was “listening in” on our dialogue! That's an excellent example of what happens when the shrink tries to set the agenda, as opposed to helping patients with what THEY want help with! In my experience, you can help individuals with schizophrenia with self-esteem, anxiety, and relationship problems with psychotherapy, and they do feel and function somewhat better, but they still, sadly, have schizophrenia. This is my thinking only, and others may differ. I know that Aaron Beck and many of his followers have done research studies claiming they can help schizophrenia with traditional CBT. I am skeptical, but have not read those studies or evaluated the data with a critical eye! So who knows? Maybe they have some decent results. Best, david 3. Author not known asks: Why don't the therapists you treat with TEAM treat themselves using self-help techniques? Why can't the TEAM-CBT therapists who have done personal work with you on the podcasts do that work themselves in self-help mode?" They know all the techniques and have all the tools. With no qualifications, I have my own theory on that, which is actually based on TEAM. I don't know how to give myself the level of E=empathy required to move on to the next stage. So I guess my question could be reworded as "Is it possible to give yourself sufficient empathy in self-help mode?" or "Are there techniques or tools you can use to give yourself empathy in self-help mode?" David's Response Thanks, cool question! Blind spot, especially in relationship problems To get experience in the “patient” role Sometimes, we all need a little help from a friend, and that can sometimes be vastly faster than trying to do everything on your own. But in terms of empathy, I believe you CAN treat yourself with empathy, warmth, and compassion, and that is actually one of the keys to recovery, whether or not you're in treatment with a shrink!   4. How does David understand the difference between healthy and unhealthy emotions? Is there any overlap between EFT (Emotionally Focused Therapy) and David's TEAM-CBT? Hi Dr. David and Dr. Rhonda, I have a question if you have a chance, and maybe this is better for an Ask David. David talks about healthy emotions sometimes, and this feels like a faint through-line to EFT model. Does David have a framework for understanding healthy emotions or emotional needs? When a client is grieving, David encourages the tears to flow and notes it's an expression of how much the client valued something. David also demonstrates what EFT would call protective anger, when using the counterattack method, “I'm tired of listening to your BS.” And lastly David demonstrates what EFT labels self-compassion while using the acceptance paradox and 5 secrets responses to critical thoughts. Thanks, Zach David's Response Thanks for the excellent question. I have to confess that I don't know much about EFT, but I think there's a lot of overlap in different “therapies” since many people “borrow” ideas from other experts, and get so excited about them that they call them their own, and simply give them a new name, claiming to have something entirely new. And it sounds like there are some definitely similarities between my TEAM-CBT and what is called “EFT.” If this is true, I'm certain I didn't do the “borrowing” since I don't attend to the work of others in the field, for better or worse. At any rate, I have always taught my students that each negative feeling has a healthy and an unhealthy version, as you can see in the following table. The main difference is that the healthy version results from valid negative thoughts, and the unhealthy version results from distorted negative thoughts. However, in the past 25 years or so, I've taken a new look at so-called “unhealthy negative feelings” in my TEAM-CBT. There, we reframe the negative feelings, showing what's beautiful and awesome about each one. IN other words, we genuinely try to sell the patient on NOT changing. Paradoxically, this approach, which I call Positive Reframing, seems to melt the patient's resistance to change, and that nearly always opens the door to the possibility of rapid change. Healthy vs Unhealthy Negative Feelings Healthy Version Unhealthy Version Sadness, grief when you've lost someone or something you loved Depression, worthlessness, hopelessness Healthy fear when you're in danger Anxiety, nervousness, worry, and panic, and phobias Healthy remorse when you've hurt someone you love Neurotic guilt, blaming yourself for something you're not entirely, or at all, responsible for Healthy inadequacy and awareness of your very real shortcomings and limitations Worthlessness, inferiority Missing someone you love Desperate loneliness, abandonment, feeling unlovable Discouragement when you fail or when things don't work you Hopelessness Sharing your anger in the spirit of love and respect Unhealthy anger, aggression, acting out your anger with the goal of hurting or upsetting the other person, or getting back at them   Thanks so much for listening today! Warmly, Rhonda 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

Ask David: Burn Out; When Challenging Thoughts Doesn't Work; and more! Featuring Dr. Matthew May In today's podcast, Matt, Rhonda and David discuss four challenging questions from podcast fans like you: 1. Joseph asks if it's okay to take a break when you get “burned out.” Below, David expands on this and describes the difference between “healthy” and “unhealthy burnout.” 2. Joseph also asks why your feelings might not change when you challenge your negative thought with a positive thought that's 100% true. 3. Dan asks about Step 4 of the Relationship Journal, which is the most difficult and important step in the TEAM interpersonal model—see exactly how you're forcefully causing and reinforcing the very relationship problem you're complaining about. For example, if the person doesn't “listen,” you'll see that you're forcing them not to listen. If she or he doesn't open up and express feelings, you'll see that you prevent them from opening up. And if you think your partner doesn't treat you in a loving and respectful way, you'll suddenly see exactly why this is happening—if you have the courage to take look and see: But if fact, this is one of the “Great Deaths” of the “self” in TEAM-CBT, and very few folks are willing to “die” in this way. 4. Finally, Clay asks about EMDR. He's been treated with it without success. David and Matt weigh in with their thoughts about EMDR. This question was not addressed on the podcast, since some practitioners of EMDR might be offended by David and Matt's thinking, but they did describe their thoughts in the show notes below. If you are an EMDR enthusiast, you might prefer NOT to read our comments. Joseph writes: Thanks, David, for sharing so much on the podcasts! I have a couple questions. Personally, I find that when I'm burnt out, I get a lot more anxious automatic thoughts. While it's definitely good to combat these distorted thoughts by replacing them with realistic ones, my takeaway is that it's also sometimes wise to change our lives / circumstances (e.g. to take a break). By the way, I also wanted to ask if you've ever faced a situation where you are convinced that a thought is distorted and irrational (and you know what the realistic thought is), but you still can't shake it off? I sometimes get stuck when I already know the "right answer" (ie. what the realistic thoughts are based on the methods you've taught), but I just can't seem to get my brain to fully believe it. For example, I was recently on vacation and a small blip made me think "my vacation is ruined!". I immediately identified it as all-or-nothing thinking, and replaced it with "my vacation is still going very well even if it's not perfect" (and I'm convinced this thought is true), but somehow my mind kept going back to the automatic thought again and again. Curious if you've ever experienced this. Thanks again so much for your time and your teaching; just wanted to say I really appreciate it! :) Regards Joseph David's Reply to Joseph. Thanks for the great questions. We address both of them on an upcoming podcast. Here's the quick response. Yes, it is okay to take a break when you feel “burned out.” However, you can get “burned out” in a healthy or unhealthy way. For example, after I edit for two or three hours, which I love, my brain gets “burned out.” So I take a break and come back later, maybe even a day later, and I feel refreshed and filled with enthusiasm about writing and editing some more, because I love these activities. When I was in private practice in Philadelphia, I saw 17 patients back to back on Wednesdays. That way, I could have a three day weekend. Actually, I loved it and as the day went on, I got higher and higher. At the end I was exhausted, but exhilarated. I was never “burned out” because I loved what I was doing, and the clinical work was SO rewarding! However, sometimes I made a mistake and a patient would get very upset, sometimes angry with me, or felt hurt. THAT was when I got suddenly burned out and exhausted. But it wasn't because of my work, or the conflict, but rather my thoughts about it, which generally involved a combination of self criticism and frustration with the patient, both the result of distorted thoughts, generally Self-Directed and Other-Directed Should Statements. And THAT kind of “burned out” won't improve with a break. The answer is challenging and changing your own inner dialogue, as well as your dialogue with the other person, using the “failure” in the relationship as an opportunity to listen and support and create a deeper and more meaningful relationship. With regard to your second excellent question, we explored that in depth in the podcast, and also made it a problem for our listeners to think about. So tune in for the answers! This is a popular question I've been answering for more than 40 years, and the answers tell us a great deal about how cognitive therapy actually works. Thanks so much, Joseph!  Subject: Relationship Journal Gem I Found Dan (a former participant in David and Jill's Tuesday training group at Stanford) writes: Hello to the Dynamic Duo (David and Jill), I came across this doc for Step 4 of the Relationship Journal, but I don't really understand it and I don't remember the context. I know it was from the Tuesday Group years ago. It says it's about conceptualizing the problem, just not sure how to utilize this in step 4. Thanks. (You will find this document in the show notes below.) ~Dan (Daniel C. Linehan, MSW, LCSW) David's Reply Hi Dan, Great question. In this document, I am trying to make it a bit easier for folks to see how they are triggering the very problem they are complaining about. So, I have listed three categories of common complaints. For example, an Empathy complaint would be that “My partner doesn't listen,” or “always has to be right.” Then you ask, “If I wanted to force my partner to behave like this, how could I so?” Well, one good way would be to interrupt when your partner is trying to talk, or argue and insist your partner is wrong when they're trying to make a point, and so forth. This would force your partner to argue and insist that they are right! It is pretty basic and obvious. But most human beings don't “get it,” and in part that's because a great many don't want to. Blaming the other person seems way more popular than looking at your own role in the problem these days. Good to hear from you on this important topic! People can usually “see” how step 3 of the Relationship Journal works—you simply examine what you wrote down in Step 2, and you can almost always see no E (Empathy), no A (assertively sharing your feelings with “I Feel” Statements, and no R (conveying respect or liking to the other person, even when you're angry.) But most people don't seem to have the natural mental aptitude or the stomach for Step 4, where you go beyond Step 3 and explain EXACTLY how you FORCE the other person to behave in the exact way you're complaining about. The document in the link is an attempt to help people with Step 4—IF you are willing to examine your own role in the problem. In Step 4, you ask yourself what category you see the other person in, and there are three choices to make it fairly simple. You might feel that they don't listen or try to see your point of view. This would be an E = no Empathy complaint. Or you might feel like they can't, or won't, share their feelings. Instead, they might just keep arguing, or they might refuse to open up. This would be an A = no Assertiveness complaint. Or, you might complaint that they don't treat you with warmth, love, or respect. That would be an R = no Respect complaint. This makes it much easier to “see” how your response to the other person in Step 2 actually causes and reinforces the exact behavior you're complaining about. Lots of people get defensive or annoyed at this step of the RJ, and refuse to continue! That's because Step 4 is all about the third “Great Death” of the “self,” or “ego,” in TEAM-CBT. Most of us don't want to “die” in this way. It can feel humiliating, or shameful, to pinpoint your own role in the problem. But, there's usually a big reward—you're suddenly “reborn” into a far more loving and satisfying relationship. In the podcast, brave and wonderful Rhonda provided David and Matt with an example when she was visiting her son and daughter in law in Germany last month to help out with their twin baby girls. This example really brings this “Great Death” to life, and we are grateful to Rhonda for helping us in this very vulnerable and real way! Feel free to ask again if I have not made it clear. To me, this phenomenon of causing the very problems we are complaining about in our relationships with others is incredibly fascinating. However, change involves the “death of the self,” which is painful, because you have to see, usually for the first time, your own role in the problem you're complaining about. It is based on the Buddhist idea that we create our own interpersonal reality at every moment of every day. In other words, we CREATE our enemies, and then whine and complaint about it! Most people don't want to see this! They want the therapist (or friend they're confiding to) to agree that the other person REALLY IS a jerk, or to blame, or whatever. They just want to complain and blame and feel superior! In my book, Feeling Good Together, I think I said something to the effect that we “want to do our dirty work in the dark.” In other words, we don't want to turn the lights on so we can “see” how we're actually causing the conflict. The person asking for help can nearly always be shown to be the 100% cause of the conflict. This technique is one I recommend when working with an individual, and not a couple. Other less confrontational techniques are probably more effective when you are working with both partners at the same time. Warmly, david (David D. Burns, MD) Here's the document: Conceptualizing the Patient's Complaint in Step 4 of the Relationship Journal (RJ) By David D. Burns, MD* Problem Area Specific Complaint—S/he Complaints about the other person's lack of E = Empathy Won't listen Does not understand me Always has to be right  Always criticizes me Constantly complains and ignores my advice Constantly brags and talks about himself / herself Doesn't value my thinking or ideas. Is defensive and argumentative Doesn't care about my feelings. Complaints about the other person's lack of A = Assertiveness Cannot (or will not) express his or her feelings Cannot deal with negative feelings Expects me to read his or her mind Clams up and refuses to talk to me Won't be honest with me pouts and slams doors, insisting s/he isn't mad! won't tell me how she / he is feeling. isn't honest with me. suddenly explodes for no reason, out of the blue. Complaints about the other person's lack of R = Respect Always has to get his or her way Is stubborn Is controlling Does all the taking, while I do all the giving Uses me Puts me down Is judgmental Does not care about me or respect me Only cares about is himself / herself Constantly complains and ignores my advice. Explanation. When you are using the Relationship Journal, you will usually have a complaint about the other person. For example, you may complain that she or he “never listens,” or “is always si critical,” or “constantly complains but never listen to my advice.” If you write down one thing the other person said in Step 1 of the RJ, and exactly what you said in Step 2, you can usually easily analyze your response with the EAR Checklist. That shows what you did wrong, and why your response was ineffective. You can also use the Bad Communication Checklist to pinpoint your communication errors, and some people prefer this format. In Step 4, you go spell out precisely why your response will FORCE the other person to keep doing the exact thing you're complaining about. One easy way to conceptualize the nature of your complaint about the other person is with our convenient EAR algorithm. This document can help you “see” the problem you're complaining about when you do Step 4 of the RJ. That makes it much easier to discover exactly how you are triggering and reinforces the exact problem you're complaining about. LMK what you think! Clay writes: Hello David, I know you no longer practice, but could I please get an opinion from you on EMDR? So far I have done about six sessions of EMDR and I feel worse than when I began. Does one typically feel worse before one feels better with EMDR? I know you are for Team CBT, and I think it has a lot of merit and science behind it! It just seems a little magical to me that by alternately tapping that I am going to resolve traumas or anxiety issues that happened a long time ago and maybe even recently, but I am going into it with an open mind and the possibilities. Best to you and your family, David, and thank you for the revolution in cognitive therapy you started with Aaron Beck and Albert Ellis! Kind regards, Clay Wilson Hi Clay, I've never been an EMDR enthusiast. To me, it's just cognitive exposure, which definitely can have value in anxiety, coupled with “eye jiggling.” Many of it's proponents seem to think that they have found the holy grail, and I have no doubt that a few will slam me for me non-supportive response! And please remember that I'm a cynic, so take it with a grain of salt. In TEAM, we use more than a hundred M = Methods, and only after doing the T, E, A steps, which are absolutely crucial to success in most cases. Best, david PS I'm copying Rhonda and Matt. If we used your question on an Ask David, would you be open to that, with or without your correct first name? Happy to disguise your name. David D. Burns, MD Dear David, I greatly value your ideas and that you are a cynic. In 6 sessions of the EMDR, I have not felt any better. You are absolutely free to use my name and you don't need to disguise it at all. I live in Columbus, Montana and as far as I know, there is only one person in Bozeman who does Team CBT. I sent her an email but didn't hear back but it's 100 miles from us anyway. Thank you very, very much for your view on EMDR! I was thinking something similar myself. All the very best to you and your family! Most Sincerely, Clay David's Response HI Clay, You're welcome. My website is full of free resources, anxiety class, depression class, more than 300 TEAM podcasts, and more. My book, When Panic Attacks, is pretty cheap in paperback. Also, beta testing of thee Feeling Good App is still free. T = Testing, E = Empathy, A = Addressing Resistance, and M = Methods (more than 100.) A is likely the most important step! Thanks, best, david Matt's Response Hi Dan and David, My guess is that EMDR showed some early results due to the tendency of most therapists to avoid exposure techniques and try to 'smooth over' anxious thinking and trauma, rather than just dive in and explore it, fearlessly. I suspect this created a large cohort of anxious and traumatized patients, waiting in the wings, for such treatment, so it showed immediate favorable data. However, this method is only one of dozens, and the setup is key. Why would you want to overcome something traumatic? Wouldn't it be more useful to remember it and avoid anything that resembles it? Meaning, there may be powerful methods, including exposure and (usually) less-effective methods, like 'eye-jiggling' and other distraction techniques out there for anyone, but why bother with these if the symptoms are helpful and appropriate? This is the main idea in TEAM . People recover when they want to recover, not when someone applies the correct methodology. -Matt Hi Dan, David, and Matt:  In addition to being a TEAM therapist, I also practice EMDR.  I find it to be very effective, especially when used within the TEAM structure.  It may not be for everyone, but it's great to have many options for our clients. -Rhonda  David's comment. Yes, and here Matt's is pointing out some of the paradoxical “Outcome Resistance” strategies we use with anxious patients when doing TEAM therapy. We become the voice of the patient's resistance to change, and verbalize all the really positive things about the anxiety symptoms: how they protect us from danger and express our core values as human beings. Paradoxically, this often reduces resistance and opens the door to change. In TEAM, we treat the human being with systematic TEAM therapy. We do not treat symptoms with techniques. The meaning of this may be hard to “see” if you haven't seen or experienced it. But there are a large number of actual therapy sessions your can listen to in the podcasts. Best, David Thanks for asking such terrific questions and for listening! We all greatly appreciate your support. Keep your questions and comments (negative as well as positive) coming! Rhonda, Matt, and David

355: Relationship Problems: Be Gone! Featuring Dr. Matthew May In today's podcast, Matt, Rhonda and David discuss relationship problems, and how to overcome them. We also give instructions on the Paradoxical Invitation, one of the most important and difficult techniques for TEAM-CBT therapists to learn. We started today's podcast interviewing Tania Ahern and Andy Persson who give a plug for the upcoming TEAM-CBT intensive from August 14 to 17, 2023 in Bristol, and incredible British city with an outstanding TEAM-CBT training program in store for you. Many notable TEAM experts will be presenting, including Drs. Leigh Harrington, Heather Clague, Marius Wirga, Stirling Moorey, Mike Christensen and many other notable teachers.  Special thanks to Peter Spurrier for being a fantastic TEAM therapist and organizer! I will also be there virtually doing a keynote address, a Q and A session, and a live TEAM-CBT demo with a workshop volunteer. The amazing Mike Christensen will be my co-therapist. Hope to see you there! Go to TEAMCBT.UK for registration and more information. Today we focus on relationship problems, starting with a real example, which often makes for the best teaching. Rhonda recently spent time with her son and daughter-in-law to help with their new twin babies. Rhonda's daughter-in-law had a very difficult delivery, and was in the hospital for several weeks following the birth of the babies. Rhonda worked relentlessly cooking and cleaning for them, feeding the babies, changing their diapers, and comforting them, and providing help for the new mom, who was overwhelmed and fearful of bathing the babies, thinking she might hurt them when attempting to bathe them. As so often happens in real life, Rhonda ran into a severe conflict with her daughter-in-law and responded with anger, and we all so often do. She reveals how terrible she and her daughter-in-law felt, and how she saved the day after deciding to have a “redo” of the interaction, using the Five Secrets of Effective Communication. Rhonda, Matt and David described one of the most difficult therapy tools in TEAM-CBT, the Paradoxical Invitation Step, and contrasted it with the Straightforward Invitation. Rhonda also mentioned some podcasts for further information on the Relationship Journal and the Interpersonal Model in TEAM-CBT. There are even more, but here are some that might interest you. My book, Feeling Good Together, is also a must-read for anyone wanting to make profound changes in the way you connect with the people you love, as well as your patients if you're a shrink! # Podcast Title Min 054 Interpersonal Model (Part 1) — “And It's All Your Fault!” Healing Troubled Relationships 54 055 Interpersonal Model (Part 2) — “And It's All Your Fault!” Three Basic Assumptions 27 056 Interpersonal Model (Part 3) — “And It's All Your Fault!” Interpersonal Decision-Making and Blame Cost-Benefit Analysis 46 057 Interpersonal Model (Part 4) — “And It's All Your Fault!” The Relationship Journal 44 226 The “Great Death” in a Corporate / Institutional Setting 56 227 Echoes of Enlightenment 43   We finished today's podcast with some entertaining role-playing exercises, using the Five Secrets of Effective Communication in interactions with extremely difficult individuals. This gave me the chance to role-play some incredibly obnoxious and practically impossible to please. My favorite role! Enjoy! Warmly, Rhonda, Matt, and David

A British Family Doctor on Burnout, Recovery and T.E.A.M in 10 Minute Consultations! Today, Rhonda and David interview Dr. Tom Gedman, a family doctor in England and one of the founders of TEAM-UK, along with Dr. Peter Spurrier who has also been a guest on a Feeling Good Podcast. Rhonda started the podcast with a kind email from an enthusiastic podcast fan who loved our podcasts with Dr. Mark Noble (#167 and #265) on the “Brainology” of TEAM-CBT. He said these podcasts were “pure gold” and appreciated a look behind the curtains to see how TEAM actually worked at the level of the brain. Tom described his burn out episodes, which started during his third year of medical school, resulting from a familiar theme—the belief that he was inferior and just not “good enough.” His inferiority complex was a severe, total body experience, with “horrible thoughts” for six months. After he recovered, he worried about going into that state again. And the stress returned again during his medical internship. He explained that as a General Practitioner (GP) in the British medical system, you only have ten minutes for each patient, and felt like all the pressure was on him to get it right, and stated that “the pressure broke me.” In Britain, you can get free therapy as a GP, and went to Dr. Peter Spurrier for help. Peter was using the TEAM-CBT he'd learned when he came to California the previous summer for one of David's four-day intensives, and Tom described him as “a natural. We made a deep connection right away and the Positive Reframing really clicked!” Tom's negative thoughts included: 1. I'm not good enough. 2. I'll fail my patients. 3. I'll do them harm. 4. I'm not smart enough. 5. I'll never be normal. He explained that the last thought triggered feelings of hopelessness, which really was the worst emotion of all. He discovered the Feeling Good Podcasts and listened to about 200 of them in just two weeks! And after two or three hour-long sessions with Peter, he recovered and actually felt like he was on a “high” for about six months. He says, “I had almost limitless confidence!” Then he had an as-predicted relapse which disappeared after a 30-minute tune-up with Peter. Tom said that the he'd always admired Carl Rogers, who emphasized empathy, and began using the Five Secrets of Effective Communication in his medical practice. This helped him clinically, and he discovered that “you don't always have to ‘help;' skillful listening is often enough. For example, patients often have to wait for months to be seen medically, and they're angry and frustrated at first. I acknowledge their frustration and let them know that I feel sad as well. This calms them down immediately.” He also gave an example of how trying to “help” a man with agoraphobia simply put the man into a state of rage. “I tried to convince him that exposure would be good for him, but we just got into an argument, and he threatened to report me to the authorities to have my medical license revoked! That experience taught me something really important about ‘helping.' Many people have intense resistance and just want to be heard and understood.” For example, one of his patients was in tears because of her father's Parkinson's Disease. The patients was helped greatly by learning He that her emotional distress was actually her love for her father, and she suddenly felt proud of her “symptoms.” Another patient with a massive opiate addiction opened up about a severely disturbing childhood incident he'd never before talked about, and then was able to cut his opiate use “way down.” We also discussed Tom's new plans for his medical practice, working with indigent individuals, and explored the possibility of testing my Feeling Good App with this population for free to see how they would take to it. He discovered that a group in England has “stolen” my names, and also have a “Feeling Good App” and a “Feeling Good Podcast,” which causes me considerable distress. We may have to rename our app the “Real Feeling Good App,” or some such name! Dr. Tom can be reached at BlueprintMedical.co.UK or at DrTomGedman.com. Tom, Rhonda, and I would also like to urge any listeners in or near England to attend the upcoming four day TEAM-CBT intensive in England from August 14 – 17th. This four day training conference will be awesome and only costs 440 pounds. Participants will receive 38 CPD points as well as credits in the TEAM-CBT certification program. For more information about the conference, go to www.TEAMCBT.UK. Thanks for listening! Rhonda, Tom, and David

Live Therapy with Cody, Part 2 of 2 Last week we presented the first of our session with Cody, a young man wanting help with his fairly severe social anxiety since childhood. My co-therapist for this session was Dr. Rhonda Barovsky, the Feeling Good Podcast co-host, and Director, Feeling Great Therapy Center. Today, you will hear the exciting conclusion of his session, and the follow-up as well! Part 2 M = Methods We focused on cognitive work and interpersonal exposure techniques as well. I will leave it to you to listen to the podcast, as I became so engrossed in what we were doing that I stopped taking notes. However, we used a number of tools within the group, including: Identify the Distortions in his thoughts Examine the Evidence Externalization of Voices Self-Disclosure Rejection Practice The Experimental Technique The Feared Fantasy And more. Cody received an abundant outpouring of love, respect, and encouragement from those in attendance (LINK). We also gave Cody two “homework” assignments to complete following the group. Do at least three Rejection Practices in the mall and notify the training group members via email within 24 hours that he had completed this assignment. Complete the Positive Thoughts column of your Daily Mood Log. If you'd like to see Cody's complet4ed Daily Mood Log, you can check this LINK. If you'd like to see Cody's intimal and final Brief Mood Survey plus Evaluation of Therapy session, check this LINK. As you can see, there were dramatic changes in all of his negative feelings. However, he wanted to retain some anger toward his childhood friends who made fun of him. Here's the email we received from Cody about his homework assignment. Hello groupers, I can proudly say mission accomplished! Although it took me around 7 hours to do it, I did it. A lot of emotions came up as I kept trying and chickening out. I really feel like something has changed in me, by the last person I felt almost no anxiety and now I keep asking myself why I was ever afraid of this (I hope it sticks. I know I'll need to keep up this momentum I'm sure). Having to do this email and being held accountable to you all was what drove me to the finish line. Thanks again, see you all next week! Thanks to you, Cody. You were incredibly inspiring in group and after and the work you did will touch the hearts of many people, just as you have already touched the hearts of all the people in our group! And thank you all for listening! Cody, Rhonda, and David

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

Ask David: Featuring Matt May, MD Can hypnosis be used for evil? Can you fall out of love? Why does cheerleading fail? In today's podcast, we discuss three intriguing questions from listeners like you: Can hypnosis be used for evil? Matt says no, David mainly agrees, but isn't entirely convinced. Is it possible to fall out of love? This can and will happen. What can we do about it? Empathy vs. Cheerleading: What's the difference between cheerleading and genuine empathy with someone who's upset? Can hypnosis be used for evil? David and Matt describe their experiences, both as kids and later as shrinks, with hypnosis. David and Matt both used hypnosis early in their careers, especially in David's one-session treatment for smoking cessation, which Matt also used. But as their TEAM-CBT skills have grown, both of them use it much less frequently. It can be used for many purposes. In a recent podcast # (link) with Dr. Jeffrey Lazarus, we learned that it can be used for warts as well as a wide range of psychosomatic problems, like Irritable Bowel Syndrome and tics, as well as bedwetting, school phobia, performance anxiety, and more. Matt strongly believes that agenda setting (also called Assessment of Resistance) is just as important in hypnosis as in TEAM-CBT. You have to first bring the patient's subconscious resistance to conscious awareness and melt it away using paradoxical techniques in order to optimize the chances of success with hypnosis. Matt pointed out that hypnotic states can be quite powerful, and can even be used for surgery, but emphasizes that people will never td what they genuinely don't want to do when hypnotized. He says that hypnosis is really a form of willful collaboration between the hypnotist and the hypnotic subject. Although stage hypnotists seem to have some kind of “Svengali” power over the volunteers who come up to the stage to be hypnotized, these people are actually subconsciously volunteering to act silly and have fun in front of the audience. This doesn't mean they are faking it, but it does put these shows into a slightly different perspective. David described many goofy things he did as a teenager after he purchased a book called “25 Ways to Hypnotize Your Friends” at a magic store in Phoenix for 25 cents, and found that the techniques actually worked with many of his friends. He sometimes had a lot of fun giving post-hypnotic suggestions, and that he and his friends found hypnosis to be incredibly exciting and fascinating. Once he hypnotized a friend named Jerry and told Jerry that after he woke up, every time he heard the word, “TV,” he would shout out “Boing” in a loud voice without realizing it. In addition, his subconscious mind would keep track of how many “TVs” he heard, and then he'd should Boing that exact number of times. David explains: Then we went to the local Dairy Queen a few blocks away all ordered at the window, one by one. When it was Jerry's turn to order, and the lady asked him what he wanted, we all started saying “TV, TV, TV” as fast as we could, and Jerry would shout out “boing, boing, boing” in a loud, confident voice! She said, “I didn't quite get what you want to order,” and when Jerry tried to order, we did it again. It seemed incredibly funny, and fun, but in retrospect I WAS using hypnosis to kind of take advantage of someone, so you might say it CAN be used for evil, perhaps. However, Jerry didn't seem to mind, and we all thought it was a pretty exciting adventure. When I was a senior in high school, one of my teachers said that hypnosis was dangerous and told me to stop hypnotizing my friends, so I got scared and gave it up until I became a psychiatrist years later. Like anything, hypnosis is just a tool, and it can be helpful for suggestible individuals, but we have more than 100 techniques in TEAM-CBT, because no one tool has the answer for everybody and every problem. David and Matt both agree with anxiety, depression, and anger are very much like self-induced trances, since you are giving yourself and believing messages (hypnotic suggestions) that aren't actually true. For example: The depression trance: “I'm no good. I'll be depressed forever.” The anxiety trance: “Something awful is about to happen. I'm in incredible danger.” The anger trance: “You're no good!” Psychotherapy can be seen as an attempt to get each patient to “wake up” from the trance that has trapped them. In David's opinion, politicians sometimes put their followers in trance-like states, getting them to believe repeated suggestions that are blatantly untrue. We saw this in WWII, where Hitler essentially “hypnotized” an entire nation to believe some horrific lies and to spur them to unspeakably horrific actions. Of course, as Matt has pointed out, you have to WANT to be hypnotized, so possibly the German people wanted to see themselves as superior human beings who had been victimized unfairly by evil forces that needed to be eradicated. So, killing and the abuse of him beings became the focus and purpose of the nation. Is this possibly also happening today? And is that why narcissistic leaders want to control the media, so they can control the “hypnotic messages” that people get, and why they lash out in such a hostile way at anyone who dares to challenge or contradict them? Is it possible to fall out of love? A podcast listener says she often falls out of love with her husband, but after they talk things over, and resolve their differences, she falls in love again. She wants more on this topic, so Matt, Rhonda and David discuss the pitfalls of pursuing perfect, romantic love. David reminds us that some of the most successful marriages are in India, where the parents decide who you will marry. David said that when he was in private practice in Philadelphia, 60% of the patients he saw did not have a loving partner, and most were trying to find someone to love. That's why this is one of his favorite topics. Then Matt, Rhonda and David contrast healthy vs unhealthy love, and Matt created the following table that contrasts them. Perfect Love By Matt with a little editing from David Unhealthy Love Healthy Love You rush to put the other person on a pedestal without knowing them. You fantasize that they are perfect and wonderful in every way. You take your time getting to know each other in a curious, vulnerable and respectful way, recognizing that neither of you is perfect. You believe that you need the other person and couldn't be happy without them. You're confident and content on your own but also enjoy the company of the other person. You selfishly focus on getting what you want from the other person. You focus on what you can give the other person, and what you can do, to improve the relationship. You imagine you will be in love forever. You accept that relationships require careful tending and nurturing, and realize that there will be moments of conflict, disappointment, and hurt feelings, which can sometimes be intense. You tell yourself that you'll never and should never have any conflicts or disagreements. You see conflict as opportunities, in disguise, for greater understanding and closeness.   Cheerleading vs. Empathy Rhonda describes a recent traumatic experience which was profoundly disturbing to her. However, when she tried to tell a friend how upset she was, her friend did “cheerleading,” telling her that she shouldn't be so upset, that she'd feel better again soon, and so forth. Rhonda said it was very annoying to be on the receiving end, and her friends efforts to cheer her up actually made her feel worse. Then, when two friends simply used the Five Secrets of Effective Communication to “listen,” it was a great relief. David recounted a similar experience when his beloved cat, Obie, disappeared in the middle of the night, and was likely killed by a predator animal in the woods behind his house. When David told his Tuesday group what had happened, one member of the group similarly tried to cheer him up, which triggered an angry rebuke from David, who told her NOT to try to take his grief away. He said, “My grief is my loving connection to Obie, who was my best friend in the whole world. I will grieve his loss for the rest of my life. And to this very day, I talk to Obie, as well as my good friend Marilyn Coffy who passed away recently, every time I go out slogging. This is not a problem that I need help with, but a gift of love.” We've touched on the codependent urge to cheerlead that so many people, including shrinks, have. For example, our podcast on “How to help, and how NOT to help,” covers this topic pretty thoroughly. However, we decided to focus on cheerleading again today, since it is such an important topic, and is a bit of an addiction that many people have. The following is a chart we discussed during the podcast, and you might find it helpful. Cheerleading vs. Empathy by David , Rhonda, and Matt Cheerleading Empathy You're trying to cheer someone up to make them feel better. You are not trying to cheer them up. Instead, you acknowledge how they're thinking and feeling, and you encourage them to vent and open up. You don't acknowledge the validity of the person's negative thoughts and emotions. In fact, when you try to cheer them up, you're essentially telling that they're wrong to feel upset. It's a subtle put down, or even a micro-aggression. You find the grain of truth in what the person is saying, even if you think they're exaggerating the negatives in their life.   Paradoxically, when you agree with them in a respectful way, they will typically feel some relief and support. The effect is irritating to almost everybody who's upset, because you aren't listening or showing any compassion or respect. You're telling them that you don't want to hear what they have to say. Cheerleading is condescending. Listening and acknowledging how they feel is a form of humility and an expression of respect. You're trying to control the other person. You're telling them how they should think and feel. There's no acceptance. You're sitting with open hands and not trying to change or control the other person. You're just trying to understand and support them in their suffering. Cheerleading is cheap and easy to learn. You're like a used car salesman, trying to promote your product. Empathy is difficult and challenging to learn because you have to let go of the idea that you know what's best for other people. Listening requires going into the darkness with the other person, this requires courage and vulnerability. You say generally nice things about someone, like you're “a good person,” or “a survivor,” thinking those formulaic words will somehow change the way the other person is thinking and feeling. You might also say, “don't be so hard on yourself,” or “think of all the positive things in your life,” or “you'll be fine.” You focus on the other person's specific thoughts and zero in on exactly what they're saying and how they might be feeling, rather than throwing vague, general positives at them. These positives are simply an annoying attempt to distract the person from their genuine feelings. You encourage the person to share and experience their negative thoughts and feelings. You believe your role is to “help,” “fix” or “save” the other person, who is broken. Your role is to be with the other person in a loving way without trying to help or save them. You are being self-centered because you're essentially preaching the gospel and exclusively promoting your own ideas. You are being other-centered, focusing entirely on what the other person is saying. You're talking “at” the other person. You are NOT talking AT them, you are being WITH them. When you empathize, you give the other person zero, and zero in, instead, on how they're thinking and feeling. That's why I (David) call Empathy the “zero technique.” But, paradoxically, when you give them “nothing” you are giving them “everything.” In case you're interested in honing your own empathy skills, you can take a look at the Five Secrets of Effective Communication (link). To develop these skills, you might want to read Feeling Good Together (link), but make sure you do the written exercises while reading. Otherwise, you'll only get intellectual understanding of them, whereas skill is what you actually need, and that can only be developed with practice! Sadly, most people, including therapists, believe that their empathy skills are already excellent, but that is rarely valid! In fact, there's a ton of room for improvement in ALL of us! We thank you for joining us today. Please keep your excellent questions and warm comments coming in. Rhonda and David want to thank Matt for his frequent, brilliant, and heart-warming appearances on the Feeling Good Podcast. Remember that we're still trying to grow our show, and recent hit 6 million downloads. We are currently getting around 160,000 downloads per month, which is terrific. It would help us a lot if you give a five star review for our show wherever you get your podcasts, as that might boost our ratings. We love our fans and thank you for listening!

Swimming in the River of Love Rhonda starts today's podcast with a beautiful podcast endorsement from a fan named Vicky, from Australia, who was thrilled with the two recent live therapy podcasts with Nazli (podcasts 301 and 302). She wrote that she felt so lucky to hear someone with the exact same negative thoughts, and same feelings of depression and anxiety, that she's had since she was 10 years old. I have often said that when therapists have the courage to do their personal work in public, you not only heal yourself and learn cool techniques first-hand and experientially, but you also heal many others who are touched and inspired by you. Thanks to all of our fans for your frequent loving comments and cool questions for future Ask David podcasts. We then give a little promotion for several upcoming group events, involving: May 2, 2022. Dr. Jill Levitt and I will be teaching an exciting, full-day workshop on “Smashing Social Anxiety: Shame-Attacking and Beyond.” It will be open to shrinks and the general public alike. The focus will be on learning to treat social anxiety, including your own! For registration and more information, please go to CBTforSocialAnxiety.com. September 13, 2022: Drs. Brandon Vance and Heather Clague start two new Feeling Great Book Clubs. For registration and more information, please go to www.feelinggreattherapycenter.com/book-club. September 14, 2022. Drs. Heather Clague and Brandon Vance will start their weekly “Deep Practice” group for training in the Five Secrets of Effective Communication. This type of practice is absolutely needed if you want to use these fantastic techniques to greatly boost your clinical effectiveness or enhance your relationships with the people you care about. For registration and more information, please go to www.feelinggreattherapycenter.com/5-Secrets. Date (to be announced). Zeina Halim soon begins the first-ever book club for When Panic Attacks. This terrific group could be helpful if you've ever struggled with phobias, social anxiety, chronic worrying, panic attacks, OCD, PTSD, and more. For registration and more information, please go to https://feelinggood.com/2022/08/08/anxiety-book-club/ Date (to be announced). Zeina Halim will collaborate with our Feeling Good App development team in an experiment to test a month's use of the Feeling Good app with or without a weekly practice group to supplement your work with the app. This exciting project is currently in the planning stage, but if you think you might be interested, please contact Zeina at Zeina Halim so she can contact you once we're ready to start. As an aside, the app will be free since we're still involved in beta tests, but the weekly practice groups will involve an additional charge. Today we feature a love story involving Dr. Cai Chen, a young psychiatrist who did his residency training in Texas and now has moved to California to be with his love, Chan Mary Soeur, RN, BSN. Both have been members of my TEAM-CBT training group at Stanford. Cai practices at the Feeling Good Institute in Mt. View, California, and Chan Mary who is pursuing a master's degree as a Psychiatric Nurse Practitioner. Cai explains that he'd felt socially anxious and lonely for used, and used the tools in my book, Intimate Connections, when he got tired of dating sites. One crucial thing he learned is that you have to stop “chasing” if you want to find love. Then he met Chan Mary in one of the breakout groups in our weekly training group. Chan Mary said, “I also used to struggle with social anxiety. Even now, on this podcast I have thoughts that I won't be as impressive as Cai. Cai is much better at expressing himself and being vulnerable in front of others. “I've been on a personal journey to get over my intense social anxiety. I've always held back in groups, and have never been the first one to reach out. “After listening to the Feeling Good Podcast's episode on how to overcome social anxiety, I decided to challenge my fears and reach out to Cai. I contacted him and told him I really admired the courage he was showing in his transparency about his feelings, and in his courage to challenge his fears with the many Interpersonal Exposure Techniques we were learning about in our training. “I also decided to try another technique, Flirting Training. I told him that I thought everything he was doing was inspirational, and that I felt close to him.” Rhonda asked about the importance of taking risks if you struggle with social anxiety. Chan Mary explained it like this: “I was extremely anxious about reaching out to someone I didn't know. For me, a simple thank you email and introducing myself was anxiety provoking because I had never done that before. I was also worried about asking too many questions because I didn't want to come off as intrusive or even bothersome.” Chan Mary continues: “After conquering my initial fears of reaching out, I went even further, I invited him to join me for a week in Hawaii as our first date in 2021 for my vacation. I usually went on a medical mission to Cambodia, but couldn't because of the pandemic. So I did the boldest thing ever—I met him in person in Hawaii!” Cai describes the fears he had: “I was scared. I thought, ;what if we get too close and our relationship falls apart.' In fact, after accepting the invite, I called and told her that I'd changed my mind. She got angry, and I realized I had mixed feelings, so I turned to David's Decision-Making Tool. (You can get it for free at the free chapter link on the bottom of the home page of David's website.) “This tool helped me see why I was stuck, so I called Chan Marie back and asked for her forgiveness. I'd been hiding my feelings, so I told her I really liked her and had been afraid of ruining a great relationship.” Chan Mary said: “I was scared, too. But I told myself to trust myself, and that it felt safe to trust him, too.” The rest, as they say, is history. The date was terrific, and after some initial hesitation, Cai decided to move from Texas to California to be with “the love of my life!” Was it all roses from then on? All relationships, I'm pretty sure, have difficulties, and Cai and Chan Mary explained that they both have trouble expressing negative feelings. Cai explained it like this: “I always try to be nice, so I push my negative feelings down, and automatically sweep them under the rug. Chan Mary helps me with this. She pushes me to tell her what I'm upset about. And although it's frightening at first, once we express our negative feelings they kid of fizzle out. Chan Mary has become an expert in David's five Secrets of Effective Communication, and that has helped tremendously.” Chan Mary explained her difficulties with negative feelings like this: “The Hidden Emotion Technique has been helpful for me when I start to feel anxious or upset. I have to reflect and ask myself, ‘What's the deeper issue here?' Often, I don't even know what I'm upset about!” Chan Mary added: “Thank you to David and Rhonda and everyone who made the Feeling Good Podcast possible. I'm just like many of your listeners, and this podcast has been life-changing. The techniques, you shared on the podcast have transformed my life! If I did not take the steps to conquer my social anxiety, Cai and I probably would not be here today.“ Cai and Chan Mary are delightful, and their obvious love is an inspiration in this time of increasing violence in the world and such intense political divide and hatred here at home. I asked where their relationship is heading and Chan Mary hinted that Rhonda and David might be getting invitations to a wedding one day soon! Cai and Chan Mary are two of my favorite people in the whole world. It's a privilege and a blessing to know them and share a little of their lives. This is Rhonda…. "I love Cai and Chan Mary, too. I was in the Tuesday Stanford TEAM Training group for years with Chan Mary, and feel really close to her for lots of shared experiences. I am lucky enough to see Cai every Wednesday in our International TEAM Therapy Training Group, and I always look forward to reading the wise comments he writes on the TEAM certified listserve. Next week, we'll look at the other side of the coin, as Professor Mark Noble leads a discussion on the recent rise in loneliness, which is often associated with social anxiety. Warmly, Cai, Chan Mary, Rhonda, and David  

304: TEAM-CBT, Spirituality, and Beyond: Featuring Angela Poch Rhonda begins today's podcast, as usual, by reading two touching emails from podcasts fans, including Coach Teddy, who said that Podcasts 295 and 296 featuring live work with Zeina were incredible, and Carol who was equally enthusiastic about Podcast 297 (on “Homework—Yuck!). Carol also strongly recommends David's book, Ten Days to Self-Esteem which is a simplified version of Cognitive Behavioral Therapy that can be used as a manual for therapy or self-help groups. https://www.amazon.com/Days-Self-Esteem-David-Burns-M-D/dp/0688094554 Today, we interview Angel Poch, a certified life coach, registered professional counselor, and certified Level 4 TEAM therapist and trainer. She lives two hours north of Glacier National Park in British Columbia, but teaches therapists and treats people virtually from around the world. Her new booklet, “The Truth Shall Set You Free,” integrates TEAM-CBT with a Christian perspective and is available for free on her website. https://www.angelapoch.com/. She is a regular in David's weekly virtual psychotherapy training group at Stanford and assists in the teaching. She has also worked tirelessly and selflessly behind the scenes making David's work way more accessible to lay people as well as mental health professionals wanting to learn more about TEAM-CBT. For example, she adds links to every new Feeling Good Podcast on David's website, so you can easily find and link to more than 300 podcasts. Check it out! She has also transformed a massive amount of David's work into electronic tools for shrinks, accessible in David's online shop: Recently, she has created two amazing new documents you can link to. One is a spreadsheet that lists 138 of David's TEAM-CBT tools and techniques, like the “Anti-Procrastination Sheet” and many others, with page links to the descriptions of how to use each tool in David's books, like Feeling Good, Feeling Great, David's TEAM-CBT therapist eBook, and many others. Check it out! This data base will be invaluable to interested lay people, therapists, and teachers who want clear instructions on how to use the Daily Mood Log, Relationship Journal, and numerous additional tools and techniques. Derek Gurney and Angela are working on an equally awesome database for the Feeling Good Podcasts: Check it out as well! Angela begins her personal statement in today's podcast by describing her struggles with depression and irritability, including some very dark days in 2006. Her doctor recommended an SSRI antidepressant, and she went to integrative health program, “Depression: the Way Out” that required participants to read Feeling Good https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380810336 Although she didn't love the book, she resonated with the idea that all of our feelings, positive and negative, result from our thoughts, or perceptions, and her depression cleared up. She liked that when she read Feeling Good, she got many new tools she could use to change her negative thoughts and feelings. She also appreciated the ideas in the book didn't go against her belief system, which many fear about psychology. David pointed out his own father, a Lutheran minister, worried about this, and was very suspicious of psychiatrists. Angela's thinking, which resonates with David's, is that the core ideas of religion and psychotherapy are actually high compatible, and even synergistic. Angela explains that when she was a young child, she didn't fit in socially or even in her own skin. “I felt like I was a boy in a woman's body. I felt like I was in the wrong body, and prayed for help.” She started to see in a very limited, childlike way, her thoughts were distorted, that a body was just a body and she could trust God wouldn't give her more than she could bear. These new realistic, counter thoughts relieved the negative body dysmorphia she'd been struggling with. She reports, “I decided it was okay to be flawed and not fit in.” The rest of her young childhood was mostly joyful. In middle school she was the target of mean-spirited bullying because she was a tomboy. She developed intense social anxiety and was relieved when her mom took her out of school. She was homeschooled for a few years and studied Karate to exercise and develop some confidence. High school brought new challenges. She describes responding with her version of the Five Secrets of Effective Communication to an aggressive bully who threatened her with brass knuckles and challenged her to fight her. However, the girl backed off and started telling people that Angela was her friend! After a bad relationship, Angela started to struggle with depression and described her suicide attempt when she was 18 because “I wanted the pain to stop.” She explains that: I met my husband, moved home, and started reading the Bible. I was impressed by the passage, “the truth shall set you free.” I realized I had to control my own thoughts rather than look for the approval of others, but she still didn't totally recovery from my anxiety. The cognitive piece in Feeling Good helped Angela a lot. She states, “I pursued a lot of careers, never holding down a job for more than 6 months, and one day someone asked if I'd considered a career in counseling. . .” She went on to take one of David's four-day live intensives in Whistler BC where she learned TEAM-CBT and hasn't looked back since! After learning and applying TEAM, Angela was able to crush her social and other anxieties. Angela has a deep love for her Creator and has done a great deal of thought about the integration of her Christian faith with TEAM-CBT. David also has a strong interest in the overlap between TEAM-CBT and virtually all religions and spiritual paths. He described an unusual and overpowerful spiritual experience he had as a medical student crossing the Nevada desert that made a strong impact on him. Angela would like to mention, “I have a profound gratitude for David's work. He makes things so clear and relatable. His approach is applicable to all faiths or no faith if one is truly ready to give up their negative thoughts and feelings. As we aim for the truth, and let go of the so called “self,” we find peace and joy. I will forever be indebted to him because I would not be able to help people without TEAM and that brings me joy every day!” I, David, would like to thank Angela for her intense and tireless devotion to helping spread the “gospel” of TEAM-CBT in so many ways! Thanks for listening today! Angela, Rhonda, and David I

Podcast #300: Celebrating Five Million Plus  In today's podcast, we celebrate, thanks to Rhonda and Fabrice, our 300th podcast, featuring some of our most beloved guests since our first podcast on October 27, 2016. We began with Fabrice Nye, who describes the birth of the Feeling Good Podcast, and two of our favorite and most popular guests, Drs. Matthew May and Jill Levitt. The schedule for all of the guests appears below. The featured guests include Fabrice Nye, Matthew May, Jill Levitt, Angela Krumm, Lorraine Wong, Kyle Jones, Brandon Vance, Heather Clague, Leigh Harrington, Sarah Hester, Brian Wright, Mark Noble, Thai-An Truong, Stirling Moorey, Rose Markotic, Mark Taslimi, Sunny Choi and Elizabeth Dandenell. Time Featured Guests 1:30-1:45 Fabrice Nye, The father of us all! #177, Research in Psychedelic-Assisted Therapy Matt May, co-therapist with David: live therapy with Marilyn & me, Many, many Ask David episodes, #265, Exposure to Leeches with Danielle Kamis Jill Levitt, David's co-therapist doing personal work with David, plus #146, When Helping Doesn't Help 1:45-2:00 Angela Krumm (#270-losing weight & flirting), Lorraine Wong (#155-treating emotional eating & #257 Intensives), Kyle Jones (Dating strategies, #151-Treating LGBTQ, #157-Psychotherapy Training, and #267-Talking to loved ones who criticize your sexual orientation 2:00-2:10 Brandon Vance- #160 Listening to the Music of TEAM #161, Music under what someone is saying #249, Report on Feeling Great Book Clubs #260, TEAM games (with Amy Spector) Heather Clague-(All of the above except #249) 2:10-2:20 Leigh Harrington, #279, Goal setting for Habits & Addictions Sarah Hester,#181, Live therapy, treatment of panic and insecurity, #193, Relapse 2:20-2:30 Brian Wright, #235, Anger in Marriage/5 Secrets Revisited 2:30-2:40 Mark Noble, #100, The New Micro-Neurosurgery, #167, TEAM and the Brain, #275, His latest thinking on how the molecular biology of stress & learning are consistent with TEAM, plus his chapbook on TEAM Thai-An Truong, #178, co-therapist with David at Atlanta Intensive Social Anxiety Be Gone, #218, Postpartum Depression, #264, How to get laid with help from the 5-Secrets #283, The “O” of OCD 2:40-2:50 Stirling Moorey, #280, A Beloved Voice from the past, #289 & 290, A case of social anxiety, personal work with Anita 2:50-3:00 Rose Markotic, #252 & 253, Sadness as Celebration Mark Taslimi, #29-35, Live sessions with Mark, “I'm a failure as a father.” #141, 2-Year follow up “I've been a failure as a father.” 3:00-3:10 Sunny Choi, #214 & 215, The Approval Addiction Elizabeth Dandenell, #240 & 241, struggling with anxiety and fear of poverty.   Rhonda, Fabrice and I want to thank all of our guests who have contributed so generously to our efforts, and to all of you, who have supported us! Most of the guests today have done personal work with David, often with Jill, Matt, or Rhonda as co-therapists, and almost all had some version of “I'm not good enough” when they were upset, and all found solutions to this which expanded their humanness and deepened their skills as TEAM therapists.  Our guests who did personal work were asked how things had been for them since doing that work, and they all reported that the results have been long-lasting, even permanent! In the following email I just received, Dr. Matthew May shared some feelings about today's show. Hi David, I like the show notes and approve of their humble nature.  Brevity is the soul of wit! If I were to edit anything, and I'm not sure that I would, it would be to list all the names of all the excellent folks who participated, in the first paragraph. My sense is that it was their vulnerability, as well as their willingness to do challenging personal work, that led to enduring improvements in mood, relationships and lives. I thought it was the personal endorsements and descriptions of how TEAM has improved their lives, that were the most compelling themes of the podcast. Adding to this, it goes without saying, that none of this would have happened without you, David.  You created this model of therapy for one thing.  You also created this community of people.  As you said before the podcast started, the most meaningful and important part of all of this has been the relationships and friendships that have developed as a result of this work.  (I'm paraphrasing and not doing a very good job of it, sadly!). In any case, I caught myself wondering if this format of therapy, one that is public and open, might be the future.  Meaning, instead of hiding our flaws and insecurities behind closed doors, if we might continue to attack the shame and stigma of “mental illness” by exposing it to the light of day, realizing that there was nothing to be ashamed of or afraid of, only opportunities to connect and be in the good company of other flawed, imperfect souls, just like us. -Matt Fabrice replied to Matt: Early Christians were doing their confessions in public—why not? ☺ Our numbers continue to grow each month, so please continue to tell your friends about us. We do not accept commercial advertising, something Fabrice suggested early in our development, so you are our only marketing team, and we thank you for sticking with us and sending us so many beautiful emails, reporting your responses to our shows, asking questions, and suggesting new topics. Our audience consists of lay people looking for personal healing as well as mental health professionals looking for new treatment tools as well as their own personal healing. Warmly, Fabrice, Rhonda, Matt and David

Hi everyone! This special podcast features one of our favorite people, Professor Mark Noble from the University of Rochester in New York. Professor Noble is a world-renowned neuroscientist and cancer researcher, one of the pioneers in stem cell research, and all-around good guy. He contributed a brilliant chapter on how TEAM-CBT interacts with the brain for my book, Feeling Great. For the past two years he has been a very beloved member of the Wednesday TEAM-CBT Training group, adding his wisdom and clarity to the teachings.  Rhonda and my co-teachers, Leigh Harrington and Richard Lam, and all of our students feel very honored to have him in our midst. This is our third podcast with Dr. Noble, and the first podcast to usher in the new year. We're excited to speak with him again today. He will update us on his latest thinking on how the molecular biology of stress and learning are totally consistent with the rapid mood changes we see in TEAM-CBT. He also describes his latest writing project, tentatively entitled, The Brain User's Guide to TEAM-CBT, and you can download it for FREE if you click here! (LINK) In this booklet Professor Noble presents the “brainological perspective” on TEAM-CBT. He emphasizes that this booklet is written at the 9th grade level so as not to intimidate anyone. If you're curious, take a look, and feel free to share it with others who might be interested. Professor Noble explains that his new booklet was inspired by patients who ask how TEAM differs from traditional (aka “normal”) talk therapy. Of course, the differences are many and profound, but one of the questions new patients and therapists ask is whether the rapid recoveries we observe during TEAM-CBT treatment are just superficial and temporary, or even fake. Mark asserts that nothing could be further from the truth, and that the thing that makes TEAM-CBT so special is how closely it is aligned with how the human brain actually works. He explains that there are ten essential steps in TEAM, starting with Empathy. He defines Empathy as “being in a safe place, where you can share feelings without being judged.” Empathy allows the patient to access the networks in the brain where the patient's pain may be stored as memories. The spoken and written language exercises used in TEAM actively and rapidly modify the networks that generate the feelings of depression, anxiety, shame, inadequacy and hopelessness. Dr. Noble places a great importance on the written Daily Mood Log, which he describes as arguably the “greatest development in the history of psychology.” He says that when you describe the horrible and traumatic things that happened to you, and you record your Negative Thoughts on paper in a systematic, step-by-step way, you can look at your thoughts, feelings, and painful memories as separate from your “self” and gain some distance from them. Then, when you pinpoint the many cognitive distortions in your negative thoughts, and substitute more realistic interpretations, you gain freedom and relief because you are actually re-wiring your brain. He said that most of our human thinking is called Fast Thinking. This is the automatic thinking that we do 98% of the time as we go through our daily lives. Fast thinking is great, but growth, learning and change can only result from Slow Thinking, where we reflect and analyze things. Slow thinking takes concentration and effort because you are changing actual networks in your brain when you challenge and crush your negative thoughts with powerful techniques like the Externalization of Voices. He says that we are not just telling people to “Stop it!” or “Get over it!” Quite to the contrary, we are teaching specific, powerful techniques that give you the chance to pinpoint and modify the exact brain networks that cause your negative feelings. He explains that “language is a powerful tool for figuring out exactly how we see the world when we're feeling down, and TEAM gives us many tools in TEAM to modify the errors in our perceptions that cause so much suffering. Mark laments on the excessive misuse of medications for individuals, including children, who are struggling with behavioral and emotional problems. He wishes more people would simply sit down with the person who is upset and ask, “What's going on? How are you feeling? What are you thinking and telling yourself?” I have had the same thought when thinking about how therapists not familiar with TEAM or Cognitive Therapy use and promote dozens of presumably therapeutic approaches without simply asking patients, “What thoughts go through your mind when you are feeling depressed, anxious, ashamed, inadequate, or hopeless?” The answers to this question provide direct and immediate access to the brain networks that need re-wiring! Mark concludes today's podcast by saying, “I went into medical research on cancer and other serious problems because I wanted to help people who are suffering. I'm convinced that TEAM-CBT, and the powerful Daily Mood Log that David has developed, have the potential to help millions of people around the world!” Rhonda and I are grateful for Mark's ongoing friendship and brilliance and want to wish all of you a happy and healthy 2022! We are both very grateful for your support during the past year and hope you will continue to mention our podcast to friends or colleagues who might be interested in learning about TEAM-CBT. We look forward to celebrating the five millionth download of the Feeling Good Podcast around July! Thank you! Rhonda and David

Podcast 265: An Extreme Leech Phobia: Once Bitten, Twice Shy! Today's podcast features the treatment of an extreme leech phobia in real time, using live leeches. Dr. Danielle Kamis, a clinical psychiatrist practicing in Los Altos, California, is our courageous patient, and Dr. Matthew May, a frequent guest on the Feeling Good Podcast, conducts the treatment, while David and Rhonda observe and comment. If you ever saw the famous Humphrey Bogart movie, “African Queen,” you know how terrifying leeches can be. But why in the world would anyone working in downtown Los Altos, California, need or want treatment for a leech phobia? Danielle is an extremely brave and adventuresome young professional woman who loves traveling to remote places around the world (Danielle is an extremely brave and adventuresome young professional woman who loves traveling to remote places around the world.  She has had a keen interest in global health work and has spent a significant amount of time doing research with indigenous population in the pre-Andes mountains of Argentina. She has also spent time living with tribes deep in the Amazon forest as well as the jungles of Sumatra. These experiences have transported her back in time to better understand the core components of humans in our most natural state. She described a terrifying experience while exploring in a jungle in Sumatra, where the leeches not only invade the water, but can also drop onto you from trees. After hiking through the beautiful, lush landscape for some time, Danielle began screaming and sobbing in terror when she noticed that her foot was bleeding because of a leech that had just detached itself. This was understandably embarrassing, and she realized that she needed to overcome this fear before going on another jungle adventure. In today's therapy session live leeches will be placed on Danielle's skin, and she will be encouraged to surrender to the anxiety and make it as intense as possible, rather than running away or trying to control or avoid it. This is an extreme form of exposure called “flooding.” It  can be incredibly effective, and often works quickly, but requires great courage on the part of the patient and therapist, as well as a high degree of therapist skill. To prepare for today's exposure session, Danielle obtained four live leeches, which she kept at her apartment. She said that even looking at the leeches slithering around in the water and thinking about them biting her made her fear instantly jump to 9.5 on a scale from 0 (not at all) to 10 (the most intense anxiety). She asked Matt if he'd be willing to do the leech exposure first. Matt agreed, since we never ask our patients to do anything that we wouldn't do, ourselves. This modeling by a trusted friend or therapist can be a useful tool in the treatment of anxiety. Danielle carefully removed one of the leeches with a spoon and placed it on Matt's forearm. After crawling around for a minute or so, the leech attached itself and begin to engorge itself on Matt's blood. Danielle watched in fascination and fear, and then it was her turn. She bravely placed a second leech on her forearm. She was afraid it was going to be extremely painful, but was surprised when it was just a mild feeling of sandpaper on her skin. Over a period of about ten or fifteen minutes, with episodes of nausea and profuse sweating, Danielle's anxiety gradually dropped from 9.5 at the start all the way to 1, and she felt triumphant. You can see some photos and videos of the session here, including our lunch prior to the session at the Phoa Cabin in downtown Los Altos. It is a favorite local spot that features tremendously tasty Vietnamese food.  (LINK) Teaching points in today's TEAM-CBT session include the following: Avoidance is one of the major causes of all forms of anxiety. When you avoid or try to escape from your fears, they will always intensify. Exposure is a powerful treatment tool for anxiety, but is not a treatment per se, and there are many additional tools with powerful anti-anxiety effects. I (David) use at least 40 tools in the treatment of anxiety, but exposure must always be included in the mix. It is probably impossible to cure any form of anxiety without exposure. All patients and most therapists resist and fear exposure. Patients fear exposure because of the intense anxiety they must endure and their belief that something terrible will happen if they don't avoid their fear, and most therapists are also afraid that the patient is too fragile, or the procedure is too extreme, and something terrible will happen. However, I (David) have never had a bad outcome when using exposure. I am convinced that poor therapy skills, and not exposure, cause negative outcomes in the treatment of anxiety. Excellent empathy is extremely important in treatment of Anxiety. Danielle mentioned the importance of her trust in Matt, and in his modeling of the exposure in the treatment. I (David) strongly agree with this, as I have had to use exposure in the treatment of my own fears and phobias and have also benefitted from doing exposure with someone I trust and admire. Once you've beaten a phobia, and no longer fear the thing that once caused terror, fears have a way of creeping back in, especially if you do not continue to face the thing our feared. To prevent this, ongoing exposure is needed. Although Dr. May treated Danielle for this problem successfully in the past, Danielle's intense fear of leeches had returned during the COVID pandemic. While some form of relapse is almost always inevitable, the good news is that facing your fear frequently can massively reduce the frequency and intensity of relapses. Danielle seemed pleased with her session and agreed to do ongoing exposure on her own every day with the leeches as homework. The next day, we received this email from Danielle. Hello! I had a fantastic time yesterday with you and I am so grateful for all of your support and guidance. Thank you so much for taking the time to help me overcome my fear and help others do the same! It was so wonderful and special seeing you all again in person. Here are some awesome photos from the session as well as our lunch at the Phoa Cabin, and this link contains two videos. Rhonda, Danielle, Matt, and David

Podcast 258: Doctor, I know you're secretly sexually attracted to me! / How to Agree with Criticisms that are Just Plain Wrong! Today's podcast features the incredibly brilliant and kindly Dr. Matthew May, who has become a semi-regular on the Feeling Good Podcast. Our show was the result of an email from Ana Teresa Silva, who is running a new and totally free weekly practice group for the Five Secrets of Effective Communication. If you want to learn those invaluable techniques, contact her immediately before they fill up at ana silva ateresasilva6@gmail.com. Her question had to do with the incredibly important Disarming Technique, which means finding the truth in a criticism, even when the criticism seems absolutely incorrect. I've posted her letter and my response at the end of these show notes. Today we tackled two kinds of incredibly difficult attacks, with lots of role-playing and (hopefully) useful feedback and teaching. One was the one listed in Ana's email, where you are accused of stealing money, but you didn't actually steal any money. So how can you agree with that? The other was perhaps even harder—what do you do when a patient accuses you of being sexually and secretly attracted to him / her? Matt, Rhonda and David illustrate a variety of strategies for responding with the Disarming Technique as well as the rest of the Five Secrets. The role-playing is challenging and immensely interesting! David emphasizes that if you want to learn the Five Secrets, three things are mandatory: An intense desire to learn. Humility. Tons of practice. David also emphasized the intense resistance nearly all humans have to all three components of EAR: E = Empathy A = Assertiveness R = Respect. I have attached a document listening 12  GOOD Reasons NOT to Listen, Not to Share Your Feelings, and NOT to treat the other person with respect. If you want to master the Five Secrets, my book, Feeling Good Together, will be an invaluable resource. If you read it, you MUST do the written exercises while reading to get any deep understanding of this approach. Simply reading will not “do it!” I want to thank Dr. May once again for hanging out with us today. In our next podcast with Dr. May, he will describe his work with a young professional woman who loved fly fishing but had an intense fear of leeches. Make sure you tune in, it will be extremely interesting, and his patient will join us, too! If you want to contact Dr. May, you can reach him at: Here's Ana's email: Hi, David. Hope you are recovering well!! I got stuck with the Disarming Technique. Last week, in the Five Secret Practice Group meeting, something came up and I didn`t know how to answer. How do we “disarm” someone who blames us for a very specific behaviour that is not true? For example: “Why did you steal my money from the drawer?” I thought we could try to find some truth in the attack noticing some reasons why the person could be mad at us or doesn`t trust us, or maybe we could ask if we did something to offend or upset her, but, at some point, we have to say that we didn't steal the money, right? And we`ll be defending ourselves. Can you help me with this? Thank you! I appreciate it. ana silva Ana Here's my response: Hi Ana, We'll do some practice on this on today's show. You might say, “I'm afraid I'll have to plead guilty to your criticism. Although I didn't and would never steal money from you, I clearly have done a terrible job of winning your trust and providing genuine warmth and support. “It's painful for me to hear how I've failed, and I feel ashamed, especially since I like you so much and value our friendship. I wouldn't be surprised if you're feeling angry, frustrated, and disappointed, and perhaps alone, too, and perhaps even anxious. “Can you tell me more about what happened, and how you feel, and all the ways I've let you down and come across as untrustworthy?” This is just a try, and the details will be different depending on who the person is and what the situation is. Hope this helps! Also, Podcast 161 might also be helpful. It's all about “hearing the music behind the words” (https://feelinggood.com/2019/10/07/161-listening-to-a-different-kind-of-music/) david Rhonda, Matt, and David (without Dr. Rutherford Knows) Rhonda and I are convinced that Dr. May is one of the greatest therapists on the planet earth. If you have a question or would like to contact Dr. May, please check out his website at: (www.matthewmaymd.com) Dr. Rhonda Barovsky practices in Walnut Creek, California, but due to Covid-19 restrictions is working via Zoom, and can be reached at rhonda@feelinggreattherapycenter.com. She is a Level 4 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. Check out her new website: www.feelinggreattherapycenter.com. You can reach Dr. Burns at david@feelinggood.com.

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

“I’m tired of being terrified. I want to be at peace!” Live Work with Elizabeth, Part 1 (of 2) This podcast features Elizabeth Dandenell, LMFT, who runs a successful treatment clinic in Alameda, California for anxiety disorders, The East Bay Center for Anxiety Relief (www.eastbayanxiety.com.). She is a certified Level 4 TEAM therapist and trainer, and also helps teach mental health professionals at our Tuesday psychotherapy training group at Stanford. We are deeply indebted to Elizabeth for allowing us to publish the very personal, dramatic and inspiring work she did that evening. I also want to thank Jill Levitt, PhD, who was my co-therapist in the work with Elizabeth. Jill practices at the Feeling Good Institute in Mt. View, California (link)  where she is Director of Clinical Training, and teaches with me at Stanford. Like most mental health professionals, Elizabeth occasionally struggles with feelings of anxiety, stress, and self-doubt, and wanted to do some personal work in a recent Stanford Tuesday group. The personal work takes courage, but is crucial to the training and personal growth of all therapists. She was hoping for help with fears that have haunted her since her father died when she was just 13 years old. She explains: I started working when I was 13 years old and that is when the pressure to make money began because my father was an unsuccessful businessman. We were all just scraping by. I started working because my father was unable to pay basic bills at times like phone and electric.  Or our car didn't always run. He was not good at running his own business and money flow was very inconsistent. I discovered when I started working that I could have some control with financial stability if I had my own money and would help out paying the phone bill occasionally. This is when the anxiety of not having enough to survive kicked in and developed the" pressure" I discussed in the podcast and in my daily mood log.. This pressure to survive has has fueled my anxiety for years. My father died from Parkinson’s Disease in a nursing home when he was 77. He wa on Medicaid because he had lost everything. I was 50 when he died. You will hear many techniques that Jill and I used during the session, including Cognitive Flooding. This is, to the best of my knowledge, one of the first times that we have captured this type of Exposure live on a Feeling Good Podcast. Combining Cognitive Flooding with the What-If Technique (pioneered by Dr. Albert Ellis) makes the confrontation with your deepest fears especially powerful.  Listening to that portion of the session will be illuminating for many therapists and patients alike, especially if you are not familiar with, or confident in, the use of exposure  in the treatment of anxiety. Elizabeth’s anxiety was triggered by an exercise we did called “No Practice” in one of the David and Jill workshops for mental health professionals. Essentially, you practice saying “no” to someone who is pressuring you and making unreasonable demands on you. But in Elizabeth’s case, and perhaps for you, too, those demands are internally generated. If you click here, you can see the partially completed Daily Mood Log that Elizabeth brought to the session. T = Testing We began our session by reviewing Elizabeth’s scores pre-session scores on the Brief Mood Survey. The scores indicated only mild anxiety and minimal anger, but these scores probably do not reflect the intensity of the anxiety and terror she often feels. We then went on to: E = Empathy Elizabeth said, “That workshop exercise (“No Practice”) got me thinking about an unresolved issue I’ve been struggling with my entire life.” She explained that I’m doing too much in my life. I complain and then I take too much on and get overwhelmed. I fill my plate too much, and I tell myself that my patients need me, so I’m always taking on new patients to keep my schedule full . . . At times I get really anxious and don’t feel competent or confident. Who I am today is due to constant pushing, pushing, pushing, and never letting up. She explained that the problem started when she was 13: We didn’t have much money, and my father died penniless, in poverty in a skilled nursing facility. I’m always pushing for fear of meeting the same fate, telling myself that if I slow down I might not have enough money for my daughter’s college education, or for our retirement. I work so hard I was once even treated for adrenal fatigue. But my husband and I are not in any financial danger now, and things are fine, and I’d love to have time for more walks, for more meditation. But I’m terrified of slowing down. We did the What-If Technique to explore Elizabeth’s fear of slowing down. What was at the root of her fears? David: What would happen if you slowed down? What are you the most afraid of? Elizabeth: We might not have enough for my daughter’s college and for our retirement. David: And then what? Elizabeth: Our daughter would have to take out student loans. David: And if you did not have enough for your retirement, and your daughter had to take out student loans, what then? What are you the most afraid of? Elizabeth: My father’s life collapsed at the end, and he ended up in a skilled nursing facility with nothing. (tears) Jill pointed out a belief at the root of Elizabeth’s fears. “If I slow down, we won’t have enough money for survival. This fear has been haunting and driving me since I was 13.” Elizabeth said it felt unjust, and that she was angry that she could not take a break without feeling a sense of panic. She said, “it’s all about family values. I wish the work ethic hadn’t been driven into me so hard.” She said she’s struggled with constant worries about money, and wondering whether she can pay her bills ever since she was 13. She said, “It’s not about having fancy things—that doesn’t interest me. It’s all about survival.” Although Elizabeth and her husband are doing really well, and her treatment center is doing really well, she constantly worries, keeps her schedule more than full, and cannot say no to a new patient. She gives herself the message that she should be working longer hours, and that she can work overtime to make room for every new patient. She said, “For years I’ve wanted not to be so overwhelmed, and I’m still stuck with so much on my plate. . . ‘I’m tired of being terrified and want to be at peace. I want to learn to let go of this constant fear, but I don’t know if I can let it go. I want to feel differently, and not just do differently. “I want to be at peace with my business. I want the freedom to say yes or no. I want the freedom of choice. “If I have a day off, I don’t know what to do. It feels weird. My greatest fear is ending up in a nursing home on Medicaid, like my father.” I decided to explore this fear once again, using the Downward Arrow Technique. David: And then what would happen? What would that mean to you? Elizabeth: My daughter would see me and realize she would have to support herself. David: And then what? What would that mean to you? Elizabeth: That would mean I was worthless. (tears) That would mean I was not enough. And then I’d be rejected. Now I’m feeling so ashamed! (more tears) At this point, we summarized what Elizabeth and been saying and feeling, and asked her to grade us on our empathy so far. Would she give us an A, a B, a C, a D, or what? This “What’s My Grade” technique is powerful and helpful, but a bit intimidating for the clinician. Elizabeth said she’d give us an A- or B+. That’s not bad, but it is really a failing grade, because we’re aiming for an A. When this happens you can ask, “What am I missing?” Elizabeth explained that we’d done a great job on the thought and feeling empathy, but she did not feel as much warmth and acceptance as she was hoping for because she was feeling very ashamed about her story Jill reminded us of the need to include “I Feel” Statements to our empathy (my bad), and then we shared our feelings of sadness and admiration for Elizabeth, and quickly got an A. As a teaching point, your perceptions of how empathic you are, if you are a therapist, will not be accurate. That’s why the “What’s My Grade” technique can be so valuable. When you fall short, the patient will tell you why, and can easily make a correction and greatly enhance the therapeutic relationship. Superb empathy is desirable, and necessary if you want to do top-notch clinical work, but it won’t cure much of anything. So we’ll need something more! Next week you will hear the amazing last half of the session, starting with A = Assessment of Resistance and then going on to M = Methods, and end of session T = Testing. In next week's podcast, you'll hear the final half of Elizabeth's session and, if you like, you can also listen to some of the Q and A from the participant's in the Tuesday group who watched the session live. Rhonda and David

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

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

How to stay true to yourself in the pursuit of fulfillment This week’s interview is incredibly special because it is my favorite one to date. In this episode, I talk to one of my dearest friends, Jason Lew, and listen as he shares his brilliance, wisdom, advice, and success, how he has pivoted, and provided for his family while following and finding fulfillment. If you are searching for something more, for what defines you and makes you unique, and how to use that to create a business and find fulfillment, listen to this episode to hear exactly how to take the leap and be truly aligned with yourself. Authentically sharing his story Jason starts off this episode describing his podcast’s premise—how he knew he was unhappy with his current role and work and was determined to find more and share that journey with those who could connect with it. We discuss his upbringing, the pressures to go to an elite school, and why he was considered the “black sheep” of his family. Taking the leap He shares the decision to go to college, and how one college party changed his life for the better, leading to his decision to drop out of college and pursue building his own business. Jason discusses the four years of struggles he faced, finally having tremendous success, and building seven-figure businesses. He digs into his realization that after 19 years in network marketing, he wasn’t happy, wasn’t feeling good, and decided to pivot again to change that. Showing up as the best version of yourself He tells his own story through shifting perspectives and the responsibility we have to own our feelings and how to do so. He shares the two sayings that helped him alter his view of challenges and helped him overcome them, and how refocusing on abundance changed everything. He describes his latest pivot, and how he is using his experiences and past successes to help others not only build the same but find fulfillment. Jason Lew Jason Lew is an entrepreneur, podcaster, and speaker. He’s built two 7-figure businesses over his 19-year career. Jason’s focus is to help professionals and entrepreneurs use their expertise to build profitable online businesses. He currently hosts The Business of Feeling Good Podcast.Quotes:“It was one of these ideas where it was, I didn’t feel it but I wanted to speak it—I wanted to speak into that intention of feeling good about the work that I was doing.” -Jason 4:19“I think that the real magic in putting yourself on social media or putting yourself on a podcast is documenting the journey.” -Jason 4:41“A- you can’t mooch off the government, B- you can’t mooch off your parents, and C- you have to love yourself—those were the 3 lessons my mom imparted on me.” -Jason 8:26“I’ve had people tell me to change my process, and I can agree with that, but I think there’s also something to know your own process of how you get through your own shi*t.” -Jason 13:48“I find that if I have a problem that I’m facing, whatever question I’m asking myself, whatever problem I’m coming across, it’s typically because I can’t see it from a new perspective.” -Jason 14:11“When in doubt, focus out.” -Jason Lew 19:51“If you really take a step back, we live in this incredible place. I always thought abundance meant making a certain amount of money...I tied my self worth to the numbers that I made, and because of that, I always thought that I was unworthy if I didn’t make that.” -Jason 24:36“If you choose what you’re being, how you show up as an individual, it then determines your to-do list.” -Jason 31:22“The whole reason I believe we’re here is to make an impact on the world and the generations that follow us and the legacies we leave behind, not just monetarily, but in the soul space.” -Tracy 38:06“Moving forward, people are ready more than ever to say ‘ok now is the time to pivot’” -Tracy 38:39

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

Get Honey for FREE at http://joinhoney.com/valleycast. The first ever attempt at THE FEELING GOOD PODCAST - A journey of good news, good habits and good conversations that bring more positivity into our lives. Don't worry, if we do more, they'll get better. Thank you to our sponsor! Video: https://www.youtube.com/watch?v=ZJ_J2VurBME The Aaron Massey Operation Covid Shield Paypal donation email is operationcovidshield@gmail.com. Makers Influence Game: makersinfluence.com

In this episode we are joined by Richard Arsenault from the All About Feeling Good Podcast.I met Richard at the Canada Fruitfest and the Woodstock Fruit Festival last year. I also ended up bumping into him in Rome last year.We talk about his transition to a vegan and raw vegan lifestyle.Learn more about Richard by following him on instagram @allabout.feeling.goodLearn more about the UK Fruitfest at: http://www.fruitfest.co.uk

      Shanna's Favorite Things:   Hale Center Theater David Burns' "Feeling Good" Podcast   Allyson's Favorite Things: Always brand "Infinity Flexfoam" pads NBC's "Manifest" Allrecipes "Chef John's Quiche Lorraine" Inspiring Sister:  Roberta Sowby    

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

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

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

Today we're getting raw and personal. If you're ready for some juicy details, then tune in right now. I'm taking you through all the ups and downs of my weight loss journeys. That's right, we're talking about more than one weight loss journey today. Because losing weight is never a one-and-done kind of thing. There's lots of twists and turns. My adventure even comes with a bikini contest! We'll all try anything once if we think it will help us lose weight. For any dentist who's ever struggled with their weight, you know how frustrating it can be to lose those pounds and keep them off. I'm sharing my personal journey with weight loss on today's podcast so you can see that you're not alone in this. Remember when I was talking about over-desire and over-hunger? This was back in Episode 3, but I'm giving a quick refresher today because this desire and this hunger are all contributing to your weight loss roadblocks. Over-hunger is why we're always starving when we're on a diet, and over-desire is why we ate that entire box of girl scout cookies for dinner. Both of these emotions are triggered by our hormones that are in charge of digesting our foods. Once you know what they are and where they come from, you can finally tap into a weight loss plan that actually works. As you listen to my personal journey today, you'll probably notice how distracted I was from healthy living. It's not easy to lose weight, especially when other variables come into play. Growing up poor means not having access to healthier foods, and raising a family and starting a dental practice makes it even harder to find time to exercise and live well. Having a lot of things on your plate, so to speak, sometimes means health and wellness falls to the wayside. There's absolutely nothing wrong with that. Life happens. What matters is that you're here today listening to how you can improve your lifestyle and get back to making healthy living a priority. My life coach techniques will show you any problem and how you can change your reaction to it. And if you've been following me, then you know that I do free consults. After listening to today's episode, if you have any questions or are curious about starting a new kind of diet, visit my website. I would love to meet you and talk one-on-one about your goals and how you can reach them! In This Episode You Will Learn The definitions of over-desire and over-hunger 1:14 How I started on my own weight loss journey 4:00 What my weight loss plan looked like after dental school 7:43 All about my second adventure in weight loss after my divorce 9:30 How over-desire snuck into what I thought was a perfect health plan 10:55 Why I signed up for a bikini contest 12:40 What changed my mind in January 2019 16:55 How my life coaching techniques work 18:25 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast

Today we’re getting raw and personal. If you’re ready for some juicy details, then tune in right now. I’m taking you through all the ups and downs of my weight loss journeys. That’s right, we’re talking about more than one weight loss journey today. Because losing weight is never a one-and-done kind of thing. There’s lots of twists and turns. My adventure even comes with a bikini contest!  We’ll all try anything once if we think it will help us lose weight. For any dentist who’s ever struggled with their weight, you know how frustrating it can be to lose those pounds and keep them off. I’m sharing my personal journey with weight loss on today’s podcast so you can see that you’re not alone in this.  Remember when I was talking about over-desire and over-hunger? This was back in Episode 3, but I’m giving a quick refresher today because this desire and this hunger are all contributing to your weight loss roadblocks. Over-hunger is why we’re always starving when we’re on a diet, and over-desire is why we ate that entire box of girl scout cookies for dinner. Both of these emotions are triggered by our hormones that are in charge of digesting our foods. Once you know what they are and where they come from, you can finally tap into a weight loss plan that actually works.  As you listen to my personal journey today, you’ll probably notice how distracted I was from healthy living. It’s not easy to lose weight, especially when other variables come into play. Growing up poor means not having access to healthier foods, and raising a family and starting a dental practice makes it even harder to find time to exercise and live well. Having a lot of things on your plate, so to speak, sometimes means health and wellness falls to the wayside. There’s absolutely nothing wrong with that. Life happens. What matters is that you’re here today listening to how you can improve your lifestyle and get back to making healthy living a priority. My life coach techniques will show you any problem and how you can change your reaction to it. And if you’ve been following me, then you know that I do free consults. After listening to today’s episode, if you have any questions or are curious about starting a new kind of diet, visit my website. I would love to meet you and talk one-on-one about your goals and how you can reach them! In This Episode You Will Learn The definitions of over-desire and over-hunger 1:14 How I started on my own weight loss journey 4:00 What my weight loss plan looked like after dental school 7:43 All about my second adventure in weight loss after my divorce 9:30 How over-desire snuck into what I thought was a perfect health plan 10:55 Why I signed up for a bikini contest 12:40 What changed my mind in January 2019 16:55  How my life coaching techniques work 18:25 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast

Welcome back to Feeling Good! I'm very excited about today's episode because I've been nerding out on thoughts, feelings, emotions, and where all these things come from. So many of you are telling me that you're stressed and worried, whether it's about your dental practice or your health and wellbeing, and believe me, I know how you feel. I've been there. We've all been there. But I don't want you to feel discouraged. I'm here to tell you that it's totally possible to feel better, and here's how: You are fully capable of feeling better no matter the circumstance when you understand where all your thoughts and emotions are coming from. Today I'm breaking down our evolutionary and natural development of emotions and why they motivate us to feel or act a certain way. All animals have emotions because it's nature's way of keeping us alive, but these days our emotions are manifesting in modern ways. Nature uses emotions to agitate us into action. These emotions cause a vibration that gets us to move within and react to our environment, but this modern environment is not in our evolutionary genetics. This causes our body to react in ways we might think are weird or out of place. I'm sharing tips today that can change the way you think about your emotions and therefore change the way you react and feel about certain modern hindrances, like a fear of rejection, for example. We all have that fear, whether it's in our interpersonal relationships or in our dental practice, and there are ways to combat this negative emotion and feel better, happier, and more at ease. The techniques to fight off these negative thoughts and feelings are known as “meta-cognition”. I'm explaining what meta-cognition is and how you can do it in today's episode. These techniques will help you create a more positive pattern of thinking. If you're interested in learning more about how you can watch the way you think and feel better no matter the circumstances, this episode is for you. Tune in now and visit my website to learn more ways to practice meta-cognition. In This Episode You Will Learn Where all your complicated feelings and emotions are coming from 3:00 Why I refer to emotions as vibrations and what this means to our wellbeing 7:20 Where feelings come from and how our thoughts influence the way we feel 10:02 Positive meta-cognition techniques to combat negative feelings 14:48 How to practice and get really good at meta-cognition 17:19 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast

Welcome back to Feeling Good! I’m very excited about today’s episode because I’ve been nerding out on thoughts, feelings, emotions, and where all these things come from. So many of you are telling me that you’re stressed and worried, whether it’s about your dental practice or your health and wellbeing, and believe me, I know how you feel. I’ve been there. We’ve all been there. But I don’t want you to feel discouraged. I’m here to tell you that it’s totally possible to feel better, and here’s how: You are fully capable of feeling better no matter the circumstance when you understand where all your thoughts and emotions are coming from. Today I’m breaking down our evolutionary and natural development of emotions and why they motivate us to feel or act a certain way. All animals have emotions because it’s nature’s way of keeping us alive, but these days our emotions are manifesting in modern ways.  Nature uses emotions to agitate us into action. These emotions cause a vibration that gets us to move within and react to our environment, but this modern environment is not in our evolutionary genetics. This causes our body to react in ways we might think are weird or out of place. I’m sharing tips today that can change the way you think about your emotions and therefore change the way you react and feel about certain modern hindrances, like a fear of rejection, for example. We all have that fear, whether it’s in our interpersonal relationships or in our dental practice, and there are ways to combat this negative emotion and feel better, happier, and more at ease. The techniques to fight off these negative thoughts and feelings are known as “meta-cognition”. I’m explaining what meta-cognition is and how you can do it in today’s episode. These techniques will help you create a more positive pattern of thinking. If you’re interested in learning more about how you can watch the way you think and feel better no matter the circumstances, this episode is for you. Tune in now and visit my website to learn more ways to practice meta-cognition. In This Episode You Will Learn Where all your complicated feelings and emotions are coming from 3:00 Why I refer to emotions as vibrations and what this means to our wellbeing 7:20 Where feelings come from and how our thoughts influence the way we feel 10:02 Positive meta-cognition techniques to combat negative feelings 14:48 How to practice and get really good at meta-cognition 17:19 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast

Professor Mark Noble was our special guest on the one hundredth Feeling Good Podcast. In that podcast, he described the effects of TEAM-CBT on the human brain. Many listeners were enthralled by Dr. Noble's revolutionary ideas! Today, Dr. Noble returns to discuss his illuminating ideas, and prevents an overview of his chapter entitled, "TEAM CBT and the Art of Micro-Neurosurgery: A Brain User's Guide to Feeling Great," which will appear in David's new book, Feeling Great, which will be released by PESI in 2020. Rhonda begins the podcast by asking how Dr. Noble met Dr. Burns. What brought the two of you together? Dr. Noble explains that he read about David's work on drug-free treatments for depression in the October, 2013 issue of Stanford Magazine entitled Mind Over Misery, This article became the most-read article in the history of the Stanford Magazine.  Dr. Noble was particularly interested in drug-free treatments for depression because of some alarming research emerging in his laboratory on the central nervous system impact of some popular antidepressants on lysosomes in the brain. So, Dr. Noble made a trip to California so he could visit David's Tuesday training group at Stanford and participate in one of David's famous Sunday hikes. This was so much fun, and so intellectually rewarding, that he become an irregular regular at the Tuesday groups and Sunday hikes! Since that time, there have been many Sunday hikes and many Tuesday groups in the emerging friendship and professional collaboration between David and Dr. Noble. David describes some of the resistance he runs into from mental health professionals who cannot believe that the rapid recoveries David sees in TEAM-CBT can be real. Most therapists were trained to believe that depression develops slowly, over many years, and that effective treatment must also be very slow, often requiring many years, or even more than a decade of weekly sessions. But Dr. Noble argues that the amazingly rapid changes David routinely sees in TEAM-CBT are actually highly consistent with the latest neuroscience understanding of how the human brain works. David and Dr. Noble on a Sunday hike In fact, Dr. Noble presents the amazing idea that if you had to invent a form of psychotherapy that was specifically developed to capitalize on how the brain works, you would come up with something very much like TEAM-CBT. Dr. Noble discusses neuroscience in simple, everyday terms that anyone can understand. Even me (david)! Dr. Noble teaches in a kind of clear, accessible way of communicating that I (david) admire greatly. I have seen this in all of the teachers that I've admired the most in college, medical school and beyond. Dr. Noble explains that if you want to change the way you think, feel, and behave, you have to change certain specific networks in your brain. That's because networks of nerves are the biological equivalents of thoughts. But how do you do that? How can you change the networks in your brain that cause you to feel depressed, anxious, and inadequate? It's through two basic concepts of neuroscience called FTWT and WTFT! In Dr. Burns' new book, Dr. Noble writes: "One of the most famous concepts in the science of learning is called, "What Fires Together Wires Together" (FTWT). Nerve cells that frequently interact with each other become functionally connected, and the more they fire together, the stronger the connections become. This is how new networks are formed and how existing networks become stronger. "In addition, nerve cells that are Wired Together tend to Fire Together (WTFT). WTFT. This idea explains why once you've learned something it gets easier to repeat it every time you do it." Dr. Noble also views TEAM-CBT as a kind of micro-neurosurgery, because you replace highly selected negative brain circuits that send distorted signals, such as "I'm not good enough," or "I'll never recover," with new circuits that are far more accurate and positive. Dr. Noble also explains why Dr. Burns' concept of "Fractal Psychotherapy" is so complimentary to our understanding of the human brain, as are the other components of TEAM-CBT, including T = Testing, E = Empathy, A = Assessment of Resistance, and M = Methods.   David and Dr. Noble following a Sunday hike, just before the dim sum feast with the hiking group at the Joy Luck Palace in Cupertino, California, Notice the slightly bulging but happy stomachs from both doctors! Dr. Noble also explains why conventional therapy--where the patient comes in week after week to vent about his / her problems--may actually make the patient worse. This is because the neurons that Fire Together every week, actually Wire Together. So, in simple neuroscience terms, conventional therapy may actually lead patients in the wrong direction, by strengthening the negative circuits in the brain. You will love this down-to-earth discussion of TEAM-CBT and the human brain! David D. Burns, M.D. & Rhonda Barovsky, Psy.D.

If you've been listening to my podcast, you might be wondering: what in the world is a life coach for dentists? What does she mean by that? What I mean is that dentistry is more than just drilling and creating tooth dust. Life is stressful enough, and my job is to help my fellow dentists reduce that stress and live better, healthier, and more fulfilling lives. Dentists face special challenges when it comes to our relationships and managing our stress, and I'm specifically trained to address these unique challenges. I'm talking about one of those unique challenges today. Today's episode is a follow up to my previous episode #3 Why I Was Overweight. I'm going to be talking about how you can make some really big changes to your lifestyle that will help you lose weight and live healthier. Nature has goals for you that influence how and why you eat - and sometimes overeat - certain foodstuffs. But we don't live in that prehistoric environment our bodies were designed for. We aren't hunter-gatherers anymore, we go to the grocery store and pick our favorite foods off a shelf. While this so much easier, it's also so much easier for us to gain weight. I have tips that can help you recognize this evolutionary process and use it to your advantage, and that's what I'm sharing with you today. I've got 6 key principles to help you lose weight. These principles will help you reduce that over-hunger and over-desire for sugary foods and help you actually stick to a diet that doesn't leave you feeling hungry all day long. You'll be able to finish that last crown at the end of the day without your stomach growling at your patients. If you're ready to learn a new way to lose weight, and actually stick to it, tune in right now to the Feeling Good Podcast for Dentists! In This Episode You Will Learn 3 basic ways I help dentists live more fulfilling lives 1:03 Steps for reducing over-hunger and over-desire 3:39 How supernormal stimuli influence our hunger patterns 6:05 How to avoid the most unhealthy foods 8:28 All about intermittent fasting and why I call it “dining in” 11:40 Techniques to train your body to become fat-adaptive (and what I mean by that) 14:29 The right ways to plan ahead and “cheat” on your weight loss plan 16:30 My favorite self-help weight loss books 18:40 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast The Obesity Code by Jason Fung The Big Fat Surprise by Nina Teicholz

  If you’ve been listening to my podcast, you might be wondering: what in the world is a life coach for dentists? What does she mean by that? What I mean is that dentistry is more than just drilling and creating tooth dust. Life is stressful enough, and my job is to help my fellow dentists reduce that stress and live better, healthier, and more fulfilling lives. Dentists face special challenges when it comes to our relationships and managing our stress, and I’m specifically trained to address these unique challenges. I’m talking about one of those unique challenges today. Today’s episode is a follow up to my previous episode #3 Why I Was Overweight. I’m going to be talking about how you can make some really big changes to your lifestyle that will help you lose weight and live healthier. Nature has goals for you that influence how and why you eat - and sometimes overeat - certain foodstuffs. But we don’t live in that prehistoric environment our bodies were designed for. We aren’t hunter-gatherers anymore, we go to the grocery store and pick our favorite foods off a shelf. While this so much easier, it’s also so much easier for us to gain weight. I have tips that can help you recognize this evolutionary process and use it to your advantage, and that’s what I’m sharing with you today. I’ve got 6 key principles to help you lose weight. These principles will help you reduce that over-hunger and over-desire for sugary foods and help you actually stick to a diet that doesn’t leave you feeling hungry all day long. You’ll be able to finish that last crown at the end of the day without your stomach growling at your patients. If you’re ready to learn a new way to lose weight, and actually stick to it, tune in right now to the Feeling Good Podcast for Dentists! In This Episode You Will Learn 3 basic ways I help dentists live more fulfilling lives 1:03 Steps for reducing over-hunger and over-desire 3:39 How supernormal stimuli influence our hunger patterns 6:05 How to avoid the most unhealthy foods 8:28 All about intermittent fasting and why I call it “dining in” 11:40 Techniques to train your body to become fat-adaptive (and what I mean by that) 14:29 The right ways to plan ahead and “cheat” on your weight loss plan 16:30 My favorite self-help weight loss books 18:40 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast The Obesity Code by Jason Fung The Big Fat Surprise by Nina Teicholz

Want to grab a glass of wine after work? Yes please! I'll meet you at the bar and enjoy myself a glass of red with you. But why are we craving this glass (or two) of wine after work? What's happening to our brains and bodies after a long day at the dental office? Where do these cravings come from and why do we always seek them out after a particularly stressful day? The secret is in the dopamine, and I'm explaining why in today's episode of Feeling Good. Nature developed systems that keep your body in line, and every action our brain thinks is essential to our survival is rewarded with a treat. In this case, that treat is dopamine, a neurotransmitter that boosts your mood and reinforces certain behaviors. Dopamine is our natural stress reliever, and we will seek out whatever action, that glass of wine, that sugary treat, or maybe even a hug from a lover or friend, in order to get that rush of dopamine. Our brain doesn't realize that some of these behaviors are unhealthy, but we seek them out because they're normal, easy, and they've become a part of our routine. This doesn't mean we don't deserve those glasses of wine after a hard day's work. What I'm here to explain today is WHY we want that glass of wine. Once you understand why, it's easier to retrain your brain and develop different ways to release dopamine and relieve stress that makes sense for our lifestyle as dentists. You don't have to keep relying on the supernormal stimuli to relieve your stress, and my way of coach-splaining in today's episode just might inspire you to start looking for new ways to retrain your brain! Tune in now to hear all about the secrets of dopamine and dentistry! In This Episode You Will Learn All the physical and mental challenges we work thru in the dental office 1:50 How the Motivational Triad influences our behaviors 4:46 How our bodies use dopamine to influence our actions 5:47 Why our brain rewards us for bad or unhealthy behaviors 9:50 How a bird's behavior mimics our own human behaviors 12:00 How life coaching can help you retrain your brain 14:59 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast

Welcome back to my third episode! This is a more science-y episode, but don't expect it to be as dry as a high school textbook. I'm talking today about the two main reasons why I was overweight. You might see a lot of similarities between my lifestyle and yours, and I hope what I've learned can help you finally kick that weight. Yes, weight gain can be narrowed down to two big reasons: over-desire and over-hunger. In my last episode, I talked about dopamine and how it can relieve your stress and make you feel great. Unfortunately, this dopamine is released whether the behaviors are healthy or not. This can trick you into eating more, especially when it comes to our favorite sweet treats and candies, or what I refer to as “concentrated foods”. You start to desire these kinds of foods that aren't always good for you and can cause you to gain weight, or make it harder for you to lose weight. Modern food is designed to hit that bliss point in our brains and release that surge of dopamine. This only entices us to eat more and more and more, and you know exactly what that leads to. Luckily, I've learned a new way to eat that overcomes this desire and helped me finally lose weight over this past year. You don't have to fight the dopamine anymore. There's a way you can break free and lose weight, and I'm talking all about it in today's episode. Tune in now to hear how sugar influences your physical hunger and why this sugar just makes you hungrier and hungrier. This hunger combined with your desire for concentrated foods is what makes it so hard to lose weight. I've designed a weight loss plan, tweaked it for the dental community, and made it possible for you to eat, stay full, and lose the weight so you can get back to the healthy lifestyle your body is really craving. In This Episode You Will Learn How over-desire triggered my weight gain 0:58 What triggers the emotions and feelings around food and weight gain 2:50 All about concentrated foods 5:15 Which combinations of foods hit that “bliss point” in our brain 8:25 All about physical hunger and why you get so hangry in the middle of the day 13:24 Where sugar is hiding in all of these “healthy” foods 19:36 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast

Welcome to the brand new Feeling Good Podcast for dentists! I'm Laura Mach, a practicing dentist and professional life coach. I've been practicing dentistry for 12 years now, so I know a little something about stress. That's why I started this podcast. I'm here to help dentists manage their stress and start treating themselves better. Whether that means balancing your schedule, managing your dental office, or just learning how to talk to yourself better - this podcast is for you. In today's first ever episode I'm giving you a sneak peek of the stress management techniques I teach as a life coach for busy dentists. I'm running my own private practice on top of being a full-time wife, mother, and life coach, and I know the toll stress can take on your life. I started this podcast to help dentists “deal with the feels”, as I like to say. We all have emotional reactions to our worrisome thoughts, and I have a few tricks that can help you manage that kind of anxiety. These emotional reactions are completely normal. It's also completely normal to worry about your dental practice and your patients. But all this worrying can disrupt your life, especially your sleep schedule. If you're losing sleep over your dental practice, tune in right now to learn the keys to worrying less. I'm here with tips on how you can let go of your perfect expectations, accept the sometimes messy disorder of the dental life, and break that vicious cycle of negative thinking. No matter what the day throws at you, from payroll to patients, you can still manage that stress and get a good night's sleep, I promise. The biggest thing you'll learn in today's episode is my technique for meta-cognition. I'm talking about how you can learn to watch yourself think and train yourself to ignore those anxious thoughts. We have over 60,000 thoughts a day, and not all of them are correct or even important. I have a few ways tricks to help you organize your thoughts so you can stay focused on what really matters and stop stressing about the things that don't. Of course, you can't get rid of your stress overnight. That's why there will be more episodes of the Feeling Good podcast coming your way. Listen now to our first ever episode so you can learn the keys to worrying less and kickoff your new, stress-free lifestyle! In This Episode You Will Learn: How I can help dentists manage their stress and balance their lives 1:30 What a stressful day for a dentist looks like 2:38 3 theories I have on why dentists worry so much 6:22 Why we have such emotional reactions to stressful thoughts 11:47 3 key ways to worry less 15:00 The practice of meta-cognition and how to do it 17:34 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast The Life Coach School

 Welcome to the brand new Feeling Good Podcast for dentists! I’m Laura Mach, a practicing dentist and professional life coach. I’ve been practicing dentistry for 12 years now, so I know a little something about stress. That’s why I started this podcast. I’m here to help dentists manage their stress and start treating themselves better. Whether that means balancing your schedule, managing your dental office, or just learning how to talk to yourself better - this podcast is for you. In today’s first ever episode I’m giving you a sneak peek of the stress management techniques I teach as a life coach for busy dentists. I’m running my own private practice on top of being a full-time wife, mother, and life coach, and I know the toll stress can take on your life. I started this podcast to help dentists “deal with the feels”, as I like to say. We all have emotional reactions to our worrisome thoughts, and I have a few tricks that can help you manage that kind of anxiety. These emotional reactions are completely normal. It’s also completely normal to worry about your dental practice and your patients. But all this worrying can disrupt your life, especially your sleep schedule. If you’re losing sleep over your dental practice, tune in right now to learn the keys to worrying less. I’m here with tips on how you can let go of your perfect expectations, accept the sometimes messy disorder of the dental life, and break that vicious cycle of negative thinking. No matter what the day throws at you, from payroll to patients, you can still manage that stress and get a good night’s sleep, I promise. The biggest thing you’ll learn in today’s episode is my technique for meta-cognition. I’m talking about how you can learn to watch yourself think and train yourself to ignore those anxious thoughts. We have over 60,000 thoughts a day, and not all of them are correct or even important. I have a few ways tricks to help you organize your thoughts so you can stay focused on what really matters and stop stressing about the things that don’t. Of course, you can’t get rid of your stress overnight. That’s why there will be more episodes of the Feeling Good podcast coming your way. Listen now to our first ever episode so you can learn the keys to worrying less and kickoff your new, stress-free lifestyle! In This Episode You Will Learn: How I can help dentists manage their stress and balance their lives 1:30 What a stressful day for a dentist looks like 2:38 3 theories I have on why dentists worry so much 6:22 Why we have such emotional reactions to stressful thoughts 11:47 3 key ways to worry less 15:00 The practice of meta-cognition and how to do it 17:34 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast The Life Coach School

Want to grab a glass of wine after work? Yes please! I’ll meet you at the bar and enjoy myself a glass of red with you.  But why are we craving this glass (or two) of wine after work? What’s happening to our brains and bodies after a long day at the dental office? Where do these cravings come from and why do we always seek them out after a particularly stressful day? The secret is in the dopamine, and I’m explaining why in today’s episode of Feeling Good. Nature developed systems that keep your body in line, and every action our brain thinks is essential to our survival is rewarded with a treat. In this case, that treat is dopamine, a neurotransmitter that boosts your mood and reinforces certain behaviors. Dopamine is our natural stress reliever, and we will seek out whatever action, that glass of wine, that sugary treat, or maybe even a hug from a lover or friend, in order to get that rush of dopamine. Our brain doesn’t realize that some of these behaviors are unhealthy, but we seek them out because they’re normal, easy, and they’ve become a part of our routine. This doesn’t mean we don’t deserve those glasses of wine after a hard day’s work. What I’m here to explain today is WHY we want that glass of wine. Once you understand why, it’s easier to retrain your brain and develop different ways to release dopamine and relieve stress that makes sense for our lifestyle as dentists. You don’t have to keep relying on the supernormal stimuli to relieve your stress, and my way of coach-splaining in today’s episode just might inspire you to start looking for new ways to retrain your brain! Tune in now to hear all about the secrets of dopamine and dentistry! In This Episode You Will Learn All the physical and mental challenges we work thru in the dental office 1:50 How the Motivational Triad influences our behaviors 4:46 How our bodies use dopamine to influence our actions 5:47 Why our brain rewards us for bad or unhealthy behaviors 9:50  How a bird’s behavior mimics our own human behaviors 12:00 How life coaching can help you retrain your brain 14:59 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast

Welcome back to my third episode! This is a more science-y episode, but don’t expect it to be as dry as a high school textbook. I’m talking today about the two main reasons why I was overweight. You might see a lot of similarities between my lifestyle and yours, and I hope what I’ve learned can help you finally kick that weight.  Yes, weight gain can be narrowed down to two big reasons: over-desire and over-hunger. In my last episode, I talked about dopamine and how it can relieve your stress and make you feel great. Unfortunately, this dopamine is released whether the behaviors are healthy or not. This can trick you into eating more, especially when it comes to our favorite sweet treats and candies, or what I refer to as “concentrated foods”. You start to desire these kinds of foods that aren’t always good for you and can cause you to gain weight, or make it harder for you to lose weight.  Modern food is designed to hit that bliss point in our brains and release that surge of dopamine. This only entices us to eat more and more and more, and you know exactly what that leads to. Luckily, I’ve learned a new way to eat that overcomes this desire and helped me finally lose weight over this past year. You don’t have to fight the dopamine anymore. There’s a way you can break free and lose weight, and I’m talking all about it in today’s episode.  Tune in now to hear how sugar influences your physical hunger and why this sugar just makes you hungrier and hungrier. This hunger combined with your desire for concentrated foods is what makes it so hard to lose weight. I’ve designed a weight loss plan, tweaked it for the dental community, and made it possible for you to eat, stay full, and lose the weight so you can get back to the healthy lifestyle your body is really craving.  In This Episode You Will Learn How over-desire triggered my weight gain 0:58 What triggers the emotions and feelings around food and weight gain 2:50 All about concentrated foods 5:15 Which combinations of foods hit that “bliss point” in our brain 8:25 All about physical hunger and why you get so hangry in the middle of the day 13:24 Where sugar is hiding in all of these “healthy” foods 19:36 Resources: Visit my website: TheLifeCoachForBusyDentists.com Listen to more episodes: Feeling Good Podcast

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

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

What can you do when you can’t identify your negative thoughts? Is it really true that our feelings always result from negative thoughts? How can I get over my public speaking anxiety? Rubens, a faithful and enthusiastic Feeling Good Podcast fan, sent me an email with a terrific question that has both  practical and theoretical implications. He wrote: Dear Mr. David, I've read "Feeling Good" and I'm reading "When Panic Attacks" now. Both have and are helping me immensely. However, the one thing I have never understood is that my anxieties and worries often don't come as a thought. For instance, I have an academic presentation tomorrow, and I'm suffering from much anxiety because of that. But the symptoms did not appear because I thought in my mind the sentence "you are going to fail!". In my case, it is usually silent. I just remember that I have a presentation tomorrow, then I immediately feel worried. My chest hurts before any thought. How do I counter-argument my thoughts, if I have none? Thank you for replying, Mr. David!  In today's podcast, Rhonda and I address this question and explain what to do when you can't pinpoint your negative thoughts. There are  two really good methods. We will also demonstrate how to deal with some of the negative thoughts that typically trigger public speaking anxiety. The cure involves changing the way you think, and changing the way you communicate with the people in your audience. If you've ever struggled with public speaking anxiety, this podcast may be helpful for you! Thank you again, Rubens, for your excellent question! David D. Burns, MD / Rhonda Barovsky, PsyD  

I recently published the results of a survey of Feeling Good Podcast fans like yourself. The findings were overwhelmingly positive and illuminating. However, there were a few criticisms as well, like the excellent and thoughtful comments Rhonda and I will address in this podcast. I appreciate negative feedback, as this provides the greatest opportunities for growth and learning.  However, like most people, I sometimes find criticisms emotionally challenging  and want to lash out, defending myself! Do you sometimes feel that way, too? When I feel defensive, its because I think I have a "self" or some cherished "territory" that's under attack. When I let go of this "self," it can be incredibly liberating to find truth in a criticism and discover that the feedback is really coming from a trusted colleague or friend, rather than some enemy who is trying to destroy or defeat you!  Here's what s/he wrote: Dr. Burns, you seem to disregard healing modalities outside of CBT. CBT is wonderful and nobody teachers it better than Dr Burns—I believe that it is a foundational practice to well-being. However, working with difficult emotions is very important and not always well addressed through CBT alone. Thinking CBT is the answer for most issues is loaded with cognitive distortions. Example--Discounting the Positive in other practices, All or Nothing Thinking, Magical Thinking, and seeing CBT as a “cure all.” In my personal healing journey CBT has been absolutely essential--as has self compassion, learning to let things go, inner child work, mindfulness, somatic awareness and more. I have noticed there has repeatedly been a dismissive tone for other valuable practices. Obviously. the Feeling Good Podcast is about CBT and sticking to your expertise is essential. However, I would be careful not to disregard other healing practices that could potentially help someone out. I have such respect for Dr Burns and his team-but your words carry weight- please be thoughtful about discounting other methods that could be helping someone. Thank you, whoever you are, for this thought-provoking feedback. And you are SO RIGHT. Cognitive Therapy has value for some problems, but it is definitely NOT a panacea. In fact, no treatment is! The belief that you have THE ANSWER for everything is incredibly misguided but unfortunately, way too common in our field.  I have no doubt that many people have shared your concerns. Let us know what you think after you hear today's podcast!  David and Rhonda

Session with Rhonda, Part 2 Last week we published the first half of the session with Rhonda, who was struggling with severe performance anxiety about her work as the new host of the Feeling Good Podcast host. We did the initial T = Testing, which indicated many intense negative feelings, as well as E = Empathy phase of TEAM therapy session. This week, we include the conclusion of the session, with A = Paradoxical Agenda Setting and M = Methods, plus final T = Testing to see how effective, or ineffective the session was. As a reminder of the first podcast, plus the work done on this podcast, you can review Rhonda's Daily Mood Log here. When you listen, you will see that the changes Rhonda experienced were amazing,. But were these changes real? It almost seem too easy, and too fast, especially for a problem that started in childhood and persisted right up to the present moment. Was the session just a publicity stunt, perhaps, or some kind of superficial quick fix? David asks Rhonda about this, as well as this question: 'If the changes were real, what caused the changes? David and Rhonda used many TEAM-CBT techniques they during the session, including these: David Empathized with the Five Secrets of Effective Communication at the start of the session during the E = Empathy phase. Of course, good empathy is necessary throughout a therapy session. David melted away Rhonda’s resistance during the A = Paradoxical Agenda Setting. These techniques included: Straightforward Invitation Miracle Cure Question Magic Button Positive Reframing Pivot Question Magic Dial The M = Methods that were helpful in this session included included: The Individual Downward Arrow to identify the Self-Defeating Beliefs that triggered Rhonda’s feelings of inadequacy.Rhonda enjoyed this exercise and felt it was on target. We identified many beliefs, including: Perfectionism Perceived Perfectionism Achievement Addiction Approval Addiction Love Addiction Fear of Rejection Submissiveness Inadequacy schema Spotlight Fantasy Brushfire Fallacy Superwoman The Interpersonal Downward Arrow to illuminate how Rhonda saw her relationship with her father, with David, and with some other people, including the podcast listeners. This is kind of like Psychoanalysis at warp speed. Rhonda said this felt uncomfortable, perhaps because it cast David somewhat as a dangerous ogre! David and Rhonda smashed several of Rhonda’s Self-Defeating Beliefs with the Feared Fantasy Technique Identify the Distortions Paradoxical Double Standard Technique Externalization of Voices Acceptance Paradox / Self-Defense Paradigm Self-Disclosure / Exposure The Experimental Technique Thinking in Shades of Gray Finally, if the changes were real, will they last? Or will Rhonda just slip back into more performance anxiety and self-doubt? You can click on this link if you’d like to review the evolution of Rhonda’s Daily Mood Log during the session, and see her ratings on the Brief Mood Survey before and after the session at this link. You can also review her ratings of David on the Empathy and Helpfulness scales at the end of the session. You can also review her interesting comments on what she liked the least, and what she liked the most about her session with David. I want to thank Rhonda, my esteemed colleague, friend, and wonderful podcast host, for giving all of this incredible gift of her humanness.  And I, Rhonda, want to thank the most marvelous, compassionate and incredible David Burns, for the gift of healing and facilitating me experiencing enlightenment and peace from these difficult feelings and negative thoughts that were devastating me.  I feel so much gratitude, for all of our work together, for you trusting me enough to invite me to be the host of these podcasts, and for the gift of your friendship.  Words can't express the full depth of my love for you and for everything you have given me both personally and professionally! Did you like the personal work we did? Was it helpful for you personally? Rhonda took a chance and was courageous to share intensely personal experience with you. Let us know if you liked this! If you are a therapist, or an interested patient, let us know if this was it a good learning experience. Would you like to hear more podcasts with live personal work? We are here to serve you, so share your thoughts and feelings with us, as well as your wish list for future podcasts! David and Rhonda

Rhonda, Fabrice and I received a number of thoughtful emails following our recent podcast on mindfulness meditation, which seems to be quite popular these days, but there some push-back from listeners who all did not agree that mindfulness is an effective way of combating negative thoughts and feelings. Email from Jeremy Hi David, I listened to the Feeling Good Podcast on meditation this morning and had some thoughts I wanted to share. For context I've been meditating daily for about 3 months. First - I personally think that if someone is struggling with depression or anxiety, TEAM-CBT is a dramatically faster acting and more powerful tool than mindfulness. I've never seen or heard about someone having a dramatic recovering in just a few hours due to mindfulness. I've never seen the idea of resistance explored in any kind of mindfulness book or article. I also don't really think much of mindfulness as a "method" in the TEAM model, because compared to the other methods for removing negative thoughts it's extremely weak. I imagine that with hundreds of hours of mindfulness practice you might reach a point where it's easier to let go of negative thoughts. (There are a lot of reports like that/) However, it's a very slow way of dealing with negative thoughts compared to externalization of voices etc.  I think for a therapist who knows TEAM to suggest mindfulness as a key practice to their patient is almost negligent, since TEAM is so much more effective. That said, I've sensed a few benefits of mindfulness which is why I've been investing my time in it: - I think you can view meditation as concentration practice, and I've found that meditation increases my ability to concentrate  - You can reach a very calm and relaxed state in meditation where you cease to have thoughts, and this state is extremely pleasurable - I've noticed that mindfulness increase my ability to enjoy experiences, including experiences I might enjoy less if I was having even positive or neutral thoughts. As an example, after about 30 minutes of meditation the other day I went for a walk in the woods and stop for about 10 minutes to look at a ridge. My visual experience was completely immersive and I even started to feel like the trees were breathing with me. It was one of the high points of my week. I suspect that even someone who had no negative thoughts might be flooded with positive but irrelevant thoughts (like a yummy meal they might be headed to eat later) would have enjoyed this scene much less.  I've also run an experiment using the PAS and CBT to remove the motivation to have distracting thoughts. (ie write down the advantages to having distracting thoughts and disadvantages of focusing on the breath, and then talk back to those) I would classify it as a highly successful experiment, after talking back to all the good reasons to think about something besides my breath my focus got dramatically better. I wonder if this technique could be used to either improve meditation or even supplant the need for it. (because it gets rid of distracting thoughts directly, while meditation is basically practice for having fewer distracting thoughts)  Anyway, just thought I would share some thoughts and ideas with you.  Best,  Jeremy Email from Paul Hey, Dr. Burns! I am with you in terms of the skepticism of mindfulness as a panacea. I also am not sure how particularly effective it is even as a tool in the fight against negative thoughts. I personally cannot seem to get anything out of it, but I am trying to make sense out of how so many people can find it useful. Perhaps you could put it like this: Mindfulness is not a specific technique for specific problems, but a general method for psychological health. If you have a specific medical condition, you'll want to get a specific treatment. Sometimes specific conditions can be alleviated by taking care of your health generally (eating healthier, sleeping better, etc.) Still, depending upon the disease, in order to get rid of it, you'll need a specific treatment. However, even when you're not dealing with a specific disease, generally good health practices can lower your chances of getting any diseases and lessen the severity when they do arise. In sum, perhaps the goals of mindfulness and CBT are different. I think that might respect what both you and Fabrice are getting at. I think this goes to answer partly a question I've had about TEAM. To what extent is alleviation of anxiety, depression, etc the final goal? Are there religious, spiritual, or psychological problems that are positive goals beyond relief? In Feeling Good, it sounded like you thought that happiness was just the absence of depression. Is that all there is to say about human flourishing? Or do you methodologically stick within the parameters of your client's value system, asking only "what can I help you with" because you're a psychologist and not a priest, for example? Paul David and Rhonda discuss several important points raised by these listeners, including: Non-specific vs. / specific interventions. David describes an elderly man named Ezekiel who had escaped from Nazi Germany as a teenager, and still felt like a “totally worthless human being” in spite of incredible success in life. He’d start out shining shoes on the streets of New York City) and end up as a wealthy industrialist, but that did nothing to boost his self-esteem. He’d decades of psychotherapy as well, but it was not effective. David encouraged him to jog long distances daily to boost the release of “endorphins” in the brain, but that did not work either. Nor would medication or meditation have worked, either. When you learn why Ezekiel felt like a “worthless human being,” you’ll see exactly why! And you’ll also learn what did work to end decades of suffering and self-doubt. The time required for meditation, not only during sessions, but in between sessions, is considerable. David would prefer his patients use this time for doing specific psychotherapy homework. Formulaic treatment. Life has always been stressful, and people are always looking for some simple “solution” to emotional problems, which seem almost universal. The current wellness fad is a great example of that. So, people promote a healthy diet, daily exercise, daily meditation, daily prayer, relaxation training, deep breathing, expressing gratitude, and a host of other things as the secret of happiness and contentment. These formulas, in my opinion (DB), do not have, and will never have, more than a placebo effect in the treatment of stress. depression, anxiety disorders, relationship problems, and habits and addictions. Sadly, those who are hugely enthusiastic about one of these fads, or formulas, will not want to hear what I just said, as sometimes we just don’t want to have our beliefs challenged. We see this resistance in politics, in religion, and in almost every aspect of our lives. Mindfulness is already a TEAM technique, even without meditation--but not a terribly effective method, in David's clinical experience. However, for certain kinds of recurrent negative thoughts, Self-Monitoring and Reattribution can be helpful. These techniques are similar to Mindfulness Meditation, but are only two of more than 100 Methods David uses in treatment, and they are not for everybody. David gives an example of the intensely anxious eye doctor with OCD who was afraid of going blind, who responded to Self-Monitoring and Response Prevention. There’s nothing wrong with a healthy diet, or meditation, or prayer, or anything that you enjoy, anything that gives you a sense of meaning. But these non-specific approaches should not be confused with specific treatments for depression, anxiety disorders, conflicts in relationships with others, or habits and addictions. Thanks for listening! David and Rhonda

Mission Accomplished! Dear Feeling Good Podcast fans, I am profoundly sad to say goodbye to my beloved friend and terrific podcast host, Dr. Fabrice Nye, who is leaving the podcast to start his own show this spring. I wish him well on his new podcast he'll be releasing soon. I'll share the specifics when they become available so loyal fans can tune in and follow him! What a joyous experience it has been working with Fabrice for the last three years. He proposed the idea of a weekly podcast in the fall of 2016 and we produced episode #001 on October 27 of that year. Together we have been able to share TEAM-CBT with many enthusiastic listeners, and just exceeded more than 70,000 downloads monthly. Please join me in wishing him well! My feelings of profound loss are comforted by welcoming another dear friend and colleague, Dr. Rhonda Barovsky, our new host. Rhonda and I look forward to creating many more fabulous podcasts for all of you. Rhonda received her doctoral degree in Forensic Psychology from the Eisner Institute for Professional Studies in 2013. Throughout her career, she has been a champion of women’s rights and defender of the victims of childhood sexual abuse. Rhonda is the founder of the San Francisco Juvenile Sex Offender Treatment Program and has served as Director of San Francisco Family Court Services. She has also worked at the San Francisco Rape Treatment Center, providing crisis and short-term counseling for adult survivors of sexual assault and their families. Rhonda is a certified TEAM-CBT therapist and esteemed teacher. In her clinical practice, she focuses on TEAM-CBT for adults struggling with depression, anxiety disorders, and relationship problems. She brings warmth, enthusiasm and brilliance to her new role as host of the Feeling Good Podcasts: "I am extremely honored to be invited to host the Feeling Good Podcast with Dr. David Burns. Fabrice Nye has been a visionary, and his shoes will be impossible to fill. I hope to add to the joy and excitement of learning and teaching TEAM-CBT along with David and having lively and productive discussions.” Dr. Rhonda Barovsky Rhonda and I will be posting two surveys shortly on my website, www.FeelingGood.com, to find out more about you. I want to find out if you are a therapist or non-therapist, and what kinds of topics might interest you the most. And unlike some tech giants, we promise to keep your information totally confidential. We don’t sell information; we just want to do the best job we can for therapists and non-therapists alike, for free. If you are a "patient," we want to accelerate your learning and your recovery as well. If you are a "therapist," we want to help you improve you skills and your joy in your clinical work.  I put the words, "patient" and "therapist" in quotes, because the line between the two is very narrow indeed! As "therapists," most of us struggle at times with the same human dilemmas that our patients face. And as we do our own personal work, as therapists, we bring far more healing and compassion to our work with our "patients!" On the show, Fabrice and David share fondest memories of the show, and Rhonda talks about new directions as she becomes the host of the Feeling Good Podcast. Fabrice also gives some hints about his new show, which will be broadcast in French and English. Fabrice will describe and translate new developments in psychology research and relate the findings to our daily lives.  Thank you so much for your awesome support over the past 2 ½ years!

In this role-reversal of the traditional Feeling Good Podcast, Dr. David Burns and his special guest, Dr. Rhonda Barovsky, interview Dr. Fabrice Nye, your beloved podcast host, on the topic of Mindfulness and Meditation, which are currently popular with the therapeutic community. Fabrice answers questions like these: What’s mindfulness? How does it differ from meditation? What’s the history of mindfulness as well as meditation? Did it originate with the Buddha, or did it date back even earlier? What are some of the goals and potential benefits of mindfulness? Why specific exercises can you do to develop greater mindfulness ? Why is mindfulness helpful? How does it work? Some people meditate in silence for prolonged times, like ten days, for example. What is the goal here? Are there any dangers of meditation? How does mindfulness differ from yoga, relaxation training, and self-hypnosis? Some people seem to love and benefit from meditation, and others find it uninteresting or even annoying. Why is this? What's the difference in these two groups of people? Is it okay not to be interested in meditation, or is something that everyone “should” do? The goal of mindfulness seems to be learning to deal more effectively with stressful thought and feelings. Does it deal with motivation and the resistance to change? TEAM-CBT makes us aware of the incredible importance of resistance, and provides many methods for reducing or eliminating resistance before you try any Method to “help” the patient. Does Mindfulness Meditation deal with resistance, or would it best be viewed as a method that can help individuals who are already strongly motivated to invest time and effort in their personal growth?

Can the Five Secrets of Effective Communication Help Us in this Era of Intensely Polarized Politics? Clearly, the nation is intensely divided, and passions on both sides of the political divide are characterized by hostility, frustration, and mistrust. Can the Five Secrets of Effective Communication help us communicate with colleagues, friends and loved ones who may have radically different political beliefs? Find out on this edition of the Feeling Good Podcast, as the David and Fabrice respond to Eileen, a podcast fan who kindly allowed us to share her intensely painful conflict with her mother with all of you. Eileen’s mother is an ardent Trump fan, and Eileen is an equally ardent anti-Trumper, and there have been plenty of tears on both sides of the aisle! Eileen wrote: “How can you talk to someone with whom you fundamentally disagree? My Mom is a big fan of the current regime (Trump) and I’m horrified by what’s happened in the past two years and what’s coming. It’s hard for me to get past my rage at her. . . intensely distorted and not-reality based beliefs, fed by right-wing media. To be clear, she thinks exactly the same about my beliefs and information sources. I feel so stuck. . . and I would love to repair this relationship with her before she dies.” Can you identify with similar conflicts in your own family or circle of friends? I know that I can, and it’s quite painful. Fabrice and I will give you our take on a new approach to this widespread problem this Sunday! While you're listening, you can take a look at Eileen's Relationship Journal. You may also want to review the Five Secrets of Effective Communication as well as the three advanced communication techniques we discussed in last week's podcast. Let us know what you think after you've listened to the podcast!

The way that you think creates the way you feel. If you have great thoughts then no problem, but if your thoughts are a little distorted, then...look out! Wouldn’t it be great if there were an easy way to look at your thoughts...and change them? As it turns out - there is! In today’s conversation we are going to show you how to identify the kinds of thoughts that lead to depression, anxiety, shame, anger, and self-doubt - and talk about the process that you can go through to eliminate those thoughts for good. Our guest is Dr. David Burns, author of the acclaimed bestseller Feeling Good and one of the leading popularizers of Cognitive Behavioral Therapy (CBT). He is also the creator of TEAM therapy, which takes CBT to the next level. Today, David Burns and I are tackling the topic of “cognitive distortions” - the messed-up thinking that can get you stuck in negative emotions. By the end of today’s episode you’ll not only be able to spot the times when your thinking gets distorted, but you’ll know what to do about it so that you can “feel good”. If you want to listen to our first episode together, where David Burns and I spoke about how to apply his work in relationships (based on his book Feeling Good Together), here is a link to Episode 98: How to Stop Being a Victim - Feeling Good Together - with David Burns And, as always, I’m looking forward to your thoughts on this episode and what revelations and questions it creates for you. Join us in the Relationship Alive Community on Facebook to chat about it! Resources: Check out Dr. David Burns's website Read David’s classic books, Feeling Good or When Panic Attacks FREE Relationship Communication Secrets Guide www.neilsattin.com/feelinggood2 Visit to download the transcript, or text “PASSION” to 33444 and follow the instructions to download the transcript to this episode with David Burns Amazing intro/outro music graciously provided courtesy of: The Railsplitters - Check them Out Transcript Neil Sattin: Hello and welcome to another episode of Relationship Alive. This is your host Neil Sattin. On today's show, we're going to cover ways that your thinking can be distorted. And, by being distorted can impact the way you feel, the way you behave, the way you interact with other people, and basically get in the way of you being an effectively functioning human being. Neil Sattin: I'm talking about cognitive distortions and they've been mentioned a little bit on the show before, but I wanted to take this opportunity to dive deeply into the ways that our thinking can just be messed up. From that messed upness - and no that is not a technical term -  comes all sorts of problems. Neil Sattin: From today's show, what my hope is for you is that you understand these things well enough so that you can spot them happening in your own thinking and perhaps in the thinking and reasoning of those around you. We're going to talk about effective strategies for changing the pattern. Neil Sattin: In order to do that, we have with us today a fortunate return visit from Dr. David Burns who was on the show back in episode 98 where we talked about how to stop being a victim in your relationship. This was an episode that was all based on David's work in a book called Feeling Good Together. Neil Sattin: If you're interested in hearing that, you can go to neilsattin.com/feelinggood. What I wanted to talk about today relates to some of the pioneering work that David did in popularizing cognitive behavioral therapy primarily through his book Feeling Good which has sold millions of copies all over the world and has been prescribed and shown to actually help people with depression simply by reading the book and going through the exercises. Neil Sattin: I'm very excited to have David with us today, we're going to talk about cognitive distortions, we're probably going to touch on TEAM therapy which is his latest evolution that's attacking some of the problems with cognitive behavioral therapy. And hear about some of the amazing results that that's getting and get some insight into how that even works. Neil Sattin: Without any further ado, let us dive right in. David Burns, thank you so much for joining us again here on Relationship Alive. David Burns: Thanks Neil, I'm absolutely delighted to be on your podcast for two reasons. First, I think you're a tremendous host. You know your stuff both technically and you know my background, you do your homework, that's very flattering to me being interviewed, but also you seem to exude a lot of warmth and integrity, just a pleasure to hang out with you a little bit today and your many, many listeners. Neil Sattin: Thank you. Thank you so much. I appreciate your saying that. This stuff is important to me. I'm hoping that this podcast makes a big difference in the world and the way that we do that is through being able to feature amazing work like what you do. I don't want to forget to mention that you also have your own podcast, the Feeling Good Podcast that has amazing insight into the work that you're doing. Neil Sattin: In fact, you record sessions with people so people can actually hear you working with clients and then explaining how you did what you did and also getting direct feedback from the people that you're working with. That's a fascinating show and how many episodes have you put out at this point? David Burns: I think Fabrice and I are up to roughly 60, in the range of 60. One really neat bit of feedback we're getting is that a lot of therapists now are requiring their patients to listen to the Feeling Good podcasts. There's been a lot of research on my book Feeling Good: The New Mood Therapy and studies have shown that if you just hand the book to someone with moderate to severe depression, 60% of them ... 65% of them will improve dramatically within four weeks. David Burns: That's really, really good news. It's called bibliotherapy or reading therapy, but now we're getting this ... I'm getting the same kind of feedback from people who are listening to the podcasts and saying that just listening to the Feeling Good Podcast had a dramatic effect on their depression or their obsessive compulsive disorder or whatever is bothering them. I'm hoping that that trend will continue. Neil Sattin: Yeah, someone's going to have to study podcastio-therapy. David Burns: Yeah, right. You may be having the same thing Neil on your relationship broadcast from people with troubled relationships following the information and the techniques you're providing and perhaps experiencing genuine improvement in their relationships, greater intimacy and love. Neil Sattin: Absolutely. I'm getting that kind of feedback all the time from listeners and I also hear that therapists, particularly couples therapists are having their clients listen to the show and even sometimes prescribing specific episodes for them to listen to. It feels really good to be able to be an adjunct part of people's progress and therapy. David Burns: Congrats. That's great. That's a real credit to the quality of what you're offering. Neil Sattin: Thank you. Thank you. Well, let's dive in. Enough kudos although it does feel really good, though I guess that doesn't surprise me considering you're the author of Feeling Good. Quick point of clarification. Is it the just handing of the Feeling Good book that has a 60 to 65% improvement rate or did the people actually have to read some of it to get that? David Burns: All they have to do is touch it. The improvement comes through osmosis and many of those who have read it have gotten worse. They don't have good data on that in the studies. It's people coming to a medical center for the treatment of depression and in the original studies, they said that they had to be on a waiting list for four weeks and during the four weeks, read this book. David Burns: Then they continued to test them every week with various depression tests and half the patients went to some kind of control group who were on a waiting list control for four weeks or they gave them some other book to read like Viktor Frankl's book Man's Search for Meaning and in all of the studies, the patients who were given a copy of Feeling Good, two thirds of them had improved so much within four weeks that they didn't need to have treatment anymore at the medical center. David Burns: They never got antidepressants or psychotherapy. Then they've done follow up, up to two year follow up studies on these patients as well. For the most part, they've continued to do well or even improve more and have not had significant relapses. The alternative groups who got Victor Frankl's book did not show significant improvement or people on waiting list control. David Burns: They were pretty well done studies sponsored by research from ... sponsored by National Institute of Mental Health and other research groups. Forrest Scogin is a clinical psychologist at University of Alabama and he pioneered a lot of these studies, but there have been probably at least a dozen replications of that finding that have been published now with teenagers, with elderly people and with people in between. Neil Sattin: Yeah, I want to just say, your book despite having been published a little while ago now is eminently readable and I did read it a while ago. In fact, I think it was one of the first "self-help books" that I stumbled across probably around when I was graduating from college. In sitting down and revisiting it in preparation for our conversation today, I was just struck by how personable, for a book that's about cognitive behavioral therapy which is something that I think just calling it that probably turns a lot of people off. David Burns: You bet. Neil Sattin: The truth is that reading it through, it just makes so much sense and I love how you bring humor into the subject and in many ways talk about yourself as an author in some of the quizzes around the kind of thoughts that undermine our self-esteem. Anyway, I definitely recommend it. Neil Sattin: If you're not one of the millions of people who have already read it, you should pick it up and if you are, I would suggest picking it up again to just glean again what more is there. We're going to talk about one of the central topics in the book which is how our thinking affects the way we feel. Neil Sattin: Maybe we just start there because that was one place where I even in upon revisiting, I got a little confused and in the past, that's made total sense to me. Yeah of course, I make something mean something and that gives me an emotional response to it which ironically makes me think of Victor Frankl's work. Neil Sattin: At the same time, I know that we have feelings that just our bodies kick in with emotional responses in a split second when something happens. That seems to precede thought. How do you parse that apart in a way that makes sense? David Burns: Well, the basis of cognitive therapy and we've moved on to something new called TEAM therapy or TEAM CBT, but I think the basis of cognitive therapy which as far as it goes it's still pure gold goes back to the Buddha 2,500 years ago and to the Greek philosophers like Epictetus 2,000 years ago that humans are disturbed not by things, but by the views we take of them that you have to interpret an event in a particular way before you can have an emotional reaction to it. David Burns: This thought is so basic that our thoughts create all of our moods. We create our emotional reality at every moment of every day by the way, we interpret things, but that's such a basic idea that many people can't get it or they don't believe it. I had an example of this at my workshop in the east coast recently - I was in a hotel. David Burns: I've had many afflictions myself in my life. I love to treat people with depression or anxiety because whatever they have I could say, "Oh, I've been there myself." I can show you the way out of the woods, but when I was little, I had the fear of heights and then I got over it completely as a teenager through a high school teacher who had me stand on the top of a tall ladder until my fear disappeared and took about 15 minutes and it was dramatically effective. David Burns: Suddenly, my anxiety went from 100 to zero and I was free, but it crept back in because I stopped going up on heights not out avoidance, just I had no reason to and then suddenly I realized it had returned. I was on a hotel on one of these glass elevators and I was going up to the 14th floor and I was looking down into the elevator and I had no emotional reaction whatsoever and it was because I was telling myself and this was automatic I guess, but you're safe. David Burns: However, if there hadn't been that glass there and it would have been the same elevator going up and looking out, I would have been paralyzed with fear and terror and it would have been a total body experience that I can feel in my whole body this extreme terror. That's the first idea that you can't have an emotional reaction without having some kind of thought or interpretation. David Burns: You feel the way you think - your thoughts create all of your moods. After Feeling Good came out, I got a letter from a therapist in Philadelphia. He was a student therapist at the Philadelphia Marriage Counsel I believe and he said he had read my book Feeling Good: How Your Thoughts Create All of Your Moods. David Burns: He said, "Well, that's a great idea, but how can it be true? If you're on a railroad track with a train coming and you're about to get killed, you're going to feel terrified. You don't have to put a thought in your mind, it's just an automatic reaction." He said, "I don't believe your claim that only your thoughts can create your moods." David Burns: I got that letter and I started thinking, I said, "Gosh, what he's saying is so obvious, how could I have missed that when I wrote that book?" I felt embarrassed and ashamed. A couple days after I got that letter, I was in a taxi coming home from the airport and at a certain place on River Road, you go over this railroad track. David Burns: I looked down the railroad track, I saw there was a car driving on the railroad track at about two miles an hour. Bumpety-bumpety-bump. I looked then in the other direction and this is ... Freight trains come through here, they never stop, they come at 65 miles an hour. I saw one about a mile and a half in the other direction. David Burns: I said, "Man, that guy is going to get smashed by the train." I told the taxi driver, "Stop, I got to try to get that guy off the railroad tracks." I ran up and knocked on the window and he rolled down the window and there's this older man there and he said, "Can you please direct me to City Line Avenue?" David Burns: I said, "City Line Avenue is 10 miles in the other direction, but you're on the railroad tracks and there's a train coming. You've got to back up. Back up to get to the road." Because he was beyond the road, where you know how they have a pile of rocks at the railroad tracks, that's where he was and I said, "Back up, I'm going to get you off the railroad tracks." David Burns: He backed up and he kept ... When he got to the road, I said, "Now turn, turn your car." Finally I had them positioned to where just the nose of the car, the front part of the car was over the tracks and I was standing in front of it. Now the train was about maybe 20 seconds from impact and they had their whistle on. David Burns: I was waving my hands like, "Back up, back up. Just back up five feet and it will save you." Instead, the guy started creeping forward very slowly. Neil Sattin: Oh no. David Burns: The train smashed into him at the side of his car at about 60 miles an hour. Neil Sattin: Oh my goodness. David Burns: Actually ripped the car in half. The front compartment was thrown about 30 feet from the tracks. They had their brakes on, the train was skidding to a stop and I ran over again to the driver's compartment and looked in, it was all smashed windows and I thought I'd see a decapitated corpse, but it hit probably an inch behind his head and it hit so fast it had just cut the car in half and he didn't seem to be that injured or anything. David Burns: He looked at me and smiled and said, "Which way exactly did you say now to City Line Avenue?" I said, "You got to be kidding me." I said, "You were just hit by a train." He said, "I was not." He says, "That's ridiculous." I said, "Oh yeah, what happened to the windows of your car?" David Burns: Then he looked and he noticed all the windows were smashed and there was glass all over. Then he says, "Gosh, it looks like somebody broke my windows." I said, "Look, where's the back seat? Where's the back half of your car?" He turned around and he saw the back half of his car was missing. David Burns: He looked at me and he says, "I think you're right. Half of my car seems to have disappeared." He says, "Where is this train?" I said, "Look, it's right there, it's 20 feet from here." Now the conductors were rushing up and the engineers and he looked at me and he says, "This is great." David Burns: I said, "Why is that? Why is this great?" He says, "Well, maybe I can sue." I said, "You'll be lucky if they don't sue you. You were driving down the railroad tracks." I couldn't understand it and at this point, the police cars came, the ambulance, they put him in an ambulance, I gave my story to the police, he looked just fine and they took him to the Bryn Mawr Hospital. David Burns: I was just scratching my head and I got in the taxi, it was just a mile from home, the taxi driver took me the rest of the way home. I was saying, "What in the heck happened?" The next day I was jogging around that same corner, of course, there was all this litter from the car or broken pieces of metal and glass all over the place and there was a younger guy maybe 50 years old or something like that going through the rubble. David Burns: I stopped there and asked him who he was and he says, "My father was almost killed by a train here yesterday and somebody saved his life and I was just checking out the scene." I said, "Well, that was me actually." I said, "I didn't understand it -  he was driving down the railroad track and if I hadn't gotten there, I think he would have been killed." David Burns: I said, "Why was he driving down the railroad track?" He says, "Well, my father has had Alzheimer's disease and he lost his driver's license 10 years ago, but he forgot and after dinner, he snuck out. He grabbed the keys and snuck out, decided to take the car for a drive." Here is the same situation, a train about to kill somebody on a railroad track about to smash into you and I had the thought this guy is in danger he could be killed. David Burns: I was experiencing 100% terror and anxiety and fear, but his thought was different. His thought was, "This is great. I might be able to sue and get a great deal of money." Therefore he was feeling joy and euphoria. Same situation, different thoughts and radically different emotions. David Burns: That's what I mean and that's what the Buddha meant 2,500 years ago when we say that only your thoughts can create your emotions. It's not what happens to you, but the way you think about it that creates every positive and negative emotion. Neil Sattin: Did you ever write back to that person who wrote you? About that train - to tell him what had happened? David Burns: I don't remember it because this was way back in 1980 shortly after the book came out. I probably did because in those days, I was so excited to get a fan letter. I never had any idea that the book would become popular, it didn't hit the best-seller list until eight years after it was published because the publishers wouldn't support it with any marketing or advertising because they thought no one would ever want to read a book on depression. David Burns: When I got a letter in the days before email, I would get so excited and I would try to contact the person and sometimes talk to them for an hour or two on the telephone thinking this might be the only fan I'll ever have. I'm sure I did write back. Neil Sattin: Speaking of that, this might be a good chance to start talking about the cognitive distortions and like the idea that this might be the only fan that you ever have, what are we talking about in terms of now we've established pretty well. The way I think about things is going to determine how I feel. Neil Sattin: Yet, there are these distorted ways of thinking about the world that really have an enormously negative impact on our ability to function and interact. David Burns: This is one of the amazing ideas of cognitive therapy that at first I didn't quite grasp, but the early cognitive therapists like Albert Ellis from New York and then Aaron Beck at University of Pennsylvania who I learned it from were claiming not only do your thoughts create all of your moods, but when you're upset, when you're depressed, when you're anxious, when you feel ashamed or excessively angry or hopeless, not only are those feelings created by your thoughts and not by the circumstances of your life, but those negative thoughts will generally be distorted and illogical so that when you're depressed, you're fooling yourself, you're telling yourself things that simply aren't true and that depression and anxiety are really the world's oldest cons. David Burns: Beck - when I first began learning about cognitive therapy from him when I was a psychiatric resident and postdoctoral fellow, he had about four distortions as I recall and he had big names for them and then I added some to those and I used to talk to my patients about all-or-nothing thinking and overgeneralization and self-blame and the different ones. David Burns: Once, I was having a session with a patient and he said, "Why don't you list your 10 distortions and hand it out to patients?" He said, "It would make it so much easier for us." I thought, "Wow, that is a cool idea." I ran home that night after work and I made the list of the 10 cognitive distortions and that's what led to my book Feeling Good. David Burns: My list of 10 cognitive distortions, it's probably been reproduced in magazines and by therapists all over the world, I would imagine easily millions of times and probably tens of millions of times, but there are 10 distortions. Number one is all-or-nothing thinking, black or white thinking. David Burns: It's where you think about yourself in black or white term, shades of gray don't exist. If you're not a total success, you think that you're a complete failure or you tell yourself you're defective. I gave a workshop with Dr. Beck at one of the professional conferences like the Association for Behavioral and Cognitive Therapies, cognitive therapy had just come out and Beck is not a very good public speaker. David Burns: I was a novice also at the time and we had a half day workshop and there were a few hundred therapists there and it was okay, but it wasn't great and they started challenging us because nobody liked the idea of cognitive therapy initially, it was scorned and looked down on. We got defensive and then afterwards Dr. Beck looked at me and said, "David, you look like you're feeling down. What's the problem?" David Burns: I said, "Well, to tell you the truth Dr. Beck, I thought we were below average in this presentation and I'm feeling upset about that." He said, "Oh, well you should, if we were below average, you should thank your lucky stars." I said, "Why should I thank my lucky stars if we were below average?" David Burns: He said, "Because average is the halfway point. By definition, we have to be below average half the time. We can thank our lucky stars we got the below average one out of the way and we look forward to an above average one the next time we present." Suddenly, my discouragement disappeared. David Burns: He was just modeling thinking in shades of gray whereas I had been thinking in black and white terms. All-or-nothing thinking is very common in depression and it's also the cause of all perfectionism - thinking if you're not the greatest, second best or average just is not good enough, it's either the world or nothing, perfection or failure and it creates tremendous problems. Neil Sattin: Yeah, I could see that also coming up in terms of comparisons like if so and so is already doing this thing, I can't possibly do that because it's so and so's domain. As if one person could own the domain for the entire world in any particular area. David Burns: Well yeah, that's another mental trick that we play in ourselves with the distortions I call mental filtering and discounting the positive. You see this all the time when you're feeling inferior and comparing yourself to other people. Mental filter is where you focus on all of your flaws thinking about all of your errors. David Burns: You don't think about what's good about you or what's beautiful about you. I did a TV show finally when the book gained popularity in Cincinnati and it was a morning show and they had a live audience and a band and he was interviewing me. It was exciting for me because it was still the first time I had any media exposure. David Burns: Then after the show, the host said, "Dr. Burns, could I talk to you for a minute?" This often happens to me when I'm on a radio or TV show because the people in the media have tremendous pressures on them and they often also feel that they're not good enough. I said, "Sure. I'd love to. What's the issue?" David Burns: He says, "Well, after every morning show, I get about 350 fan mails, fan letters or calls or whatever." He said, "They are 99.9% positive, but everyday I'll get one critical letter. One critical feedback and I dwell on that one constantly and make myself miserable and ignore all the other positive feedback." That's called mental filter because you filter out the good stuff and you've just focused on your flaws. David Burns: A lot of the people listening to the show right now do that. Then an even bigger mental error is called discounting the positive - when you say that the good things about you don't even count. You may have done this to yourself when someone gives you a compliment, you might tell yourself, "Oh, they're just saying that to be nice to me. They don't really mean it." You discount that positive experience. David Burns: I had a colleague who got upset when he recently won the Nobel prize, one of my college roommates, and the reason he got upset is he said they haven't recognized my best work yet. So those are three of the 10 distortions. Neil Sattin: Yes. One of my favorites I think comes next on your list, at least the list I'm looking at after discounting the positive which is the ways that we jump to conclusions. David Burns: Right. There's two common patterns here, jumping to conclusions that aren't warranted by the facts and mind-reading and fortune-telling are two of the commonest ones. Now, fortune-telling is when you make a prediction about the future, an arbitrary prediction about the future and all anxiety results from fortune-telling, telling yourself that something terrible is about to happen - like when I get on that plane, I just know it will run into turbulence and crash. You feel panic and anxiety. David Burns: Depressed people do fortune-telling as well. Hopelessness results from predicting that things will never change, my problems will never get solved, I'm going to be miserable forever. Almost every depressed patient thinks that way and that's actually why many people with depression commit suicide because they have the illogical belief that their mood will never improve, that they're the one untreatable person. David Burns: Mind-reading is the other common form of jumping to conclusions and this is real common in social anxiety, but Neil, I'm sure you see it in a lot of people with relationship problems. Neil Sattin: Absolutely. David Burns: But mind-reading is where you assume you know how other people are thinking and feeling without any evidence, without any data. I used to struggle with intense social anxiety among my many other fears and phobias that I've had and overcome over the years, but the anxious person - say you're at a social gathering and you think, "Oh, these people won't be interested in what I have to say and they never feel anxious. I'm the only one who feels insecure." David Burns: Then you also may have the thought, "Oh, they can see how anxious I am and they're going to be real turned off by me." Then what happens is that when you start talking to someone, you get really busy worrying about how they're not going to be interested in you. You try to think of something clever or interesting to say while they're talking. David Burns: Then when they're done, instead of repeating what they said and expressing an interest in what they said, you make the little speech you had prepared. That turns the other person off because I think, "Wow, David doesn't seem interested in me. I was just telling him about my son, he was just accepted to Harvard and now he's talking about something else." David Burns: That person pretty quickly loses interest in you and says, "Oh, I have to talk to so and so on the other side of the room." Then you, the shy person get rejected again which is what you thought was going to happen. Although these are distortions, you're thinking in an unrealistic way, they sometimes feel like self-fulfilling prophecies so you don't realize that you're fooling yourself. Neil Sattin: Right, because when you're in it, then you seem to be getting plenty of evidence that it's true. David Burns: Yes, and another form of evidence comes to another distortion. One name I made up called emotional reasoning where you reason from your feelings. You see this in angry interactions, you see that in anxiety and in depression. The depressed patient is giving themselves all these messages like I'm a loser, I'm no good and beating up on yourself and then you feel ashamed and guilty and worthless and inferior and inadequate. David Burns: Then you say, "Well, I feel like a loser, I must really be one." Reasoning from your emotions, thinking your emotions somehow reflect reality. That thought by the way is one we skipped over - overgeneralization. That's number two on the list actually, right after all-or-nothing thinking. David Burns: Overgeneralization, this is a Buddhist thing, really overgeneralization. It's where you generalize to yourself from some specific event. For example, I have a free training for Bay Area psychotherapists every Tuesday evening at Stanford and you don't have to be a Stanford student to come,  I give unlimited free psychotherapy training to therapists who can come to my Tuesday group and any of the listeners or therapists near in the Bay Area on a Tuesday email me and you're welcome to attend my Tuesday training group. David Burns: Then I also have free hikes every Sunday morning and we go out hiking for maybe three and a half hours on the trails around my home and I treat people for free on the hikes. We do training and one of the women on the Sunday hike, I'll keep it vague to protect her identity, but she just had a problem with her boyfriend and they broke up and then she was telling herself, "I'm inadequate ... I'm unlovable" kind of thing. David Burns: "This was my fault and I must have been doing something wrong." You see, when you think like that and most of us do when we're upset, she's generalizing from this event, that it didn't work out with her boyfriend to then this global idea that "I'm inadequate. There's something wrong with me" - as if you had a self that wasn't good enough. David Burns: Then people also say, "I'll be alone forever. I'm unlovable. This is always happening to me." That's all over generalization where you generalize from a negative event and you see it as a never-ending pattern of defeat. You also see it as evidence that you're somehow defective or not good enough than when you're thinking these things, they seem so true - just as believable as the fact that there's skin on your hand. David Burns: You don't realize that you're fooling yourself, the pain that you feel is just incredible. I know that of the many people listening to this show right now, I'm sure you can identify this with this that you've had thoughts like that and you know how real and painful these feelings are. David Burns: It's one of the worst forms of human suffering, but the good news is and we haven't gone around to that, but not only are there fantastic techniques, cognitive therapy techniques that we've been talking about from my book feeling good described in there or my feeling good handbook so that you can overcome these distorted thoughts and get back to joy and self-esteem quickly, but also my group at Stanford over the 10 years, the past 10 years, we've created even more powerful techniques and to help bring about really high speed recovery for people struggling with depression and anxiety. David Burns: The new techniques are way more powerful than the original cognitive therapy although those methods are still fabulous, but maybe we'll have time to talk about some of these. David Burns: But there's more distortions to cover. Neil Sattin: Yeah. Maybe what we could do because I'd love to balance this out and I want to ensure that we cover the other distortions. We have maybe four more. At the same time, maybe let's break from the distortions just to change things up a bit and start entertaining that question of, "Alright, yeah. I relate to some or all that we've even listed so far." Neil Sattin: What are some of the initial steps that someone could talk because where I tend to go with this is like, "Well, these belief patterns like you talked about, "I'm unlovable" as one, those seem to emerge from a place that's immutable. It's something that's really deep in someone's psyche and yet, you're suggesting that there's ways to transform that that are really quick and direct and give someone a felt experience of the truth that's not that thing. David Burns: Yeah, that's right. You can group the techniques into cognitive techniques to crush these distorted thoughts and motivational techniques to get rid of your ... To bring your resistance to change to conscious awareness and melt away the resistance. The patients become incredibly motivated to crush their thoughts. David Burns: An example of the way the cognitive techniques work, what is crucial and this is one of the first things when we first created cognitive therapy in the mid 1970s was to write the negative thoughts on a piece of paper. It's a very humble thing to do, but it can be dramatically effective because then you can look at the list of 10 distortions and immediately, pinpoint the distortions and that makes it much easier to talk back to these disruptive thoughts and poke holes in them. David Burns: I'll give you an example of my own personal life because I've used these techniques myself and if they hadn't worked for me, I never would have become a cognitive therapist and now a TEAM CBT therapist, but when I was a postdoctoral fellow, I used to go to Dr. Beck's weekly seminars and I would present all my most difficult cases and get tips from him on how to treat these people with what was then the rapidly emerging brand new cognitive therapy and it was an exciting time, but one day, I talked to him about a patient that wasn't paying the bill, that I've had a bad session with this patient and asked him for some guidance. David Burns: He actually was pretty critical of the way I had dealt with this patient. I became awfully upset, I got depressed and anxious and I was riding home on the train and my head was filled with negative thoughts and negative feelings. Then when I got home, I told myself, "Well David, you probably better run, go on a long six mile run and get your brain endorphins up so get over your depression" because those were the days when everyone was believing the phony baloney that somehow exercise boosts brain endorphins and will reduce depression. David Burns: I went out on this long run and the longer I ran, the more believable my negative thoughts became. I said, "David, what are you telling yourself?" I said, "Oh, I'm a worthless human being. I have no therapeutic skills, I'm going to be banned from the state of Pennsylvania and they'll take away my medical license, I have no future in psychiatry. I'm a worthless human being, I'm a bad person." Stuff like that. David Burns: It seemed overwhelmingly true. I said, "Are there some distortions in your thoughts David? Look for the distortions like what you tell your patients." I said, "No, there are no distortions in my thoughts. This is just real." I was telling myself it's so weird to hear, you're something like 30 years old or however old I was, 31, it took you all of this time in your life to realize what a horrible loser you are. David Burns: It's as if I had seen the truth for the first time and it was devastating. Then when I got home, I said, "David, why don't you write your thoughts on a piece of paper? That's what you make all of your patients do." I said, "Oh no, no, my thoughts are real, that won't do any good." Then I told myself, "But isn't that the same way you're whining just like your patients whine and resist? And you force them to write their thoughts down on a piece of paper. You tell them they have to do that. Why don't you try that David?" David Burns: I said, "No, no, it wouldn't do any good. I really am a worthless human being. This is true." Then I said, "No David, you're still resisting. Take out a piece of paper and do what you tell your patients to do." I said, "Oh okay, I'll do it just to prove that it won't work." I wrote my thoughts down. Number one, I'm a worthless human being, number two, I have no therapy skill. David Burns: Number three, I screwed up with this patient. Number four, they'll take away my medical license, stuff like that. I wrote down four or five thoughts. Then I said, "Now, are there any distortions?" I looked at my own list of 10 distortions. I said, "Wow, those thoughts are pretty distorted. It's all-or-nothing thinking, black and white thinking like I'm not allowed to make a mistake with a patient. It's overgeneralization, I'm generalizing from the fact that I screwed up with this patient in a session to, "I am a worthless human being," it's fortune-telling, "I have no future in psychiatry." David Burns: Jumping to conclusions, self-blame, hidden "should" statements, that's another distortion. I shouldn't have screwed up, I should always be perfect. It was emotional reasoning, I feel worthless, I must be worthless. I suddenly saw those distortions and then I said, "Now, can I write a positive thought to challenge these negative thoughts?" That's the other part of the exercise. First you write the negative thought, then you identify the distortions, then you write a positive thought. David Burns: The positive thought has to be 100% true. Rationalizations and half truth will never help a human being. I came up with this positive thought. I said, "David, you're just a beginner. You have the right to make mistakes. In fact, even when you're 75 years old years from now, you might be a great therapist, but you'll still make mistakes and learn from them. That's part of the territory." David Burns: "You're absolutely permitted to do that. Instead of beating up on yourself, why don't you talk it over with your patient tomorrow and tell him that you made a mistake and see if you can repair that rupture in your relationship with the patient." All of a sudden, I said, "Is that true?" "Yeah, that thought is 100% true." How much do I believe this rubbish that I'm a worthless human being and all of that and my belief in those negative thoughts went to zero and my negative feelings just disappeared in a flash entirely. I said, "Wow, this shit is pretty good. This really works." Hope you don't have to edit out that word. Neil Sattin: No, that's fine. That's fine. David Burns: Then the next day I saw the patient, I said, "You know Mark, I've been feeling terrible since last session and ashamed because I don't think I treated you right." I was putting pressure on you because of the unpaid balance and I didn't put any emphasis on your suffering and what's going on with you as a human being I just imagine you felt so hurt and angry with me and discouraged and I'm just overjoyed that you came back today rather than dropping out of therapy so we can talk it over and see if we can deepen our relationship. David Burns: He just loved that and we had the best session ever, he gave me perfect empathy scores at the end of the session, but that's just an example from my personal life and I'm sure the people here can relate to that, but I've developed probably 50 or 100 techniques for crushing negative thoughts and I've made it sound easy, but it isn't always easy because you might be very, very trapped in your negative thoughts. David Burns: You might have to try several of the different techniques before you find the one that works for you. I want to be encouraging to the listeners and to therapists who may be listening, but I also don't want to make it sound like something overly simple or overly simplistic because it's really a pretty high-powered, sophisticated type of therapy. David Burns: Fortunately, many people can make it work on their own, but anyway, that's the half of the treatment breakthroughs and that was called the cognitive revolution and my book Feeling Good really helped usher that in when feeling good came out in 1980, cognitive therapy was virtually unknown and they were just a handful of cognitive therapists in the world. David Burns: Now, it's become the most popular form of psychotherapy in the world and the most researched form of psychotherapy in all of the history of psychology and psychiatry. Neil Sattin: I wonder if we could emphasize because I'm thinking about how we talked about the technique for identifying a negative thought, identifying the cognitive distortion or distortions that are happening and just to talk about the importance of actually going through that exercise and writing it down. Neil Sattin: Maybe you could just talk for one more minute about why that part is so important. Why is it important to actually write that stuff down versus to do it in your head? David Burns: I think that the negative, the power of the human mind to be negative is very profound. The negative thoughts are like a snake eating its tail, they go round and round and one leads to the next. David Burns: In the early days, I used to try to do cognitive therapy without the written exercise and to this day, new therapists still try to do that. They think they're too fancy that writing things down is too simplistic or something like that and they're going to be deep and just do verbal, deep stuff with people, but the problem is, the human mind is so clever. David Burns: Each distortion reinforces another one and each negative thought reinforces another one and you go round and round and round. That's why doing it verbally or in your head when you're alone is rarely going to be effective, but when you write the negative thoughts down one at a time and number them with short sentences, that makes it much easier to identify the distortions in them and turn them around. David Burns: There are three rules of thumb. There's an art form to writing them down. Everything is more sophisticated than I make it sound in a brief interview. There's a lot of rules of the game. For example, when you're writing down negative thoughts, you should never put an emotion or an event. David Burns: People have a negative thought like Trisha rejected me and I feel terrible. Well, that's not a negative thought. That's an event. Trisha rejected me and I use a form called the Daily Mood Log and at the top you put the event and then you circle all of your emotions and put how strong they are between zero and a hundred. David Burns: These emotions might be feel guilty, ashamed, lonely, depressed, worthless and then the negative thought would be the interpretation of that event like I must be unlovable, I'll be alone forever. Then those are things that have distortions. A second rule is don't ever put rhetorical questions in the negative thought column. David Burns: If you say something like, "Oh, why am I like this? Why am I so anxious in social situations?" Or "What's wrong with me?" You can't disprove questions so instead you can substitute the hidden claim behind the question which is generally a hidden should statement like I shouldn't be like this or I must be defective because I'm so anxious in social situations or some such thing. David Burns: There are probably one or two other rules of the game and my book When Panic Attacks which is one of my newer books on all the anxiety disorders, Feeling Good is on depression. When Panic Attacks is on all of the different kinds of anxiety. I think the third chapter shows how to fill out the Daily Mood Log and what the rules are to follow to enhance the effectiveness of it so you'll be more likely to have a successful experience. Neil Sattin: Great. The idea is that it's simply by doing this process that the things shift. It's not like there's ... You go through the process and then maybe you would track your mood afterwards and see, "Wow, I'm actually feeling better than I was before" just by simply doing that? David Burns: Well, a lot of people can feel better just by doing it, but the research has shown that two thirds of people just by reading Feeling Good, they can improve a lot in depression, but some people need the help of a therapist and it isn't true that everyone has to do it on your own, sometimes you need another person to get that leverage to pop out of it. David Burns: Another thing that's helpful when you're writing down your negative thoughts is Beck's theory of cognitive specificity. You see, Buddha said our thoughts create our emotions, but Beck took it to the next level and said different patterns of thoughts create different types of emotions. David Burns: If you're feeling guilty, you're probably telling yourself that you're a bad person or that you violated your value system. If you're feeling hopeless, you're definitely telling yourself that things will never change, something like that. I'll be miserable forever. If you're feeling anxious, you're definitely telling yourself something awful is about to happen. David Burns: "When I get on that show with Neil, I'll screw up, my brain will go blank." That type of thing. When you're feeling sad, you're telling yourself... or depressed, that you've lost something central to your self-esteem. When you're feeling angry, you're telling yourself that someone else is a loser that they're treating you unfairly, that they shouldn't be that way. David Burns: These rules can also help individuals pinpoint your negative thoughts. Once you see what the emotions are, then you know the kind of thoughts to look for. One last thing is sometimes people say, "Oh, I don't know what my negative thoughts are." I just say, "We'll just make some up and write them down and number them." David Burns: Then I say, "Are your thoughts like this?" They say, "Oh, that's exactly what I'm thinking." Those are a few tips on refining the part with the negative thoughts. But now we have even more powerful techniques that have evolved in my work with my training and development group at Stanford. Neil Sattin: Yeah, before we talk about those, which I hope we will have time to do - there are a couple of things that jumped out at me. One was as you were describing the distortions that we've already talked about, it popped into my head that this is often at the source of most conflict that happens in couples - that either one person is having distorted thinking or one person is protecting themselves from their own distorted thinking. Neil Sattin: For example, your partner says something and you have this feeling like, "Well, that's not true. I got to defend myself from that accusation." David Burns: That's right yeah. Neil Sattin: You jump into this place of conflict that's all about proving that this negative concept you suddenly are perceiving about yourself isn't true. When that negative concept in and of itself might be an example of you just having a distortion - like for instance, "my partner is mad at me, that must mean they think I'm a horrible human being." David Burns: Yeah, what's huge what you just said, when we're in conflict with people, there's a lot of inner chatter going on in addition to the verbal altercations, the arguing, the escalation, the defensiveness - and some of the distortions will be focused on the other person and some of the distortions will be focused on yourself. David Burns: You see all of the 10 cognitive distortions in relationship conflict, but they have a little bit of a different function I would say. Now, let's say you're angry, Mary is angry at her husband Sam, she's ticked off and then if you look at her thoughts, they have all 10 distortions. David Burns: She'll tell herself things like, she might be thinking, "Oh, he's a loser. All he cares about is himself. The relationship problems are all his fault, he'll never change." That type of thing. You sell all-or-nothing thinking, mind-reading, imagining how he's thinking, you see blame, you see hidden should statements, he shouldn't be like that, he shouldn't feel like that. David Burns: You see discounting the positive, mental filtering, overgeneralization, magnification, minimization. You see all the same 10 distortions. The only difference is that when you're depressed and I can show you that your thoughts about yourself are distorted and that's not true that you're a loser, you're going to love me, the therapist, you're going to appreciate that and you're going to feel better and you're going to feel better and recover from your depression. David Burns: When people are in conflict and we're having distorted thoughts about the other person, we're generally not motivated to challenge those distortions because they make us feel good. We feel morally superior to the other person. I don't generally work with people too much on changing their distortions about others because they don't want to hear it. David Burns: If the therapist finds out that this woman, that her thoughts about her husband are causing her to be upset, not her husband's behavior, and in addition that her thoughts about her husband are all wrong, wrong, wrong, they are all distorted, she'll just fire the therapist and drop out of therapy and she'll have two enemies, her loser of a husband and her loser of a therapist. David Burns: That's why I developed some of the techniques we talked about in the last podcast we did on relationships. I used slightly different strategies, but you're right, those distortions are incredibly positive and the other kind of distortion you have when you're in conflict if someone's criticizing you, again you may start thinking, "This shows that I'm a loser, I'm no good. I should be better than I am. If you're criticizing me, that's a very dangerous and terrible situation." David Burns: By attending to those kind of thoughts that make you feel anxious and ashamed and inferior and guilty and inadequate, then you can modify those and then do much better in the way you communicate with the other person because your ego isn't on the line. An example with me is in my teaching, I always get feedback from every class I do, every student I mentor or supervise from every workshop and I get it right away, I don't get it six months from now, I get it the very day that I'm teaching. David Burns: I get all kinds of criticisms on the feedback forms I've developed even if I have a tremendous teaching seminar, I'll get a lot of criticisms especially if they feel safe to criticize the teacher. I find that if I don't beat myself up with inner dialogue, then I can find the truth in what the student is saying and treat that person with warmth and with respect and with enthusiasm even. David Burns: Then they suddenly really love the way that I've handled their criticism and it leads to a better relationship and that's true between partners or in families as well. That inner dialogue that's where we're targeting ourselves and making ourselves needlessly anxious and defensive and hurt and angry and worthless when we're in conflict with someone - that can be adjusted and modified to really enhance relationships. Neil Sattin: The two distortions that we hadn't really covered yet, you just mentioned them and I thought ... We've mentioned them all at this point, but some of them like blaming, whether it's blaming yourself for a situation or blaming others for a situation, that seems a little self-evident. Neil Sattin: I'm curious if you could talk for a moment about labeling and then also magnification and minimization just because I think those are the two that we listed, but didn't really cover. David Burns: Did we mention shoulds? Neil Sattin: Let's mention them and I think again, that might be something that's a little more understandable for people, but yeah, let's do this. David Burns: Oh yeah, okay. Yup. Well, labeling is just an extreme form of overgeneralization where you say I am a loser or with someone else, "He is a jerk." Where you see yourself or another person as this bad glob so to speak. Instead of focusing on specific behaviors, you're focusing on the self. When you think of yourself as a loser or a hopeless case, it creates tremendous pain. David Burns: When you label someone else as a jerk or a loser, it creates rage and then you'll often treat them in a hostile way and then they treat you in a hostile way and you say, "Oh, I know he was a loser." You don't realize you're involved in a self-fulfilling prophecy and you're creating the other person's, you're contributing to or creating the other person's hostile behavior. David Burns: Magnification or minimization is pretty self-evident - where you're blowing things out of proportion - like procrastinators do that. You think about, "All you have to do, all the filing that you're behind on." It feels like you have to climb Mount Everest and you got overwhelmed and then minimization, you're telling yoruself, "Oh, just working on that for five or 10 minutes would be a drop in the bucket. It wouldn't make a difference." You don't get started on the project. David Burns: We've done those two. The should statement say I think is very subtle and not obvious to people at all that we beat up on ourselves the shoulds and shouldn'ts and oughts and musts and we're saying, "I shouldn't have screwed up, I shouldn't have made that mistake. I should be better than I am."   David Burns: That creates a tremendous amount of suffering and shoulds go back - if you look at the origin in the English dictionary, maybe we did this in our last podcast, I don't recall that if you have one of these thick dictionaries, you'll find the origin of the word should is the Anglo's accent word scolde, S-C-O-L-D-E where you're scolding yourself or another person, where you're saying to your partner, "You shouldn't feel that way." Or, "You shouldn't believe that." David Burns: We see that politically, two people are always blaming someone they're not in agreement with and throwing should statements at them. Albert Ellis has called that the "shouldy" approach to life which is a cheap joke I guess, but it contains a lot of truth. The feminist psychiatrist Karen Horney who actually I think was born in 1890s did beautiful work on shoulds - when my mother, when we moved to Phoenix from Denver, I think my mother got depressed and she read a book by Karen Horney on the Tyranny of the Shoulds, how we give ourselves all these should statements and make us feel like we're not good enough and we're not measuring up to our own expectations and create so much suffering. David Burns: I think that book was very helpful to her and then Albert Ellis in New York saw that, he argued and I think rightly so that most human suffering is the result of the shoulds that we impose on ourselves or the should statements that we impose on others. Neil Sattin: Well, if that's true, then maybe that should be what we take a moment to attack and I'm wondering if you have a powerful crushing technique that works with shoulds whether it's and maybe it would be a little bit different, the ones that we wield against ourselves versus so and so should know or should have done this differently. David Burns: Right. Well, a lot of the overcoming has to do with the mystical, spiritual concept of acceptance, accepting yourself as a flawed human being is really the source of enlightenment, but we fight against acceptance because we think it's like giving in and settling for second best. We continue to beat up on ourselves thinking if we hit ourselves with enough should statements, we'll somehow achieve perfection or greatness or some such thing. David Burns: One thing that I learned from Ellis that has been really helpful to my patients is that there's only three correct uses of the word should in the English language. There's the moral shoulds like the 10 commandments, thou shalt not commit adultery, though shalt not steal or thou shalt not kill. David Burns: There's the laws of the universe should where if I drop a pen right now, it should fall to the earth because of the force of gravity and then there's the legal should. You should not drive down the highway at 90 miles an hour because that's against the law and you'll get a ticket. Now, I had a colleague who came on one of the hikes who has a developmentally challenged child, say a son just to disguise things a little bit and she's from a very high achieving family, Silicon Valley family just to say the least. David Burns: She and her husband are giants, geniuses and then she went to the grammar school for the parent's day and they had all the kids and they have their daughter in some very expensive private school. The kid's pictures were up on the wall and then she saw her son's picture and it was just very primitive compared with the other children who are real high-powered children from high powered families. David Burns: Her son struggles severely and then she saw that and she felt the feeling of shame. Then she told herself, "I should not feel ashamed of my son." That's hitting herself with a should statement which it's like she doesn't have permission to have this emotion and that's what we do to ourselves.   David Burns: That's not a legal should, it's not illegal to feel ashamed of yourself or your son. She then was also of course feeling ashamed of herself. It's not immoral and it doesn't violate the laws of the universe. A simple technique that Ellis suggested and it's so simple it goes in one ear and out the other instead of saying, "I shouldn't, you can just say it would be preferabe if or I would prefer it if or it would be better if." David Burns: You could say it it would be better, it would be preferable if I didn't feel ashamed of my son, but that's the human feeling and probably other parents feel upset with their children, they feel ashamed sometimes of their kids or angry with their kids. It's giving yourself permission to be human and that's called the acceptance paradox. David Burns: The paradox is sometimes when you accept your broken nature, accept your flaws and shortcomings, you transcend them. I've often written that acceptance is the greatest change a human being can make, but it's elusive and Buddha tried to teach this 2,500 years ago when I saw on TV and I don't know if was just a goofy program, but it was on PBS that he had over 100,000 followers in his lifetime and only three achieved enlightenment. David Burns: I think it was frustrating to him and disappointing, but I can see it clearly because what he was teaching was so simple and basic and yet it's hard for us to grasp it and that's why I love doing therapy because we've got powerful new techniques now where I can bring my patients to enlightenment often in a single therapy session if I have more than an hour. David Burns: If I have a two hour session, I can usually complete treatment in about a session and see the patient going from all the self-criticism and self-hatred and misery to actually joy and euphoria. It's one of the greatest experiences a human being can have because when my patient has a transforming experience, then it transforms me at the same time. Neil Sattin: Can you give us a taste of what some of the more powerful new techniques are and how they might work in these circumstances? David Burns: Yeah, they're pretty anti-intuitive and it took me many years of clinical practice before I figured it out and before it dawned on me. I would say very few therapists know how to do this and it's absolutely against the grain of the way therapists have been trained and the general public have been trained to think about depression and anxiety as brain disorders. David Burns: The DSM calls them mental disorders. We've gone in the opposite direction and I'll just make it real quick because we're getting long on people's time here I'm afraid, but when I am working with a person, like last night at my Tuesday group, we were working with a therapist and someone who's in training to become a therapist and she was being very self-critical and telling herself she wasn't smart enough and just beating up on herself and saying that she was defective and she should be better at this and she should this, she shouldn't that. David Burns: She was feeling like 90% depressed and 80% ashamed and intensely anxious. One thing I do before I ... She had all these negative thoughts, "I'm defective" and I don't have the list in my hand, but she had about 17 very self-critical thoughts. After I empathized and my co-therapist was Jill Levitt, a clinical psychologist who I teach with at Stanford and Jill is just a gem, she's fantastically brilliant and kind and compassionate and humble. David Burns: After we empathized with this individual and I'll just keep it vague because most therapists feel exactly the same way so I won't give any identifying details, but we asked this young woman, "Would you like some help today?" With her depression and anxiety. If we had a magic button on the table and she pressed it, all our negative thoughts and feelings would instantly disappear. David Burns: Would she press the magic button? She said, "Oh yeah, that would be wonderful." I guess she's felt this way on and off throughout her life since she was a little girl that she is somehow not good enough. Then we said, "Well, we have no magic button, but we have amazing techniques." But before we use these techniques, maybe we should ask, "What are your negative thoughts and feelings show about you that's beautiful and awesome?" David Burns: Also, "what are some benefits to you in having all of these negative thoughts and feelings?" She was very puzzled by that at first as most therapists are like, "How could there be benefits from having depression? We learn that's some kind of mental disorder or major depressive disorder, dysthymic disorder, all these fancy names pretending that these are mental illnesses of some kind. David Burns: But then she got in the flow, we primed the pump a little bit and she was able to come up with a list of 20 overwhelming benefits to her and beautiful things about her that were revealed by her negative thoughts and feelings. For example, when she says, "I'm defective." She will say, "Well, it shows that I'm honest and accountable. Because I do have many flaws." David Burns: Then a second benefit was "it shows that I have high standards." I was able to say, "Do you have high standards?" She said, "Absolutely." I said, "Have your high standards motivated you to work hard and accomplish a lot?" She says, "Oh yeah, absolutely." That was the third benefit. Then the fourth benefit is her self-criticism showed that she's a humble person. That was the fourth benefit, the fourth beautiful thing it showed about her. David Burns: Then we pointed out that humility is the same as spirituality. Her self-criticism shows that she's a humble and spiritual person and then her sadness showed her passion for what she hopes to achieve which is a role as a therapist and a good therapist and her self-doubt keeps her on her toes and motivates her to work really hard. David Burns: Her suffering shows enhances her compassion for others and her shame shows that she has a good value system, a good moral compass and on and on and on, then we came up with a list of when we got to 20 benefits of her negative thoughts and feelings, then we simply said to her, "Well, maybe we don't want to press that magic button because when your negative thoughts and feelings disappears, then these other good things will disappear as well. Why in the world would you want to do that?" David Burns: We have become the role of her subconscious mind and the therapist is paradoxically arguing for the status quo and not arguing for change. The therapist's attempt to help or change the patient is actually the cause of nearly all therapeutic failur

"I'm a failure. . . I'm not good enough. . . My life will be empty and meaningless without . . . " Sound familiar? Sometimes, the messages we get from society, and the impossible standards that we accept, can lead to enormous, intense suffering. Several months ago I received a compelling email from a young woman named Daisy who asked about the message we get from society that lead to suffering. Fabrice and I were so inspired that we devoted an entire Feeling Good Podcast to it (Podcast 038: Negative Messages from Society) The theme of the podcast, as well as the three subsequent podcasts, was how to pinpoint and modify the Self-Defeating Beliefs (SDBs) that lead to depression, anxiety, and relationship problems. Today, Fabrice and I are thrilled and honored to present an entire TEAM-CBT therapy session with Daisy, along with her husband Zane.

    Today on the Podcast my conversation with Dr. Phil Carson. We talk about his book  How To Live Until You Die: The 7keys To live Happy Healthy and whole. Dr. Carson is passionate about Natural health.Dad of 5 children and married beautiful wife Kim. Dr. Phil also practicing pharmacist since 1985 and the Co-founder of the Life Transformation Medical Center. He website has lot useful information to living healthy and happy. We Talk about: Being Dad and Husband Natural health Drinking plenty of water How Important sleep plays in your life Deal with stress.         Links:  carsonnatural.com The Feeling Good Podcast carsonnatural.com shop and E-courses feeling-good-Friday Dr. Carson Book  How To Live Until You Die: The 7keys To Live Ways to subscribe to the podcast! Click here to subscribe via Apple Podcast Click here to subscribe via Android Subscribe to the email newsletter Help support the show! No sitting on the sideline Patreon Page Amazon.com affiliate link  Facebook Page    

The Dark Night of the Soul (Part 1) The first live therapy podcasts with Mark (the man who felt like a failure as a father: podcasts 29 – 35) were enormously popular, and many people have asked for more. David and Fabrice were delighted with your responses, so the next three podcasts will feature a therapy session with Marilyn by David and his highly-esteemed colleague and co-therapist, Dr. Matthew May. These three podcasts will include the entire session plus commentary the session unfolds. We are extremely grateful to Marilyn for her courage and generosity in making this extremely private and intensely personal experience available to all of us. I believe the session will touch your heart, inspire you, and give you courage in facing any problems and traumas that you may be struggling with. According to the theory behind cognitive therapy, people are disturbed not be events, but rather by the ways we think about them. This notion goes back nearly 2,000 years to the teachings of the Greek Stoic philosopher, Epictetus, who emphasized the incredible importance of our thoughts—or “cognitions”—in the way we feel. Fifty years ago, this notion gave rise to a new, exciting, drug-free treatment for depression called “cognitive therapy,” which was based on this basic notion: When you CHANGE the way you THINK, you can CHANGE the way You FEEL—quickly, and without drugs. That’s why I wrote my first book, Feeling Good: The New Mood Therapy, because I was so excited about this notion and the powerful new “cognitive therapy” that was rapidly emerging. The idea behind cognitive therapy is simple. When you’re upset, you’ve probably noticed that your mind will be flooded with negative thoughts. For example, when you’re depressed, you may be beating up on yourself and telling yourself that you’re a loser, and when you’re anxious you’re probably thinking that something terrible is about to happen. However, it may not have dawned on you that your thoughts are the actual cause of your negative feelings. In addition, you’re probably not aware that your negative thoughts will nearly always be distorted, illogical, or just plain unrealistic. In Feeling Good, I said that depression and anxiety are the world’s oldest cons, because you’re telling yourself things that simply are not true. In that book, I listed the ten cognitive distortions, such as All-or-Nothing Thinking, Overgeneralization, and hidden Should Statements, that trigger negative feelings. In the years since I first published Feeling Good, my list of cognitive distortions has gone worldwide, and is used by enormous numbers of mental health professionals in the treatment of individuals struggling with depression and anxiety. The notion that depression, anxiety, and event anger result entirely from your thoughts, and not upsetting events or circumstances external events is enormously liberating, because we usually cannot change what’s actually happening, but we can learn to change the way we think—and feel. But a lot of people don’t buy, or understand, this notion which seems to fly in the face of common sense. For example, you might argue that when something genuinely horrible happens, such as failure, losing a loved one, or being diagnosed with terminal cancer, it is the actual event and not your thoughts, that triggers your negative feelings. And you might also argue, perhaps even with some irritation, that your thoughts are definitely not distorted, since the actual event—such as the cancer—is real. Would you agree? I know that’s what I used to think! The next three podcasts will give you the chance to examine your thinking on this topic, because Marilyn is struggling with a negative event that is absolutely real and devastating. As the session with begins, Marilyn explains that she was recently diagnosed with Stage 4 (terminal) lung cancer, which came as a total shock, especially since she’d never smoked. As Drs. Burns and May go through the T = Testing and E = Empathy phases of the TEAM-CBT session, they learn that Marilyn has been struggling with extreme levels of depression, anxiety, shame, loneliness, hopelessness, demoralization, and anger, to mention just a few of her negative feelings. If you’d like, you can review a pdf of the Brief Mood Survey and Daily Mood Log that Marilyn completed just before the session began. You will see that her negative thoughts focus on several themes, including Her fears of cancer, pain, and death. Her thoughts of spiritual inadequacy, doubting her belief in God, wondering if there really is an afterlife, feeling that she’s not spiritual enough, and thinking that she’s perhaps been duped by religions. Her feelings of incompleteness at never having had a truly loving life partner. Her feelings of self-criticism, beating up on herself for excessive drinking during her life. Click here for Marilyn's Brief Mood Survey, pre-session. Click here for Marilyn's Daily Mood Log. The next Feeling Good Podcast with Marilyn will include the A = (Paradoxical) Agenda Setting phase of the TEAM therapy session, and will include the Miracle Cure Question, the Magic Button, the stunning Positive Reframing Technique, and the Magic Dial. The third and final podcast will include the M = Methods phase, including Identify the Distortions, the Paradoxical Double Standard Technique, Externalization of Voices, and Acceptance Paradox, end of session testing, and wrap-up. Although the subject matter of these podcasts is exceptionally grim and disturbing, we believe that Marilyn’s story may transform your thinking and touch your heart in a deeply personal way. Because Marilyn is a deeply spiritual person who suddenly finds herself without hope and totally lost, we have called part one, The Dark Night of the Soul.

A reader ask how to handle relapses following recovery from depression. David emphasizes the importance of this question, since there is a 100% probably that every patient will relapse following recovery. And if the patient has not been properly prepared, the relapses can be disastrous. But on the other hand, if the patient has been prepared, the relapses do not have to be problematic. What is a relapse? David defines a relapse as one minute or more of feeling crappy. Given that definition, we all relapse pretty much every day. However, some people can pop out of a bad mood really quickly, while others can get stuck in these “relapses” for weeks, months, or even years. David describes the Relapse Prevention Training (RPT) techniques he has developed, but cautions that RPT does not make sense until the patient has experienced a complete elimination of symptoms. If the patient is being treated for depression, that means that the score the depression test has fallen all the way to zero (no symptoms whatsoever) and that the patients feel joy and self-esteem. There are four keys to David’s RPT, including: The patient must be informed that relapse is an absolute certainty. The question is not “will this patient relapse” but rather, “when will this patient relapse?” Patients have to know that the therapy technique that worked for them the first time they recovered will always work for them. It might be the Cost-Benefit analysis, Pleasure-Predicting Sheet, Acceptance Paradox, Double Standard Technique, Five Secrets of Effective Communication, Hidden Emotion Technique, or Experimental Technique, or simply recording their negative thoughts on the Daily Mood Log and identifying the distortions in them. Patients need to identify and modify the Self-Defeating Beliefs (SDBs) that triggered their depression and anxiety in the first place, such as Perfectionism, Perceived Perfectionism, or the Achievement, Love or Approval Addictions. In several previous podcasts, David and Fabrice have described the Uncovering Techniques that can be used to quickly pinpoint any patient’s SDBs. Patients need to write down and challenge the Negative Thoughts that will inevitably emerge at the time they relapse, such as “This relapse proves I’m hopeless after all,” or “This relapse proves the therapy didn’t work,” etc. David and Fabrice illustrate step #4 using a powerful technique called Externalization of Voices. David has patients record this role play procedure on a cell phone or other recording device so they can play it and listen if needed during an actual relapse. David explains that he used this approach with every patient he discharged, and encouraged them all to come back anytime they had a relapse that they couldn’t handle. In spite of having more than 35,000 therapy sessions with individuals with severe depression and anxiety, David says that he can count on two hands the number who every returned for “tune-ups” following termination of therapy, and in most of those cases, the patients were able to recover once again in just or two sessions. In the next Feeling Good Podcast, David and his highly esteemed colleague, Dr. Matthew May, will begin their live work with Marilyn, a severely depressed colleague who is facing “The Dark Night of the Soul.” Fabrice, as usual, will narrate and elicit enlightening commentaries on the therapeutic strategies that David and Matt are using as the session with Marilyn unfolds.

The title of David's TEAM-CBT eBook for therapists is Tools, Not Schools, of Therapy. David explains that the field of psychotherapy is dominated by numerous schools of therapy that compete like religions, or even cults, each claiming to have the answer to emotional suffering. So you’ve got the psychodynamic school, and the psychoanalytic school, the Adlerian school, the Beckian cognitive therapy school, the Jungian school, and tons more, including EMDR, behavior therapy, humanistic therapy, ACT, TMT, EMT, and so forth. Wikipedia lists more than 50 major schools of psychotherapy, but there are way more than that, as new schools emerge almost on a weekly basis. David describes several conversations with the late Dr. Albert Ellis, who argued that most schools of therapy were started by narcissistic and emotionally disturbed individuals. Ellis claimed that most were self-promoting, dishonest individuals who claimed to know the true “causes” of emotional distress and insisted they had the “best” treatment methods. And yet, research almost never supports these claims. David, who is a medical doctor, points out that we don’t have competing schools of medicine. Can you imagine what it would be like if we did? Let’s say you broke your leg, and went to a doctor who prescribes penicillin. You ask why he’s prescribing penicillin for a broken leg, and he explains that he’s a member of the penicillin school. He says he always prescribes penicillin—it’s good for whatever ails you! That would be like an Alice in Wonderland world. And yet, that’s precisely how psychiatry and psychotherapy are currently set up. If you’re depressed and you go to a psychiatrist, you’ll be treated with pills. If you go to a psychoanalytic therapist, you’ll get psychoanalysis. Or if you go to a practitioner of EMDR, TFT, or Rational Emotive Therapy (RET), you’ll get EMDR, TFT, or RET. David argues that this just doesn’t make sense. David argues that the fields needs to move from competing schools of therapy to a new, science-based, data-driven psychotherapy. He emphasizes that we’ve learned a lot from most of the schools of therapy, and that many have provided us with valuable insights about human nature as well as some useful treatment techniques. But now it’s time to move on, leaving all the schools of therapy behind. David acknowledges that this message may seem harsh or upsetting to some listeners, and apologizes for that ahead of time. David and Fabrice also discuss the spiritual basis of effective psychotherapy, and David describes the reaction of his father, a Lutheran minister, on the day that David was born, as well as a tip his mother gave him when he was in third grade. In the next Feeling Good Podcast, David and Fabrice will describe Relapse Prevention Training, since the likelihood of relapse after successful treatment is 100%. But if the patient knows what to do, the relapse doesn’t have to be a problem.

The Beatles tell us that all we need really need is love, and in her famous song, “People,” Barbara Streisand proclaims that “People who need people are the luckiest people in the world.” But is this really true? Fabrice asks David whether love is a human need? David describes hearing Dr. Aaron Beck proclaim that love is not an adult human need, and feeling shocked, during one of Dr. Beck’s cognitive therapy seminars in the 1970s. Although initially skeptical, David did a number of experiments to test this belief, and came to a startling conclusion. David describes the impact of needing love on his depressed and anxious patients, including lonely individuals who were constantly being rejected in the dating scene. You’ll find this podcast provocative, controversial, and hopefully interesting. We’ll also include a survey you can complete below, indicating your thoughts about this topic! In the next Feeling Good Podcast, David and Fabrice will discuss Tools, Not Schools, the title of David’s TEAM-CBT eBook for therapists, and the following podcast will discuss Relapse Prevention Training, since the likelihood of relapse after successful treatment is 100%. But if the patient is prepared and knows what to do ahead of time, the relapse, while often painful and disturbing, doesn’t have to be a significant problem.

David describes his treatment of a physician with OCD who was tortured by the fear that he would impulsively throw his newborn baby over the railing of his second-floor apartment. He also describes a psychologist with OCD who washed her hands more than 50 times a day for fear of contamination. In addition, she spent hours every day making sure that nothing in her house was arranged in groups of three—including furniture, table settings, decorative objects, magazines on tables, and so forth. Arrangements in groups of 2 were okay, as were groups of 4, 5 or more objects. Why was she so obsessed? What were the hidden emotions that fueled these obsessions and compulsions? David and Fabrice will give you the chance to pause the recording on three occasions to jot down your hypotheses before they give you the answers. It won't be important to get it "right," but it is highly desirable to take a stab at it. This podcast will be of interest to you if you or a loved one is struggling with OCD, or any form of anxiety, including phobias, panic attacks, chronic worrying, and so forth. That's because the hidden emotion phenomenon, or excessive “niceness,” may be a the root of your fears as well. Bringing those feelings to conscious awareness will often lead to sudden relief, or even a complete elimination of your symptoms. In the next Feeling Good Podcast, David and Fabrice will describe dramatic examples of exposure and response prevention in the treatment of OCD, including a woman who was tortured by the fear that she’d received the wrong baby at the hospital after her first child was born. What causes these bizarre symptoms, and what’s the most effective treatment? Stayed tuned and you’ll find out!

Listeners submitted questions on OCD (Obsessive-Compulsive Disorder): Is it an organic illness? Are drugs necessary in the treatment? What’s the best book to read if you want to heal yourself? What’s the prognosis? Drs. Nye and Burns begin by explaining OCD and answering the questions. David emphasizes the importance of using four treatment models when working with OCD—the cognitive model, the motivational model, the exposure model, and the hidden emotion model if you are hoping for a rapid and complete elimination of symptoms. Treatment that focus on only one treatment method, such as exposure and response prevention, may have only limited success. He describes his treatment of a medical student named Ralph with classic OCD. Ralph was frequently plagued by the fear he was dying of AIDS; then he’d get so anxious that he’d go to the emergency room and insist on having a blood test for HIV. These always came out negative, and this brought temporary relief, but within a few days Ralph would be worrying about AIDS again and feeling the overwhelming compulsion to get yet another blood test. The case was especially curious because Ralph was engaged and faithful to his fiancé, so there was no rational reason for him to think he had become infected with the HIV virus. However, he’d tell himself, “Maybe I drew blood on a patient with AIDS and then pricked myself with the needle, and then forgot. And how can I know that this didn’t happen?” This are extremely typical of the kind of obsessions that plague OCD patients. Ralph would torture himself with these thoughts until he succumbed to the urge to get another blood test for AIDS. Although years of conventional psychotherapy had failed this patient, the Hidden Emotion Technique led to an incredible recovery in just a few minutes during a therapy session. You will find this true story inspiring and amazing! And David provides an even more amazing 40-year follow up report! In the next Feeling Good Podcast, David and Fabrice will describe more examples of patients with severe OCD who experienced dramatic relief because of David’s Hidden Emotion Technique. This technique can be helpful for all anxiety disorders, and not just OCD. However, David emphasizes that this is just one of many techniques he uses in the treatment of anxious patients. He cautions therapists against thinking three is just ONE best technique for any anxiety disorder, including OCD. See link to podcast #027: Scared Stiff — The Hidden Emotion Model.

In this week's episode, The Knowbodies sit down with Dr. Phil Carson of Carson Natural Health and Wellness Consulting. Dr. Carson is a Pharmacist by trade and is now the host of The Feeling Good Podcast where he focuses on natural healing practices. In this episode we focus on: Dr. Carson' background as a Pharmacist How he transitioned from relying on pharmaceutical interventions and started to seek out more natural healing options How a difficult childhood led to Dr. Carson's interest in stress management How stress can dictate both our mental and physical well-being if we let it Dr. Carson's advice on best practices for managing stress Dr. Carson's take on the opioid crisis and how alternative medicine will have a role to play in solving it If you enjoyed this episode and are interested in learning more about Dr. Carson and Carson Natural Health and Wellness Consulting check out: http://carsonnatural.com/ and on social media at Carson Natural -The Knowbodies

What are the root causes of depression? Anxiety? Relationship problems? In this, and the next two podcasts, you will discover the answer! Cognitive Therapists believe that negative thoughts, or cognitions, can exist on two different levels. When you’re upset, you’ll have Automatic Negative Thoughts (ANTs) in the here and now, and they’ll usually be something like this: Depression: You may be telling yourself that you’re a loser, or a failure, or that you’ll be miserable forever. Anxiety: You’re probably telling yourself that you’re in danger, and that something terrible is about to happen. “When I get up to give my talk at my church group, my mind will probably go blank and I’ll make a total fool of myself!” Relationship conflicts: You may be telling yourself that someone you’re ticked off at is a self-centered jerk who only cares about himself or herself and shouldn’t be that way! Individual Downward Arrow But why do we get these ANTs in the first place? Cognitive therapists believe that Self-Defeating Beliefs, and other deeper structures in the brain, make us vulnerable to painful mood swings and conflicted relationships with the people we care about. To help you pinpoint your own Self-Defeating Beliefs, David has created two uncovering techniques called the Individual Downward Arrow and the Interpersonal Downward Arrow, and Albert Ellis, the noted New York psychologist, created a third called the “What-If” Technique. In today’s podcast, Drs. Burns and Nye illustrate the Individual Downward Arrow technique, using as an example a psychologist named Harold who was understandably devastated when his patient unexpectedly committed suicide. You can follow along on this PowerPoint presentation starting with Harold’s Daily Mood Log with David and Fabrice while they illustrate the Individual Downward Arrow technique. [office src="https://onedrive.live.com/embed?cid=4C33CD5BBD389DD2&resid=4C33CD5BBD389DD2%21158&authkey=AMjeMe-n6Qmswxc&em=2&wdAr=1.3333333333333333"] Once they come to the “bottom of the barrel,” they will ask you to pause the recording, and see if you can pinpoint five or six or more of Harold’s Self-Defeating Beliefs, using the list of 23 Common Self-Defeating Beliefs. David emphasizes that we create our own emotional and interpersonal reality at every moment of every day, but we aren’t aware of this, so we often feel like victims of forces beyond our control. We are really talking about emotional and interpersonal enlightenment, and the uncovering techniques will make this ancient Buddhist concept more understandable for you. If you’d like more tips on precisely how to do the Individual Downward Arrow Technique, you can read David’s recent Feeling Good Blog on this topic! In our next Feeling Good Podcast, David and Fabrice will illustrate the Interpersonal Downward Arrow Technique, which will allow you to complete a course of psychoanalysis in just 5 to 7 minutes, rather than the 5 to 7 years free associating on the couch. It is truly psychoanalysis at warp speed, and is pretty amazing! And when you change the beliefs that trigger interpersonal conflicts, you can change them and enjoy greater satisfaction in your relationships with the people you care about. But sometimes, that requires a little bit of courage! And in the third Feeling Good Podcast on the uncovering techniques, David and Fabrice will illustrate Dr. Albert Ellis' famous "What-If Technique." If you struggle with any type of anxiety, including fears and phobias, this technique can help you uncover the feared fantasy at the root of your fears, so you can challenge the monster and attain freedom from the fears that hold you back!  

“My problems are real! The world really IS screwed up! And that’s not a distortion. So what can I do about my severe depression and anxiety?” David and Fabrice discuss two questions submitted by Feeling Good Podcast listeners. #1. Shari writes: “I read your book Feeling Good and now I am reading your book When Panic Attacks--thanks to April's podcast with you. I still struggle but recently our current political situation and environmental research about our negative impact on earth—has triggered severe anxiety and depression again. The problem is that I don't think my thoughts are distorted—it certainly seems logical to assume that life on earth is threatened. So I am not sure how to do this. How can I make progress with my mental and emotional health while being aware of situations around the world? Any advice or thoughts would be deeply appreciated.” This is a wonderful note, and I’m sure that huge numbers of people feel the same way, in varying degrees. So how can we attend to our own emotional well-being in the face of genuine adversity? Dr. Burns discusses this from the perspective of Paradoxical Agenda Setting, which is the key component of TEAM-CBT, and emphasizes the most common therapeutic error of all—jumping in to try to help, without seeing all the really GOOD reasons for the patient NOT to change. From this perspective, Shari’s question becomes the most important question in all of psychiatry and psychotherapy—how do we help patients who may not want to change? #2. After listening to the A = Agenda Setting portion of the live therapy with Mark, Paul submitted this question: “Hi David, Thanks to you, Fabrice and Jill for this episode - as with the previous episodes with Mark, this has really helped in bringing the TEAM approach to life. As I have been using your books in the past few years to self-treat feelings of anxiety and depression, I was very keen to hear how the new agenda setting step works. I am wondering what your thoughts are on how effectively the "A" step can be carried out by a patient on his/her own (i.e. without someone else verbalizing the reasons not to change / playing the part of the patient's sub-conscious)? Do you have any tips? I think I heard Mark say something to the effect that, on his own, he wouldn't have thought of all the positives that you came up with in the session. Thanks again for sharing these great tools and techniques - looking forward to the "M" step soon. Paul” This was another terrific question on a topic of great importance. David explains that it is actually easier for patients to learn to use Positive Reframing and the other Paradoxical Agenda Setting techniques than for therapists to learn them. Because of his excitement over this prospect, David has just begun a new book which will show depressed and anxious individuals exactly how to do this on their own in a step-by-step manner. He is optimistic that the new TEAM-CBT techniques, in book form, may be even more helpful to patients than his first book, Feeling Good: The New Mood Therapy. Research studies indicate that 65% of patients with moderate to severe depression improve substantially within four weeks of receiving a copy of Feeling Good, even without any other treatment. Dr. Burns is hopeful that his new book will provide the answers for the 35% who were not helped by Feeling Good. So the answer is yes, I think many individuals WILL be able to do the “A” step on their own, and I am hopeful the positive impact will be great! If you would be interested in David's new book, please indicate this in the Survey attached to this podcast. David and Fabrice have exciting plans for upcoming podcasts. They will be addressing these two questions in one or two podcasts: Is it possible to measure our “worthwhileness” or “worthlessness” as human beings? Do we even have a “self”? These two questions have been discussed by experts for thousands of years, going all the way back to the Buddha, and most recently by the incredible Austrian philosopher, Ludwig Wittgenstein. And although the answers are tremendously simple, people can’t seem to “get it.” The issues are not simply philosophical, but eminently practical, since most depression and anxiety result from the perception that one is “worthless,” or “inferior,” or simply “not good enough.” In addition, David and Fabrice are hoping to create a second live therapy session broken into smaller podcast chunks, but featuring David and a totally awesome former student and now highly esteemed colleague, Matthew May, MD. For the past ten years, David has been telling workshop audiences that Matt is one of the finest therapists in the world. So this is an event you won’t want to miss! Click here to listen to Fabrice being interviewed on Dr. Carmen Roman's podcast.

This is the last live therapy podcast with Mark, the physician who was convinced he was a failure as a father because of his difficulties forming a close, loving relationship with his oldest son. Although the session appeared to go well, we can’t be sure until we see Mark’s end of session mood ratings on the Daily Mood Log and on the Brief Mood Survey and and Evaluation of Therapy Session. David emphasizes that therapists’ perceptions of patients are notoriously inaccurate, but most therapists are unaware of this because they don’t use the rigorous testing procedures at the start and end of sessions. To review Mark's partially completed Daily Mood Log, CLICK HERE. Jill and David will ask him to complete the additional negative thoughts on his own after the session. To review mark's end of session Brief Mood Survey and Evaluation of Therapy Session, CLICK HERE. After David review’s the phenomenal changes Mark reported from the start to the end of the session, David asks if the ratings were genuine, or, as some listeners might suspect, faked in order to try to please the therapists. Mark bursts into tears and says, in a choked voice, that it was a life-changing experience. After the end of the session, David and Fabrice discuss a number of highlights from the work with Mark: The testing indicated a complete or near-complete elimination of symptoms. In 2 ½ hours, Jill and David have essentially completed an entire course of psychotherapy. Although there may still be some work to be done with Mark, the hard part has already been completed. David emphasizes that he now views psychotherapy as a procedure to be done at one sitting, much like surgery, with brief follow-up visits, rather than a long, drawn out procedure meeting once pre week for months or even many years. And although a single 2 or 2 1/2 hour session may be more costly than a traditional 50-minute hour, it can be vastly more cost-effective Than dozens of sessions with little or no progress. In addition, it is vastly better for the patient who walks out feeling good today, rather than having to endure weeks, months, or even many years of traditional talk therapy or antidepressant drug therapy. David and Fabrice talk about the fact that no one is permitted to feel happy all the time, and that Mark’s negative thoughts and feelings WILL return, David defines a “relapse” as one minute or more of feeling lousy. Given that definition, we will ALL relapse forever! But it doesn’t have to be a problem for Mark if he is prepared for this, and knows how to pop out of the relapses quickly, rather than getting stuck in them. This is where Relapse Prevention Training (RPT) becomes so important following the initial dramatic recovery. RPT only takes about 30 minutes and is easy to learn, and will perhaps be the topic for a future Feeling Good Podcast if our listeners express an interest in it. David discusses the difference between an Internal Solution and an External Solution. In this session, David and Jill have guided Mark in the Internal Solution—this means crushing the negative thoughts that triggered Mark’s feelings of unhappiness, anxiety, shame, failure, and anger for years, if not decades. Now that he is feeling so much better about himself, he may want some help with the External Solution. This will involve learning how to develop a more loving relationship with his son using tools like the Relationship Journal and the Five Secrets of Effective Communication. This will be far easier now that Mark is no longer using up all his energy beating up on himself and feeling depressed and inadequate. David wraps up by talking about the true wealth we have as therapists. Although we won’t develop the riches of a Bill Gates doing psychotherapy, we do have the fabulous and precious opportunity to see people as they really are inside, and to witness miracles like the one we saw in the session with Mark. David expresses the hope that listeners have benefitted by listening. Although we are all different, most of us have had the painful experience, like Mark, of believing we were somehow failures, or inferior, or defective, or simply not good enough. We are deeply indebted to Mark’ courage and generosity in giving us the opportunity to see the solution to this ancient and almost universal human problem! There are many resources for listeners who want to learn more about TEAM-CBT, including: David’s exciting two-day and four-day training workshops, listed on his website, feelinggood.com. Tons of free resources for patients and therapists at feelinggood.com. Please sign up using the widget in the upper right hand corner of any page on his website and you will receive email notifications and links to every post. David’s psychotherapy eBook entitled Tools, Not Schools of Therapy. David’s Tuesday psychotherapy training groups at Stanford, which are co-led Jill Levitt, PhD and Helen Yeni-Komshian, MD. The training is free of charge to Bay Area and northern California therapists. You will have the chance to do free personal work, too! David’s famous Sunday hikes, also free to members of the training groups. Paid online and in-person weekly TEAM-CBT training groups, plus intensive TEAM-CBT treatment programs, at the Feeling Good Institute in Mt. View California. In addition, many TEAM-CBT training and treatment programs are now offered in many cities throughout the US and Canada. For more information, visit feelinggood.com or www.feelinggoodinstitute.com.

In today’s episode, Dr. Carmen interviews Dr. Fabrice Nye, a therapist from Silicon Valley. Dr. Fabrice uses an interesting mix of transpersonal psychology, spirituality and cognitive behavioral therapy. He has his own podcast in iTunes called The Feeling Good Podcast, and says he prefers to use tools rather than schools of therapy and whatever works when working with clients. Please enjoy this interesting and inspiring interview today. What you will learn in today’s episode: • Dr. Fabrice’s story going from the IT/engineering world to psychotherapy, and his philosophy of a holistic and spiritual approach to psychotherapy. • A motivational approach and model of therapy called TEAM, which stands for testing, empathy, agenda setting and methods. • The difference in the wording: emotions vs feelings. • Why we tend to shy away from the uncomfortable emotions and seek out the pleasant ones • The importance of empathy with clients and why there’s no healing until there is enough of a bond between therapist and client. • The value in spending time breathing (e.g. belly breathing) with a client so they can be in a more calm state and regain a level of self-control • Dr. Fabrice’s approach in getting as stable as he can and then waiting for others to join him at that level, rather than matching people on the level of anxiety they are at. • The most common and most damaging mistake people do with their emotions (avoiding them) and advice for somebody in this state. • The distinction between and different approaches towards the anxiety provoking emotions (like fear, worry, shame, frustration) and the depressive type of emotions, (sadness, the blues, loneliness, abandonment, hopelessness and despair.) • How to see negative symptoms as a reflection of the fantastic human being you are. • The way culture can create differences in approaches to emotions • The importance of education about the evolutionary mechanisms that are causing some of our modern emotions. • The daily habit Dr. Fabrice recommends that contributes to emotional success (mindfulness) and what the STOP technique is • Dr. Fabrice’s tips for someone starting their healing journey Suggested resources: Dr. Fabrice website and FB http://drnye.net http://www.facebook.com/DrNye Dr. Fabrice podcast: http://j.mp/feel-good-podcast Books he talked about: Man’s search for meaning by Viktor Frank http://amzn.to/2p7kH15 Loving what is: Four questions that can change your life by Byron Katie http://amzn.to/2ofAPyF The website he recommends: https://feelinggood.com Dr. Carmen Roman website: http://www.carmenroman.net Music by www.bensound.com  

The Phil Carson StoryPhil Carson is a pharmacist who thinks outside of the box. His business, Carson Natural, helps people find natural solutions to their health problems. Phil Carson is living the dream, but it was not always the case.A few years ago, he had to close up his dream business. It failed. Or, did it. Phil did what he needed to do providing for his family. Along the way, a path re-emerged on how he could successfully open his dream.This episode shares that story.Phil Carson BackgroundPhillip Carson a Registered Pharmacist, Doctor of Pharmacy with licenses in MS and TN is a 1985 graduate of the University of MS School of Pharmacy. Since earning his degree in Pharmacy Phillip has been certified as a Compounding Pharmacist, a Diabetes Care Pharmacist and most recently a Consulting Pharmacist. Phillip has also earned certifications in Lipid Management, Gastroesophageal reflux disease (GERD). He has earned numerous certifications in Natural and Alternative Medicine Therapies for weight loss, fibromyalgia, ADD/ADHD and many other health conditions.Believing in and promoting healthy marriages and families as well, Phillip and his wife Kim have been married for over 30 years and have 5 happy and healthy children.Links and ResourcesCarsonNatural.com Visit Dr. Phil's websiteBuy Dr. Phil's book, How to Live Until You Die: The 7 Keys to Living Happy, Healthy, and WholeCheck out Dr. Phil's podcast, The Feeling Good Podcast  

The key is bringing the patient’s subconscious resistance to conscious awareness, and melting it away with paradoxical techniques. This is absolutely critical if you are hoping to see a complete elimination of symptoms in any type of anxiety. You may recall that the Outcome Resistance for anxiety disorders usually results Magical Thinking—the anxious patient may be suffering intensely and asking for help, but secretly believes that something terrible will happen if the treatment is successful and the anxiety disappears. In other words, most anxious individuals are convinced that the anxiety is protecting him or her from some catastrophic event. David brings this concept to life with a dramatic description of his treatment of a young man named Sam who’d been struggling with intense PTSD—Post-Traumatic Stress Disorder— for six months following a traumatic interaction with two sadistic gunmen. David and Fabrice also discuss metaphors for understanding how healing actually occurs. Most therapists think of depression and anxiety as mountains that have evolved slowly, over years or decades. They sometimes also believe that treatment and recovery will also requires years and years of treatment, with very slow progress. Of course, if the therapist and patient believe this it will function as a self-fulfilling prophecy. In sharp contrast, David describes a new way to think about recovery, as something extremely rapid, a personal transformation that happens suddenly, within a very brief time period within a therapy session. But this remarkable phenomenon is only possible when the patient’s resistance to change has been skillfully and compassionately addressed by the therapist. At that point, the patient and therapist are on the same TEAM, working together collaboratively. Then, amazing changes can often unfold quickly. Plans for future Feeling Good Podcasts will include a series of fascinating podcasts that will feature an actual live therapy session, with David and his colleague, Dr. Jill Levitt, acting as co-therapists, including commentaries on how each step of T.E.A.M. is being implemented. This will give you the unique opportunity to look behind closed doors so you can observe actual healing taking place. In addition, a future “Ask David” podcast is planned, as well as a podcast on “The Truth about Benzodiazepines,” plus podcasts featuring more treatment methods for anxiety such as Interpersonal Exposure Techniques and Cognitive Flooding. Dr. Burns also promises a fascinating Feeling Good Podcast on the use of the Five Secrets of Effective Communication with violent individuals who are threatening, hostile, and dangerous.

Dr. Phillip Carson wants you to live a more balanced, healthy and vibrant life. He has over thirty years experience in traditional and natural medicines and daily mindfulness is a philosophy he lives by. Dr. Phil is a pharmacist and also host and creator of The Feeling Good Podcast where he answers health questions and discusses the latest in health and wellness. Last March, Dr. Phil partnered with a colleague and opened the Life Transformation Medical Center in his local community in Mississippi. Contact Info Website: www.CarsonNatural.com Blog: Free Guides www.CarsonNatural.com/MindfulnessMode "The 7 Keys To Living Happy, Healthy and Whole" and "The 7 Keys To Stress Relief" Podcast: The Feeling Good Podcast Most Influential Person My grandmother. I lived with her a lot when I was growing up. She taught me to pray, to read, and she read the Bible to me all the time. She taught me to relax and we spent time putting puzzles together. She was a great influence. Effect on Emotions Mindfulness has affected my emotions in a very positive way; like I was talking about with my prayer walks. It was part of my daily routine of meditation. It calms me and helps me start my day off right. It's very important to me; it has helped me tremendously. Thoughts on Breathing The deep breathing that I do is so relaxing. One of the things that I do, (and I tell other people to do this as well), is when I feel stress or I feel like things are crashing in on me, I'll stand up and I'll take some deep breaths. I Inhale and exhale slowly, and as I'm exhaling, I say I'm blowing the stress away. That's been a tremendous help to me. Suggested Resources Book: Fully Alive: A Journey That Will Change Your Life by Ken Davis App: Evernote Advice for Newbie My oldest son was in a situation when he was in high school. The way we raise him, the way we raised all our children, to be mindful of other people's feelings and to be a person that stands up for somebody that's being bullied or being made fun of or put down and not to ever take part in that but to be a friend to those people. He was in a situation where that was happening to a young guy in the classroom one day. He stood up for that guy and actually got physically attacked for standing up for him.We've taught our kids to be mindful of those kind of things. because that's something that really touches me and hurts me when I see somebody being mistreated that way. So they're very mindful of that and I'm grateful for that.

Todd and Cathy share wisdom from Wayne Dyer and Tony Robbins about feeling good and why it increases our ability to parent well. They also discuss Good Night Stories for Rebel Girls and why this book prompted an important discussion. They talk about George Michael, different types of fear, and why we need to know what we are FOR rather than against.

Todd and Cathy share wisdom from Wayne Dyer and Tony Robbins about feeling good and why it increases our ability to parent well. They also discuss Good Night Stories for Rebel Girls and why this book prompted an important discussion. They talk about George Michael, different types of fear, and why we need to know what we are FOR rather than against.

Dr. Phil Carson is pharmacist, podcaster, blogger, speaker and life coach. Paul and Dr. Phil discuss how to lead Healthy, Happy, and Balanced lives.  As president of Carson Natural Health and host of The Feeling Good Podcast, Dr. Phil teaches us how to think outside the box and equips us to make right choices to achieve optimal health. Additionally, Dr Phil has an inspiring story that we all can learn from on how faith, perseverance, friendship and giving can turn your life around.  From failure to realizing improbable dreams – that journey is available to you. Visit GodZoneShow.com for show notes and to ask a question or leave a comment. Sheila's Shofar – Today's Call-to-Action - Tip of the Day   Today –Practice Daily One-Item Thankfulness check it out – my call to action tip for the day. Conversation with Dr. Phil Carson      Amazing Snippets from Dr. Phil: Meditate on these Guest Snippets to see the useful wisdom that might come from God's voice and resonate with your heart and be implemented today on your journey.  A lot of time when bad things happen, people often turn their back on God, they run from God, they get angry at God, but our strength was strong enough to know we needed to run to God not away from him.      Key Points Discussed: Phil's business failure to restoration story of God's guidance. How to Live a Healthier, Happier, and Balanced Life. Methods for staying focused on God's guidance. Resources for reducing stress in your life. What kind of water should you drink? The importance of regular collaboration with friends. Dr. Phil''s Take-Away Wisdom that leads to action today:  Start allowing God and others to help you by regularly speaki into your life.  Don't close yourself off and try to be Superman or Superwoman. Resources Mentioned 48 Days to the Work You Love: Preparing for the New Normal by Dan Miller The Feeling Good Podcast hosted by Dr. Phil Carson Dr. Phil Recommends Resources Fully Alive: Lighten Up and Live – A Journey that Will Change You Life by Ken Davis Connect with Dr. Phil Carson  http://carsonnatural.com/ Leave a Message for Paul or Ask Paul a Question http://godzoneshow.com/contact/