Podcasts about sdbs

Ask David How Can I Change an SDB (Self-Defeating Belief)? How Can I Cope with Intense Public Speaking Anxiety? Featuring Rhonda Barovsky, Psy.D., Matthew May, MD, Jason Meno and David Burns, MD (Jason is an AI Scientist on our Feeling Great App Team) Anonymous asks: How can I change an SDB (Self-Defeating Belief)? Hiranmay asks: How can I deal with my intense anxiety before public speaking. Answers to Your Questions Note: These answers below were written BEFORE the podcast, and the live discussion always adds new and different angles. Today, Jason Meno, our beloved AI guy on our app team, also chimes in on the many super questions submitted by Andrew (#3 - #10.) 1. Anonymous asks: How can I change an SDB? Dear Dr. Burns, I'm an avid listener of the Feeling Good podcast and for the past few weeks, an avid user of the Feeling Great app. Thank you for your incredible work and dedication to making people everywhere feel better about themselves. I have a question about self-defeating beliefs that I'm hoping you can address, either on the show or on your website. You have mentioned on several occasions that SDBs are the root cause of negative thoughts and consequently of negative feelings. Yet, to me it doesn't feel like SDBs are really addressed enough on the podcast. There seem to only be a handful of episodes covering the topic. It also seems there is a very limited toolbox of methods to use on SDBs, almost like dealing with them is considered an afterthought. If SDBs really are the cause of it all, shouldn't the primary focus be on defeating them first and only then, on defeating negative thoughts? I'm just a little bit lost when it comes to defeating SDBs, which seem to be way harder to deal with than negative thoughts. Any insights or thoughts on the subject will be greatly appreciated. Sincerely, Anonymous David's reply Dear Anonymous, Will start a new Ask David with your excellent question. Thanks, david First, you can look up Self-Defeating Beliefs in the search function on my website, and you'll find many great examples. Here's what I got just from "Self-Defeating Belief." You could also search for a specific type, like Perfectionism, Perceived Perfectionism, Achievement Addiction, Love Addiction, Approval Addiction, Submissiveness, etc. In general, there are two approaches to any SDB. Four approaches can be used in this order: Do a Cost-Benefit Analysis of the SDB. If Disadvantages outweigh Advantages, use Semantic Technique to modify the SDB. Do an experiment to see if the SDB is actually valid. Use the Feared Fantasy Technique to put the lie to the SDB at the gut level. Here's our latest thinking, which is a step beyond the four steps above. Do a Daily Mood Log on one specific moment when you were struggling with your SDB. We will discuss these ideas in greater depth on the show, of course! You can also find a great deal on SDBs in my books, like Feeling Good, the Feeling Good Handbook, and more. But right now, I don't even know what SDB you might want help with / more information about. Also, in the Feeling Great App, there's a terrific class called "Your PhD in Shoulds." It includes a lesson on perfectionism. 2. Hiranmay asks: How can I deal with my intense anxiety before public speaking without working on the negative thoughts I have afterwards, like “I am going to mess this up” “People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool.“ “This talk is important, it must go well! Here's his email: Dear Dr. Burns, I love your books and the feeling good podcast. They have made such a huge difference in my life (in a good way of course). I have an “ask David” question on acute anxiety: If I have to play a badminton match or give a presentation, I usually get some or a lot of anxiety the day before the big event as well as the morning of. I then use all the methods you have taught, and the anxiety reduces. However, it usually comes back with a bang just before I give the talk or play a match. Cognitive techniques are not very helpful to me 30 minutes or 5 minutes before the presentation or match. I don't have the time to sit down and write my thoughts or cannot focus at all on my thoughts. Are there any strategies to reduce this form of acute “relapse” or nerves. Here are some more details: Event: 30 minutes before my presentation. I just entered the seminar room, and the first speaker is about to start their talk. I am next. I can feel my heart starting to pound and I am getting the familiar sense of anxiety and nerves. Thoughts: “I am going to mess this up”. “People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool“. “This talk is important, it must go well”. Although to be honest, this is my analysis of what my thoughts were after the fact. 5-15 minutes before the presentation, I usually just notice my thoughts racing. To reiterate: I am not looking for help with working on these thoughts after the presentation. Any strategies to acutely deal with anxiety or rather relapse of anxiety when I don't have time to use all the wonderful TEAM tools would be very helpful. Thanks so much. Best, Hiranmay (pronounced he-run-may) living in Basel, Switzerland. David's Reply Sure, as a starting point I'd like to see your work with these thoughts on a Daily Mood Log. Do you have one that you could send me, with the percents filled in, etc. That will allow me to see what your strategies are on challenging these thoughts, and whether you can knock them out of the park, or only challenge them “somewhat.” Best, david You can see Hiranmay's excellent DML if you check here. David Continues Hi Hiranmay, It sounds like are not interested in help with the thoughts you recorded in your email below, since this, by definition, is “after the presentation.” If you like, you could perhaps “make up” some thoughts you might be having BEFORE you start to speak. As someone who has had, and recovered from crippling public speaking anxiety, I have tons of powerful techniques, but would need some help from you so I'll have something to go on. By the way, I absolutely DO NOT BELIEVE you when you say those are not the thoughts you are having in the minutes before you begin to speak! So, your requirement that we are not allowed to work on them is a bit of a hindrance. As an aside, I will include this in an Ask David podcast, if that is okay! Sincerely, david I asked H to send me a copy of his Daily Mood Log, which was really well done, and responded with a few suggestions. Then I sent this note: David's Subsequent Response One thing I noticed on your Daily Mood Log is your fear of making a mistake, or having a critical question from someone in the group, or not being able to impress your audience sufficiently. These fears are common in public speaking anxiety. We've all struggled with them at one time or another, I think!  I have changed my focus from needing to impress the audience with myself or my talk, and instead I try to remember to try to impress them with themselves, and how awesome they are. Here's an example. I once gave a presentation on the serotonin theory of depression for about 1,000 psychiatrists at a prominent medical school in Texas. It was going well and suddenly a man at the rear stood up and started shouting something like this: “I'm so sick of all you establishment researchers thinking you know so much and ignoring my work. I have discovered the cause and cure for depression in my laboratory. (He claimed it was some kind of vitamin deficiency.) But everyone is ignoring my work (and more ranting and raving.) There was a chilled silence in the room. Here's how I responded: “I appreciate was you're saying, and I agree. I think our current focus on deficiencies in brain serotonin is extremely misguided, and predict, as you say, that research will show that the chemical imbalance theory of depression is not valid. And often, the most important breakthroughs come from laboratories like yours, where someone who is unknown discovers the actual cause of an illness after being ignored for years and years. I'd be honored if you'd approach me at the end of my talk so I can learn more about your pioneering research!” Notice I did not defend myself, but tried to make HIM feel good. At the end of my talk, about 20 or more people came crowding up to the podium with questions and such. I saw him at the back of the group, pushing his way to the front. I braced for another attack. He said, “Dr. Burns, that was the best presentation I've ever heard by far on the serotonin theory of depression. If you would give me permission, I would love to show your slides to my students and colleagues!” I have very little fear of being attacked by people in the audience, and I now speak all the time in front of groups. I used to have paralyzing public speaking anxiety. But the monsters I feared were all in my brain! Warmly, david   Andrew asks 8 cool questions! (#3 - #10) which are listed below, along with my answers. Jason Meno also sent some awesome answers, which you'll find below as well, right after my answers to the 8 questions.  

 FROZEN: Part 2 of 2 Featuring Personal Work with Cody Today, you will hear the exciting conclusion of the work that Jill and David did with Cody, a young man who sometimes freezes in social situations due to feelings of anxiety. He actually froze up when Jill and David were working with him in part 1 last week. What will they do? Tune in today and you'll find out! Before I describe Cody's session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements. For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at Intensive Information / Registration The online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year! But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree! In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. 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. Beginning of Part 2 with Cody You will hear some of the tools that seemed especially helpful, including Self-Disclosure Positive Reframing, not only for his negative feelings but also for his freezing Identify and Explain the Distortions Externalization of Voices with Acceptance Paradox the Feared Fantasy the Experimental Technique And more. Whether you are a shrink or general citizen, I think there might be a lot for you to learn from Cody, not only about techniques to treat social anxiety and feelings of inadequacy, but also about enlightenment as well. ‘ That's because the goals of a TEAM-CBT session are not just the reduction of negative feelings, but the complete obliteration of negative feelings, along with jumping on a psychic trampoline that catapults you into a state of profound self-acceptance and enlightenment. At least, that's my take on it! Did it really happen? Here's how Cody was feeling at the start of the session, along with his goals for each feeling at the end of Positive Reframing, and his feelings at the end of the session. As you can see, all of his negative feelings went to zero. Emotions % Before % Goal % After Sad, blue, depressed, down, unhappy 40 10 0 Anxious, worried, panicky, nervous, frightened 95 15 0 Guilty, remorseful, bad, ashamed 20 5 0 Inferior, worthless, inadequate, defective, incompetent 40 10 0 Lonely, unloved, unwanted, rejected, alone, abandoned 50 10 0 Embarrassed, foolish, humiliated, self-conscious 100 30 0 Hopeless, discouraged, pessimistic, despairing 50 15 0 Frustrated, stuck, thwarted, defeated 50 15 0 Angry, mad, resentful, annoyed, irritated, upset, furious 30 5 0 Confused 60 10 0   What explains these seemingly impossible changes in a single therapy session? And are they real, or is this all just a bunch of hype? Stay tuned and let us know what you think at the end! Early, I had a challenging exercise to do on Cody's SDBa. Here's the solution. To my way of thinking, Cody's Downward Arrow chain of thoughts suggest a number of related Self-Defeating Beliefs, including: Perfectionism: I should always try to be perfect. Perceived Perfectionism: Others will not love and accept me if they see that I'm flawed or if I screw up. I must earn the respect of others. Approval Addiction: I need everyone's approval to be worthwhile. Achievement Addiction: My worthwhileness and capacity for happiness are based on my intelligence, achievements, and productivity. Fear of Rejection. Being rejected and alone would be devastating. Worthlessness Schema (possibly): I'm not inherently lovable, likeable, or worthwhile. Mistrust Schema (possibly): Other people are unsafe or predatory, and powerful, and eager to judge or hurt me. (David: this is a new one similar to Perceived Perfectionism, but this belief puts more of a negative twist on the perception of inherent malevolence in others.) You always have to be the patient's point of view about the SDBs, so these are just my guesses. End of Session Thanks so much for listening, and a big hug for Cody for sharing his inner self with all of us! To me, this is the best teaching because it is real, and you can see what the shrinks REALLY do behind closed doors. You also get to see shrinks as struggling, vulnerable, and imperfect human beings, just like yourself! Cody, Rhonda, Jill, and David

FROZEN: Part 1 of 2 Featuring Personal Work with Cody In today's, and next week's, podcasts. we present the next episode of live work with Cody. The first, which featured Rejection Practice for social anxiety, was published as Podcast #326 on January 9, 2023 at this LINK. My co-therapist for this session was the wonderful Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mt. View, California (LINK.). Before I describe Cody's session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements. For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at Intensive Information / Registration The online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year! But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree! In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. 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. Now, back to the podcast, in which you'll hear some additional TEAM-CBT magic. Cody asked for help with a problem that's been bugging him for some time. He sometimes freezes up when asked to do a role play or answer a question during psychotherapy training sessions. This typically leads to an awkward silence, and feelings of intense anxiety, inadequacy, frustration, embarrassment and more. Here's how he described it: Upsetting event: I was doing a suicide screening role-play with our clinical supervisor and other therapists. After working through the first step of the role-play, I froze and did not say a word! Here's how Cody was feeling. Emotions % Before % Goal % After Sad, blue, depressed, down, unhappy 40     Anxious, worried, panicky, nervous, frightened 95     Guilty, remorseful, bad, ashamed 20     Inferior, worthless, inadequate, defective, incompetent 40     Lonely, unloved, unwanted, rejected, alone, abandoned 50     Embarrassed, foolish, humiliated, self-conscious 100     Hopeless, discouraged, pessimistic, despairing 50     Frustrated, stuck, thwarted, defeated 50     Angry, mad, resentful, annoyed, irritated, upset, furious 30     Confused 60       As you can see and might imagine, the most intense feelings were anxiety and embarrassment, but several other feelings were fairly intense as well: such as feeling alone, discouraged, frustrated, and confused. These were some of his negative thoughts on the Dailly Mood Log that he brought to the session, and the percent he believed each one. Thought 5a, b, and c are an Individual Downward Arrow series, designed to get at the Self-Defeating Beliefs underneath the Negative Thoughts. What do you think Cody's SDBs are? Take a guess, and then you can look up the answers, or at least my own thinking, at the end of the show notes. Negative Thoughts % Belief 1. I shouldn't have screwed up. 80 2. I'm not good enough. 80 3. I don't belong here/I shouldn't be here. 50 4. Something is wrong with me (my brain) 100 5a. Everyone thinks I'm an idiot        ↓ 100 5b. I should not be in this ↓profession  ↓ 70 5c. I failed to find something I'm good at. ↓ 70 6. I'm worthless 60   Although freezing in social situations is fairly common, it can be incredibly challenging and painful for those who experience it. Cody said: Sometimes they try to help, or may switch to someone else. It sucks, and everyone feels awkward. The hangover can last a few hours or a day, and keeps me up at night. Over time, some emotions get worse, especially the feelings of depression and inferiority. I asked if there was also some hidden anger behind his anxiety when called on to perform in a group setting. He said, Definitely. I feel irritated if I didn't sleep that well the night before. My heart may not be into it 100%. I sometimes feel forced into it (performing), and just don't want to be put on the spot. . . What makes it bad is the belief that everyone is looking at me and the belief that I'm being evaluated. One of the most challenging and exciting events in the work with our courageous Cody was when he actually froze during the session! This gave us the chance to demonstrate and apply in real time. As you know, TEAM is extremely rich in specific methods to help patients within and between therapy sessions. What would be YOUR approach to helping Cody? Or, if you also struggle at times with social anxiety SDB, what is your prescription for yourself? As usual, Jill and I went through the T, E, A, M. sequence in our session with Cody, which, of course, is highly and totally individualized for every person we work with. In today's podcast, you will hear the T = Testing and E - Empathy portions of the session. Next week, you will hear the A = Assessment of Resistance and M = Methods portions of the session. You might be curious to find out which techniques we used, and what approach was the most effective. So tune inn next week to find out! End of Part 1 Some of the tools that seemed especially helpful included Self-Disclosure Positive Reframing, not only for his negative feelings but also for his freezing Identify and Explain the Distortions Externalization of Voices with Acceptance Paradox the Feared Fantasy the Experimental Technique And more. Whether you are a shrink or general citizen, I think there might be a lot for you to learn from Cody, not only about techniques to treat social anxiety and feelings of inadequacy, but also about enlightenment as well. ‘ That's because the goals of a TEAM-CBT session are not just the reduction of negative feelings, but the complete obliteration of negative feelings, along with jumping on a psychic trampoline that catapults you into a state of profound self-acceptance and enlightenment. At least, that's my take on it! Did it really happen? Here's how Cody was feeling at the start of the session, along with his goals for each feeling at the end of Positive Reframing, and his feelings at the end of the session. As you can see, all of his negative feelings went to zero. Emotions % Before % Goal % After Sad, blue, depressed, down, unhappy 40 10 0 Anxious, worried, panicky, nervous, frightened 95 15 0 Guilty, remorseful, bad, ashamed 20 5 0 Inferior, worthless, inadequate, defective, incompetent 40 10 0 Lonely, unloved, unwanted, rejected, alone, abandoned 50 10 0 Embarrassed, foolish, humiliated, self-conscious 100 30 0 Hopeless, discouraged, pessimistic, despairing 50 15 0 Frustrated, stuck, thwarted, defeated 50 15 0 Angry, mad, resentful, annoyed, irritated, upset, furious 30 5 0 Confused 60 10 0   What explains these seemingly impossible changes in a single therapy session? And are they real, or is this all just a bunch of hype? Stay tuned and let us know what you think at the end! Early, I had a challenging exercise to do on Cody's SDBa. Here's the solution. To my way of thinking, Cody's Downward Arrow chain of thoughts suggest a number of related Self-Defeating Beliefs, including: Perfectionism: I should always try to be perfect. Perceived Perfectionism: Others will not love and accept me if they see that I'm flawed or if I screw up. I must earn the respect of others. Approval Addiction: I need everyone's approval to be worthwhile. Achievement Addiction: My worthwhileness and capacity for happiness are based on my intelligence, achievements, and productivity. Fear of Rejection. Being rejected and alone would be devastating. Worthlessness Schema (possibly): I'm not inherently lovable, likeable, or worthwhile. Mistrust Schema (possibly): Other people are unsafe or predatory, and powerful, and eager to judge or hurt me. (David: this is a new one similar to Perceived Perfectionism, but this belief puts more of a negative twist on the perception of inherent malevolence in others.) You always have to be the patient's point of view about the SDBs, so these are just my guesses. End of Session Thanks so much for listening, and a big hug for Cody for sharing his inner self with all of us! To me, this is the best teaching because it is real, and you can see what the shrinks REALLY do behind closed doors. You also get to see shrinks as struggling, vulnerable, and imperfect human beings, just like yourself! Cody, Rhonda, Jill, and David

With spending against governmentwide acquisition contracts reaching an all-time high in fiscal 2023, the Office of Federal Procurement Policy is pushing agencies to make changes to ensure a healthy amount of small businesses participate on these vehicles.In a new memo from OFPP, the Biden administration is telling agencies to take specific steps like on-ramps, applying the “rule of two” and even not using a “best-in-class” contracts should they be detrimental to small firms, when managing or buying from a multiple award contract.“This guidance takes an important step in ensuring our diverse base of small businesses have opportunities in a greater diversity of acquisition strategies,” said Small Business Administration Administrator Isabel Casillas Guzman in a blog posted by the Office of Management and Budget today. “By taking advantage of the strategies in this guidance, the federal government will be able to increase the number of small business firms in the federal supplier base and increase contracting opportunities for small disadvantaged businesses (SDBs).” Learn more about your ad choices. Visit podcastchoices.com/adchoicesSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

With spending against governmentwide acquisition contracts reaching an all-time high in fiscal 2023, the Office of Federal Procurement Policy is pushing agencies to make changes to ensure a healthy amount of small businesses participate on these vehicles. In a new memo from OFPP, the Biden administration is telling agencies to take specific steps like on-ramps, applying the “rule of two” and even not using a “best-in-class” contracts should they be detrimental to small firms, when managing or buying from a multiple award contract. “This guidance takes an important step in ensuring our diverse base of small businesses have opportunities in a greater diversity of acquisition strategies,” said Small Business Administration Administrator Isabel Casillas Guzman in a blog posted by the Office of Management and Budget today. “By taking advantage of the strategies in this guidance, the federal government will be able to increase the number of small business firms in the federal supplier base and increase contracting opportunities for small disadvantaged businesses (SDBs).” Learn more about your ad choices. Visit megaphone.fm/adchoices

TEAM-CBT Celebrates Diversity Today's featured image is Sean Williams, co-founder of the BAD Group Rhonda starts today's podcast with a terrific endorsement from Steve, from England. He really liked Feeling Great, and said he benefited from the personal work with Dr. Mark Taslimi that we published as the first live therapy on the Feeling Good Podcasts (see podcasts 29-25 and 141.) Steve wrote that the live work, and the teaching points that Dr. Jill Levitt and I made during the podcasts to explain our strategies, is the best learning by far. Rhonda and I strongly agree, and I feel fortunate to have been able to publish many additional live TEAM-CBT sessions since that time. It is my hope that some day these live therapy podcasts will be used in teaching graduate psychology classes so that future practitioners can pick up where we left off and benefit from the rapid treatment techniques we've developed. Today we interview Amber Warner, LCSW, Sean Williams, LCSW and Chelsea Dorcich, MFT. Amber is a Level 3 certified TEAM therapist, living and working in Lake County, where she provides mental health care in a rural community. She has a private practice that includes a virtual practice for anyone in the State of California. Amber has been a member of our Tuesday TEAM-CBT group for the past year. Chelsea is also a Level 3 Certified TEAM therapist with a private practice for anyone in the State of California. Both Chelsea and Amber work at the Feeling Good Institute in Mountain View, California. Sean is a Licensed Clinical Social Worker and also Level 3 TEAM-CBT therapist and co-founder of the TEAM CBT Clinicians of BAD, for Black African Descendants, along with Amber and Chelsea. He is a long-time and beloved member of the Tuesday training group at Stanford. He currently resides in Colorado and works for the Ohio State University where he works with active duty and retired soldiers regarding their PTSD suicidal ideation and trauma. He treats patients and also supports the Ohio State University's research. He also has a part-time private practice for people who live in Indiana. Amber got our podcast going by saying: “My introduction to TEAM-CBT was in 2017, while at a Sunday workshop about 1 1/2 years ago. I'd been struggling with grief after accidently finding out my employer had hired others at a higher salary, so I started a Daily Mood Log and did a downward arrow (this is an uncovering technique) using one of my negative thought. I discovered that my Self-Defeating Belief (SDB) was not included in David's list of 23 common SDBs. “I felt like all the weight of the world was on my shoulders because my employer had hired white people with less experience at higher salaries. I asked myself what I was going to do. “Do I care to stand up for myself? It felt like a heavy dilemma. I decided to face my fear and talk it over with my employer. It took some time, but things eventually turned out in my favor.” Way to go, Amber! Amber mentioned that Philip Lolonis, LCSW, a member of our TEAM-CBT community, urged us to create and teach an introductory TEAM-CBT course for African-American clinicians in 2021. Amber reached out to Sean and Chelsea and asked if they'd be interested in creating a “Clinicians of Color” group on Facebook. And that got the ball rolling. Rhonda asked, “What kinds of challenges have you faced?” Sean said that one barrier was the whole process of getting licensed. It requires a lot of time and money, nearly always meaning large loans and years of training. One goal of their group is to assist interested people through from initial training through the licensing clinicians, as well as introduce TEAM therapy to the larger therapeutic community. There are very few Black mental health professionals within the TEAM community. Amber explained that one of their goals is to provide support and encouragement to young Black men and women who might want to enter the counseling profession by attending medical school, or a doctoral or graduate school in counseling or psychology, or obtaining a certified coaching diploma. Amber also stated that TEAM-CBT has made a powerful impact on her, Chelsea and Sean, so they formed an affinity group, TEAM CBT Clinicians of B.A.D. Their primary goal is to support and encourage clinicians of color to learn and practice TEAM-CBT and explore culturally responsive methods to enhance the therapeutic alliance and improve treatment outcomes. Sean explained that he was introduced to TEAM and David's work around the year 2000. He was looking at books in the self-help section of a Barnes and Nobles bookstore, but most of them were too expensive. He said, “Most of them were too expensive, but then I saw Feeling Good lying on a table, and it was only $8.95, so I purchased it and read about the list of cognitive distortions that David had created. That book changed my world view and changed me as a clinician. I realized that I really wanted to disseminate this information to clinicians of color.” Sean explains why he resonated with Feeling Good: “Many of the cognitive theoretical principles were extremely empowering to me. In “Feeling Good” there was a diagram of a man where it demonstrated how human beings process their experiences through thoughts, beliefs and assumptions. The whole idea of my thoughts impacting my emotions and behaviors was mind blowing to me and still is. It made me recollect on all my past struggles such as relationship break ups, job losses, public speaking anxiety, and so forth, and my reactions towards those situations unbeknownst to me at the time were primarily based on my thoughts about those events. I believe that it's important that all people have access to these powerful therapeutic interventions regardless of race, ethnicity or culture. The reason why it's important to disseminate these powerful tools to people of color is because people of color are reporting high rates of psychological distress but are less likely to get treated for it. “According to webmd.com ‘…African Americans are more likely to report feelings of sadness, hopelessness, and worthlessness than are adult whites. Still, in 2018, 18.6% of white Americans received mental health services, compared to less than 9% of African Americans.' “I think TEAM-CBT can even help alleviate suffering related to racial stress. Although racism is a non-distorted reality the concepts in “Feeling Good” and the whole TEAM framework can orient a person to adopt the healthiest possible perspective when moving through those realities.” Chelsea said she learned about TEAM-CBT when she moved to the Bay Area in 2017. She says, "I also found that TEAM was a roadmap and a blessing. I could really connect. This is an amazing framework for everybody!” We also discussed one pitfall that some clinicians fall into. The idea that our thoughts, and not events, create all of our feelings can be liberating. But it can also be used to invalidate genuine, healthy anger. Racial bias and cruelty are real. "They are NOT cognitive distortions," she says. "Racial bias is very real. But TEAM-CBT can free us from the inner prison of depression and anxiety and self-doubt that results from distorted perceptions. Of course, sometimes perceptions are totally valid, and sometimes it's time to fight and stand up for what's right." David added that "We had to do a lot of fighting and protesting in the 1970s, when the Viet Nam war was waging, and the forces of darkness were powerful and destructive. Now, it seems, we have many more battles to fight, and we are lucky to have crusaders like Chelsea, Amber, and Sean. "Thank you for what you are doing!" Thank you all for listening today. Chelsea, Amber, Sean, Rhonda, and David Following the show, Sean kindly emailed me with some information addressing some of my questions about black people and the mental health system in the United States. He wrote: Although I was super anxious, I really enjoyed doing the podcast with you two. I used the “Dare to be Average” principles in Feeling Good to help me relax and it worked! Here's a few additional notes about black people and our mental health system. I hope it helps! Insights into Diversity By Sean Williams, LCSW Why is it important to disseminate TEAM-CBT to people of color? Data from the American Psychiatric Association (APA) shows that only 2 percent of the estimated 41,000 psychiatrists in the U.S. are Black, and just 4 percent of psychologists are Black. On college campuses, close to 61 percent of counseling center staff are White, and 13 percent are Black, according to a 2020 Association for University and College Counseling Center Directors survey. he shortage of psychiatrists and counselors of color has severe implications for all Black individuals needing treatment. A 2019 survey by the Substance Abuse and Mental Health Services Administration (SAMHSA) found nearly 5 million, or 16 percent, of Black Americans reported having a mental illness. However, only one in three Black adults who needs mental health care receives it. Because of the scarcity of mental health professionals of color, it can be difficult for Black Americans to find a practitioner with whom they feel comfortable enough to share any race-related trauma. One 2016 study in the Journal of Black Psychology found that African American therapists and their patients often had relationships marked by a “distinct sense of solidarity … as evidenced by having a better understanding of the context of Black clients' lives. For more information, see https://www.insightintodiversity.com/addressing-the-lack-of-black-mental-health-professionals/

284: Ask David, Featuring Matt May, MD Defeating your Self-Defeating Beliefs. Help with fear. Dealing with people who gossip. Today, Rhonda, Matt and David answer three challenging questions submitted by fans like you. Caroline asks: I've done Cost Benefit Analyses (CBAs) for many of my SDBs (Self-Defeating Beliefs), and the disadvantages greatly outweigh the advantages? What's the next step? Al asks: Can you help me with fear? Khoi asks: How do you deal with colleagues who gossip about your boss? Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1: Caroline asks: I've done Cost Benefit Analyses (CBAs) for many of my SDBs (Self-Defeating Beliefs), and the disadvantages greatly outweigh the advantages? What's the next step? Hi David I finally got all the CBAs from my Self-Defeating Beliefs done. I have a ton of them. I also did a CBA on Self-acceptance and a CBA on Self-Criticism. I found out, that the disadvantages of my Self-Defeating Beliefs are massively higher than the advantages. Only with Self-Acceptance the Advantages were much higher than the Disadvantages. Now that I have got all these CBAs done, what do I do with my findings? Do I rewrite my Self-Defeating Belief into something more realistic or lets say, into something with acceptance? Thanks for your help! Many greetings Caroline David's reply Great work. Yes, you can, as a first step, or next step, rewrite each belief so the disadvantages disappear, and you get to keep the advantages. This will be different for each person, and it is called the Semantic Technique, but here is an example: SDB: Achievement Addiction: My worthwhileness depends on my productivity and achievements. Revised version: I can enjoy working hard and being productive, but my “worthwhileness” as a human being does not depend on my successes, failures, or hard work. There are many things in life I can love and enjoy. It isn't just all about achievement and productivity. I can learn from failures and mistakes. They make me more “human,” and not “worthless” or even “less worthwhile.” In fact, I have no desire or need to be “worthwhile.” It's a nonsensical, meaningless concept. People don't much care about how “worthwhile” I am. They care about how I treat them! That's just an example of how I deal with this particular belief. Giving up the “Achievement Addiction” actually helps me achieve more, because the pressure and the anxiety is gone. But I still enjoy working and creating stuff! Another dimension has to do with giving up the habit of beating up on yourself. We are talking about depression and inadequacy here. It touches also on anxiety, but anxiety can have other SDBs as well. d 2: Al asks: Can you help me with fear? Dr Burns, I need help with fear. Can you send me podcasts dealing with that subject? Thank you very much. David's reply Tell me which of the many already published, and available via search function on my website, you have already listened to? And how much of my book, When Panic Attacks, have you read? May make this an Ask David, since it seems lots of folks are not using the massive free resources I've already developed. Have you take the free anxiety test and course on my website, feelinggood.com? The free anxiety course is, in fact, a compilation of some of the best podcasts on fear. david 3: Khoi asks: How do you deal with people who gossip about your boss? Hello Dr Burns, Thanks for your time to write so many great books and creating this podcast. I am from Vietnam and know about you and your book thanks to the publisher to translate into Vietnamese. When I read your book, it is very simple fact but very true at the same time. I wonder how can I not know about your book earlier? Actually, I read a lot of self-help books but I find most would say about what should I become or be, but don't really show me how to do it. As you said, the idea I feel because I thought is not new, but I don't know how to change my thought and beliefs after reading these books. Your books show me simple techniques but very useful and effective. And I really like your 5 Secrets of Effective Communication, especially these podcasts, because it helps me understand more clearly. One difficult situation that I don't know how to apply, is when somebody attacks somebody else, not me. For example, my colleague criticizes my boss (behind his back) via email message or face to face with me. I am afraid if I agree with her, my boss might think I talked behind his back too. So, should I just keep silent for this case because she does not attack me? Another situation is when 2 people attack each other, like 2 of my staff argue with each other, and I cannot agree with one side because it will make the others get mad with me. Do you have any advice on this? Thanks Dr Burns. David's reply Good question, and I will include in an Ask David, if that is okay. My short answer is that in most situations, and especially in a business environment, I do not try to "help" other people who are arguing or not getting along. That is simply asking for trouble and push back. When someone is bad mouthing another person, you can possibly use Feeling Empathy and say "it sounds like you're pretty unhappy with person X, and I know that can be uncomfortable when you're not getting along with someone," or some such general comment. Then you could distract the person with some Stroking, like "I really admired your report at the company meeting," or some such thing. We can check with Rhonda and Matt and see what they think on the live podcast. In a personal situation, you could use an "I Feel" situation, like "I actually get along with person X, but of course we all have our flaws, or some such thing. But in a work environment, I think you are right that it is important to play it safe and to be thoughtful about interactions with colleagues! So, I commend you on your excellent questions, even though I might not yet have the best answer for you! David  Rhonda, Matt, and David

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

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

How to Change a Self-Defeating Belief (SDB) Many of you have expressed an interest in my free Tuesday training group for mental health professionals. Today, you can attend, thanks to the generosity of our group in allowing the group to be recorded on Zoom, and thanks Zeina, the group member who courageously volunteered to have us work on her “Achievement Addiction.” I also want to thank my beloved and brilliant co-teacher, Dr. Jill Levitt, who always adds tremendously to our group, on so many different levels. Last week, we taught the group members how to pinpoint Self-Defeating Beliefs that trigger depression and anxiety, and we promised to show them how to challenge and modify a Self-Defeating Belief in the group you’re about to “attend.” We decided to focus on the Achievement Addiction, which is the belief that your worthwhileness as a human being depends on your achievements and productivity. Perhaps you share this belief! Most people do. Here’s how a Self-Defeating Belief works. Let’s say that you base your self-esteem on your achievements. As long as you think you’re achieving and being successful, we would predict that you’ll feel happy and contented. But we would also predict that you may experience episodes of depression, anxiety, and self-doubt when you fail or fall short of your goals and expectations. That’s when you’ll be most likely to start beating up on yourself with distorted negative thoughts, like “I’m a loser,” or “I shouldn’t have screwed up,” or “I’m not good enough.” So, in short, the combination of an SDB (“My worthwhileness is based on my achievements”) plus a negative event, like a perceived failure, triggers distorted thoughts (like “I’m a failure” or “loser”) which trigger negative feelings, like depression, anxiety, shame, inferiority, or even suicidal thoughts. In addition, cognitive therapists believe that if you modify the SDB, it will not only help you in the here-and-now, but it can also make you less vulnerable to painful mood swings in the future. But how in the world can you do that? If you like, take a look at the list of 23 common Self-Defeating Beliefs and see if you can find any of yours! Zeina said she wanted help with her tendency to base her feelings of happiness and self-esteem on her accomplishments. In the group, we demonstrated four techniques for changing this or any SDB, including: The Cost-Benefit Analysis.  You list the advantages and disadvantages of the belief you want to change. You can find the one we worked on with Zeina during the group if you click this link. If you want a blank one you can work with, you can find one on page 2 of this link. The Semantic Technique. This involves change at the intellectual level. if the SDB is not working to your advantage, could you modify it so you can keep all the advantages you listed while getting rid of most if not all of the disadvantages. This is a bit of practical personal philosophy exercise with significant emotional implications. The Feared Fantasy. Here's where change at the gut level begins, and you also can begin to challenge the idea that high achievers really are more worthwhile. The Double Standard Technique. Here's where change at the gut level continues, and you can hear a beautiful example in Zeina's dramatic interaction with Dr. Levitt. In today's part 1 podcast, we completed the Cost-Benefit Analysis. I would urge you to do your own CBA while you're listening. When you're done, balance the advantages against the disadvantages on a 100 point scale. Put two numbers in the circles at the bottom to show whether the advantages or disadvantages are greater. For example, if the advantages of this belief greatly outweigh the disadvantages, you might put 80 - 20 in the two circles. If the advantages and disadvantages of this belief are about equal, you can put 50 - 50 in the two circles. And if the disadvantages are somewhat greater, you might put 45 - 55 in the two circles. When you do your own weightings, please note that the number advantages or disadvantages is not important--that's because one advantages could outweigh several disadvantages, and vice versa. Instead, look at the lists as a whole and ask yourself how they feel, and how this belief is working for you. In addition--and this is super important--remember that you are NOT evaluation the advantages and disadvantages of achievement. There probably aren't any disadvantages of achievement! Instead, you are evaluating the advantages and disadvantages of basing your self-esteem and feelings of worthwhileness on your achievements and productivity. At the end of the group work with the CBA, I emphasize that the goal of the CBA is simply to find out if you (or in this case Zeina) want to change your SDB. This is a motivational question. If the advantages and disadvantages are about equal (50 - 50), or if the advantages out weight the disadvantages (eg 60 - 40), then there may be no reason to change the belief. But when the disadvantages outweigh the advantages, you can then change the belief so that all the disadvantages diminish or disappear entirely, while at the same time you keep all the advantages. That sounds like a pretty good deal! In next week's podcast, you'll learn how to make this happen with the help of the Semantic Technique, Feared Fantasy, and Double Standard Technique! There are a great many additional techniques for challenging and modifying any SDB as well. The four I listed above are just a kind of “Starter Kit” for SDBs to give you a feel for how some of the techniques work. If you like this podcast, we may focus on other SDBs as well, such as the Approval Addiction, the Love Addiction, and more. Let us know if you’d be interested, and which beliefs interest you the most. We’ve already done a podcast on perfectionism, as well as a popular Live TV program on perfectionism on Facebook that features Jill and me, but there are tons of beliefs we haven’t yet addressed. To make today’s podcast more dynamic, you can do your own Cost-Benefit Analysis while you watch, and make sure you do your own weightings at the bottom, just like the therapists in our Tuesday training group. I think you’ll enjoy it, and it might nudge your thinking a little, too! Please let me know if you've enjoyed "eavesdropping" on my Tuesday training group, and if you'd like more Feeling Good Podcasts like this in the future. Let me know, too, if you'd have an interest in attending a weekly TEAM therapy training group for therapists or for the general public. My new book Feeling Great, is now available on Amazon (see the link below) as a hardbound volume or as an eBook. It features all the new TEAM therapy techniques, and is geared for therapists as well as the general public. Rhonda and David

Weekly News update of Salesian life and work among the young in South Asia. This episode highlights Covid-19 relief, 3 SDBs infected, DB University, FM Radio UNICEF project . Brought to you by Salesian TV and Bosco Information Services, South Asia. www.donboscosouthasia.org

Audio of my talk given at the first Diffractions/Sdbs workshop on Patchwork. My thesis is that rigorous (voluntary) enforcement of honesty using blockchain + IoT (Internet of Things) presents an opportunity for leftists to solve the game-theoretic problems of communism in a potentially scalable way. I got flak for this being "fascist," which led me to write a short extension and clarification entitled, Fascism Over Yourself Is Called Autonomy.  You can read the transcript of this podcast here. Diffractions Collective: https://www.diffractionscollective.org SDBS: https://sdbs.cz If you'd like to discuss this podcast with me and others, suggest future guests, or read/watch/listen to more content on these themes, request an invitation here. Big thanks to all the patrons who help me keep the lights on This conversation was first recorded on September 22, 2018 as a livestream on Youtube. To receive notifications when future livestreams begin, subscribe to my channel with one click, then click the little bell.

How can you get rid of Self-Defeating Beliefs? Although any of the 100 + TEAM-CBT methods can be used to modify an SDB, four methods will be highlighted in today's show. Cost-Benefit Analysis Semantic Method Experimental Technique Feared Fantasy For more information on how to change SDBs, you might want to watch the extremely popular David and Jill  FB Live show on Overcoming Perfectionism (recorded on November 11, 2018). What research has been done on SDBs? This topic was not discussed in the show, but individuals with an interest in research might want to read David’s study with Dr. Jackie Persons on the causal connections between depression and SDBs about dependency (attachment) as well as achievement (perfectionism) in several hundred patients in Philadelphia during the first 12 weeks of their treatment at David’s clinic. The study confirmed That both types of SBS were significantly correlated with depression severity at intake and at the 12-week evaluation. In addition, changes in depression were correlated with changes in SDBs. However, a sophisticated statistical analysis with structural equation modeling techniques did not confirm that SDBs had causal effects on depression, or that depression had causal effects on SDBs. Instead, SDBs and feelings of depression appeared to share an unknown common cause. Persons, J. B., Burns, D. D., Perloff, J. M., & Miranda, J. (1993). Relationships between symptoms of depression and anxiety and dysfunctional beliefs about achievement and attachment. Journal of Abnormal Psychology, 101(4): 518 - 524.  

Rajesh asked: Is it possible to change an SDB? Does the mere knowledge of an SDB change it? How long does it take to change an SDB? How do you change SDBs? Nikola asked: Aaron Beck said the SDBs never really go away. They just get activated and deactivated and activated again. Does this mean that depression is an incurable disease that will keep coming back over and over again? What’s the point in battling against a core belief if it cannot be changed? Fabrice and I appreciate your questions--they often give us ideas for shows! In today’s Podcast you'll learn the answers to several questions about Self-Defeating Beliefs. What’s the difference between Self-Defeating Beliefs (SDBs) vs. Cognitive Distortions? The thoughts that contain cognitive distortions, such as All-or-Nothing Thinking, Overgeneralization, Discounting the Positive, and Self-Blame are distortions of reality, they are the cons that trigger depression and anxiety. When you're upset, these thoughts will flood your mind. These thoughts can be show to be false, and when you crush a distorted negative thought, you'll immediately feel better. Self-Defeating Beliefs are stipulations, values that you've set up for your self. For example, you may base your self-esteem on your accomplishments due to your belief that people who accomplish more are more worthwhile as human beings. SDBs like this cannot actually be shown to be false--they are simply your personal, subjective values, and they are thought to be with you all the time, and not just when you're depressed, anxious, or angry. The question with an SDB is this: What are the advantages and disadvantages of having this value system? How will it help me--what are the benefits--and how might it hurt me? What's the downside? Why are Self-Defeating Beliefs thought to be important? When you challenge and defeat a distorted thought, you feel better in the here-and-now. When you challenge and change an SDB, you change your value system at a deep level. This is thought to make you less vulnerable to painful mood swings and relationship conflicts in the future. What are the different kinds of SDBs? David’s list of 23 Common SDBs is attached. This list is not comprehensive, as there are many more, but the ones on the list are very common. There are several categories of SDBs. Individual SDBs are often “Self-Esteem Equations” Perfectionism Perceived Perfectionism Achievement Addiction Approval Addiction Love Addiction Interpersonal SDBs are expectations of what will happen in certain kinds of relationships, or relationships in general What’s your understanding of the other person’s role in your relationship? What adjectives describe him or her? What’s your understanding of your person’s role in the relationship? What adjectives describe you? How would that kind of relationship feel? What rules connect the two roles? Other kinds of SDBs Anger / conflict cluster Entitlement Truth Blame Anxiety cluster Niceness Conflict Phobia Anger Phobia Emotophobia Submissiveness Spotlight Fallacy Brushfire Fallacy How can you identify your own, or a patient’s, Self-Defeating Beliefs? Look at the list of 23 individual SDBs (easiest). You might want to do that right now. Review the list, and you'll probably find many of your own beliefs! Individual Downward Arrow Interpersonal Downward Arrow  

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.

One Voice... www.VSBAOnline.com | Lack of access to capital and credit opportunities is one of the key factors in gauging if one is economically disadvantaged. When coupled with social disadvantage it is a measure of how effectively one can compete in the free enterprise system. Can 8(a) Certification really help small SDBs become competitive through access to capital and credit? In this episode, we will discuss this topic and much more! Hope you can join us.

The future US Air Force's backbone consists of one fighter aircraft and one bomber: the F22 Raptor and the B2 Spirit. F22 Raptor: Set to replace the F117 Nighthawk and the F15 Eagle, this $350 million stealth fighter aircraft is the ultimate air superiority weapon. In addition to carrying a significant amount of air-to-air missiles (ex. AIM-120 and AIM-9), the F22 can travel at Mach 2.42 into enemy airspace without being detected. Also, its radar will allow it to see all enemies way before the enemies suspect anything. The radar also has the ability to jam an enemy aircraft's systems, while the computer can easily link up with an allied F22s computer. When it comes to precision ground strikes, the F22 relies on its JDAMs and SDBs.B2 Spirit: At $2 billion each, the B2 is worth more than twice its weight in solid gold. Though it is slow, it can go anywhere in the world with only one in-flight refueling. Its greatest feature, however, is its boomerang flying wing design which allows it to have a radar signature equivalent to that of a small bird. But just because it is stealthy does not mean that it cannot carry a huge payload. In fact, it can carry 80 "dumb bombs", 36 cluster bombs, 16 "smart bombs", and 16 nuclear bombs. Also, it can drop 16 different bombs at 16 different targets simultaneously.For more information, read:USAF Fast Facts by Trident Press Internationalwww.f22fighter.comHow Stealth Works in the B2Military History Podcast is sponsored by Armchair General Magazine