Podcasts about team cbt

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

I'm angry! A Once-UndocumentedImmigrant Speaks from the Heart-- Live Work with Sunny, Part 2 Last week you heard Part 1 of the Live work with Sunny, who's struggling with radically conflicting emotions. On the one hand, he has finally achieved his dream of an incredibly happy and fulfilling life, but he is frequently plunged into profound despair, fear, and anger because of the increasingly adverse political climate for people who are “different”—in gender identity, sexual orientation, nationality, political beliefs, skin color, and more. And he is shocked, fearful, and angered by the mean-spirited treatment so many are receiving—and which Sunny has endured throughout much of his life as well. Today, you will hear about how we set the A = agenda for our session with Sunny, along with the M = Methods we used. You can find Sunny's goals for each negative feeling at the end of the Positive Reframing, and at the end of M = Methods, if you Click here His scores on the Empathy and Helpfulness Scales in the Evaluation of Therapy Session were perfect. Here are some of the take-home lessons from this session with Sunny. 1.  Unhealthy negative feelings result from distorted negative thoughts, like “I'll be miserable forever.” Healthy negative feelings, in contrast, result from thoughts that are realistic and, for the most part, undistorted. Healthy negative feelings do not usually require any kind of “treatment,” but skillful empathic listening and support will nearly always be appreciated. 2.  Empathy can be very powerful, and it is absolutely necessary for a meaningful therapeutic relationship, but empathy alone is not enough to change the way someone feels. 3.  Finding compassion for someone who has harmed you, while extremely challenging, can also bring you peace. 4.  Emotions such as anger, sadness, and anxiety are important protective instincts. And one can feel these emotions and be compassionate and loving at the same time. 5.  As a therapist it can be tempting to either assume that you can't help a patient because their feelings are “normal,” or to try to cheerlead or problem-solve for a patient to cheer them up, but the TEAM-CBT model allows us to collaborate with the patient, understand when and how they want to change, honor their resistance to change, and offer them the tools they need to change in a way that honors their values. Thank you so much for listening and joining us. Rhonda, Jill and I are deeply indebted to you, Sunny, for your courage and vulnerability last week and today, letting us into your world on such a personal level. We love you and will always be grateful to have you in our lives, both professionally and personally! Sunny, Rhonda, Jill, and David

Ask David: The Awesome Hidden Emotion Technique Featuring Matthew May, MD with Rhonda and David The following answers to Ask David questions were written prior to the live podcast where Matt, David, Rhonda, and others discuss the questions in real time. Their answers may differ from Dr. Burns responses listed below. 1. Michael asks: How did you invent the Hidden Emotion Technique? It's been incredibly helpful to me! Hello, Dr. Burns, Your lifelong work continues to be invaluable to me and so many others, and I apologize if this question was answered on a previous podcast. To my knowledge, it hasn't been. I was wondering how you discovered or created the hidden emotion model? I recently struggled with inexplicable death anxiety that came on every night since college started back up, and I was at a loss, until I remembered the hidden emotion model and wondered if there was something I wasn't acknowledging? Sure enough, I discovered I was actually quite resentful of my new schedule not allowing me to easily fit the gym into my schedule unless I wanted to forgo valuable sleep. Once I had addressed this resentment, the death anxiety vanished. I would love to know how this wonderful technique became part of your phenomenal practice! -Sincerely, Michael Polus. David's reply You can read all about it in When Panic Attacks, when I learned about it accidentally based on an interaction with a patient who was stuck. Perhaps we can answer it on a podcast. Thanks! david   2. Janie asks: How can I help a patient who ruminates? My client ruminates, that is she experiences repetitive thoughts about conversations and gets stuck in the negative feelings that come from dwelling on those thoughts and conversations. She has referred to it as repetitive thinking about conversations that were distressing in some way. She replays the conversation in her head, and evaluates and re-evaluates her responses. She then plays the conversation using possible different responses she COULD have used and worries whether these would have been better responses. The first individual is a friend where the friendship is very challenging and interwoven into many parts of my patient's life. My patient ruminates about conversations and wonders over and over if she said the right thing or wonders how the friend took what was said. It is a loop that my patient often gets stuck in for long periods of the day. The second individual is my patient's husband. With him, she ruminates about how to say things to him so she can motivate him to be involved in the ways she wants him to be. We will work on these relationships using the 5 secrets eventually, but first she'd like to work on the rumination because it takes up so much of her time. How can I help her? David's Reply I would recommend TEAM CBT in a step-by-step manner. I do not, in general, like to throw techniques at people based on a description of a problem. Motivational techniques to reduce resistance and bring resistance to conscious awareness. Paradoxical Cost-Benefit Analysis Dangling the Carrot / Gentle Ultimatum / Sitting with Open Hands The Hidden Emotion Technique What If / Downward Arrow Technique ERP (Exposure plus response prevention) Many other techniques inspired by methods a and b above (TEAM CBT) Feared Fantasy: confronting her worst fear Five Secrets of Effective Communication Work on acceptance: she is perfectionistic and self-critical Hidden Emotion: anger Thanks for listening (and reading the show notes), David, Rhonda and Matt

Ask David My friend won't say thank you! Dating Anxiety Religion vs. Psychotherapy We want to remind you about an awesome virtual workshop on habits and addictions that Dr. Jill Levitt and David will be presenting on March 28, 2025 We will feature powerful new paradoxical techniques that will blow your socks off. It will be from 8:30 to 4:30 and you will earn 7 CE credits while having fun and learning how to heal yourself AND you patients. Check it out! It's less than two weeks away, some check it out while you still have time! You'' LOVE it and LEARN a LOT! Registration and More Information Here! As is so often the case, the answers to these questions that appear in the show notes were email replies to the person before the show. To get the full discussion, make sure you listen to the actual podcast, as the answers often evolve in unexpected ways when the “experts” hash it out! Today's episode is chock full of personal stories (some racy), expert Five Secrets advice and demonstration,  philosophical / spiritual discussion, and secrets of successful (and racy) dating. 1. Brittany asks: What can I do say to a friend who does not say “thank you” when I pay for our meal or drive a long distance just to see them? 2. Jaydipe asks: How can I get over my anxiety around attractive women? 3. Ali asks: Can religious beliefs cause or intensify feelings of anxiety? (David will talk about the synergies between TEAM CBT and spirituality in all religions. He will also mention the potential antagonisms.)   1. Brittany asks: What can I do say to a friend who does not say “thank you” when I pay for our meal or drive a long distance just to see them. Hello David and Rhonda, I have a friend who typically does not say thank you to me when I pay for a meal out or drive us a long distance. I am someone who always says thank you even if the other person just bought us $10 worth of fast food or gave a short ride. I find myself feeling resentful towards my friend for not saying anything when I pay and drive us around all day. It makes me feel like they don't appreciate it. At the same time, talking about it and sharing my feelings would then feel like I'm asking them to say it, and then it would not feel authentic. I have said something about it in the past, and they were like I'm sorry, thank you. But it didn't mean much at that point. Is this one of those annoying traits I just learn to accept? Thank you, Brittany David's reply Well, you could just use a gentle I Feel statement, which might be paradoxically stronger, but combined with Stroking. Like this, "Jennie, you know I think the world of you, and greatly enjoy our times together, but when I pay for lunch, or drive a distance to hang out with you, you rarely ever say "thank you," and then I feel hurt and unappreciated." Something like that combines Stroking with I Feel and might be effective. But I always rate myself on what I do, or say, and not so much on how the other person reacts. You could, perhaps, also ask if they are upset with you about something that they've had trouble expressing to you. Best, david 2. Jaydipe asks: How can I get over my anxiety around attractive women? Hi David Many thanks for the podcast I'm struggling with social anxiety and talking to attractive women and I've watched all the podcasts relating to it. I think deep down I have a shame around finding women attractive, so I find it difficult to express interest in them. I find that I can talk to them easily during activities like climbing or co workers, but even on dates with women I can't seem to take things forwards playfully like you'd expect on a date. I'm too serious and I think that turns people off. I feel like I'm under the spotlight and I have to impress them otherwise they won't like me. I know this isn't true and I've been trying to get myself to do exposure therapy by asking girls for their numbers and being rejected so it helps with that. Also, I struggle with societal expectations, I hear women say that they don't want to be approached or talked to or anything so I just end up avoiding them because I don't want to annoy them, but it holds me back from getting the sex and relationships I want Any help much appreciated Thanks, Jaydipe David's Reply I have included your excellent question on an upcoming Ask David. In the meantime, have you read my book on dating, Intimate Connections? Best, david PS Should I use your first name, or a fake first name? 3. Ali asks: Can religious beliefs cause or intensify feelings of anxiety? Dear Dr. Burns, After reading your books, I've started to recognize that many of my anxious beliefs seem to have a religious background. For example, in the Bible, there's a verse from John 5:14: “Later Jesus found him at the temple and said to him, ‘See, you are well again. Stop sinning or something worse may happen to you.'” Here's where I struggle: I want to live my life freely, which includes things like being with different girls before marriage (something I already do). But according to religion, this is considered adultery and a sin. Another verse that weighs heavily on me is from Matthew 5:27-29: “You have heard that it was said, ‘You shall not commit adultery.' But I tell you that anyone who looks at a woman lustfully has already committed adultery with her in his heart. If your right eye causes you to stumble, gouge it out and throw it away. It is better for you to lose one part of your body than for your whole body to be thrown into hell.” I often find myself looking at beautiful women on the street, which Christianity teaches is sinful, and this sometimes leads to feelings of guilt. I wonder: do I need to leave religion altogether to break free from these negative, self-critical thoughts? I also have other related thoughts that seem to link my faith with the good things happening in my life. For instance: My life is going well right now. My parents are alive, my brother is getting married, I'm healthy, and I've been fortunate in many ways. I've had incredible experiences, like participating in two Erasmus+ exchange programs in Poland and Lithuania during university, volunteering in Latvia for a year, and even having my New Zealand visa approved in a highly competitive process (only 100 spots for 85 million people, and the application closed in 5 minutes!). I often think that these blessings are because I believe in Jesus, follow the Bible, and try to live as a good person who avoids sin and doesn't deceive others. But then these anxious thoughts arise: I should always be thankful or pray, or else my life will fall apart. If I leave religion, something bad might happen—my parents could fall ill or pass away, and it would all feel like my fault for turning away from Jesus. Without faith, I'd lose my good fortune(luck), my appearance, and my opportunities. Wherever I apply to would be rejected, then I would understand that it was Jesus in the first place doing all of these things in my life, not me or vice versa! I'd find a terrible job, terrible working environment, terrible mutual relationships. Then everything would be my fault and I'd tell myself I should have believed in him in the first place but now I deserve everything that happens to me! These thoughts are overwhelming, and I'd love to hear your perspective on how to approach and challenge them. Thank you so much for your time and the invaluable insights you share in your work. Warm regards, Ali David's reply Hi Ali, Sorry you are struggling with so many restrictions, judgments, and inhibitions! I can imagine it triggers anxiety, guilt, inadequacy, resentment, discouragement, and more. You can let me know! If you want, I can include this as an Ask David question on a podcast, with your first name, or a fake first name. Let me know if this works for you. Also, what religion are you? I know that many religions around the world can be very fundamentalistic and super strict in their teachings. My own religious upbringing had a touch of rigidity, too. Best, david Ali's response to David Hello again, Actually, my family comes from the Christian (Orthodox-Armenian) minority in Turkey, where I was born and raised. So, I am an Orthodox Christian. You're absolutely right that I struggle with many restrictions and judgments. I'd love for you to include this as an "Ask David" question on a podcast since I haven't seen any episode (and I've listened to most of your recent podcasts, including number 408: Do You Believe in God? Does God Exist?) that addresses this topic. By the way, I already use an alias, so "Ali" is a fake name, but you're welcome to use it in your podcast! Here's a quick DML (Daily Mood Log) to clarify what I'm dealing with: The Upsetting Event: Doing my daily half-hour Bible reading before bed and coming across certain verses. Emotions: Sad: 60% Anxious/Worried: 70% Inadequate: 60% Guilty/Bad: 90% Abandoned: 70% Pessimistic/Discouraged: 80% Stuck: 75% Angry/Resentful: 75% Tricked/Duped: 80% Although I don't consider myself a devout Christian, over the past few years, I've started reading the Bible—the Old and New Testaments. Initially, I read them in my native language, but now I read in English to fully understand the content. Growing up in the church, I believed everything the priest taught. However, encountering some events and stories that seem illogical to me has made me question my beliefs. I often feel tricked and wonder if I've truly believed in all this. At the same time, I feel anxious and worried, as if questioning or criticizing my religion is a betrayal of God. Please let me know if you need any additional information. Ali David's reply Thanks, Ali, this is super. I was also raised in a somewhat strict Christian (Lutheran) home, and as a child had plans to become a minister, like my dad. In college, I learned critical thinking, and began to question some of what I was taught when I was growing up. For example, there seemed to be a bit of a bias against Jews, and my dad said they had to convert to Christianity to be  ”saved” and, I guess, avoid going to hell after they died. That didn't sound right at all, not loving, as Christ taught, who was himself a Jew, but hostile and judgmental. And I had good friends who were Jewish, so it felt offensive. Same with people who were gay. A strong bias that this was somehow “bad” and sinful, or something like that. Christianity, in the sense of the Catholic church, was really created by people a couple hundred years after Christ died, and they were reflecting their own human biases when they wrote the new testament and translated the old testaments. For better or worse, I am personally not afraid to disagree with much of what is in the Bible, and interpret it, not literally, but as a series of stories trying to communicate important spiritual truths, but these truths get quite distorted when people began focusing on literal truths, rather than “seeing” the message. Literal translations of religion risk missing the spiritual meaning and truth. This is especially true of the orthodox movement within any religion. This tendency toward being literal, rigid, and judgmental may be a partially inherited, genetic trait. Regardless, to me, it is offensive and ugly, and definitely not religious, but quite the opposite. In the early days, lots of religious cults emerged, and they all had their own special leaders. If your leader couldn't walk on water, that guru was considered inferior. So, it was fashionable to say that your spiritual guru could “walk on water.” What does that really mean? To me, it means that this person is pretty special, and much kinder and more loving than most others, and can perhaps convey some spiritual truths to us. But actual walking on water is a magic trick best left to television and stage magicians. This is my thinking only, and I do not wish to impose my thinking and beliefs on you or on anybody! I had tremendous respect and admiration for a Catholic nun, Sister Shela Flynn, who worked at my clinic in Philadelphia because she wanted to learn how to do CBT. She was humble and wonderful, and once shared with me that she also thought the stories in the bible were primarily metaphors, just stories trying to convey this or that idea about love, humility, and so forth. Not literally true stories you “had to” believe to be a “good Christian.” An, in addition, using my philosophy and CBT training, there is really no such “thing” as a “good Christian.” Positive and negative labels can be useful but can also be hurtful and destructive. Will stop babbling, and feel free to reject or ignore some or everything I am saying! But on an emotional level, I feel hurt, and angry about the literal “rules-based” versions of religion. Because I see, all over the world, atrocities being committed to a massive degree in the name of this or that “religion.” I am most comfortable with Buddhism, but even then, many people take it literally, make up rules, and so forth, just like other religions or spiritual “paths.” For some reason, people love to make up rules and then try to force others to conform to their beliefs and rules. This is due, in large part, to arrogance, and the desire to feel “special” and “superior” to others. These are not, to my way of thinking, spiritual qualities, but quite the opposite. Finally, I do not mention religion in my therapy, which is 100% secular, and based on research and on scientific research on how people actually change. But at the moment of recovery, which often happens in a flash, rather suddenly, the patient often “sees” something of a spiritual nature which they had not seen or grasped before. I have never seen anyone lose their religious beliefs because of effective therapy, but quite the opposite. In fact, what we might call “recovery from depression” (or some other problem) sometimes looks an awful lot like what the religious mystics from all religions have called “enlightenment.” So, that's the sermon my dad would have perhaps wanted me to preach from a pulpit! I guess this is my pulpit, and you are in my congregation! And this Sunday morning here in Los Altos, so that's the end of today's sermon! Best, david Contact information You can sign up for the David and Jill workshop on healthier habits here: cbt-workshop.com

Getting to Know David David Answers Personal Questions! We all know David Burns as the creator of TEAM-CBT, but not many people get to know David, the person. It is fun to know David the person, because he is just like all of us. He is a real person (not a robot), full of life and love. I want everyone in our audience to be able to relate to David on a deeper level, to feel a sense of connection with him, and hopefully for all of us to build our sense of community with each other. Thanks so much to Stan Dickens, TEAM UK, for submitting these questions and sparking this discussion. The complete list of questions was much longer, but I (Rhonda) have selected the ones listed below. I hope you like listening to this podcast, Rhonda The questions are not necessarily in the order listed below, but all are answered on this podcast. David's answers are all 100% spontaneous, and you will hear them on the podcast! Music & Entertainment 1.  Which band do you like most, the Beatles or the Rolling Stones? (David, please say The Beatles!) 2.  Following on from that, what kind of music do you listen to? Can you tell us about some of your favorite musicians, bands, or composers? Here are some links to just a few of a great many favorite songs of mine. David Tom Waits Never Let Go (of your hand) https://www.youtube.com/watch?v=pROjyuj2P8k&list=RDpROjyuj2P8k&start_radio=1&rv=fGe2igm7Ieo Rickey Nelson It's Up to You https://www.youtube.com/watch?v=vsBP5P0Xe2c&list=RDvsBP5P0Xe2c&start_radio=1 James Brown Please Please Please https://www.youtube.com/watch?v=vruy2GRUsV8 Mick Jagger and Muddy Waters Please Don't Go! https://www.youtube.com/watch?v=Mbao_laqF8E Jim Croce I'll have to say I love you in a song https://www.youtube.com/watch?v=WB6FQBp-YwU Last Train Home Pat Metheny https://www.youtube.com/watch?v=goXJTv_U-PM Lucy Thomas “Hallelujah” https://www.youtube.com/watch?v=dLk9pzmaFHY 3.  If your life were turned into a film, who would play you? 4.  Can you speak with an English accent? Would you be brave enough to give it a try right now? Career & Professional Reflections 5.  If you hadn't dedicated your life to cognitive behavioral therapy and mental health or authored Feeling Good, what might you have done instead? 6. Is there a common misconception about you or your work that you'd like to clear up? Personal Insights & Philosophy 7.  If you could have dinner with three historical or modern figures, dead or alive, who would it be and why? 8.  If you could give your younger self just one piece of advice, what would it be? 9.  How did you meet Melanie, and what do you love most about her?

Vaping--Why and How I Quit. Featuring Dr. Kyle Jones Today we feature a beloved friend and esteemed colleague, Dr. Kyle Jones who will talk to us how he escaped from his vaping addiction. Kyle is a clinical psychologist in private practice, now residing in Los Angeles. However, he works virtually throughout California. He co-leads the OCD Consultation Group, a monthly consultation group for clinicians wanting to improve their competence in treating OCD. He also servs on the adjunct faculty at Palo Alto University where he teaches in the clinical psychology masters and PhD programs. He's recently joined the alumni council in the Department of Psychological and Brain Sciences at the University of California, Santa Barbara. This is the fourth in our recent series on TEAM CBT for habits and addictions (431, Screen Addictions with Brandon Vance; 437, Porn Addiction with Thai An Truong; 438, Overcoming Habits & Addictions with Jill Leavitt). We want to remind you about an awesome virtual workshop on habits and addictions that Dr. Jill Levitt and I will be presenting on March 28th. We will feature powerful new paradoxical techniques that will blow your socks off. It will be from 8:30 to 4:30 and you will earn 7 CE credits while having fun and learning how to heal yourself AND you patients. Check it out! Registration and More Information Here! Today, Kyle gave a brief history of vaping, which entered the scene around 2010, and described the experience as pleasurable and addictive. An estimated 3 million teens are addicted, and the flavored versions are quite tasty, but banned in California. He described his first exposure to smoking when he was 19, and living in Paris. It was “the” thing to do at that time, but he eventually gave it up, but later began to take a hit or two of vaping at a party, and then purchased his own vaping device in 2023. “Shamefully, he says, I tried to hide it from my partner and from other people, and I would vape in the bathroom.” He vaped for most of 2024, but explains that eventually, it got out of hand. At New Year's 2025, he listed the advantages versus the disadvantages of vaping, and made the decision to give it up. This was difficult because of the withdrawal effects that lasted for several weeks, including intense cravings, fatigue, difficulty sleeping, irritability, anxiety, and the urge to overeat. The TEAM CBT technique that helped the most was HAL, the Habit and Addiction Log, and we demonstrated the Devil's Advocate Technique. Rhonda and David played the role of the Tempting Thoughts and Kyle bravely battle back. Here's the list of thoughts: 1. I'm driving, so I can just vape in the car. 2. Here's a chance for a nice break. I can vape right now! 3. I can take another hit, no problem! I'll just get a little feeling of pleasure. 4. I need It tastes sooo gooood! We translated the “I” statements into “you” statements to maximize the temptation, and were as seductive as possible. But no matter how hard we tried to tempt Kyle, he won “huge” and hit it out of the park. We discussed Relapse Prevention, and Kyle described being at a party on Friday where some people were vaping and sharing the vape. We also described and illustrated the powerful Triple Paradox, which works paradoxically. I have personally trained Kyle in TEAM CBT, along with many other fine TEAM teachers, and he was always brilliant, compassionate and extremely effective in his therapy work. He works with the full spectrum of mood and anxiety disorders, and has a bit of a specialty in the treatment of OCD. Thanks for listening today!

Episode 438 The TEAM Approach to Habits and Addictions Powerful New, Radically Different Approaches that Can Help! Today, Dr. Jill Levitt joins David and Rhonda to discuss and illustrate the TEAM CBT approach to habits and addictions and give a little promo for their upcoming online workshop on Habits and Addictions on March 28, 2025. You can sign up for the workshop here: cbt-workshop.com Although the workshop is for mental health professionals, participants will have the chance to work on their own habits and addictions during the workshop in order to gain a more in-depth understanding of the new treatment methods for: Overeating / binging / restricting Drugs Alcohol Procrastination Doomscrolling Excessive cell phone use Internet addiction Excessive use of social media Shop-a-Holic Biting fingernails Video games Gambling And more David emphasized that nearly all current treatment methods frequently fall short because they focus on control of symptoms using behavior modification rather than the cause. He describes a research study at the Stanford inpatient unit that indicated that 50 common DSM Diagnoses (such as mood disorders, anxiety disorders, personality disorders, and more) were not significantly correlated with any of the DSM addictive / misuse disorders including drugs, alcohol, eating disorders, and gambling, which was not really consistent with the beliefs of many that emotional factors play a central causal role in addictions. In fact, the only significant correlation he noted was between depression and overeating, but the correlation was in the negative direction—in other words, higher levels of depression were associated with weight loss, not weight gain. And, in addition, the magnitude of the correlation was extremely small, indicating that other factors play a far more important role. So, what is the explanation for this puzzling and anti-intuitive finding? David described a 5-item survey he developed which asks about temptations in use or give in to your habit / addiction in the past week. This tool, in contrast to all of the DSM diagnoses, was very strongly correlated with all the addictions. This suggests that we give in to our habits and addictions for one simple reason--they make us feel great! At least in the short term! 150 years ago, they didn't have an epidemic of obesity in America. Why not? Life was likely just as stressful as it is now, maybe even more so! But what they didn't have was all the fast food restaurants and all the gooey, tasty foods that are abundantly available today, and they didn't have the resources to purchase them, either. This doesn't mean that behavioral models or diets or other tools have no value. But the TEAM CBT model focuses first on assessing the patient's motivation for and resistance to treatment using a variety of powerful and innovative new techniques, including: The Triple Paradox The Ten Positive Distortions The Habits and Addictions Log (HAL) The Devil's Advocate Technique The Five-Minute Rule The “I Stubbornly Refused” Technique The Anti-Procrastination Sheet Relapse Prevention Techniques utilizing The Externalization of Voices The Acceptance Paradox Stimulus Control And more They emphasized that these are methods, but not in the ordinary sense, because they rely heavily on the use of paradox, which is unfamiliar to many therapists, and require a great deal of skill. Jill and David first discussed the nature of tempting thoughts and how positive distortions work. Then, they illustrated the Devil's Advocate Technique with Rhonda who volunteered to work on her temptation to overeat chocolate, and especially chocolate chip cookies with peanut butter, and listed several of her tempting thoughts, including: 1. A little chocolate chip cookie can't hurt. 2. I have to keep them in the house because my husband loves them. 3. Just one cookie. It will taste SOOOO Gooood! 4. I can always work out a little more. 5. That cookie smells Sooo Good! I just CAN'T resist. Jill and David played the tempting part of Rhonda's brain, and she played the part that resisted the temptations. She started strong, but her conviction seemed to weaken on the third thought, and she didn't win “huge.” Instead of doing a role reversal to “help” or “save” her, David said that perhaps that wasn't really something she was willing to give up, and perhaps we could work on something else instead. She INSTANTLY did a complete turnaround and won “huge” when they gave her another chance to defeat the tempting voice. David and Jill emphasized that paradox nearly always wins, and “helping” nearly always fails. But this is why these methods are so challenging—because the therapist's well-intentioned attempts to help nearly always backfire, and yet are extremely difficult to resist. Jill and David emphasize that prior to doing this type of role-playing method, it is crucial to find out if this is something the patient really wants help with, and Jill emphasized that we rarely or never impose an agenda on any patient. We do not have any belief that there is a “correct” way for people to be. Rhonda—or any patient--will first have to convince us that this is something she really wants help with. And that will be one of the many take home messages for the therapists who attend on March 28th. Thanks for listening today, and be sure to tune in again next week! Jill, Rhonda, and David

Overcoming Your Porn Addiction Featuring the Awesome Thai-An Truong!

Swimming in an Ocean of Gold-- The Unique Magic of TEAM-CBT!

Jacob Towery, MD   Michael Luo, MD   Finding Humans Less Scary The 3rd Annual Triumphant Return of the Incredibly Popular and Awesomely Effective Social Anxiety Marathon Two Full Days of Unbelievable-- and Incredibly Cheap-- Help for You!  Featuring Two Super-Shrinks--Drs. Jacob Towery and Michal Luo March 29-30 2025, Palo Alto, California (In-Person Only, No Zoom)  9:30 AM - 5:30 PM Saturday and Sunday Today we interview two eminent and fantastic psychiatrists, Dr. Jacob Towery and Dr. Michael Luo, who describe their upcoming and mind-blowing two-day social anxiety weekend marathon, This intensive experience is dedicated to addressing and drastically reducing feelings of social anxiety. What's that? Social anxiety simply refers to the intense discomfort that so many people struggle with in social situations and interaction's with strangers. This will NOT just be some kind o head trip or motivational talk, but rather a fabulous experiential journey into a new and more confident you! Do you want freedom from your fears? Do you want a new life and a radical shift in your views of other human beings. Do you want great love, more friendships and deeper and more genuine connections? Then this is for you! JUST say YES! How much does it cost, you ask? It cost a great deal in terms of courage and the decision to change your life--but it's ridiculously cheap in terms of $.:All we ask is your $20 donation to one of the charities listed on the website. The location will be secret until you register, but it will be in Palo Alto, California. Seating, as in previous years, will be strictly limited, so ACT FAST to reserve your spot! How does it work? Well, you'll learn and practice many of the popular and powerful TEAM-CBT methods, in real world settings, such as Shame-Attacking Exercises, Smile and Hello Practice, Talk Show Host, Rejection Training, Flirtation Practice, Self-Disclosure, the Survey Technique, and much, much more. Thank you for listening today! Jacob, Michael, Rhonda, and David

FULL SUMMARY AND LINKS:https://eggshelltherapy.com/podcast-blog/2025/01/16/ai-therapist/I have recently released a new podcast episode, where I interviewed Dr. David Burns, the author of 'Feeling Good' and CBT pioneer! In his latest research, he showed that AI therapist platforms can sometimes outperform human practitioners in providing consistent, empathetic responses to patients.Here are some quotes from the interview that may surprise you: "We more or less proved that this idea that depression is due to a deficiency of this neurotransmitter, serotonin, can't possibly be a valid theory.""Empathy from a computer outperforms by a big margin human empathy.""Empathy, whoever gives it, sucks in terms of healing power. It's not enough to cure depression or panic attacks or anything else.""The app, if anything, is just as effective or slightly more effective, the more severe the patient's problems are."https://youtu.be/QF8GYvlTmfU?si=L_LA0QJItKpjCmiiAbout Our Guest Stanford psychiatrist Dr. David Burns, renowned for developing high-speed, effective approaches to Cognitive Behavioral Therapy (CBT), joins us today. His 1980 book "Feeling Good" is probably the most recommended self-help book by mental health professionals in the United States. His follow-up work "Feeling Great" builds on decades of clinical innovation, introducing his TEAM-CBT methodology that has revolutionized how we approach rapid recovery from depression and anxiety.In his latest research, Dr. Burns has explored the intersection of AI and psychotherapy, examining how machine learning could transform our understanding of cognitive distortions and therapeutic interventions. His findings suggest that AI therapist platforms can sometimes outperform human practitioners in providing consistent, empathetic responses to patients. Create Harmony This is a podcast about setting an intentional rhythm, savoring life's blessings and...Listen on: Apple Podcasts SpotifyEggshell Therapy and Coaching: eggshelltherapy.com About Imi Lo: www.imiloimilo.comInstagram:https://www.instagram.com/eggshelltherapy_imilo/ Newsletters: https://eepurl.com/bykHRzDisclaimers: https://www.eggshelltherapy.com/disclaimers Trigger Warning: This episode may cover sensitive topics including but not limited to suicide, abuse, violence, severe mental illnesses, relationship challenges, sex, drugs, alcohol addiction, psychedelics, and the use of plant medicines. You are advised to refrain from watching or listening to the YouTube Channel or Podcast if you are likely to be offended or adversely impacted by any of these topics. Disclaimer: The content provided is for informational purposes only. Please do not consider any of the content clinical or professional advice. None of the content can substitute mental health intervention. Opinions and views expressed by the host and the guests are personal views and they reserve the right to change their opinions. We also cannot guarantee that everything mentioned is factual and completely accurate. Any action you take based on the information in this episode is taken at your own risk.

Tahn Wanders . . . and Wonders A Young Monk's Search for Peace and Happiness Today we are honored by a second visit from Tahn Pamutto, who first appeared as a podcast guest on November 4, 2024, where he described his transition from a soldier in Iraq to an ordained Buddhist monk. He also gave us a taste of Buddhist teachings, and compared them to what we to in TEAM-CBT. There were certainly a number of areas of overlap. For example, as a psychiatrist, my goal is often to help bring patients as rapidly as possible from a state of unhappiness and depression to a state of joy and enlightenment, using a number of specific psychological techniques we call TEAM-CBT. But part of this is spiritual in nature as well. Tahn's role as an ordained Buddhist monk is similar, in part. His goal is help people who ask for guidance how to discover the cause of unhappiness, and the path to happiness, using a number of spiritual exercises, including meditation. But part of these exercises are psychological as well. Today, Tahn began by contrasting a spiritual vs a materialistic view of life, and emphasized that the materialist view cannot solve the problem of unhappiness or provide us with happiness. This is, in part, because material things are impermanent, and will all ultimately disappear. Negative feelings, like unhappiness, actually result from our thoughts--how we view the world. The world is the world, and you can accept that, or you can protest and shout angrily that things “should” be different or “shouldn't” be the way they are, but your feelings will always result from the way you think about the world. He said that when he was growing up, all his needs were taken care of, and happiness was fleeting, so he embarked on a search for answers. Who was I, and why was I struggling with so much unhappiness? He said, “To explore and really find out who I was, I'd have to depart from my comfort. When I joined the army, it sounded great. It was all about patriotism, loyalty, honor, service, and all kinds of positive values. . . But then at some point, they say that's time to invade this or that country, and you have to try to make that work, since you can't challenge the mission. The Iraq war was going on, and I spend 13 months there. But if your mission is wrong, you will keep suffering, no matter how hard you try. Did the people in Iraq really want us there? Are we really doing anything that's positive or good? And what is it that I really want to do with my life? One thing we have to recognize is two things that cannot be denied: our mortality and the existence of unhappiness. As I began to accept these two inevitable facts, I also realized that there is no quick solution, and that the reality is that our unhappiness may not end on its own. We may go to sleep, and escape for a while, but when we wake up, we will still be unhappy. We could even imagine being reincarnated and having a different body, a different religion, or living in a different time, but our suffering still won't change. I may be a different person, but I will still be unhappy. I asked myself if and how I could train myself to accept what life brings me. . . and wondered whether is would be possible to pursue unending happiness? And if so, how would I go about it? What I do? When I was in Iraq, I applied for conscientious objector status and eventually got out on an early retirement. Then, I began looking for an experienced, humble teacher who could share their knowledge with me. I bought a backpack and some hiking shoes, and began to search so I could learn what I needed to learn. I didn't have much knowledge of Buddhism at all at that time. I left my mother's house in New Jersey and started walking. I walked 20 miles, but realized I was going in the wrong direction, and had to walk 20 miles back and start over, walking in the opposite direction. The first night of my journey, I got exhausted and slept on a park bench. In the middle of the night, I thought I heard loud explosions, and woke up feeling terrified, but it was just acorns falling down from the oak tree I was sleeping under. In the Army I had learned the wrong way, and that's why I decided to search, but any old street in New Jersey probably didn't have what I was looking for. I decided to search for the answer in Asia instead, and wandered in India, Thailand, Korea, Japan, and Taiwan. I went into Temples and Mosques. I had the romantic notion that some wise bearded man would come out of nowhere and tap on my shoulder and say, “We've been waiting for you, Tahn! You have finally arrived!” But it doesn't work like that. In Thailand, there is a monastic level to society, as well as a commercial level. Thailand and Burma are certainly not perfect as countries, but have a higher than average level of happiness because the people are generous and help each other. If I wanted, I could just go and stay at a Temple. Much of their society is based on the joy of giving and receiving. People in the monastic level are living primarily on donations. I decided I wanted to become a monk. That was what I wanted to do. I learned about the importance of the “Contemplation of Death.” Most people want to avoid thinking about death. But death and the loss of all materialistic things is inevitable. You cannot avoid it, and might want to base your daily decisions on this fact. For example, you could ask yourself, “Suppose I knew that I would die this evening. What would I do today? Would I continue shopping for a couch? Or feuding with my neighbor?” If you did this contemplation every day, you might discover that you're doing what you think you should do, rather than what you want to do. You may be pursuing materialistic goals that inevitably cause unhappiness. Let's say you live in a small cabin, and notice some leaves on the floor. You might decide to sweep the leaves out of the cabin. Then, if you die, they will find your body on a clean floor. That would make it easy for someone else to move into the cabin. This path (the daily Contemplation of Death), he explained, is one way to get to the destination of unconditional happiness. Rhonda asked Tahn why he decided to become a teacher. He explained that he did not make that decision, but as he wandered and practiced the monastic life, people would stop and ask him questions about truth and enlightenment and the meaning of life, and so forth. Over time, he realized that because of his travels and searches, he began to gain more and more experience, and sometimes had something to offer individuals who were earlier in their journeys, and also looking for guidance. He said that the reality of being a monk is not glamourous. Our needs are really pretty minimal. We need food, shelter, clothing, and medicine if we are sick. But beyond that, the monk gets little. If you need clothes, you may have access to a pile or rags that you can sew together to make a piece of clothing, or you may have to eat the leftovers when others have finished eating. You have to learn to live on what extras might be given to you. He explained that I've actually been surprised by how much love and support there is in the world. I've been well-taken-care-of. My main interest has been to learn about the mind. Of course, we have our basic needs to survive, but what are we doing to develop spiritually? He mentioned that the monastic order is not structured, it is not a hierarchy, and you can come and go anytime you want. The Buddha accepted the strong desire of his followers to evolve into a church, as a structure to preserve the teachings, but this was a compromise. The Buddha was simply sharing something  that had already existed before he was born, something that anyone can discover, with or without a structure or system. At some point, you may say, “I quit,” and start to do what you want to do, know that your time to be alive is limited. Here are some of the questions people ask Tahn in his travels. How can I deal with my intense anger? Tahn said, "When people “find me” when I am traveling, or wandering, they often think that “this encounter was meant to happen.” He said that Buddhists do not proselytize, and there is no concept of “conversion.” He teaches people that “You are going to have to die. You're are going to have to give it all up one day.” He asks, “What are you seeking? What is ailing you?” He tells us that the Buddha taught us the cause of all unhappiness, and how to find happiness. Anyone can find what the Buddha discovered. The goal is the cessation of unhappiness. Is never-ending happiness possible? Tahn said: We certainly know that clear days, with no clouds, are possible. The clouds are not a part of the sky, they are just droplets of moisture, and the sky is not affected by the clouds. Clouds and unhappiness are very evitable. Tahn finished by saying, “Our unhappiness is independent from our happiness.” That's my best translation of the interview, and I'm sure I missed a lot, and misinterpreted parts as well. I do know that it was a great pleasure and honor to spend 90 minutes with Tahn. I hope you learned something and found Tahn's story interesting. And here's one tip that's helped me, and it might help you on your own journey. Sometimes, when I hear a Buddhist story or teaching, it sounds nonsensical at first. I can't “get it.” Then, a few days later, the meaning often comes, or at least A meaning, and I feel happy to have learned something kind of cool! Hope you have that experience, and apologize for any incoherence you find in the show notes, today! Warmly, Tahn, Rhonda, and David

Live work with Joshua-- The Secret of Self-Esteem I was recently a guest on the “Philosophical Weightlifting” podcast with host Joshua Gibson (link). At the end of the interview, he asked if I could give an example of some of the techniques in TEAM-CBT, so I decided to jump right into a live demonstration, in real time, which we are publishing on today's podcast. I am very grateful to Joshua and hope you enjoy the session as much as we did! The session covers a number of topics that just about everyone can relate to, including a couple extremely common Self-Defeating Beliefs: The Achievement Addiction The Love Addiction The Inadequacy Schema (“I'm not good enough.”) It also covers some familiar territory, including the question, “Am I good enough?” It also provides an answer to the questions: “What is the secret of self-esteem,” and “what is the secret of sex appeal?” To kick things off, Joshua shares an upsetting event along with some of his negative thoughts and feelings. The upsetting event was feeling attracted to a young woman who waited on him in a restaurant, and then going to his car and wishing he'd asked for her personal information for a date. Then he courageously went back and did just that, but got shot down. Paired with this experience, his overwhelming thoughts and how strongly he believes each one are: I won't be successful. 85% I won't get to live the life I want to live. 70% I won't find love. 90% I'm not attractive. 100% This is a list of Joshua's negative feelings, and how strong each one was at the start of the session: Feeling % Now % Goal % End Anxious 95%     Sad 90%     Guilty 85%     Inadequate 90%     Lonely 90%     Embarrassed 90%     Hopeless 85%     Frustrated 70%     Angry (with self) 75%     Two things stand out when you examine this list. First, Joshua is an attractive, friendly, and personable young man hosting a popular podcast. If we didn't have these estimates of his feelings, you would have NO WAY of knowing how he felt inside. These feelings are all very severe. So many people we greet in our daily lives are similar—looking terrific on the outside, but dying of loneliness and unhappiness within. Second, he is experiencing nine different types of similarly elevated negative feelings, and not just one negative feeling. This confirms statistical modeling I've done with data from the Feeling Great App. There appears to be an unknown “Common Cause” in the human psyche that activates numerous feelings simultaneously. This is like the “dark matter” of the human psyche. We can prove its existence, but don't yet know precisely what it is! However, our goal today will be to see if we can help Joshua change the way he's feeling, regardless of what's causing his pain. Positive Reframing Tool Feeling Positives Frustration It has motivated me to work hard   It shows I have not given up Anxiety Keeps me from putting myself at risk   It has inspired me to face my fears and grow Sadness Shows how much I care about others   Helps me understand others who are suffering, like my mom   Shows I have high standards and high expectations Guilt Shows that I want to live up to my expectations   Shows that I have a strong moral compass Inadequacy Shows I'm honest about my flaws and eager to improve   Show I'm humble   Makes me approachable Loneliness Has helped my develop independence and autonomy   Has motivated me to reach out to close community and to create my own Embarrassment Makes me behave in socially desirable ways Hopelessness This serves as a driving force   Shows that I'm a critical and realistic thinker   Protects me from disappointment Anger (at self) Shows that I have high expectations for myself and hold myself to a nigh standard You can see Joshua's goals for each negative feeling after we used the Magic Dial. The whole idea was to lower his negative feelings, not all the way to zero, since that would also wipe out all these positives, but lower them enough so that he would suffer less and still preserve all the many positives we listed, and more. Feelings Table with Goal column filled in Feeling % Now % Goal % End Anxious 95% 20%   Sad 90% 10-15%   Guilty 85-90% 15%   Inadequate 90% 10%   Lonely 90% 20%   Embarrassed 90% 10-15%   Hopeless 85% 20%   Frustrated 70% 20%   Angry (with self) 75% 5%   As you can see, he decided to lower all of his negative feelings if possible. Now, we're ready for the M = Methods of TEAM-CBT. Joshua said he wanted to work on, “I'm not attractive” first. I asked Joshua how and why he came to this conclusion, since he is clearly a large and attractive guy. He confessed he had severe acne when he was an adolescent, and now has scarring that makes him look “disfigured”. Although he probably does have some scars, I asked Joshua if he thought this thought might contain some cognitive distortions. He immediately mentioned All-or-Nothing Thinking (AON). I asked Joshua to “Explain this Distortion.” Specifically, I wanted him to imagine that I was a fourth grade student, and to explain to me in simple terms WHY this thought is an example of AON, why the AON in this case is unrealistic and misleading, and why it is also unfair. He did a great job, and this reduced his belief in the thought to 50%. As an exercise, can you think of some additional distortions in this thought? Briefly stop this recording so you can write them down on a piece of paper, and then you can look at the answers at the end of the show notes. “Explain the Distortions” was an excellent first step, but it was not enough, so we went on to the Paradoxical Double Standard Technique. I played the role of a long lost identical twin or best friend who was just like Joshua. I explained that I thought I was not attractive, and asked him what he thought. He did a tremendous job, and argued that this was not really valid, and I asked if he was being honest or just trying to cheer me up. He said he was being completely honest. Then we switched into high gear, using a much more aggressive technique, the Externalization of Voices, including Self-Defense, the Acceptance Paradox, and the Counter-Attack Technique, with perhaps a couple additional techniques thrown in. He got some strong momentum and blew all four negative thoughts out of the water. We were out of time, but did take the time to rate how he felt at the end, which you can see below. Feelings Table at the End of Session Feeling % Now % Goal % End Anxious 95% 20% 0% Sad 90% 10-15% 0% Guilty 85-90% 15% 0% Inadequate 90% 10% 0% Lonely 90% 20% 0% Embarrassed 90% 10-15% 0% Hopeless 85% 20% 0% Frustrated 70% 20% 0% Angry (with self) 75% 5% 0% Answer to the quiz question above: The thought, “I'm not attractive contained many distortions in addition to AON, including: OG = Overgeneralization MF = Mental Filtering DP = Discounting the Positive MR = Mind-Reading Mag/Min = Magnification and Minimization ER = Emotional Reasoning LAB = Labeling SH = Hidden Should Statement SB = Self-Blame I was extremely grateful and honored to be a guest on Joshua's wonderful podcast, Philosophical Weightlifting, and invited him to join our Tuesday psychotherapy training class at Stanford because of his work in coaching. If you are a mental health professional, including a therapist or coach, contact me and let me know! The classes are two hours weekly and free of charge, although some course materials are required. Thank you so much, Joshua, for sharing your “inner self” with me and all of your and our podcast fans! And thank you, all of you, for listening or watching today! Rhonda, Joshua and David The following is an awesome email I received from Jason Meno right after he listened to the Joshua session. Hey there! I just finished listening to the last hour segment of David's "Philosophical Weightlifting" podcast episode with Joshua Gibson (it starts at about 1:13:52). It was fun to see a 45-minute TEAM session in action. I thought the Externalization of Voices (EoV) that was done here that seemed to work really well, really fast. It also highlighted a lot of complex dynamics that I see David use a lot. Here's my analysis of what went down and what I think we can learn from it: Joshua's attack: Joshua's negative thought was "I'm not attractive", but when it came time for him to attack, he said, "You know Joshua, you are disfigured and because of that you're unlovable and that's an unavoidable thing you're going to have to deal with." This attack is a lot more powerful than just the thought "You're not attractive." It digs into hurtful labels, hopelessness, and frustration. When you are in the position of roleplaying as the negative voice, there's often new and subtle dimensions that come out of it. Right now we are making it easy for the user to attack the AI by just printing out their negative thoughts, but I think letting the attack be more dynamic would be a lot better. David uses Be Specific: "Can you tell me in what way I'm disfigured?" I REALLY like Be Specific. It sets things up very well. I'd love to do this as part of the EoV formula. Joshua answers: "Yes, so you had acne growing up and now you have scars as a result and that makes you look different from everyone else." David uses Paradoxical Acceptance / Humorous Magnification: "Well, thank you, wise guru. I'm enlightened now and see that I'm some kind of ugly monster who's going to scare all the women in the United States. But what you're saying is a lot of horseshit, and you know it." David's sarcastic tone belittles the negative voice's criticism, which also lightens up the absurd magnification that follows. He then quickly rejects the absurd and flows into healthy acceptance following this. David uses Straightforward Acceptance: "But it's true I'm not perfect, and I did have acne, and I do have scars, and there there's plenty of Hollywood movie stars who have some kind of fantastic looks." There's something very powerful about going from the absurd magnification into this healthy acceptance. It's kind of like framing the horrifying absurd with the moderately painful truth makes the truth a lot easier to accept. David uses Defense: "I have a lot about me that's attractive that I can be proud of, including my love, my humility. I've built a tremendous body that 99% of men would be the envy of, and 100% of women would love to touch and fondle." The self-compassion and focusing on specific strengths and pride in accomplishments seems to a very effective defense. There's also a little magnification and humor going on here too that works well. This is a lot stronger than a lot of defenses I see where people just say the thought is being distorted or unfair. David sets up the Counter-Attack Technique: "But there is one thing that's very, very unattractive about me that you didn't mention." Joshua asks: "What's that?" David uses the CAT: "That's that effing crappy voice in my head belittling me and constantly putting me down. And when I'm not listening to you, I'm feeling pretty damn happy. So, to quote the Buddha and Jesus alike, shut the f up." One of the things that seems to make the CAT really effective is when you can take the negative voice's criticism and throw it right back at the negative voice itself. In this case, the negative voice is the real unattractive quality. Awesome work David, and I'd love try out this EoV framework in the app. Best, Jason Roughly one week after the session with Joshua, Rhonda and David interviewed him for his reflections on the session and an update on how he's doing now. He said: I've reflected a lot on this, and what has changed for me. There were many things that impacted me, but positive reframing was a game-changer. For example, if I get anxious, I welcome the feeling, and tell myself, "This anxiety will help me with this project." I was getting a tattoo, and it hurt, so I told myself, "I'm glad it hurts. This pain protects my body." And, of course, people with leprosy lose the ability to feel pain, and the consequences are disastrous and tragic. He continued, I have become more accepting, and talk openly about my appearance. I've had the courage to face that fear. The theme of my life has been, "I'm not good enough." But now I remind myself that I've done all kinds of cool stuff. For example, I coached several people into the top five in the United States in power lifting. I'm way less self-critical now. I visited, and loved, the Tuesday group at Stanford. I didn't judge myself but just jumped in and did what I could do! We concluded the session with some Relapse Prevention Training, using Externalization of Voices to challenging his previous negative thoughts, including the thoughts he will have when he relapses. such as I'm not good enough. I'm a hopeless case. The therapy didn't work on me because I'm different. I'm a hopeless case. We used Externalization of Voices with role-reversals, and Joshua won "huge!" His final response was, "There's pain and joy in life. I'll feel joy and love!" Thank you for listening today. We hope you enjoy the intensely personal work with Joshua. Let us know what you think, and if it touched you if you've ever felt like you weren't "good enough!" Warmly, Joshua, Rhonda, and David  

The Story of My Life, Part 1 David is interviewed by Joshua Gibson, Host of the Psychological Weightlifting Podcast   Hi! Today will be a bit different. I appeared as a guest on a cool podcast called Psychological Weightlifting, hosted by Joshua Gibson. I kind of described the trajectory of my career, starting with my post-doctoral depression research at the University of Pennsylvania School of Medicine, with an intermediate stop at the former Presbyterian University of Pennsylvania Medical Center, where I had a run-in with a violent individual named Bennie, and culminating in my work refining TEAM-CBT in my years on the adjunct faculty at the Stanford Medical School. Joshua and I really hit it off, and at the end of the podcast, he asked me if I could briefly illustrate some of the techniques I've developed in TEAM-CBT. I asked if he had an negative thoughts that we might work with, and boy, was I in for a big surprise. In fact, you'll hear all about it next week! Thanks for listening today! Joshua, Rhonda, and David

Waking Up Dreading the Day Mother-Daughter Problems Patients Who Are Afraid of Their Feelings Romantic Problems, and More Questions for today: Rose asks: I wake up dreading the day. What can I do?! Maggie integrates TEAM-CBT with prayer and asks for help with mother / daughter issues. Simon asks: “How can we deal with patients who are afrad of their feelings?” Amanda asks: “Help! I have a romantic relationship conflict! What should I do?” Aaron asks: Why are feelings of depression and anxiety correlated? In other words, why do they frequently go hand in hand? The following questions and answers were written prior to the live podcast. Make sure you listen to the podcast to get the full answers, including role-play demonstrations, and so forth.   Rose asks: I wake up dreading the day. What can I do?! Hi David, I've been reading your book, "Feeling Good," for help with my anxiety ever since my 100-year-old mom moved in with me.  Your techniques are helping, but every morning I wake up anxious, dreading starting my day.  Is there a technique to help with this? I really am working to change my thoughts from negative to more positive thanks to you. I look forward to hearing from you. Rose David's reply In my book, Feeling Good, I urge people to write down your negative thoughts, and emphasize that it won't work very well unless you do this. Many people refuse. How about you? What were the thoughts you wrote down when you woke up feeling upset and dreading your day. Could use as an Ask David on a podcast if you like. Best, david Rose wrote: Thanks for your speedy reply.  I'm new at this and just started reading the book yesterday, but I will start writing down my thoughts.  Thanks for your help. Maggie integrates TEAM-CBT with prayer and asks for help with mother / daughter issues. Dear Dr. Burns, I want to begin by expressing my deep gratitude for your work, which has had a profound impact on my life. Your book Feeling Good: The Workbook helped me overcome a very dark period of depression after being diagnosed with infertility. It truly transformed my mental health, and I continue to rely on your techniques—especially your list of cognitive distortions, which I use often to stay grounded. Your podcast has also been a great resource for me, and I've noticed recent episodes touching on the self and spirituality, which caught my attention in a special way. I felt compelled to share something personal with you. While your methods gave me the tools to change my thinking, I also found solace and strength through my faith. Prayer was an essential part of my healing process, and for me, it provided something beyond my own power. In moments when I felt I couldn't make it through on my own, the belief that there is a God I can turn to brought me peace and comfort. Both your work and my faith were crucial in my journey. Your research and teachings helped me take control of my thoughts, but my relationship with God gave me hope when I needed it most. I believe that the combination of these two—your scientifically backed methods and the power of prayer—made a tremendous difference in my recovery. I'm also excited about your app, but as someone living in Honduras, I was unable to download it. I would love to know if there are plans to make it available outside the U.S. in the near future, as it would be an incredible resource for me and others in similar situations. Lastly, can I make a suggestion for a podcast subject?  Mother daughter issues. I really need help in this area of my life. Thank you for your dedication to helping others. I hope that sharing my experience offers some insight into how both your studies and faith in something greater can bring peace and healing. With gratitude, Maggie David's reply Thanks, and we'd love to read part of your beautiful note, with or without your correct first name, on a podcast. If you can give me a more specific example of the mother daughter issue you want help with, it would make it much easier to respond in a sensible way! Warmly, david Maggie responded Dear Dr. Burns, Thank you so much for your thoughtful response and for asking me to clarify my suggestion regarding mother-daughter issues. I deeply love my mother, and I know she means well, but our relationship has become increasingly challenging as she gets older. One of the major difficulties I face is her tendency to offer passive-aggressive criticism, which leaves me feeling undermined. I've always known her to be this way—she was never very affectionate, and I've gotten used to that. However, lately, it feels like it's getting worse. She's hard of hearing, even with a hearing aid, and often adopts a “my way or the highway” attitude, which makes conversations with her exhausting. Simple moments where I hope to share something exciting are often met with dismissive or critical remarks. Here are three examples of the kind of interactions that affect me: I recently purchased tickets for a trip to Australia with friends, and her response was to ridicule my choice, saying that Spain or Italy is a much more beautiful destination. I had just bought the tickets, and all I wanted was for her to share in my excitement. I sent her a picture of a new piece of art I was excited about, and her immediate reaction was, “I liked the other one better. That one doesn't match the color of the walls.” As I was about to leave for a party with my husband, she commented, “Don't you think you're wearing too much makeup?” These kinds of remarks constantly make me feel inadequate, and it's emotionally draining. As a result, I've found myself avoiding calling or visiting her. However, this leads to feelings of guilt, especially because I love my father very much, I enjoy his peaceful company and wise conversation and advice, and not visiting them also affects my relationship with him. What I struggle with most is that I know I might regret not spending enough time with her as she gets older, even though she isn't sick or dying. I just don't know how to manage the criticism without feeling constantly undermined, and I'd appreciate any advice you might offer on how to navigate this dynamic while preserving my sense of self-worth. Thank you again for your time and for the incredible impact your work has had on my life. With gratitude, Maggie David's reply I notice you're pointing the finger of blame at her. If you want to shift things, it can be helpful to examine your role. I'm attaching a copy of the Relationship Journal. Please do three of these, one for each example below. You already have half of Step 1—what, exactly, did she say. To complete Step 1, circle all the feelings you think she may have been feeling. Then complete Steps 2 and 3, which should be fairly easy. Then I can take a look, and we'll see what we can figure out, if you'd like. Also, this will not be therapy, but general teaching. LMK if that's okay. Best, david Here are the three examples she provided, along with how she responded to her mom: Three Maggie examples of interactions with her mother (Ask David podcast) #1 Mom said: Dear, I would never have thought of Australia as a destination. I would much rather fly to Italy or Spain, filled with culture, art, and great food. Sydney would be the LAST place I'd want to visit! I replied: Well, mom, we've already been to those places, and we love a great adventure, and we're really excited by the outdoors. #2 Just as we were about to leave, Mom said: “Don't you think you're wearing too much make up?” I replied: I probably am, I didn't notice (and rushed immediately to my room to remove it.) #3 I share a piece of art I brought home, and Mom said: “I liked the one you had before. It matched the walls much better than this one. Why did you change it? Who is the artist?” I replied: “Well, we have to like it because it's the only wall in the house where it will fit, so we're just going to have to live with it.” Simon asks: “How can we deal with patients who are afraid of their feelings?” Dear Dr. David Burns, Hi, my name is Simon and I'm a clinical psychologist from Chile, sorry if my English is kind of broken, it isn't my first language. First of all, I want to tell you how grateful I am for your great work and all the knowledge you give to the general public for free. Of course I also must praise the work of the entire team working at the podcast (which I am the biggest fan from my country). I hope one day I can be a certified team cbt therapist myself in the future, but that would be a different story. I think the world needs more people with such a love for mental health and I hope I can continue to listen to your content for more years to come. Today I wanted to ask you guys some questions related to feelings. I have applied some techniques to myself and my patients and it's really mind blowing noticing how effective they are. Nevertheless, I still have one patient who struggles with accepting or permitting himself to feel his feelings. He is grieving the loss of his father and he is very good convincing me that if he does feel his sadness or anxiety (as I suggested him), he may go crazy and commit suicide. He reports good empathy from me, but I'm afraid that he may be too nice to criticize me. So, I ask for your opinion: How can we deal with patients who are afraid of their feelings? How can we build a solid relationship with our patients regarding this subject so they can finally vent these feelings? Thank you all for all the hard work and have a great day! With Love, Simon David's answer Hi Simone, Thanks for your kind words, and may want to use your question on an Ask David. LMK if that's okay. Here's the quick answer. It sounds like venting feelings is your agenda. Nearly all therapeutic failure comes from well-intentioned therapists who try to “help” or “rescue” the patient. I get the best results working on the things my patients want help with. Rhonda has a free weekly group on Wednesdays at mid-morning, and I have a free weekly training group at Stanford on Tuesday evenings (5 to 7 PM California time.) You'd be welcome to join either. Best, david Amanda asks: “Help! I have a romantic relationship conflict! What should I do?” Hi Dr Burns! Firstly, I would like to thank you for your tremendous work and heart to help people who are suffering from depression & anxiety around the world. I found your book in 2021 through a YouTube video you did with Tom Bilyeu and the rest was history. I went down to our local bookstore to get Feeling Good and I was reading it everywhere I went. It saved my life and cured my anxiety! Every time I hit a roadblock, I will go back to the book and try the techniques. I also love the podcasts as they have been very helpful for me. Shoutout to Rhonda and Dr Matt May too! I currently face an issue and would like to submit it as a question for Ask David series. Please address me as Amanda. I am in a stable and committed relationship (for 8 years) but am facing issues with my boyfriend which causes resentment between us. Meanwhile, a friend pursued me despite knowing that I am in a relationship. He told me during a meetup that he felt attracted to me and asked if I will choose him if I am single. I was attracted to this guy as he is confident, funny and carefree, which are qualities that I desire and find lacking in myself. I like him but I know that he is not a good match for me because of his actions and behaviour. The actions seemed manipulative and reflected some narcissistic tendencies. At the start, he would text me frequently then the messages became short when I declined to meet up on a 1-1 basis with him as I want to protect my own relationship. He would drop me a short message every week, using intermittent reinforcement, to ask me how I am doing and then asked if we could meet up for a meal. Example 1: Guy-"Lunch?" Me-"Ok if it's with the group." Guy-"Ok." End of communication. Example 2: Guy-"How are you recently?" Me- "I am feeling better, thanks for checking in!" Guy- "Thumbs up emoji" End of conversation. If I initiate a meetup to run errands or for a meal, he would accept it readily. In a way, there is only communication and interaction when we meet up and I know this is not a healthy interaction or something that I want. Fast forward, I ignored him and he is in a relationship now but our dynamics remain the same. If I reached out to him for a meal, he would respond and behave in a caring way when we met. He offered to buy food for me when I was sick and find ways to continue to meet up. I feel that this guy is just trying to get me as it gives him an ego boost (and thrill) that I care for him even though I am in a committed relationship. In our last meetup recently, I made sure to record how I felt and noticed that the satisfaction level has gone down to about 60% as compared to  previously when I was eager to meet him. I would like to reduce it to 10% or even 0%. I also recorded my satisfaction level when I did things alone or with my boyfriend. I realized that my satisfaction/pleasure level is higher and more consistent when I do things that I set out to do on my own and there are times it is enhanced/lowered when I spend time with my boyfriend. Using the daily mood log, the upsetting event is: I will ignore this friend for a period of time then I will go back to the same communication and meetup with him. Then, I'm stuck in the same dynamic again. My negative thoughts are: I will never be able to get out of this. I am doomed. I have no power or control, he has all the power. People always take advantage of me because I'm weak. I am a loser because I keep going back. I will never be happy again since I cannot overcome this. Things will be as such. This chapter will leave a mark on my life and I will be miserable. I am a horrible person for allowing myself to fall for someone while being in a relationship. I have been re-reading the chapter in Feeling Good on love addiction and spending more time with myself to build a relationship with myself so that I can be happy alone. I am also using the cost benefit analysis to melt my own resistance so that I do not go back but I do not seem to be able to totally defeat the negative thoughts above. I hope to receive some guidance related to this on the podcast if possible. Thank you so much! Love, Amanda David's Reply Hi Amanda, Thanks so much. There are many paths forward, but one thing that might help would be to use the Decision Making Tool since you seem to be unclear on what you want to do. That might be a good first step, or next step. You can download it from the bottom of the home page of my website, feelinggood.com. I can understand your negative feelings and confusion and self-doubt, anxiety, discouragement, frustration. I'm just speculating. There are many ways to challenge your thoughts, but some good positive reframing might help before trying to  challenge them, so you could check out your goals for each negative emotion. Including a recent Daily Mood Log, in case you don't have one. All the best, david PS What you are doing all makes good sense, developing a relationship with yourself, doing a cba, etc., Kudos! In addition, the “25 things I'm looking for in an ideal mate” tool in Intimate Connections might also be helpful. Aaron asks: Why are feelings of depression and anxiety correlated? In other words, why do they frequently go hand in hand? Hi Dr. Burns, I am rereading When Panic Attacks, this has lead to a question. In the book you mention that one theory about why people have both anxiety and depression is that they "can't distinguish different kinds of emotions." Can you expand on this to help me better understand what this means? My interpretation now has me thinking that people are just saying they are depressed and anxious because they don't understand what each word for the emotions means. Thank you for your help, Aaron W. California---LMSW (Idaho)  David's reply David D. Burns, MD Sure, but that is not my thinking, just a common theory that of course deserves respectful consideration and testing. To me, depression is the feeling that accompanies loss, and anxiety is the feeling that accompanies the perception of imminent threat or danger. Beck put it like this: Anxiety is like clinging by your fingertips at the edge of a cliff, fearing you will fall at any moment. Depression, in contrast, is more like thinking you have already fallen, and you are at the bottom of the cliff, broken and injured beyond repair. Here are a couple other things that might interest you. When people are depressed, they will also report feelings of anxiety nearly 100% of the time. However, when they are anxious, they will only report feelings of depression about half the time. This is because you can have some type of anxiety, like a phobia such as the fear of heights, or elevators, or flying, but not feel depressed about it. And here is one more tidbit. My research on the beta test data from our Feeling Great App indicates that all seven negative feelings we measure are strongly correlated and go up or down together, which was quite unexpected. The statistical models that simulate the data provide strong evidence for an unknown “Common Cause” that activates all negative emotions simultaneously. We are trying to figure out what that Common Cause might be. It is a bit like “Dark Matter.” Scientists have proven it's existence, but don't yet know what it is. And this unknown Dark Matter represents 95% of the matter in the universe. The statistical models also provide strong evidence that the Feeling Great App helps people because of its strong causal impact on this unknown “Common Cause.” Would love to include this an Ask David in a podcast. Would it be okay? Warmly, david Aaron replies Hi Dr. Burns, I would be honored if you used my question in your podcast. Please let me know when that podcast is posted! I would love to watch it. In the email you sent, are you saying that one theory is that people just cannot accurately define what they are feeling? David replies again Yes, that is one theory, and I have seen that some people, including therapists, have trouble recognizing the names of feelings that their patients are having, based on what the patient says, and also they sometimes have trouble knowing how they are feeling, using “I Feel” Statements. This is, I think, part of what has been called “Emotional Intelligence.” And, just like any skill or talent, there is a great deal of individual difference in “Emotional Intelligence,” and likely some cultural differences as well. I have heard that up until recently, the Chinese did have a word for “depression,” but when a person was appearing depressed, they were kept indoors out of a sense of shame. Thanks! david

How to Give Critical / Negative Feedback In a Loving, Constructive Way AND How to Avoid the Common Traps Today's podcast features Dr. Jill Levitt, Director of Training at the www.FeelingGoodInstitute.com in Mountain View, California and co-leader of David's weekly TEAM-CBT training group at Stanford. Rhonda and I are psyched, because every podcast or teaching event with Jill is almost certain to be fabulous. And this podcast is no exception! Rhonda asks members of her Wednesday training group (see below for contact information of you think you might want to join) to take turns teaching the group.  One week she was puzzled because almost no one filled in their feedback forms, and when she asked them why, they said that they had some concerns about the teaching but didn't feel comfortable criticizing the person who taught. Some of the criticisms they share with Rhonda were: It was boring. I didn't learn anything new. The teacher didn't explain anything in a way that I could understand. Is this a problem that you have as well? Do you find it hard to criticize others, and keep quiet on the assumption that saying nothing is better than opening your mouth and saying something hurtful? If so, I have some good news and some bad news for you. First, the bad news. Tonight, you'll discover exactly why and how saying nothing is actually a pretty hostile and mean thing to do. But here's the GOOD news. You'll also learn the secrets of how to deliver criticism in a way that's loving, authentic, and helpful if—and that might be a big IF—that's something you're willing to do! A sage—cannot remember who—once said that “When you say nothing, you're actually shouting quietly. What in the world does THAT mean? And Robert Frost, in his famous poem, Fire and Ice, wrote: Some say the world will end in fire, Some say in ice. From what I've tasted of desire I hold with those who favor fire. But if it had to perish twice, I think I know enough of hate To say that for destruction ice Is also great And would suffice. Essentially, Frost is saying that if you're angry, there are two classic ways of being aggressive; you can be fiery and agitated and attack the other person, verbally or physically, or you can be cold and withdraw, saying nothing, so as to freeze the other person out. These are opposite extremes but are equally destructive. And, for most of us, difficult impulses to resist. But there's a third alternative, which might be, according to Robert Frost, the “road less traveled by.” You can express your negative feelings, including anger, in a respectful, or even loving way. And that's the focus of today's show. My show notes will only give an overview, but the richness of this particular podcast is in the actual dialogue and role-play demonstrations with critical feedback. We began with an overview of some of the key techniques when giving someone negative feedback, including stroking and “I Feel” Statements, but emphasized that your tone, goal, and spirit is the entire key to how you come across, and how the other person responds. Jill told a moving and dramatic story of an interaction with her mother, who has been quite ill, and she'd been having a really hard week. Her mom sent Jill a lengthy text outlining all of her problems and ending with, “you guys don't really know how I'm hurting,” and the implication was, “you don't know--or care.” This was understandably hurtful to Jill. Jill's about the most awesome daughter any mother could have. Jill wanted to clear the air and tell her mom how she'd felt, rather than keeping her negative feedback hidden. Her mom clearly felt lonely, so when Jill saw her in person, she said something along these lines: “I know you've been struggling, but I felt hurt and discounted when I read your note. I felt like the things I've done didn't matter, and I felt hurt.” Her mom began to cry and said, “the last thing I want you to feel is that I don't appreciate you.” This conversation was challenging, but brought them much closer together. The podcast crew discussed the important question of our mixed motivations about sharing our feelings, and our confusion about how to do this in an effective, loving way, if you do decide to open up. Rhonda confided that she'd never had those kinds of open conversations with either of her parents, and that these kinds of difficult conversations can come from a place of love. You can review the Five Secrets of Effective Communication if you click HERE. The Five Secrets are all about talking with your EAR: E = Empathy, A = Assertiveness, and R = Respect. However, there's a lot of intense resistance to using the Five Secrets, so I promised to include my list of 12 GOOD Reasons NOT to Listen (E = Empathy) Share your feelings (A = Assertiveness) Treat the other person with respect (R = Respect) That makes 36 reasons in all! You can link to the list HERE. People want to feel understood, and the best way to make that happen is by giving what you hope to receive. And you can learn how to listen more skillfully If you read my book, Feeling Good Together, and do the written exercises while reading. You'll learn a ton that can change your life and greatly enhance your relationships with the people you love. Thanks for listening today!! Jill, Rhonda, and David

The Feared Fantasy Festival! Featuring Jill Levitt, PhD Rhonda asked about the differences between the four Feared Fantasy Techniques and what each one is used for. So we're dedicating today's podcast to answering that question and bringing them all to life. We are honored to be joined by our beloved and brilliant Dr. Jill Levitt, the Director of Clinician Training at the Feeling Good Institute in Mountain View, California. Below I have listed the four Feared Fantasy Techniques. As you can see, each one targets a different Self-Defeating Belief. Approval Addiction: I need everyone's approval to feel happy and worthwhile. Perceived Perfectionism: I must impress others to be love and respected. People will not love or accept me if they see my flaws and shortcomings. Achievement Addiction: My capacity for happiness and my worthwhileness as a human being depend on my achievements, intelligence, success, and productivity. Love Addiction: I need to be loved to feel happy and worthwhile. Submissiveness: I must make others happy, even at the expense of my own needs and feelings. Here are the Feared Fantasy Techniques used for each SDB: Approval Addiction / Perceived Perfectionism: “I judge you.” Achievement Addiction: “High School Reunion.” Love Addiction: Rejection Feared Fantasy Submissiveness: No Practice During the live podcast, we did a deep dive on each of the four Feared Fantasy techniques, and emphasized that the goal is actually enlightenment, and it's based on the teachings Tibetan Book of the Dead that when you finally challenge and confront the monster you've feared and run away from in all of your previous reincarnations, you will discover the the monster has no teeth, and that your fears throughout all of those reincarnations were based on a cosmic joke. This can create something called "laughing enlightenment," so you no longer have to go through the life death cycle, but can go instead to Nirvana--or something along those lines! You really must listen to the podcast to "get" the impact of these Feared Fantasy role plays, and role-reversals, to see how simple, easy, and obvious self-acceptance, and enlightenment really are, and you will see and hear how we fight to protect and defend ourselves from attack, and end up feeling trapped yet again in our needs to be "special" or "worthwhile." David pointed out that when you let go of the idea that you have a "self," your suffering can disappear because you will no longer have to wonder whether your "self" is good enough, or worthwhile enough. Jill complemented this line of thinking by pointing out that the technique, Be Specific, is one important key in most of these techniques. We can be flawed in all kinds of specifics, but that will never hurt unless you generalize to your "self." No self, no problem, as some mystics have said. And that is SO TRUE! David also discussed throwing away the idea that you are worthwhile, or that you need to be more worthwhile, and described how he and his wife saved a mouse that had somehow gotten into their house, but the poor thing was terrified and heroically tried to survive, hiding out in their kitchen. Instead of trying to kill it, they fed it nuts and grapes. Eventually, they caught it in a safe trap, and set it free, and left a last meal for it outside, which it found and happily ate. It was a deep dive on Feared Fantasy and lots of spiritual and philosophical topics, and we hope you enjoyed it! Although we did not cover this topic in the podcast, there are quite a number of additional role play techniques in TEAM-CBT, too, as you know, including: to help with Self-Critical Thoughts: Paradoxical and Straightforward Double Standard Externalization of Voices to help with Uncovering Techniques, like the Individual Downward Arrow Man from Mars To help with Tempting Thoughts Devil's Advocate Technique Tic-Tok Technique to help with Resistance Externalization of Resistance How Many Minutes? to help with the Five Secrets / Relationship Conflict Intimacy Exercise One Minute-Drill Perhaps you can think of more, too! The generous use of role-playing techniques is one of the unique features of TEAM, but for whatever reason it seems like few therapists use them. This is perhaps unfortunate because they tend to be more potent, emotional, and fast acting than many if not most other techniques. Warmly, david

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

The Mindfulness Mystery Tour! And Two Mind-Boggling Discoveries about Meditation! Featuring Jason Meno Today, Jason Meno, our beloved AI guy on the Feeling Great App team, shares some incredible and innovative research he recently did on the effect of meditation on how we think and feel. As you know, basic research is a high priority of our app team, and our major focus is to make basic discoveries in how people change, and especially on what triggers rapid and dramatic change. We use that information to develop and refine the app on an ongoing basis, and also to contribute to basic science. Jason recently created a “New Cool Tools Club” which has 160 members who Jason can notify whenever he has a cool new app tool that he wants to test. If you are interested in joining, you can find his contact information at the end of the show notes. There is no charge if you'd like to join this group! Jason had a strong background in Buddhism and has been working with our company for several years, focusing in the last year on the AI chat bot portion of the Feeling Great App. He has meditated for many years, and uses TEAM-CBT as well to deal with his personal moments of stress and unhappiness, something that most if not all of us experience at times! Introduction Jason was interested in evaluating the short-term impact of meditating, and did a literature review but found that most or all of the published studies had a focus on the effects of daily meditation over longer periods of time, like two months for example. He was also interested in how long and how often people should meditate, and what types of meditations, if any, were the most effective. So, he decided to test a one-hour meditation experience consisting of five ten-minute recorded meditations, including A body scan meditation, systematically relaxing various parts of your body, beginning with your feet and toes. A breathing and counting meditation, where you focus on your breathing and count the breaths going in and out. A loving kindness meditation, starting with sending feelings of love, happiness, and health first to someone you love, then to yourself, then to someone you aren't especially close to, or don't particularly like, and on and on until you are projecting love and kindness to the entire universe. A mindfulness exercise where you notice if you are thinking, hearing, watching, remembering, and so forth as various thoughts pass through your mind. A “Do Nothing” meditation where you are instructed to simply “do nothing” for ten minutes. Because previous research on meditation did not use scales that assessed specific kinds of negative feelings in the here-and-now, he decided to use the highly accurate 7-item negative feelings sliders as well as the 7-item positive feelings sliders prior to the start of the medicine, after each meditation, and at the end of the app. He also asked many questions about motivation and expectations prior to the start of the meditation experiences, all answered from 0 (not at all) to 100 (completely), including How familiar are you with David's work? How familiar are you with meditation? How strongly do you believe that meditation will make you feel better? How strongly do you believe that meditation will be rewarding? How strongly do you believe that meditation will only have a small effect? How strongly do you believe that meditation will be a waste of time? How strongly do you believe that meditation will make you feel worse? How strongly do you believe that it will be painful or difficult? You can find these data at this link. He also asked every participant to generate an upsetting negative thought, like “I'm a loser,” and use 0 to 1000 sliders to indicate how strongly they believed that thought, and how upsetting it was. 60 individuals started the experiment, and 35 completed it, with 25 dropping out prematurely before they completed some of the meditations. He presented the data as a two-group analysis, those who completed and those who failed to complete the hour of meditation. Here, are just a few of the preliminary findings, and more refined analyses are planned so we can look at causal effects. Both groups were moderately to very familiar with David's work and with meditation. The completers had higher scores on the questions about positive expectations than the dropouts, although the differences were not great. The dropouts had substantially higher scores on four questions about negative expectations for the experience, like “it will be a waste of time” or “it will be painful or difficult.” The initial scores on the belief in the negative thought were similar in the two groups (76% and 74%, respectively), but the Upsettingness of the thought was a bit higher in the completers (83% and 79%. The mean of the initial scores on the 7 negative feelings sliders was significantly higher in the dropouts (37% and 46%, respectively), while the initial scores on the 7 positive feelings sliders was somewhat lower in the dropouts (49% and 45%, respectively). Both groups expected a modest reduction in negative feelings and a modest boost in positive feelings during the hour of meditation. Results on the 35 completers After the first ten-minute meditation, there were significant reductions in the negative feeling sliders (from 37% before to 25% after) and increases in the positive feeling sliders (from 45% before to 55% after). There did not appear to be any additional improvements in negative or positive feelings in the subsequent four meditations. There was a significant reduction in the belief in the negative thought after the first meditation, and the reduction continued throughout the next four meditations. (76% to 54%), for a reduction of 29%. There was a significant reduction in the upsetness caused by the negative thought after the first meditation, and the reduction continued throughout the next four meditations (79% to 47%) for a reduction of 40.5%. You can find the remarkable results if you click here! There are many fascinating results, but one of the most amazing--which we've replicated almost exactly in independent beta tests--is the remarkable similarity between the changes in negative and positive feelings the participants predicted, and the actual results. They are so close it looks like somebody faked the data, but that's not the case at all. We will have to do more analyses to figure out what this means, but in simple terms, this seems to be iron clad proof that our expectations of the mood changing results of any intervention can be tremendously powerful. In fact, you could argue--and it would need further statistical analyses to test--that the causal impact of the expectations eclipsed the causal impact of the actual intervention, which in this case was meditation. One of the cool things about quantitative research is that it nearly always shoots down our favorite hypotheses, and also gives us new and totally unexpected gifts to stimulate our thinking! In this instance, there were at least two mind-boggling and toally unexpected results: When people mediate, the improvement in negative feelings is accompanied by parallel reductions in participants belief in their negative thoughts. Participants predictions of the changes in seven negative and seven positive feelings by the end of the hour of meditation were spot on, and seemed almost impossibly accurate! Discussion The findings are exciting and specific, and suggest that the reduction in negative feelings during meditation may be, and is, mediated by the reduction in the users' belief in their negative thoughts. We will attempt to look into this more deeply using non-recursive analytic methods with SEM (structural equation modeling). All samples are biased, and it can sometimes be extremely helpful to understand the bias in your sample when interpreting the results. The sample in this case included users favorably disposed to meditation, and responding to an email inviting them to participate in a meditation experiment. Only those who persisted the full hour were analyzed in the final outcome data, which could be another source of bias in the data. How much improvement would we have documented if we were analyzing completers (45) AND dropouts (35)? Actually, this type of analysis is possible using Direct FIML (Full-Information Maximum Likelihood) with SEM techniques. I will, in fact, do these analyses as soon as I get the data set from Jason. This will allow me to estimate the scores at the end for all participants, including those who dropped out. It seems mathematically impossible, but it actually can be done. If those who dropped out are systematically different from those who continued, it will “know” and correct for this. For example, if those who dropped out were, on average, doing more poorly, then the estimates based on those who persisted will be biased, and the degree of bias could potentially be infinite. The SEM analyses will also tell us if there are no significant differences in those who  persisted and those who dropped out. Finally, the data LOOKS like the meditation “caused” some fairly significant improvements, although the results were in some ways puzzling. Using SEM, I should be able to determine whether, and to what degree, the improvement was simply a “placebo” effect resulting from the participants expectations of improvement, as opposed to an actual result of the meditation. So, stay tuned for updates on this amazing and deeply appreciated research initiative by our beloved Jason Meno! Thanks for listening today. Rhonda, Jason, and David

418 The Fear of Driving Featuring Werner Spitzfaden, LCSW and Rhonda Barovsky, PsyD Today, we feature Werner Spitzfaden, LCSW, a Level 3 certified TEAM-CBT therapist who recently treated Rhonda, who's driving phobia returned during the pandemic because she did very little driving at that time. After you overcome any fear or phobia, it has a way of returning if you don't continue confronting your fear. Werner describes his skillful and compassionate work with Rhonda! Werner is a dear colleague and friend with over 35 plus years of clinical experience treating phobias, such as the fear of flying, claustrophobia (the fear of being trapped in small places), and driving (especially over bridges and overpasses). He also treats depression, panic and other forms of anxiety, and works in corporate environments to improve communication and teamwork. Let's dive right in, Please take a look at Rhonda's completed Daily Mood Log, As you can see, the upsetting event was thinking about driving over an overpass, and she rated her initial anxiety cluster at 100%, indicating extreme anxiety. She was also 90% ashamed, and 80% Inferior, worthless, inadequate, defective, and incompetent. She was also feeling 99% embarrassed, foolish, humiliated, and self-conscious, and 85% hopeless, despairing, frustrated, stuck, angry, annoyed, irritated, upset, and devastated. Her sadness was only modestly elevated at 25%. There are several teaching points. First, most of Rhonda's negative feelings were severely to extremely elevated. Second, although she is asking for help with a phobia, anxiety often goes hand-in-hand with a wide variety of negative feelings, including shame and inadequacy. This is because anxious individuals often feel like there's something terribly and shamefully wrong with them. Rhonda's feelings of shame are not unusual. Shame is a central feature of anxiety, whereas a loss of self-esteem is a central feature of depression. Werner added that the fear of driving often goes along with the fear of heights as well as claustrophobia. Rhonda admitted to engaging in many “safety behaviors” which typically make anxiety temporarily better but worse in the long run. Rhonda's "safety behaviors" included  going out of her way when driving to avoid scary overpasses as well as asking her husband to drive her many place. As you can see, these totally understandable “safety behaviors” relieve your anxiety in the here-and-now because they are forms of avoidance, but that's why they makes anxiety worse in the long run. The urge to avoid of the thing(s) you fear is universal among individuals struggling with all forms of anxiety. Werner emphasized the importance of empathy in the initial phase of treatment, and throughout the treatment, since trust and the courage to face your fears is so central in the treatment of all forms of anxiety and, of course, depression as well. Rhonda invited Werner and another TEAM-CBT colleague, Lee Flowers, to stay with her in Berkeley during the recent TEAM intensive that David and Jill Levitt directed at the South SF Conference Center near the airport. She drove the group to and from the workshop to face her fears and get some motivation and support at the same time. You can see many of her negative thoughts about driving on Rhonda's completed Daily Mood Log, including these: The bridge will collapse. 95% Other cars will make the bridge unstable. 100% I'll have a heart attack. 95% I'm so dumb for not driving on this overpass. 1005 I'm an ass. 100% I can't do this. 100% I'll die. 100% Lee and Werner will see me at my worst. 100% I need to study the exact route before I start. 100% I'll get into an accident. 100% As you can see, the list includes a mixture of fear-inducing thoughts as well as self-critical thoughts and shame-inducing thoughts, like "Lee and Werner will see me at my worst." Whenever you are working with anyone with anxiety, you have to emphasize first, to create trust, warmth, and understanding. This won't cure anyone of anything, but will give your patients the courage to face their fears when you get to the M - Methods portion of your TEAM session. After you get your A in empathy, you can move on to A = Paradoxical Agenda Setting. That where you bring Outcome and Process Resistance to conscious awareness. Then you melt them away using a variety of TEAM-CBT techniques. Outcome Resistance means that Rhonda may have mixed feelings about a “cure” for her driving phobia. In other words, although she WANTS to get rid of this fear, she may subconsciously NOT want to get rid of it. Can you think of why? Take a moment to think about it, and make a guess. You'll find the answer at the end of the show notes. Process Resistance means she may WANT a cure for her driving phobia, but may not be willing to do what it takes to defeat this fear. What will she have to do? Take a moment to think about it, and make a guess. You'll find the answer at the end of the show notes. Werner and Rhonda described a number of TEAM-CBT M = Methods that they used to reduce Outcome Resistance, including The Miracle Cure Question The Magic Button Positive Reframing The Pivot Question The Magic Dial. To put this phase in a nutshell, Werner highlighted how Rhonda's intensely negative feelings helped her and revealed many positive things about her core values as a therapist and human being. This is a shame-reducing technique and you can use the Magic Dial to ask your patient what they would like to dial each negative feeling down to, without reducing them all the way to zero. You can see Ronda's goals on Rhonda's completed Daily Mood Log in the Emotions Table Next, Werner worked on Process Resistance, bringing the work on Paradoxical Agenda Setting to closure. At the start of the M = Methods portion of their work, Rhonda identified the distortions in two of her thoughts (“I'm dumb,” and “I can't do this.”). See how many distortions you can find. Wrote them down on a piece of paper and when you're done you can see the answers at the end of the show notes. Werner pointed out that Rhonda's anger, directed against herself, had become a springboard for agitation which intensified her anxiety. Werner and Rhonda challenged some of her negative thoughts with Examine the Evidence, Externalization of Voices (illustrated live during the podcast),Double Standard Technique and the Paradoxical Double Standard Technique as well as a Fear Hierarchy, which you can see if you click here. The also did Cognitive Flooding (also called Imaginal Exposure) three times, and by the third time Rhonda could only increase her negative feelings into the mild range, whereas they had started out in the extremely elevated range. They also used breathing exercise plus getting into the here-and-now to calm herself while driving over overpasses. All of this was background work for actually driving during the intensive, and the highlight was driving home in the dark on the third evening of the intensive. For Rhonda, this was the most fearful thing of all!  She said at the start her anxiety was "greater than 100%," but she felt triumphant when she arrived home. Werner gave her specific homework, like driving over a specific overpass four times, and also encouraged Michael, Rhonda's husband, not to give in to her requests to do the driving on a planned trip to visit friends in Sacramento. I am deeply grateful to Rhonda for giving us such a raw and real glimpse into her courageous and victorious win over her intense driving phobia, and a big thanks also to Werner for being such a kind and powerful TEAM-CBT therapist, teacher!, and beloved friend! Thanks for listening today, Rhonda, Werner, and David Solution to puzzles above Outcome Resistance: If she's “cured,” she'll have to start driving much more, and that will include driving over overpasses and bridges. This concept will freak her out now, because she's still afraid something horrible might happen if she stops avoiding them. Process Resistance: To overcome her fears, she'll have to face them and experience some fairly intense fear along the way. Werner can support her, and drive with her, as he did, but she will still freak out at first when driving on overpasses and bridges. The distortions in those two negative thoughts included All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Mind-Reading, Magnification and Minimization, Emotional Reasoning, Hidden Shoulds, Labeling, and Self-Blame.

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/

  Question #1: John asks: Can you do TEAM on your own? Question #2: John asks: Can you provide more insights or instructions on how to do Positive Reframing on your own? It seems to be an incredibly important key to TEAM-CBT. Question #3: Ann asks: What can I do when I blush and my face turns bright red? Question #4: Dylan asks: Can you have a delayed reaction to the CBT exercises? #415 September 23 Ask, New questions Question #1: John asks: Can you do TEAM on your own? Oh, one other point that occurred to me, the people doing personal work on your podcasts are generally TEAM CBT therapists or people familiar with the TEAM model. They are obviously very familiar with the steps and techniques in TEAM, and yet they seem to require the insight and guidance from yourself and Jill. Why do you think that is if they are so well versed in TEAM already? Does that mean that a person from the general public doing their own work using your books without the guidance of a TEAM therapist is futile? Or would you always recommend someone using a therapist? Kind Regards John David's response Can we include it in another podcast? Would love to just read it and jam on it with R and M. Warmly, david Question #2: John asks: Can you provide more insights or instructions on how to do Positive Reframing on your own? It seems to be an incredibly important key to TEAM-CBT. On Mon, Aug 5, 2024 at 9:24 PM John Macken wrote: Hey there David and Rhonda, I hope you're keeping well, this is John from Ireland, we had a previous correspondence on Should statements! David, thanks very much for asking for access to the beta app, I'm really enjoying the modules! I heard you say on one of your apps that you are planning some workshops in relation to the app, will they be available online do you think? Would love to tune in if possible! I am always grateful for your inspiring work! I love your passion for the work that you and Rhonda do and that comes across from both of you during every podcast episode. Your FG community sounds amazing! Who knows, maybe one day I'll ditch the corporate career and join the cult! I have another question on Positive Reframing! As someone who is still trying to find my own journey to enlightenment following many months of anxiety and depression, I feel I am falling at this positive reframing step. I still find I am bumping up against resistance and I feel that my positive values and benefits don't count. It's almost as if there is some kind of discounting the positive going on like my negative points vastly outweigh my positive points. It's like there is such a negative filter there is no space for recognizing positive qualities. I was listening to the beginning of Episode 310 where a listener had an excellent contribution on Positive Reframing from your live work with Nasli. That got me thinking, would it be possible to hear more insights and detail on how to perform your own Positive Reframing work? Or do you have guidelines or a worksheet anywhere? It feels like the most powerful of all the steps! Among the many incredible tools that have been created under TEAM it seems the Agenda setting piece is probably the most powerful and innovative. I have listened to many of your Live Sessions intently and it seems that your gift and that of Jill Levitt is in convincing the patient of the beauty of their depression and anxiety. It feels that they are almost recovered or very nearly once you go through that step. On the face of it, it looks like what you're doing is very simple but there is a nuance and complexity to it that is incredible and without sounding too grandstanding or over dramatic this "gift" seems to be where the healing power lies. If you could bottle that gift you would change the world or be a billionaire or both! It is astounding to listen to. I would love to hear more about your insights into this area and how people can unlock this for themselves. For example, I found podcast 387 on Acceptance and Daring to be average incredibly powerful and insightful and convincing and these are pieces I'm trying to implement in my life. Love and admire your work and would love to make it over to one of your in person workshops someday when they are available to the general public, Warm regards John David's response We will address positive reframing on the show. Question #3: Ann asks: What can I do when I blush and my face turns bright red? Dr. Burns, I hope you're both doing well. I wanted to share with you that you have changed my life dramatically. I have always thought that everyone else had a problem as far as attitudes and behaviors. But you have taught me through all three of your books and podcasts that my thoughts are why I've been so anxious and depressed. I have been on medication since I was 20 years old. Now, I'm weaning off of my medication because of all of the work I've done with your book and a therapist trained in TEAM therapy. My relationship is much better with my husband and it was me that was pushing him away from me. Talk about enlightenment!? I'm anxious about getting completely off of my clonazepam because it helps me “control” my face from turning red. My red face makes me so anxious and I start sweating profusely whenever I'm in a situation that's embarrassing. Thank God, my menopause has helped me with explaining why my face is so red. This has been going on since I can remember. I think I was 5 years old in school when it first happened. Most people stare at me because my face gets really red. I've repeatedly tried looking at people, while my face is turning red, to see if they are truly looking at me and sometimes they are and not. The redness lasts for around two minutes but if feels like hours. What can I do? I want to get off all of my meds but my psychiatrist says to do it slowly. I haven't listened to all of your podcasts but I don't think there's one out there regarding a 49 year old lady suffering from a red face. Maybe an ask David? I hope I've been specific enough for you. I cannot thank you enough for everything you do for people. Thank you, Ann Zernone David's response Yes, we actually had a podcast on this exact thing, and happy to add it to the next Ask David if you like. Best, david 88 Role Play Techniques: Feared Fantasy Revisited https://feelinggood.com/2018/05/14/088-role-play-techniques-feared-fantasy-revisited/ 168 The Blushing Cure https://feelinggood.com/2019/11/25/168-ask-david-the-blushing-cure-how-to-heal-a-broken-heart-treating-anorexia-and-more/ Question #4: Dylan asks: Can you have a delayed reaction to the CBT exercises? Hi David, I'm a big fan of your work. Quick question: do you commonly come across people who do CBT exercises and they don't get their anxiety or depression levels reduced super low right after doing the exercises but a couple days later they experience the results? Dylan Aames Unfit Productions, LLC President @JohnnyPlissken-xs7hq  • 12 hours ago David replies Will talks about having this same experience on the live show.

Feeling Down? Try the Feeling Great App for Free! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it  out at FeelingGreat.com! Life Coaching: A New Dimension in Counseling Today we discuss the recent upsurge in life coaching, and feature one of the leaders in this emerging field, Angela Poch, and one of her wonderful students, Lorna Bird. Lorna Bird Angela Poch (see featured photo) is a Registered Professional Counsellor (RPC) with the Canadian Professional Counselling Association, certified Master Life Coach, and TEAM-CBT Level 4 Advanced Therapist and Trainer. She has been teaching health and wellness for over 30 years and was Vice President of Education with the Adventist Association of Health & Wellness Coaching. She has written several articles and books on health and wellness including, “The Truth Will Set You Free.” She has a YouTube channel (@talkingteamcbt) interviewing clinicians about their journeys with TEAM-CBT. She also has a channel on psychology and health (@bodymindhealth4u). Lorna Bird holds a Diploma of Counseling from Australia and is a certified Life and Health Coach. She is also a Level 3 certified TEAM-CBT therapist  https://www.yestohealth.com.au/ Angela and Lorna will give us the true scoop on coaching. To get started, what IS coaching, and how does it differ from psychotherapy? I am aware that our podcast goes worldwide, so the answer may differ depending on the country or state where you live. According to AI, “In California, the term "psychotherapist" is defined in the Civil Code to include a number of mental health professionals, including psychologists, psychiatrists, and clinical social workers. In general, anyone who provides psychotherapy or counseling in California, whether in person, by phone, or online, must be licensed.in California.” Coaching is quite different. Again, according to AI, “In California, there are no specific state-mandated requirements for individuals to use the term "coach" or practice life coaching, meaning anyone can technically call themselves a coach without obtaining a specific license.” Angela Poch resides in Canada, and she has been a leading and beloved member of the TEAM-CBT community. She emphasized several differences between a “coach” and a licensed mental health professional: Diagnosis: A coach does not diagnose clients into the familiar DSM categories of “mental disorders,” such as “Major Depressive Illness,” “Bipolar Disorder,” “Schizophrenia,” or any of the hundreds of “mental disorders” listed in the DSM. In the same vein, licensed mental health professionals will typically screen for suicidal thoughts and urges, and will treat suicidal individuals, but this is forbidden territory for coaches. Purpose / aims of coaching: The purpose or aims of coaching do not, as a rule, involve delving into your past to search for the “cause(s)” of your problems, such as adverse childhood experiences or traumas. Instead, the focus of coaching is primarily on making changes in the here-and-now in how you think, feel, and relate to others. This might involve learning to challenge distorted negative thoughts so you will think and feel more positively about your life, as well as how to relate to others more skillfully. Coaching is goal-oriented and forward-moving rather than dwelling on the past. Of course, good counsellors and licensed mental health professionals may also provide tools to move forward as well, so there can be overlap. Training / credentialing: Because coaching is so new, there are not yet any widely accepted standards or requirements for calling yourself a “coach.” There is a varying degree of training to be “certified,” which might just consist of watching a couple videos to 100's of hours of supervision with the ICF (International Coaching Federation), and everything in between. Here's a generalized diagram Angela created to help with further clarification. NOTE: many TEAM-CBT therapists also are client/goal focused as well as and will often use coaching-style tools. Angela described a 20-hour “Feeling Great Coach” certification program she has developed. Her program is based almost entirely on TEAM-CBT and includes a final exam you must pass to get certified. She also offers a TEAM-CBT Masterclass & Mentoring Program for both coaches as well as therapists that includes live training twice a month, online practice groups, case consultation in small groups, one-on-one mentoring sessions, and personal work as well. She said this integrates seamlessly with FGI's Fast Track program, any of David's intensives, or the Tuesday group for those who want more individualized support and training. Lorna enthusiastically described her experiences learning from many of Angela's training programs. I (David) have had the pleasure of knowing and working with Angela for many years now, starting with her attendance at a number of my intensives and two-day TEAM-CBT training programs in Canada. Lorna is really enjoying the Masterclass Mentoring Program and recommends you take Angela's free workshop called “Effective Compassion.” You can check it out at www.teamcbt.ca/effectivecompassion How do I, David, feel about coaching? I am, for the most part, enthusiastic, but with a few reservations. I would have to confess that I spent 5 years in medical school, four more years in psychiatric residency, plus two years in post-doctoral research training at top institutions, but did not learn much at all, if anything, that has really helped me treat human beings who are hurting. Of course, I did learn how to prescribe drugs for those with severe difficulties, like Bipolar I Disorder, or Paranoid Schizophrenia, but that definitely did not require years and years of intensive medically oriented training. All I ever really wanted to do was psychotherapy. In my last year or so of post-doctoral psychiatric training, I discovered cognitive therapy, although it was not a part of the required curriculum, and learned quite a lot that has been really helpful in working with patients. But for the most part, all of the extensive medical training I received had very little, at best, to do with how I now work with patients, and an awful lot of what I do was things I had to figure out for myself. I do have great respect for psychology training (either clinical psychology or PsyD training), because of the emphasis on research and critical thinking, but I do think there is lots of room for new approaches such as coaching to emerge and evolve, and it seems to be the case that more people than ever are still struggling with depression, anxiety, addictions, rage, and more. Like any field, I think coaching is vulnerable to misuse by narcissistic individuals who wish to deceive or exploit the general public, and individuals who are naïve or unaware of the background or training of their therapists are perhaps at great risk of abuse. But I would also say that this problem is in no way limited to coaching, since a great many licensed mental health professionals have been charged and convicted of all manner of unethical conduct and as well as malpractice over the years as well. That's why I'm enthusiastic about responsible leaders who, like Angela Poch, are blazing new trails and setting the bar high for those who wish to enter the field of life coaching. I'm also delighted to see that for years now, the Feeling Good Institute (FGI, feelinggoodinsititute.com) has included coaches in their superb training programs as well, and many high profile individuals you may be familiar with, like our beloved Professor Mark Noble, have taken and benefit from TEAM-CBT certification via the FGI. To learn more, contact Angela at feelinggreat@angelapoch.com or visit https://angelapoch.com/ to learn about Angela's many training and treatment programs. You can reach Lorna at:yestohealth777@gmail.com or https://www.yestohealth.com.au/ And here is the contact information for TEAM-CBT Australia: https://www.teamcbtaustralia.com.au/

Feeling Down? Try the Feeling Great App for Free! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it  out at FeelingGreat.com! What's a Give-Get Imbalance? What's the Best Treatment for Anxiety and Dysthymia? Can you do Externalization of Voices on Your Own? The show notes for today's podcast were largely written prior to the show. Tune in to the podcast to hear the discussion of these questions by Rhonda, Matt, and David. And keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks! Suzanna asks: What's a “Give-Get” imbalance? And how can you get over it? Martin asks: What's the best treatment for anxiety and dysthymia? Eoghan (pronounced Owen) asks: Can you do Externalization of Voices on your own?  1. Suzanna asks: What's a “Give-Get” imbalance? And how can you get over it? Description of Suzanna's problem. Suzanna is a woman with a grown daughter with severe brain damage due to a severe brain infection (viral encephalitis) when she was an infant. Suzanna was constantly giving of herself and catering to her daughter. She explains that her daughter can be very demanding and throws tantrums to get her way, and kind of controls the entire home in this way. She can only talk a little and has the vocabulary of about a two-and-a-half-year-old. She can mostly express the things she wants or doesn`t want on a very basic level. She mostly understands what I want from her, but mostly does not want to do what I ask her to do. She can be very stubborn. And I cannot reason with her because she has her own logic and, in her eyes, only her logic is valid. Maybe all a little bit like a two-and-a-half-year-old. Suzanna struggles with negative feelings including guilt, anxiety and depression, because she is constantly giving, giving, giving and feeling exhausted and resentful. And she tells herself, “I should be a better mum.” Can you spot any distortions in this thought? Put your ideas in the text box, or jot them down on a piece of paper, and then I'll share my thinking with you! What are the distortions in the thought, “I should be a better mum”?   There are many distortions in this thought, including All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Magnification and Minimization, Emotional Reasoning, Self-Directed Should Statements, and Self-Blame. There may be one or two more, too! The first step in change nearly always includes dealing with motivation and resistance. Suzanna decided to do a Cost-Benefit Analysis, as you can see below, and a revision of her Self-Defeating Belief, as you can see below. Another helpful step might include “No Practice,” which simply means saying “no” so you don't constantly get trapped by “giving,” as well as “giving in.” A third critically important strategy involves the mom and dad making the decision to work together as a loving team in the management of a troubled child, rather than fighting and arguing with each other, as we've discussed on previous podcasts. However, in many, or possibly most cases, the parents are not willing to do this. They are more concerned about being "right" and so they continue to do battle with each other, as well as the child who needs a more loving structure. David Cost-Benefit Analysis Self-Defeating Belief: I should be a better mum to my daughter Advantages of this belief(How does believing this help me?) Disadvantages of this belief(How does believing this hurt me?) This thought motivates me to: Put myself out. Push myself to give what I have.  Find ways to advance her development.  Find ways to involve her in everyday life. Invest myself into her and her life as much as I can, physically, emotionally and time wise. Try to find ways that my daughter can have a fulfilling life. Try hard to connect to her, her pain, her needs, her sadness and her frustration. Try to make her life as easy as possible. Try my hardest to see her world through her eyes and gain deeper understanding of how she feels. Try to understand what is upsetting her when she throws a tantrum. Stay healthy and fit to have energy for her. Try to make her life rewarding and meaningful. Fulfill my duty as a mum to my daughter who needs my support. I can feel good about myself. I satisfy other people's expectations of me.  Protects me from criticisms from my husband               I am a prisoner to my daughter. No matter how hard I try I don`t seem to make a meaningful difference to her life and to her development. I am a “Siamese Twin” to her. I cannot move or do anything if she doesn`t want to. I reason with my emotions instead of thinking rational at times. I let my daughter get away with “murder”. I find excuses for her behaviour.  I find excuses for her why she cannot behave differently. I beat up on myself when I feel I failed her. I take all responsibilities away from My daughter and make them my own. I blame myself when I cannot motivate her to do something. I blame myself when she is bored and unhappy. I feel guilty doing my own things. I feel guilty when I do not involve her in my activities. I feel guilty when I expect her to do entertain herself for a while.  I cannot live my own life. I cannot be myself at times. She rules my life, and she lives my life. I feel trapped and frustrated.  I feel I need to constantly entertain her. I feel responsible for her happiness. I feel responsible when My daughter is sad and frustrated. I feel exhausted and overwhelmed at times.  I feel unhappy and unfulfilled.           Advantages: 20 Disadvantages: 80  Semantic Method: Re write your personal value I want to be a mum to My daughter and help her along and invest myself into her. But I also want to treat myself the way I treat her. She has a “right” to live a happy and fulfilling life, but so do I. Our needs and desires are equally important and deserve the same attention and care. I can only continue to look after My daughter well if I look after myself too and take myself and my needs and desires as seriously as I do hers. There needs to be a give-get balance so that both of us can be healthy and happy and stay healthy and happy. I want to help her to slowly take new steps into independence and support her lovingly along the way.   2. What's the best treatment for anxiety and dysthymia? Hello Dr. Burns, What method of treatment would you suggest for GAD and dysthymia? 3rd wave CBT, ACT? What is best based on science? Can you recommend some books please? thank you Martin David's Reply My books are listed on my website, FeelingGood.com. They all describe my approach, which is a bit like CBT on steroids. But every patient is treated individually and uniquely, following a structured and systematic approach that facilitates rapid and dramatic change. I don't recommend “methods of treatment” or “schools of therapy” based on so-called “diagnoses,” but treat the individual with TEAM. Every session with every patient is an experiment, with precise measures at the start and end of every session. The new Feeling Great App, now available, gets a mean of 50% or more reductions in seven negative feelings, such as depression, anxiety, and more, in 72 minutes of starting to use the bot. You can check it out for free! Anxiety and depression often co-exist, and the app targets both. My book, When Panic Attacks, describes my approach to anxiety, based on four models of treatment: the Motivational, Cognitive, Exposure, and Hidden Emotion Models. If you use the search function, you can find podcasts describing those models. Also, there's a free anxiety class on this website. Thanks, Martín, for your excellent question! Best, david 3. Can you do Externalization of Voices on your own? Hi David, Long time listener of your great podcast and huge fan of your book Feeling Great. I've often heard you mention that “externalization of voices” is one of, if not the most powerful CBT techniques. I am just wondering if it is still almost as effective when done solo without a therapist i.e. the person takes on both the roles of positive and negative by recording themselves talking or similar? Also, have you any data comparing the efficacy of TEAM CBT work carried out solo using Feeling Great/your podcast as a guide vs. TEAM CBT performed with a trained TEAM therapist? I am very much looking forward to the Feeling Great app launch in the UK as hopefully that will be a much more effective way to do personal work without a therapist. Many thanks, Eoghan (pronounced Owen) David's reply Thank you, Eoghan! Appreciate your support and thoughtful question. I don't have any data on the use of EOV on your own. One could use a recording device, like your cell phone, and record  your negative thoughts in second person, “you,” and try to defeat them when you play them back, one at a time. But in my experience, people nearly always need an experienced role player to do role reversals to show them how to get to a “huge” win. People almost never get a huge win when doing it for the first time, because the therapist (in the role of positive self) can model unfamiliar strategies for the patient. Generally, a hugely successful response involves a combination of self-defense, self-acceptance, and the CAT, or counter-attack technique. And sometimes other methods as well, like Be Specific, for example Radical new learning is definitely the key to success with EOV. Now, thanks to the app, everyone can practice, since we've trained our Obie Bot to role-play with users, do role reversals, give feedback, and so forth. Great question that I will include in the next Ask David if that's okay! We are also exploring the combination of the Feeling Great App plus a trained TEAM therapist from the Feeling Good Institute in Mountain View, California. We are hoping that 1  + 1 may equal 3. Wouldn't that be awesome? What I've found when doing research is that the results are virtually always wildly unexpected! Somethings come out great, and some things come out dismally. I always tell myself that “the Lord giveth, and the Lord taketh away!” Seems to be the rule in research! Especially when you're wanting to be guided by the truth, and not so much by your hopes and expectations. Best, David

Feeling Down? Try the Feeling Great App for Free! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it  out at FeelingGreat.com! What's the Meaning of Life? Before we start today, I have a special shoutout to Max Kosma, our new colleague, friend and brilliant technical guru who helped make our new video studio possible! Next week, we'll see if we can pipe him in to say hello to all of you. His spirit is joyous, infectious, incredibly generous and supportive. Thanks, Max! Rhonda opened today's podcast with a vibrant and inspiring endorsement from Jeff, a podcast fan who was raving about the Feeling Great App. Thank you Jeff, and please check out our new app at FeelingGreat.com. Important Announcement Rhonda, along with a group of dedicated TEAM Therapists, including Amy Berner, Brandon Vance, Leigh Harrington, Mariusz Wirga, and Mark Noble, has just created a new non-profit organization called TEAMCBT International (TCI). TCI will provide seed money in the form of no-or-low-interest loans for groups around the world who want to offer TEAM-CBT intensives for therapists in your country. Rhonda has been instrumental in the organization of successful intensive workshops in India, Poland, Mexico, England and Ireland. They have been well received, but can be somewhat costly to produce, so Rhonda's new group is ready to provide a helping hand. I've had the honor of presenting keynote addresses, live therapy demos, and Q and A sessions in many of those programs, and have totally enjoyed them. A big hug and THANKS to Rhonda once again! To learn more, just go to TEAMCBT.International. Today, Matt joins us for a discussion of the meaning of life, something young people often worry about, but people of any age can be concerned. So, today, you may finally find the answer to that lofty question! But first, I (David) mentioned a little about one of last week's questions, “Is the universe real?” I provided the type of answer the famed philosopher, Ludwig Wittgenstein, might have provided. Namely, that the question is nonsensical, it is language “out of gear.” So, we can dismiss the question, as opposed to trying to answer it. HOWEVER, the question DOES make a ton of sense when we ask if human beings are “real.” And I am not referring to some metaphysical nonsense, but rather the tendency of many people to present a happy or confident false front, all the while feeling empty, lonely, anxious and ashamed inside. Two of the now more-than-140 TEAM techniques include Self-Disclosure and the Survey Technique, where you take the chance of opening up about some of the secrets you've been hiding, and ask others what they think about you. Although this takes tremendous courage, it often results in tremendous warmth and connection to others. I provide a description of a young man who disclosed a tremendous amount he'd been hiding in our recent Tuesday group at Stanford, and he was convinced the group would judge him and look down on him. But just the opposite happened. He encountered a flood of warmth, admiration, and respect from the people in our group. A small miracle, perhaps, but a real and meaningful miracle at the moment when his universe suddenly became “real” and radically different from the dangerous and critical world he'd feared and imagined. Then we tackled today's philosophical question: “What's the Meaning of Life?” As usual, our brilliant and beloved Matt May began with a description of an extraordinarily depressed patient he once treated who'd been hospitalized for 180 days with no improvement, including a very dangerous suicide attempt. Matt was worried for the patient's safety, so told the referring doctor that he'd been willing to talk with the patient while the patient was still in the safe environment of the hospital. The patient called Matt and, after some listening and empathy Matt said he would like to help and that there would be committed to helping the man and thought he could help him make a complete recovery, work with this man, and thought there was an excellent chance for significant progress, perhaps even complete recovery, but the patient probably wouldn't want to work with him.as long as he'd be willing to give Matt what he needed in order to work together effectively. Matt suggested the patient give him a call. On the call, Matt told him he might not be able to afford treatment, since part of the “cost” of therapy was that the patient had to make a commitment to life, and that he must agree never to attempt suicide no matter what, for the rest of his life. After a couple days of reflection, the man convinced Matt that he WOULD make that commitment. Then Matt described the man's problem. Both of his parents were world famous, successful scientists, and during his upbringing, his parents emphasized how fantastic and rewarding a career as a scientist could be, and he was convinced that his parents expected him to follow in their footsteps. He had "learned that doing science was the "meaning of life" and would inevitably result in his feeling satisfied, joyful and proud. So. sure enough, this young man, who was extremely bright, pursued a scientific career, and eventually one of his papers was accepted for publication in one the world's most prestigious research journals. There was a big party at his laboratory, and everyone congratulated him and sang his praises. But there was one big problem. He felt nothing! Of course, he smiled and didn't let on that he felt nothing. He tried to act happy, but simply WASN'T. He said, “I faked it.” He concluded that he must be defective, since he'd done what he was supposed to do, in order to feel joyful and happy, but he felt nothing, even though he had fulfilled his parents dreams and expectations for him. This plunged him into his severe depression, with the familiar theme of “I'm not good enough. In fact, I am deeply flawed and defective, incapable of feeling joy or happiness. There must be something terribly wrong with me!” Sound familiar? Did you ever feel like YOU weren't good enough? During an early session, Matt asked his patient what he really enjoyed, what he'd really LIKE to do with his life. The patient confessed, after much resistance, that he felt that his fantasies were totally ridiculous, but what he really loved were trains, photography, and painting. He said his dream job would be to be a conductor or engineer on a train where he could take pictures of the scenery and especially, the people on the train. BUT, he said, that would be meaningless, since he wouldn't be contributing to science and would be letting everyone down., etc. etc. etc. I bet you can guess what followed! If you were his shrink, what would you say or do? Put your ideas here, into the text box, and then I'll tell you!   If you took a guess, thanks! If you didn't, no problem. Matt suggested he do those very things—take a train somewhere, start snapping photos, and do some painting. Predict how satisfying each thing will be (0 to 100) BEFORE you do it. Then do it, and record how satisfying each activity actually was on the same scale of 0 to 100. He exclaimed, “I'd LOVE to do that,” and started crying. His depression score immediately fell to zero. The next week he brought a large cardboard box to his session. It was filled with books on ancient philosophy and how to find the “meaning of life.” He said, “I don't need these anymore, so they're a gift to you!” Matt said, “I don't need them either!” Now you know about the “meaning of life.” We discussed some of the many meanings in this story, including: Rhonda pointed out what Kurt Vonnegut said on the meaning of life. He said, “We're all here to fart around!” David discussed the basic idea that it's not what we're doing, but our thoughts, that trigger ALL of our feelings. And at the moment you learn to turn off that critical voice in your brain, you will experience your own “enlightenment. David has also said, over and over, that when you discover that you no longer need to be “special,” you can experience the “Great Death” of the “self,” but it's not like a funeral. It's more like a celebration, because when you lose your “self,” and discover you didn't “need” the things you wrongly thought you needed (like love, achievement, perfection, etc.), at that moment you'll experience enlightenment and you'll inherit the world, and life, and deeper connections with the people you love. There's not one “meaning” to life. There are many meanings every day. And today, for Matt, Rhonda and David, it is VERY meaningful and joyful just to hang out with each other, and with you, so we can shoot the breeze together! Or, as Kurt Vonnegut said, so we can "fart around" together. Please keep your wonderful questions and comments flowing, and be sure to catch us in our new video version on my feeling good YouTube channel. Warmly, Rhonda, Matt, and David

Special Announcement #1 The Legendary Summer Intensive Starts on Thursday of this week! Featuring Drs. David Burns and Jill Levitt August 8 - 11, 2024 Click for registration / more information! This workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Podcast #408-- Does God exist? We started today's podcast with a beautiful testimonial and a shout out for the intensive from August 8 to 11, 2024 at the South San Francisco Intensive in person or virtually if you prefer. To learn more, contact www.CBTintensive.com. Act fast because the intensive is on Thursday of this week when today's podcast will be published. Today, we tackle another popular and intensely debated philosophical / religious puzzle: Does God exist? People have very heated views, one way or the other. I (David) will start with a brief explanation of a Wittgenstein answer to this question, and then for the most part, we will focus instead on the question of how we all incorporate spirituality into TEAM-CBT. Wittgenstein emphasized that philosophical problem exist when we debate about the meanings of words or terms that are vague, or poorly defined. Traditionally, we think there are three positions one could take: Theism: You believe that God exists. Atheism: You do not believe in God. Agnosticism: You say that you do no know whether or not God exists. My own thinking, which is strongly influenced by Wittgenstein, would be that I don't understand any of those three stances because I have no idea what you mean by your use of the word, “God.” What is it, exactly, that I'm supposed to believe in, or not believe in? To me, the question, “Do you believe in God,” is nonsensical, so I simply do not deal with it. All of the three positions listed above are based on the idea that the word, “God,” has some kind of clear meaning that we can all agree upon. But it clearly does not. You might define “God” as the “creator of the universe.” Well, there is certainly something magical and mysterious about the existence and creation of the universe (assuming it did begin with some kind of “big bang.”) Some questions might include “Where did all the energy come from all of a sudden?” Or “Are there many universes?” These are valid questions, and physicists are pursuing the answers, which is very exciting and fantastic. But they are generally not invoking the concept of a “God,” although some undoubtedly would say that they do “believe in Gad.” Regardless, I cheer them on and find every new discovery about the nature of the universe, and how the universe works, endlessly fascinating! For today, we will ask a much simpler question of whether and how we include some kind of spiritual dimension into our work as shrinks. This is a topic that is equally exciting, and definitely meaningful. Rhonda got us started by explain that she sees the belief in God as a matter of faith, and is not something that can be tested empirically, which is certainly true. She says she does believe in God, or some “higher power,” but does not believe in a God who “rules over things.” She was raised in the Jewish religion, and says that many Jews believe that God exists in everyone . This sounds a little like Hinduism, which traces back at least 2500 years ago, and possibly as early as 5000 years ago. I believe that the Hindus believe that God exists in everything. The practical impact of the belief that God exists in all of us, is that we will treat each other with love and respect, since we are all an expression of God. She also said that we can “create God among us as a community.” Matt said that he was raised as a Christian and that when he was growing up he had heard about miracles, like Jesus raising Lazarus from the dead in the New Testament on the Gospel according to John. He said that he views our work with individuals who are severely depressed as a kind of spiritual healing, even though we are working with purely secular methods. This is especially true when we are working with individuals who appear to be paralyzed by depression, claiming they are unable even to get out of bed, people who bombard themselves with harsh criticisms, and feel hopeless and ashamed. Matt said that self-acceptance (accepting ourselves exactly as we are) is one of the many tools we use, and that he (Matt) loves to think about the ripple effects of our work, which not only transforms the lives of individuals who awaken from their depressive trance, but this also has enormous positive effects on their friends and family as well. He asks, “How do we achieve this?” I (David) loved hearing from Rhonda and Matt on spirituality in TEAM, and pointed out many areas of overlap between TEAM and the Christian theology I was raised on, since my dad was a Lutheran minister. For example, The TEAM concept that you do not, and cannot, earn genuine feelings of worthwhileness or self-esteem through achievement. In other words, your worth is not your work, but something you give yourself unconditionally. In Christianity, we are sometimes taught that you cannot get to “heaven” through your good works. Enlightenment is a gift, a decision, and not something you have to earn. We also teach that humans are not purely good, but have a mixture of positive and negative motives, and that many people suffer because of guilt and regret about past errors or sins. When we are teaching the Acceptance Paradox, we are teaching a “letting go” of the inner abuse we endure from that relentless, critical voice in our brains, labeling us and telling us that we aren't good enough, we're “bad,” we're “losers,” and so forth, using powerful tools like the Externalization of Voices. In Christianity, this message is delivered in my ritualized ways, including the act of communion, confessing your sins and accepting the blood and body of Christ who “died for your sins.” This is just another way of sending the message that it is okay to accept the fact that you are flawed and fallen, and yet still worthy of God's love—and your own love! In the interpersonal TEAM model for troubled relationships, the entire emphasis on pinpointing your own role in a problem with a friend, colleague, loved one, or stranger, instead of casting blame on the other person and feeling angry and morally superior. My Relationship Journal is a tool designed to facilitate this process very rapidly. In Christianity there are many messages about taking out the moat in your own eye, as well as the idea that when you blame others, and cast judgment, you condemn yourself. There is a strong emphasis on humility and accountability in TEAM-CBT. This often comes up during positive reframing; we talk about how the patient's self-criticisms are often an expression of high standards, honesty, and humility, and that these are beautiful qualities that are real, important, and powerful. And this similar, it seems to me, to the Sermon on the Mount, where Jesus talked about “blessed are the meek, for they shall be called the Children of God.” There are many, many additional areas of overlap, and many books have been written on this subject. During the podcast I provided examples of how the spiritual and psychological realms can meet and reinforce each other at the moment the patient recovers and discovers their own enlightenment. I am proud to have developed TEAM-CBT, and it is clearly infused with many spiritual dimensions, even though it is entirely secular. I mentioned that I was born on a Sunday morning, and my dad said it was the only time he was unable to preach his sermon. He was too excited, especially since my parents had become reconciled to the notion that they could not have children. He called me David Dean Burns, and hoped that someday I would become D.D. Burns, D.D. DD is an honorary degree in theology, and he (and everyone) assumed that I would one day be a minister, like was. He was L.C. Burns, DD. (Lyle Charles Burns) I went in a different direction, but have kind of returned to my original calling, though threw an unexpected route, and hope you have all enjoyed our “sermons” this morning. I would add that I would never impose my beliefs or spiritual orientation on any patient, and only ask about the integration of their successful recovery with their own religious beliefs AFTER they have recovered, so as to add a deeper level of meaning to the work and transformation that they experienced. We only emphasized the Jewish and Christian approaches to spirituality because that was our upbringing, but the spiritual “discoveries” during TEAM treatment are actually compatible with nearly all, if not all, religions and spiritual paths. Warmly, Rhonda, Matt, and David

Ask David Bipolar, the Dark Side, Changing Behavior We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes. We love your questions. Remember to send them to David@feelinggood.com. Announcement: Our awesome summer intensive is returning after a long, five years due to the pandemic. It is typically the most outstanding and rewarding TEAM-CBT training of the year, and it will take place again and the wonderful South San Francisco Conference Center from August 8 – 11, 2025. You can attend in person if you register soon, since in-person seating will be strictly limited and only a small number are still available. You can also attend the online, live-streamed version of this program at a substantial discount. The online experience and small group exercises will be similar for the in-person and online participants. Check out the details, including early-bird discounts, at www.cbtintensive.com www.cbtintensive.com Hope to see you there! Warmly, david Today's Questions Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I'm suffering. What can I do NAME WITHHELD asks: Can or should a person really and truly accept their dark side? Trainor asks: In TEAM there is a strong emphasis on changing the way you think. But is it sometimes also important to change your behavior, or to make real changes in your life, or to help others who need help changing their circumstances==for example, people who are struggling in poverty.   1. Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I'm suffering. What can I do? Hi David, Many years ago I used your book to beat depressive thinking… in the last three years I've been diagnosed with Bipolar Disorder and have found my depressive thinking too difficult to budge with your book. I'm really suffering; any ideas about what I could do? Thank you for your service to humanity. I always recommend your book. David's response Hi Alison, A therapist could help. The new Feeling Great App could help. And tons of free resources at www.feelinggood.com. In addition, can you please give me an example of the negative thoughts you can't budge. Then we can point things out in the podcast and try to figure out why you're getting stuck! I have found that doing cognitive therapy / TEAM-CBT with individuals with Bipolar Disorder is exceptionally helpful during the depressed (not manic) phase, and works pretty much the same way as with anyone who's feeling down. Best, david   2. NAME WITHHELD asks: Can or should a person really and truly accept their dark side? Hello David, My name is NAME WITHHELD and I am doing my PhD degree in Neuroimmunology in LOCATION WITHHELD. I had come across your book feeling good and your podcasts by one of my therapists - they have had an immense impact on my way of thinking. I really love disarming and using “I feel” statements to connect! I had also realized that by finding some genuine truth in a person's belief even if it sounds ridiculous, I would automatically develop certain level of respect for that person! I really love that! I feel really happy that I can respect a person even without accepting his/her beliefs!! I am now working on my distortions. I really love working on my mind that way. Anyway, I have wanted to ask you if a person CAN accept his/her dark side? I seemed to have loathed myself for quite a long time and couldn't stand living alone without a partner or a person around. I hated myself for disrespecting my mother whilst growing up. But, sometime during Dec last year, I had had an epiphany of why things happened the way they did and somehow, I learnt that the reason why I had disrespected my mother was because my father, after their separation, kept filling my mind about how wrong my mother was for breaking up the family and I believed him because I had a good rapport with him, than I had with my mother. Also, my mother was very awkward in building a relationship with me and I had misconstrued that with her indifference towards me. After that, I stopped hurting myself over it because I had learnt to empathize with myself then. I sobbed profusely that day. Is it really possible to truly accept yourself? I feel at ease a lot more these days than I used to before. But I also have to battle my distortions too on a regular basis! Please help me out here! Thank you so much for everything that you have done!! I really love your work!! Regards, NAME WITHHELD David's reply Thanks so much. I hid your name and location, and hope that's okay, and we WILL include your excellent question on our upcoming podcast. My brief reply is that all human beings have a “dark side,” and that we are far better off accepting it, as opposed to denying it and seeing ourselves as “totally good,” because then we might see others as “totally bad,” and feel morally superior. This dynamic is the cause of wars and a great deal pf hatred and suffering.   3. Trainor asks: In TEAM there is a strong emphasis on changing the way you think. But is it sometimes also important to change your behavior, or to make real changes in your life, or to help others who need help changing their circumstances--for example, people who are struggling in poverty. Hey David! I have asked several questions over the years (I asked about A.I. which I much enjoyed the episode on that!), so feel free to ignore this email if you feel I've overburdened you guys. Anyway, I had a question about changing thoughts versus circumstances. You often say that our thoughts create all of our emotional and interpersonal realities. I thought maybe a better or more nuanced definition would be to also mention that events CAN change our feelings but they do so through changing our thoughts. I have heard Matt May mention this idea in some circumstances as the "low road to recovery." Where you actually get the thing you think you need and as a result feel better. However, I thought about certain situations where changing the circumstance could also be a valid solution to an individual's problems. Take someone living in poverty, I am certain that CBT could help this person change their emotions around the experience of living in poverty. But would bringing the individual out of poverty be considered a "low road to recovery"? Or could we say that bringing someone out of poverty is also a valid way of changing their emotional distress? Like sort of how therapists use both exposure and cognitive techniques to quell phobias or certain anxieties. I personally like this definition because it includes the ability to change your circumstances as a method to change your thinking, without it being the only method. It also makes sense in a world where people want to make changes in society (giving women the right to vote, ending child labor) and create environments that foster positive thinking. I think so much focus on the cognition (while fundamentally true) makes it feel like people should focus exclusively on changing the way they think about a situation. When, in reality, it seems like we can both change our circumstances and thinking simultaneously to make our lives better. Anyway, just wanted to know what you thought about this idea. Thanks for everything you do, Trainor Peters P.S. I have nearly completed my first year of my psychology undergrad to become a counselor. In great part to you and all the wonderful people on your podcast. So, thank you! David's reply. Thanks, Trainor, I will add this excellent question to our Ask David list, if that's okay, and discuss with Matt and Rhonda on a podcast. My hospital in Philadelphia was located in an inner-city neighborhood, and many (perhaps most) of our patients have very limited resources. Some were homeless, and many had not completed the 5th grade. This gave me abundant opportunities to work with people with “real” problems in addition to their distorted perceptions. In addition, I have always emphasized that sometimes you need to change the way you behave in the “real” world in addition to changing the way you think about it. We'll give these topics a deeper dive on the live podcast discussion. And, best of luck in your ongoing training! Once you are in a graduate program, you will be eligible, if interested, to join one of our two free weekly TEAM-CBT training groups, which are both virtual. Warmly, david Thanks for listening today! Rhonda and David 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. But there's some good news, too! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out!

#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!      

 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

393 Marina Dyck on TEAM for Insomnia Today we feature Marina Dyck, a TEAM-Certified Clinical Counselor in private practices in Swift Current, Saskatchewan, Canada. She works with individuals and families struggling with trauma, anxiety, depression, and relationship issues. She combines the latest research in neuroscience, powered by TEAM-CBT, and what she calls the "whole person" approach. Marina describes her innovative TEAM-CBT treatment for patients with trouble sleeping. Many of them toss and turn at night, unable to turn off their anxious and agitated brains, so they ruminate over and over about problems that are bugging them. Sound familiar? Here's David's quick, step by step overview of Marina's treatment approach, which is based on the steps of TEAM and the Daily Mood Log. Step 1. Let's imagine you're the patient (or the shrink), so you start with a brief description of the Upsetting Event at the top of the Daily Mood Log. It could be something as simple as ”Lying in bed for several hours, unable to get to sleep because I keep ruminating about a report I have not finished for work,” or some other problem. Step 2. Identify your negative feelings and estimate how intense each one is on a scale from 0 (not at all) to 100 (the worst.) For example, you may be feeling: Sad, down: 80% Anxious, panicky: 95% Guilty, ashamed: 70% Inadequate, incompetent, inferior: 90% Alone: 100% Discouraged: 80% Frustrated: 95% Angry, annoyed: 100% Step 3: Record your negative thoughts and how strongly you believe each one from 0% to 100%. For example, you may be telling yourself: I have to get to sleep! 100% If I don't get to sleep, I'll never be able to function tomorrow. 90% I should have completed my report for my boss today. 100% I should get out of bed and work on it. 90% There must be something wrong with me. 100% etc. etc. Step 4. Identify the distortions in these thoughts, like All-or-Nothing Thinking, Fortune-Telling, Should Statements, Emotional Reasoning, Magnification, and more. Now, if you're a shrink, after you've empathized, do the A = Paradoxical Agenda Setting or Assessment of Resistance. If you're a general citizen, you can do Positive Reframing. In other words, instead of trying to make your negative thoughts and feeling disappear entirely by pushing the Magic Button, you can ask two questions about each negative thought (NT) or feeling: How might this NT or feeling be helping me? What does this NT or feeling show about me and my core values that's positive and awesome? Example. In the current example you are 95% anxious and panicky about your report for work as well as the fact that you can't relax and fall asleep. Could there be some positives in your anxiety and panic? For example, these feelings might show Your intense commitment to your work. They may be a reflection of your high standards. Your anxiety, while uncomfortable, has probably motivated you to work hard and achieve a great deal. Your anxiety may protect you from danger and keep you focused on what you have to do to succeed and survive. Your anxiety could be an expression of your respect for your boss and for the company you're working for. Your desire to do a good job is probably a reflection of one of your core values as a human being. You could make similar lists for other feelings as well, like feeling down, guilty, discouraged, angry, and so forth. At that point, you can set your goals for every negative feeling. For example, you might decide that 15% or 20% might be enough anxiety and panic, and that 15% shame would be enough, and so forth. You can record your goals for each negative feeling in the goal column of your Daily Mood Log. This is much easier than if you try to reduce them all to zero by pressing the Magic Button. And even if you could, then all of the positives you listed would go down the drain, right along with your negative thoughts and feelings. Instead, you can aim to reduce them to some lower level that would allow you to relax while still maintaining your core personal values. Now we're ready for the M = Methods portion of the TEAM session. You will enjoy this portion of the podcast. Marina led Rhonda in three classic TEAM methods: The Paradoxical Double Standard Technique, the Externalization of Voices, and something Marina calls Distraction Training, which is actually a mix of Image Substitution, self-hypnosis, and relaxation training. Essentially, you focus on something positive and relaxing, as opposed to ruminating about all you have to do. This approach will come to life when you listen to the podcast, and I think you will agree that it IS innovative and significantly different and from 99% of what is currently sold as “insomnia treatment!” Marina emphasizes that you, the client, will have to agree to spend 15 to 20 minutes per day doing written work with the Daily Mood Log, or all bets are off. In addition, I would like to add that you and your shrink (or you and your patient) will have to find effective ways to combat each patient's ruminations and negative thoughts, because we're all quite different and our problems will usually be unique. In fact, that's why I (David) have created way more than 100 methods for challenging distorted thoughts. But here's the basic idea: When you learn to CHANGE the way you THINK, you can CHANGE the way you FEEL as well as the way you SLEEP! Thanks so much for listening today, and happy dreams! Marina, Rhonda and David  

Holding space for your child's feelings is often easier said than done. When your child is struggling in some way it can be easy to fall into the trap of trying to cheer them up, solve their problem, or convince them that there's nothing to be upset about. Using the 5 Secrets of Communication, a TEAM-CBT technique, is a great way to hold space for your child and strengthen your connection with them. In this episode Dr. Coor does a “5 Secrets” deep dive with Chelsea Dorcich, a level 4 TEAM-CBT therapist who works with children and adolescents. Project Parenthood is hosted by Dr. Nanika Coor. A transcript is available at Simplecast.Have a parenting question? Email Dr. Coor at parenthood@quickanddirtytips.com or leave a voicemail at 646-926-3243.Find Project Parenthood on Facebook and Twitter, or subscribe to the Quick and Dirty Tips newsletter for more tips and advice.Project Parenthood is a part of Quick and Dirty Tips.Links:https://www.quickanddirtytips.com/https://www.quickanddirtytips.com/subscribehttps://www.facebook.com/QDTProjectParenthoodhttps://twitter.com/qdtparenthoodhttps://brooklynparenttherapy.com/

Do we have a "Self"? Or "Personality"? What's the best way to combat Should Statements?  Is TEAM effective without a therapist?  What's the Difference between Positive Reframing and Positive Thoughts?  Note: The answers below were written by David prior to the podcast, just to give some structure to the discussion. Keep in mind that the actual live discussion by Rhonda, Matt and David will often go in different directions with different information and opinions. So, please listen to the podcast for the more complete answers! Questions for today's Ask David Podcast: Stefan asks if we have a “self” or a “personality.” Slash wants to know how to combat a “Should Statement.” Magellan asks about the effectiveness of TEAM without the guidance of a therapist. Werner asks about the differences between Positive Reframing and the Positive Thoughts you record on the Daily Mood Log.   1. Stefan asks if we have a “self” or a “personality.” What is the so-called “Great Death” of the “self,” referred to in Buddhism? Hi David, I really love your work, both the books and the podcast you've created. Lots of great tools there. I think your down-to-earth approach is effective and great in de-mythologizing mental health care. Still, one thing has been bugging me about your approach: the fact that you quite casually seem to discount the existence of the self. As a theologian I understand this position. In discounting the self as a construct, you'll open the way to less resistance and more acceptance. I studied both Christianity and some Buddhism, and in that tradition the self is essentially something to let go of as an illusion. I think you called this the death of the ego, and it's common in many mystical currents both within and without the major religious traditions. However, by embracing this tradition in a therapeutic setting, I think there's a great risk to gloss over long-held implicit beliefs or patterns in the construction of a personality that might hold people back from reaching their full potential. More specifically, I'm talking about schemas or Lifetraps (in the terminology of Jeffrey E. Young and Janet S. Klosko). I know Aaron Beck supports their work to address these “chronic self-defeating personality patterns” that are usually considered the be part of the self. What's your take on their work? Kind regards, Stefan David's reply Hi Stefan, Personality, like "self" is not a "thing," but just the observations that different people have different behavioral patterns. So, some are more outgoing, for example, while others are more introverted and shy and insecure. The only meaning of "self" is the context in which the word appears. So, "behave yourself" simply means that you are misbehaving and need to stop! Can you come to the Sunday hike is a question. It does not need the add on, "and do you plan to bring you 'self.'" The only meaning of any word is the context, and many uses in the English language, or any language. Nouns do not always refer to "things." Words are just sounds that come out of our mouths. I don't go into this much because few people "get it." Thanks so much, Stefan. Warmly, david PS The above is my take on Wittgenstein's Philosophical investigations, published after he died in 1950. . Second PS I had a random and fairly weak thought, but here it is. When doing my daily “slogging” a while back, I was going through a pleasant and familiar path and noticing how beautiful everything was, and had the thought, “This land is so valuable and expensive, and I'm SO GLAD I don't have to own it. It would involve a nightmare of paper work, taxes and all kinds of worries. But I can just enjoy it without any of those burdens of ownership. Then I thought of the “self,” and what a heavy burden it is to “have one,” and worry about whether or not it is “good enough,” or “inferior,” and so forth. Selves tend to be a bit overweight, and heavy to carry around. And how much more fun, beautiful, and rewarding life is without having to have a “self” to worry about. Rhonda found this helpful after a time feeling confused about the "self," and Matt added this: "Right, and if we own the 'land' one day, and it changes, the next moment, is it the same 'land'?  Do we still own it?" Matt's "Self" Thoughts Wittgenstein is one of my favorite philosophers due to the elegance of his solution to philosophical problems, which is to recognize that they are not, in fact, ‘problems'.  Instead of trying to answer the question, ‘is there a self', ‘do I have a self', he would point out that these questions are meaningless and can't be answered. One way to bring these questions into a form that could be useful and answerable, is to define the terms.  What is the ‘self', and what can it do?  How would I know, if I had a ‘self'?  If the definition was in the form of a testable hypothesis, we'd be a step closer to arriving at a meaningful answer. In some cases, this answer is incredibly meaningful, in terms of our mental state and relationships.  Let's try on a few possible definitions of ‘self' and consider some experiments that could be done to test whether these hold water. ‘Self':  (from Meriam Webster):  one's essential being, which separates them from others.  (I don't find this definition useful, because now I just have to define what is an ‘essential being'?  What are we talking about? ‘Self':  The subject of our experience; the thing that is thinking our thoughts, and feeling our feelings.  (This is also problematic for many reasons.  First, it's based on an unproven assumption that experience requires an experiencer.  Descartes believed this but Nietsche retorted that this logic was highly flawed as it smuggles the ‘self' into the equation without any justification.  Further, there are many ‘nondualistic' philosophies that challenge the ‘separateness' of ‘self' and experience.  Meaning, the presence of thought doesn't mean anything other than the presence of thought.  We ought to be skeptical of introducing additional complexity into the situation according to the principle of ‘Occam's Razor', that the simplest hypothesis that explains all the observations is more likely to be correct). ‘Self':  The ‘CEO' of your mind, the aspec of yourself that is directing your body, attention and decision-making.  (This is problematic in many of the same ways as the above definition.  It's also the most readily falsifiable definition.  We can experiment with our ability to control our decision-making in a variety of ways, one of which is to see if you can ‘choose', with your ‘self' not to understand the words on this page.  Or to sit quietly and not think.  If our ‘self' can't use its ‘free will' to control the brain's activities in such simple ways, why would we imagine that we have a self, controlling our brain, at all? In fact, most of us believe in a ‘self', which, if we attempt to define it carefully, it can be proven NOT to exist.  However, this is an unacceptable conclusion for many people, even though it results in a form of enlightenment.  This form of enlightenement is slightly different from ‘self acceptance'.  It's more like ‘waking up from a dream of a self' than ‘acceping a flawed self'. All that said, yes, it's often incredibly useful to inspect our assumptions about our ‘self', in terms of our ‘roles' and ‘rules' in our relationships.  David offers the ‘Interpersonal Downward Arrow' to do this in a single session.  There, we might discover we are stuck in a belief system that is counterproductive, like, ‘we must be perfect', ‘we should never have conflict', etc.  There are countless ways people think about their ‘self' which can be productive or a ‘trap'.  Obviously, if we had no sense of our identity, purpose, role, etc., it would be hard to know what to do with our ‘selves' on a day-to-day basis!   2. Slash asks how she can combat her “Should Statement.” Hi David I did some exercises and found I a believe that I should play guitar effortlessly or else I should enjoy the process of learning. My disadvantages are greater in CBA. Now what thought should I replace with so that I could have the advantages too. Slash David's reply Thanks, Slash! It is a should statement. Essentially, your “should” doesn't make sense since there is no rule that says you should, must, or ought to enjoy something you don't enjoy right now, so you are just putting pressure on yourself unnecessarily. I once had a patient who had previously been treated briefly by Dr. Albert Ellis when he was in New York. He was on vacation, and was feeling depressed and telling himself that he SHOULDN'T be unhappy since he was on vacation. He thought he SHOULD be enjoying himself. He said that the thing that helped the most was when Dr. Ellis said, “Where the F__K is it written that you are obligated to enjoy being on vacation?” (Ellis used that word a lot!) He said he immediately gave himself permission to feel miserable on vacation, and instantly felt better! This is an example of what I call the Acceptance Paradox. When he accepted his unhappiness, instead of struggling in shame to make it go away, it disappeared. I have a similar story. I used to have a keen interest in collecting coins from around the world, and when I was an intern at Highland Hospital in Oakland, I used to enjoy going to the local coin stores to see if I could find some interesting foreign coin to purchase for a few dollars. This was always exciting, but one day I was in the S & D Coin store just a few miles from our apartment, realized I was totally bored and had lost my interest in collecting foreign coins. I told the friendly dealer, and he said, “Oh, don't worry about it. Just do something else in your free time for a few weeks and your interest in collecting will probably come back.” So, I did that, and that's just what happened. Essentially, he was also giving me “permission” to feel the way I was feeling, and not the way I thought I “should” feel! And when I accepted my negative feelings, they ran their course and disappeared. That worked for me, but there are a lot of methods in TEAM, and you sometimes have to try quite a few before you find the one that works for you, since we're all different. The “go to” method for Should Statements is called the Semantic Technique. Using this method, you could tell yourself, “Right now I seem to have lost interest in music. It would be great if it comes back again, and probably will. But it's natural not to feel excited about music all the time.” Notice that I used “it would be great if” in place of the “Shoulds.” As an aside, we just completed a new class for the Feeling Great App entitled “Your PhD in Shoulds.” You might want to check it out. There's also a lesson on perfectionism at the end of the class. Best, david Cost-Benefit Analysis If I make mistakes, then I am not talented enough to play guitar.(associating my self worth with talent of playing guitar.) Advantages of Believing This Disadvantages of Believing This 1.It will push me to work harder. 1.There is lot of internal pressure. 2.It will motivate me to try different things until I find any solution. 2.It makes me depressed. 3.It can help me to be perfect/achive skills like my idol guitarist. 3.It ruins my currently playing technique I want to master. 4.People will admire me. 4.It makes me stuck at particular point from where I am not able to move forward. 5.It shows that I am one cut above others. 5.It hinders my progress with respect to guitar playing skills. 6.People who think I am not enough I can prove it to them. 6.It makes me frustrated irritated. 7.It can help me to be confident. 7.Endless cycle which I feel I am stuck in the moment and cant get out of it.   8.The quest to achieve will take forever which will make me hopeless and which further decreases my tolerance to make mistakes/which will further make me vigilant to see my mistakes as fault which cannot be corrected.   9.My moral goes down.   3. Magellan asks: Can you do TEAM-CBT without a shrink? Dear David, Could you tell us about studies of the effectiveness of any written TEAM or other therapy materials offered without therapist guidance (for example when people are on a waitlist to see a therapist)? I think I heard of one done with Feeling Good. I wonder if one may be done with Feeling Great. Thanks, Magellan David's response: We have impressive results with our app, which I can describe. It is completely automated without therapist guidance. It is kind of like my first book, Feeling Good, on steroids! I also have precise data on waiting list controls. The waiting list do not improve until they start the Feeling Great App and then they experience rapid and dramatic changes with a couple days. There's no doubt about the effectiveness of the app. Also, there's extensive research proving the effectiveness' o my first book, Feeling Good. There's no question about the effectiveness of these self-help tools. I have many questions about the effectiveness of human shrinks, however!   4. From Werner Spitzfaden: Positive Reframing vs Positive Thoughts I periodically come across clients who get confused by the concept of the Positive Reframing vs Positive Thoughts on the DML. The question they pose is if the Positive Reframe is similar to the Positive Thoughts on the DML? After some explanation I focus on Positive Reframing as a way of seeing that even the most difficult and painful thoughts and feelings reveal something powerful and awesome about us and then ask if that's true about them. This focuses on Outcome Resistance. The positive thoughts on the DML focus on defeating their negative thinking with 2 conditions needing to be present: their new positive thought needs to be believable and it has to drastically reduce the distress resulting from your negative thought. This focuses on the early stages of Methods coming after looking at Distortions followed by the Straight Forward Technique. I would love to hear David's take on this. David's Response Yes, Werner, you are right! The goal of Positive Reframing is not to “Cheerlead” or to persuade the patient that their negative thoughts are not correct, but rather to help them see why they may fight to hang on to their negative thoughts and feelings, because they are beneficial and helpful in many ways. This is the latest list of questions you can ask when doing PR with a negative thought. Most will also apply to a negative feeling. What is the truth in this negative thought? (This is essentially the Disarming Technique applied to your own self-criticism) Why might this negative thought or feeling be healthy and appropriate, given my circumstances. Why might this negative thought or feeling be helpful to me? What does it show about me and my core values that's positive and awesome? What might be some negative consequences of giving up this negative thought or feeling? You were spot on about Positive Thoughts. To be helpful, they must fulfill two conditions. They must be 100% true. Half-truths and rationalizations are rarely or never helpful/ They must drastically reduce your belief in the distorted negative thought. Hey, Werner, we miss you like crazy in the Tuesday group and in our (now small and humble) Sunday hikes. Hope you're doing well.  

Transgender Issues Featuring Dr. Robin Mathy Emily Dickinson, from Amherst, Massachusetts, was one of the greatest American 19th century poets, and after hearing one of our Amherst professors explain her life and work, I fell in love with her incredible poetry. When she attended Mt. Holyoke College as a freshman, she was obligated to sign up as a “Christian,” a “Non-Christian with hope,” or a “Non-Christian without hope.” She was the only student who had ever signed up as a “Non-Christian without hope,” and she was given one semester to change her registration category. When she refused, she was asked to leave, and spent the rest of her life living in Amherst, baking cookies for children and writing her fabulous poems, which were sometimes included in her cookie packages. Her poetry was all about loss, which was much the story of her life. However, she was not self-pitying, which is part of what makes her poetry so sad and magical. Emily Dickinson always dreamed of visiting the west, but never got the chance to travel much beyond the outskirts of Amherst. She once wrote, To make a prairie, It takes one clover, and a bee. One clover and a bee. And reverie. The reverie alone will do, if bees are few. Tears come to my eyes every time I think about that poem! When I was a student at Amherst, we used to visit her grave, and I once actually knocked on the door of the house where she once lived. I explained I was a huge fan and actually got the chance to look around. I actually found a poem scribbled on a scrap of paper on a window ledge. Today we interview Dr. Robin Mathy, who describes herself as “A human who hopes.” Robin is a well-published expert on LGBTQ issues, with a specialization in transgender research and political activism based on science to debunk hateful myths about sexuality. She is also a new member of our Tuesday training group at Stanford! In addition to studying to become a TEAM therapist, Robin is a Doctor of Social Work student at Tulane University.  She is a researcher and activist who has published four books and more than 50 peer-reviewed articles or book chapters.  She is a beloved member of David and Jill's Tuesday TEAM CBT group. Rhonda kicked off today's podcast by reading two very moving endorsements from people who heard part 1 of the live work with Jessica, “Living with Regrets,” which we had published just prior to our interview with Robin. Then Rhonda kicked off our dialogue with Robin by asking if there are any special treatment considerations when you are working with trans individuals. Robin said that there really aren't—TEAM-CBT is already highly personalized and individualized, so we let the patient set the agenda. Robin emphasized the importance, of course, of being warm, affirming, and supportive. In addition, do not assume that the patient is there because of gender identity issues, or automatically refer them to a support group on that topic, because the patient's issue may be radically different, and that would amount to stereotyping your patient. I asked Robin for a simplified introduction to LGBTQ, including what these terms actually mean. That's because I have to admit I never had any good sexual diversity training during my medical school or psychiatry residency, and I suspect that some of our podcast fans, perhaps many, would also appreciate a little enlightenment based on science. Robin pointed out that transgender has to do with identity issues: what is your sense of self? Do you see yourself  more as a woman or a man? And sometimes, this will be quite different from the gender you were assigned at birth. So, for example, you may be assigned as a boy at birth, but your sense of who you are may be a girl, when you are young, and a woman as you develop during puberty. In this case, you would be a trans-gender woman. To be respectful, you should refer to a transgender woman as she or her. And, of course, if you were assigned as a girl at birth, but your sense of who you are is a boy/man, you would be a transgender man, referred to as he / him. Some transgender people are nonbinary, meaning they do not want to be referred to as either a man or a woman, and they do not want to be referred to with either binary pronoun. To be respectful and sensitive, you should always ask someone what pronouns they prefer. In contrast, the terms, LGBQ, do not refer to gender identity, but rather to sexual attraction. So, a lesbian is a woman who is sexually or romantically attracted to women, and a gay man is attracted to men, and so forth. The term, “cis,” refers to your gender that was assigned at birth. According to the National Center for Transgender Equality, When a person begins to live according to their gender identity, rather than the gender they were thought to be when they were born, this time period is called gender transition. Deciding to transition can take a lot of reflection. . . . Possible steps in a gender transition may or may not include changing your clothing, appearance, name, or the pronoun people use to refer to you (like “she,” “he,” or “they”). But it can be a bit more complex. Robin says: A lot of people like me do not actually identify as transgender. I was assigned as a male at birth, but I have always felt like a girl / woman. I think of myself as gender-diverse, not as transgender. . . I remember taking a bath with my sister when we were young, and I realized that I had something that didn't belong on me. . . . My parents raised me as a boy, but I was always effeminate. As I developed as a teenager, my transition was from being “me” to being “fully me” and completely embracing my identity as a woman. This was freeing to me. We are taught to believe that there are two types of chromosomes that determine our gender: XX for female and XY for male. But this is misleading because there is actually a broad range of chromosomal makeups (sex), sexual attractions as well as gender identities, and gender identity and sexual attraction can be completely independent. For example, someone can be a transgender woman, and be attracted to either men or women or both. Robin pointed out that some transgender women can look like glamorous women, and two transgender women have actually won national beauty contests. "It is cruel," Robin suggests," to insist that transgender women must use men's bathrooms, just because they have the XY chromosome set." She pointed out that gender identity usually develops by age 7, but in trans individuals the incongruity between their gender identity and sex assigned at birth crystallizes at around age 10 or 11, during puberty. Although many transgender people recall being gender nonconforming and/or identifying as another gender in early childhood, we now know this is not always the case. We discussed the pain of discrimination trans individuals face, and Robin described her own suicide attempt in her early twenties, in part because her male sexual organs and secondary sex characteristics like facial hair “disgusted me.”  Fortunately, she was assigned a very understanding gay psychiatrist in the hospital, and he said that she could start transitional hormone therapy right away if she was interested, and this was a great help. She said that she was a candidate for the Olympic wrestling team, and it was clear that she did not appear feminine to others because of her muscles, and she experienced a great deal of ridicule and rejection when began to transition. This negative bias included some medical professionals she consulted for help. Eventually she was able to obtain gender-affirming surgery. She said she came out as gender-diverse in March 2023 to be an advocate because 24 states in just the past three years have banned gender-affirming medical care for minors. Robin also clarified the meaning of the term, queer, which used to be a pejorative term. Now it is embraced by the LGBTQ community as a term referring to all sexual and gender minorities. Toward the end of our interview, Robin emphasized the importance of hope, and said she had a “glimmer” of hope, even in her darkest hours. To learn more about Robin's pioneering work, or if you are interested in the science and research regarding transgender issues, Robin warmly invites you to visit her YouTube channel, (27) Robin Mathy - YouTube. She says, “Please feel free to disseminate the information” and wants you to know that “I love comments (positive and negative).” So give her some feedback if you're so inclined! Thanks for listening today! Robin, Rhonda and David

The Anxious Child— Three Common Errors Parents Make, and How to Avoid Them!  Featuring Dr. Taylor Chesney Today we interview Dr. Taylor Chesney who is the Director of the New York office of the Feeling Good Institute. She specializes in the treatment of children and teens, and today will tell us about the three biggest errors parents make in dealing with anxious kids. Dr. Chesney has been a guest on several of our podcasts in the past (episodes 107 and 263, and Corona Casts 4 and 6) and is a terrific teacher and therapist. She recently taught a 12 week course for therapists working with teens and children (ages 6 to 18) and their parents and brings us some of the highlights today. She always begins treatment by interviewing the child and the parents and pinpoints what they want help with. Then she assesses how hard they are willing to work to bring about that change. The goals may be quite different for the child and the parents. It's crucial to develop a meaningful therapeutic contract with the children, as well as the parents, as opposed to thinking your role is to “fix” the child for the parents. If the child is less than 11 years old, she meets with the parents first. If the child is 12 and up, she meets with the child first. Either way, she empathizes with the child and encourage them to tell their side of the problem. During or after empathizing, she does Positive Reframing, to show the child what their negative feelings, like depression and anxiety, show about them that's positive and awesome. For example, if you're sad about not being invited to a birthday party, it shows that you value friendships, and that you care a lot about other people. If the child is anxious, she will teach them how their anxiety can be helpful. For example, if the child is a good athlete or student, anxiety can be an important motivating force in their success. But sometimes we might get too anxious and feel intensely anxious about something that is not actually dangerous. Then you might experience your anxiety as trouble eating, a belly ache, trouble sleeping, or some other symptom that gets in the way of your optimal functioning. The most important question with parents and children is usually: “Do you want to learn some tools and skills to help you change the way you feel?” She also teaches children and teens what different kinds of emotions are, and the kinds of thoughts that trigger them. For example, if you feel anxious, you're probably telling yourself that you're in danger and that something bad is about to happen. If you feel guilty, you're probably telling yourself that you've done something bad, or that you hurt someone you love; and if you're feeling angry you may be telling yourself that someone is trying to hurt you or take advantage of you. Taylor brings the core cognitive therapy ideas to life with examples that children can understand.  Here's how she explains the idea, taught by Epictetus nearly 2,000 years ago, that our feelings do not result from what happens to us, but from our thoughts about what's happening. Let's say that you got a 90 on a test. How would you feel? You might feel overjoyed if you studied hard and felt like you did a good job and got a wonderful grade. However, if you felt like you had to get a 95 to raise your semester grade in the class to an A, and you even skipped going to the prom to study extra hard, you might feel sad, ashamed, frustrated, angry, and disappointed, telling yourself that you “failed.” Same grade, but two radically different emotional reactions, depending on how you think about your grade. Conclusion: it's not what happens, but what you tell yourself, that triggers all of your positive and negative feelings. Taylor said that anxiety is incredibly common in her clinic population and that surveys indicate that a whopping 25% of children have an anxiety disorder. She teaches her patients that anxiety in children, teens, and adults results from giving in to the urge to escape from a frightening or uncomfortable situation instead of facing your fears and discovering that the monster has no teeth. For example, Taylor was in the ocean with her 9 year old son, and there were jellyfish in the ocean. Her son was terrified and wanted to get out of the water and back to the shore. Taylor asked him what he was telling himself, and he said he was thinking that the jellyfish were bad. She also told him, “It's okay to be afraid and to be careful and avoid the jelly fish, but you can also choose to stay in the ocean. Then we can have some fun together playing in the water.” He decided to stay and have fun and felt proud of himself! She described Three Common Mistakes parents make in dealing with an anxious child. Error #1: The Quiet Out Trap She explained that we love our children, and don't want them to suffer, so we may give them an easy way out. For example, if your child is afraid to go to the party when you are dropping them off, you might say, “If you don't want to go to the party, we can go home.” This seems like a kind and loving thing to do, protecting your child. However, you're teaching the child that he or she can escape from anxiety through avoidance, so the child's fear of social interactions actually increases. It also teaches the child that you don't think they can handle the situation. An alternate response would be to say, “Let's go in and sit down together!” She advised against cheerleading or trying to convince your child that they have nothing to be afraid of (e.g. “it's not that scary” “there's nothing to be afraid of.”) Instead, you can tell them that it's okay to feel the fear but do it anyway, and you can often model that together with them. Error #2: The Escalation Trap In this trap, you let your fearful and avoidant child become more and more anxious and demanding, until they freak out and throw a temper tantrum, and then you give in to them. This, again, provides immediate relief, but in the long run you are training them to escalate and throw a tantrum to escape from having to face their fears, and on a broader scale, any time they want to get what they want. Error #3: The Mental Filtering Trap Mental Filtering is one of the ten original cognitive distortions, and it means focusing on the negatives in any situation and ignoring, or discounting the positives. It's a common cause of depression, but can also be a communication error if you focus excessively on what your child is doing wrong. Instead of pointing out your child's errors, you might say, “Johnny, I love how you stayed calm when X happened. You're really getting good at that.” In other words, you can comment on what they are doing right. She said that showing kids how to be successful is more effective than berating them for what they're doing wrong. This is an effective and low-stress way of reshaping their self-defeating behaviors. David mentioned that this positive style of communicating can also be highly effective in a work environment, and that he uses it a great deal in his interactions with colleagues on the app team. If done in a genuine way, it can quickly reduce conflict and enhance morale and mutual respect. How to Teach Parents David asked Taylor if many parents resist implementing these kinds of changes. Taylor said that if she calmly and clearly teaches the parents what they're doing that isn't working, using the Five Secrets of Effective Communication, most parents quickly become motivated to grasp their mistakes and change their strategies in dealing with their children. Taylor also “Sits with Open Hands” when making suggestions to parents. She explains it like this: This means that if what the parents are doing works for them, and they aren't willing to work hard to make changes, I accept this. But if they're willing to work hard and change, we can work together to help them implement more effective parenting strategies. Getting parents to work together as a team can be very important, but some parents may fight over the best way to discipline and raise their kids. These conflicts between mom and dad are one of the major causes of the unhappiness in the kids and get in the way of change. Taylor emphasizes “Little Steps for Big Feets,” and might set small attainable goals for the parents who are at odds. For example, can they just sit next to each other and perhaps even “fake” a unified front for one conversation? Parents do not have to commit to making these changes “for the rest of their lives,” but make experimental small changes instead, for a small discrete period of time, and then check in and see if the change makes a difference. If it does, they may be motivated to continue to try to implement more changes. Taylor typically works with children and their parents for 12 to 16 sessions and gives them a tool set to change some specific problem they came to therapy to solve. She has worked virtually for the most part since the start of the pandemic, but is now starting to see some people in person again. She offers classes for mental health professionals and also runs a monthly case consultation group on the last Wednesday of every month from 12:30 – 2 pm EST. For more information, you can reach Dr. Chesney at Taylor@FeelingGoodInstitute.com. Every fall, Taylor teaches a 12-week training course for therapists on TEAM-CBT for children and adolescents. You can also check the www.FeelingGoodInstitute.com website for more information on TEAM-CBT training for children and adults. Thanks for listening today! Rhonda, Taylor, and David

Personal Work with Dr. Tom Gedman-- Overcoming Performance Anxiety The Triumphant Conclusion Last week you heard Part 2 of our personal work with Dr. Tom Gedman, which included T = Testing and E = Empathy. This week you will hear the dramatic and inspiring conclusion of the session, including A = Assessment of Resistance and M = Methods. Dr. Tom's beloved pal   Start of Part 2 A = Assessment of Resistance We began with the Invitation Step, asking Dr. Gedman what he hoped to accomplish in today's session. His list included: Develop some clarity on the direction of my business. Become more authentic in my video recordings promoting my clinical work. Increase in self-confidence. Feel accepted by David and Rhonda. My ability to push ahead during recordings instead of stopping and backing down because it isn't “good enough.” Dr. Gedman said that he'd gladly push the Magic Button to make his negative thoughts and feelings instantly disappear, but agreed to look at some of the positives in them first by asking these types of questions of each negative thought or feeling. Is there some truth in this negative thought? Could this negative thought or feeling be appropriate or even healthy, given my circumstances? How might this negative thought or feeling be helping me? What does this negative thought or feeling show about me and my core values that's positive and awesome? Could there be some negative consequences of giving up this negative thought or feeling? The Positives in My Negatives Negative thought: “I can't be authentic on videos. I look like such s smug phony.” I want to be other-centered, and focused on how I might be able to relieve the emotional struggles and health problems of my patients. I value being authentic and genuine. I want to help people who resonate with my message. I don't want to hide. I want to be open with my flaws. I value honesty and integrity. I value humility. I value compassion. Negative feeling: sadness I care a great deal about my dream. I don't want to fail and let my family down. Negative feeling: shame Motivates me to work harder Shows my love for my family. I'm aware that I'm letting down the very people I want to help. Negative feeling: inferior, inadequate Show that I respect and admire the many people who have superior skills at talking live in front of a camera. Shows that I'm aware of what others have accomplished. Shows I don't feel superior to others. The idea behind the Positive Reframing is to help the patients see that their negative thoughts and feelings are not the expression of what's “wrong” with them, but what's right with them. This paradoxically reduces the resistance to change and opens the door to the possibility of rapid recovery. You can see Dr. Gedman's goals for each of the negative feelings on his Daily Mood Log if you click here. As you can see, instead of trying to eliminate his negative thoughts and feelings by pushing the Magic Button, he has decided to dial them down to lower levels with the Magic Dial. Of course, these are only goals. We will need methods to challenge and smash his negative thoughts so we can reduce his negative feelings. M = Methods Rhonda, Tom, and David used a variety of methods to work on several negative thoughts Tom wanted to work on first, including numbers 1, 2, and 4 from Tom's Daily Mood Log.. I can't be authentic. I look like a smug phony. 100% I waste so much time on my videos. I should be quicker. This should be easier. 100% David and Rhonda will judge me for what I'm doing. 80% We used several methods including Explain the Distortions, Survey Technique, Externalization of Voices (with Self-Defense, Acceptance Paradox, Counter-Attack Technique,) and more You can see Dr. Gedman's end-of-session scores on his nine negative feelings on his Daily Mood Log if you click here. As you can see, eight of the feelings fell all the way to zero, and his feelings of inadequacy fell from 100 all the way to 5. Toward the end of the session, we discussed Tom's medical and psychological philosophy, which might appeal to some of our podcast fans, especially if you live in England. First, he uses TEAM-CBT in individual two-hour sessions to help help people who are struggling with feelings of depression and anxiety. He finds this work thrilling because you can often see amazing changes within a single session, just like we saw in Tom's work today. Dr. Gedman also hopes to develop TEAM-CBT groups as well. This can be difficult because you need many referrals, but in my experience, TEAM groups can be incredibly effective, and cost-effective as well. In addition, Tom also has a Functional Medical Practice which focuses on developing healthy nutritional and eating habits, consistent exercise, limiting the intake of toxins, developing loving relationships via the Five Secrets of Effective Communication, and enhancing spirituality. If you would like to contact Dr. Gedman and learn more about his clinical practice, he can be reached at www.DrTomGedman.com. Toward the beginning of these show notes, I reminded everyone of how anxious and insecure our beloved Rhonda felt at the start of our work together, when she took over for Fabrice. And now, she seems to be the poster child for charm, warmth, humor, and charisma. That doesn't usually happen automatically. Rhonda, like Tom, did her hard personal work, using the Daily Mood Log and several TEAM-CBT methods. But one thing that has been especially helpful to her, after initially “beating” her insecurity, has been the constant exposure work, with hours of weekly podcast recordings. I, too, have had the chance to do constant, ongoing exposure for my own extreme feelings of inadequacy in front of live audiences or cameras, since I teach every week at my Stanford psychotherapy training class, as well as frequent  workshops, In addition, I have recorded almost daily for the Feeling Great App, which should be released in the first quarter of 2024. This exposure work has helped me cement and extend my gains in overcoming my own performance anxiety. I plan to contact Tom to recommend the same. Perhaps in England they have program similar to Toastmasters, where you can have the chance to speak in public frequently and get valuable feedback from peers and colleagues. I want to give a big hug and thanks to you, Tom, for sharing your intensely personal and real personal work with all of us today, and thanks, too, for reminding us of our own humanity and the magic of humility and the “Great Death” of the “Self.” Thanks for listening today! Tom, Rhonda, and David

What was therapy like in the years leading up to the advent of CBT? Has CBT now been over-sold? How does CBT differ from "the power of positive thinking"? How can therapists who use CBT avoid invalidating clients' feelings? When, if ever, should people listen to their negative thoughts? To what extent can a person's good qualities contribute to their depression? Can empathy be learned? Is it possible to cure depression in a single psychotherapy session? What is TEAM-CBT? Is exposure therapy cruel? What are some strategies for silencing the voices in our heads that lead to depression, anxiety, and other negative mental states?David Burns is Adjunct Clinical Professor Emeritus of Psychiatry and Behavioral Sciences at the Stanford University School of Medicine, where he is involved in research and teaching. He has previously served as Acting Chief of Psychiatry at the Presbyterian / University of Pennsylvania Medical Center (1988) and Visiting Scholar at the Harvard Medical School (1998), and is certified by the National Board of Psychiatry and Neurology. He has received numerous awards, including the A. E. Bennett Award for his research on brain chemistry, the Distinguished Contribution to Psychology through the Media Award, and the Outstanding Contributions Award from the National Association of Cognitive-Behavioral Therapists. He has been named Teacher of the Year three times from the class of graduating residents at Stanford University School of Medicine, and feels especially proud of this award. In addition to his academic research, Dr. Burns has written a number of popular books on mood and relationship problems. His best-selling book, Feeling Good: The New Mood Therapy, has sold over 4 million copies in the United States, and many more worldwide. When he is not crunching statistics for his research, he can be found teaching his famous Tuesday evening psychotherapy training group for Stanford students and community clinicians, or giving workshops for mental health professionals throughout the United States and Canada. Learn more about him at feelinggood.com.Further reading:Feeling Great: The Revolutionary New Treatment for Depression and Anxiety by David BurnsANNOUNCEMENT: EA NYC is hosting Spencer for a live recording of our podcast on January 30, 2024! The event is titled: "The moral status of insects and AI systems, and other thorny questions and global priorities research, with Jeff Sebo and Spencer Greenberg". If you'd like to attend in person, click here! Staff Spencer Greenberg — Host / Director Josh Castle — Producer Ryan Kessler — Audio Engineer Uri Bram — Factotum WeAmplify — Transcriptionists Miles Kestran — Marketing Music Lee Rosevere Josh Woodward Broke for Free zapsplat.com wowamusic Quiet Music for Tiny Robots Affiliates Clearer Thinking GuidedTrack Mind Ease Positly UpLift [Read more]

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  

Jessica Malvicino Live Work With Jessica-- Living with Regrets Rhonda and I recently did live work at a TEAM-CBT intensive in Mexico City. Our “patient” was a 40 year old mental health professional named Jessica with many years of unhappiness because of a decision she made when she was just 17. Perhaps you've also looked back on your life and thought, “If only I would have . . . “ done something I didn't do,” as well as, “I wish I hadn't done X, when I was young.” Last week you heard the initial Testing and Empathy portions of the session with Jessica. Today you'll hear the Assessment of Resistance, Methods, and final Testing..     Part 2 of the Jessica Session A = Assessment of Resistance Jessica said her goal for the session was learning to accept life and move on, and not have such constant feelings of emptiness, with so many “I should have” thoughts running through her brain. Although Jessica, like most people, said she'd press the Magic Button to make all of her negative thoughts and feelings disappear, we decided to do some Positive Reframing first, to see if there were some positives hiding in her negative feelings. We asked the following questions about a number of her negative feelings and thoughts: Why might this thought or feeling be appropriate and healthy? Why might this thought or feeling be helpful to you? Why does this thought or feeling show about you and your core values that's positive and awesome. ? As you probably know, the goal of there are two goals for this paradoxical exercise: First, we want to bring the patient's subconscious resistance to conscious awareness. Second, we want her to see that her struggling and suffering is NOT the result of what's WRONG with her, but rather, what's RIGHT with her. The moment that people really “see” and “get” this, there's often a sharp and sudden reduction in feelings of shame, and a strong burst of motivation to crush the negative thoughts at the heart of her misery. Here are some of the Positives we listed: SADNESS My sadness shows my passion and love of dancing. It shows my dedication to the idea of having a fulfilling career. It shows that I'm a very loving person. ANXIETY, WORRY, NERVOUSNESS These feelings show that I'm responsible motivate me to complete tasks help me avoid procrastination make me vigilant and protect me from danger SHAME These feeling show that I'm concerned about others I'm human I want to please others with my career I admire my mom and want to make her proud I want her to admire me I'm humble I want to feel close to others ANGER These feelings show that I'm a caring and passionate person I have character I have a moral compass I'm feisty and strong I'm accountable My anger also empowers me After listing these and other positives, Jessica decided to use the Magic Dial to reduce her negative feelings to lower levels, but not necessarily all the way to zero, as you can see in the goal column on her emotions table: Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, depressed, unhappy 90 20   Foolish 100 0   Anxious, worried, nervous 90 10   Discouraged 97 5   Bad, ashamed 95 0   Frustrated, stuck, defeated 100 5   Inadequate 90 0   Angry, mad, resentful, annoyed 95 10   Lonely 92 5   Other         Then we went on to M = Methods These were some of the negative thoughts that Jessica wanted to challenge, along with the percent she initially believed each of them: I'm a failure. 90% My mom is to blame for not understanding the career path that I wanted. 90% I was an idiot for not following my dreams. 100% Nothing will truly fulfill my professional career. 100% I have to “settle” for my professional career now.100% She had many others ad well. We used a variety of techniques to challenge and crush these thoughts, including the Externalization of Voices with Self-Defense, the Acceptance Paradox, and the CAT (Counter-Attack Technique), and used frequent role reversals to help Jessica get to “huge” wins when she was in the role of her positive thoughts. Here you can see Jessica's scores in the “% After” column. As you can see, her scores were extraordinarily low, which is terrific. Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, depressed, unhappy 90 20 0 Foolish 100 0 3 Anxious, worried, nervous 90 10 0 Discouraged 97 5 0 Bad, ashamed 95 0 0 Frustrated, stuck, defeated 100 5 10 Inadequate 90 0 0 Angry, mad, resentful, annoyed 95 10 5 Lonely 92 5 0 Other         Typically, such drastic and sudden reductions in negative feelings not only indicate “recovery,” but the experience of feelings of joy and enlightenment. At the end we asked Jessica two questions: Are the scores valid, or is she just trying to please us? If they are valid, what were the most healing and helpful aspects of the session? As you listen to the end of the live session, you'll find out what she said! Rhonda and I hope you enjoyed the session with Jessica. We believe that live work with real people, and not role players who are pretending to be in therapy, is invaluable, and one of the best—and only—ways to learn many of the subtleties of rapid and effective treatment. And if you are a general citizen, and not a therapist, I hope your found our work with the brave and wonderful Jessica to be inspirational and educational, especially if you have also sometimes felt depressed, anxious, or ashamed, and if you have found that regrets about the past can put a real damper on your capacity to live and enjoy your precious present moments! Our best teaching is usually through live work, and so we give you, Jessica, a warm thanks and salute for the great teaching YOU have done today! Thanks for listening, everybody! Jessica, Rhonda and David  

Live Work With Jessica-- Living with Regrets Rhonda and I recently did live work at a TEAM-CBT intensive in Mexico City. Our “patient” was a 40 year old mental health professional named Jessica with many years of unhappiness because of a decision she made when she was just 17. Perhaps you've also looked back on your life and thought, “If only I would have . . . “ done something I didn't do,” as well as, “I wish I hadn't done X, when I was young.” Today you'll hear the initial Testing and Empathy portions of the session, and next week you'll hear the Assessment of Resistance, Methods, and final Testing.. Part 1 T = Initial Testing DAVID WILL SUMMARIZE SCORES ON BMS AND DML You can also see her scores on the emotions table of her Daily Mood Log here. Emotions % Now % Goal % After Emotions % Now % Goal % After Sad, depressed, unhappy 90     Foolish 100     Anxious, worried, nervous 90     Discouraged 97     Bad, ashamed 95     Frustrated, stuck, defeated 100     Inadequate 90     Angry, mad, resentful, annoyed 95     Lonely 92     Other         As you can see, these negative feelings were all incredibly intense. E = Empathy Jessica, who grew up in Florida, explained that she started ballet dancing at the age of 3, and when she was 17, she won a prestigious full scholarship to study and have the chance to join a world renowned ballet company. Jessica was incredibly excited, but her mom did not see ballet as a “true career.” In addition, her mother was quite protective, which was not uncommon in the Cuban community, and told Jessica she could only accept the scholarship if she agreed to live with her grandparents in New York. Jessica angrily rebelled and turned down the offer. Although she continued to dance professionally until her first daughter was born 14 years ago, she battled with feelings of anger and regret the entire time, while also blaming her mother for her. unhappiness. She eventually got a bachelor's degree in journalism, and worked in television for a period of time. Then she got a master's degree in counseling, and found that she loves clinical work and helping people. However, she continued to live with feelings of regret and anger directed at her mom from age 17 to her current age of 40, for a total of 23 years, and explained that she frequently “takes it out” on her mom during periods of irritability. She also has feelings of grief about what she's lost when she see her young niece dancing ballet beautifully now. This statement brought tears to her eyes. Jessica described all the sacrifices she'd made when growing up in order to become a top dancer, including periods of bulimia to maintain the thinness that her teachers always stressed. She explained that “everyone did it—they weighted us frequently and would grill us if we were even a little bit overweight. . .” and this was all in order to fulfill her ultimate dream of becoming a world class ballerina, a dream that vanished. Jessica gave Rhonda and David an A on Empathy, and said that the self-disclosure felt uncomfortable, but helpful. Next week, you'll hear the inspiring conclusion of the work with Jessica!

Why Therapy Fails One of the most common reasons patients contact me is to find out why the therapy isn't working. They may be TEAM-CBT patients or patients of therapists using other approaches. Therapists also ask for consultations on the same problem--why am I stuck with this or that patient who isn't making progress? In the Feeling Good App, my colleagues and I have been looking into this as well. Most app users report excellent and often rapid results, but some get stuck, in just the same way they might get stuck in treatment with a therapist. I have tried to organize my thinking on this topic, because if you can diagnose the cause of therapeutic failure, you can nearly always find a solution. Of course, the app is not a treatment device, but a wellness device, but the same principles apply. So today, Rhonda, Matt and I discuss a couple reasons why therapists and patients alike sometimes get stuck. Matt described a patient who was misdiagnosed with a psychotic disorder who turned out to have sleep apnea. When the proposer diagnosis was made and treated, the patent suddenly recovered. Rhonda described a patient who jumped from topic to topic and always brought up a new problem before completing work on the previous problem. This problem was solved when Rhonda explained the importance of sticking to one problem for several sessions, until the problem was resolved. The patient then began to make progress. David described a depressed woman from Florida who was stuck in treatment, and not making progress, and then the therapist said "I just can't help you," This hurt and confused the patient who wrote to me. There were essentially two problems--the patients depression what brought her to therapy in the first place, and her unresolved hurt feelings when the therapist "gave up" on her. This problem reflected many failed relationships is the patient's life. This was resolved when the patient took the initiative to schedule a session to talk about the conflict more openly with excellent results. In addition, the patient had heard that she "should" accept herself, but didn't know how to accept her constant self-critical troughs and intensely negative feelings. I suggested she make a list of the benefits of her negative thoughts and feelings, as well as the many positive things they showed about her and her core values as a human being. She came up with an extremely impressive and long list! For example, her criticisms showed her high standards, her humility, her dedication to her work, her accountability, and much more. In addition, she'd achieved a great deal because of her relentless self-criticisms. I asked her why in the world she'd want to accept herself, given all those positive characteristics She decided NOT to accept herself, and was delighted with her decision. She said she felt profound relief! An unusual, but awesome, path to acceptance! In other words, she ACCEPTED her "non-acceptance." I hope you find today's podcast interesting and helpful. Of course, ultimately therapy is part science and part human relationship art. That's why Rhonda and I offer free weekly training groups for therapists who wish to develop their therapeutic skills. The groups are on zoom so therapists from around the world are welcome. Matt offers a consultation group (free to Stanford psychiatric residents) every other Tuesday for therapists who want help with difficult, challenging cases. To learn more, you'll find details and contact information at the end of the show notes. When Therapy Doesn't Work-- And How to Get Unstuck (for Therapists and Patients)  By David Burns, MD Here's are some of the most common reasons why therapy might fail or appear to be stuck / without progress. Some of them will be of interest primarily to clinicians, while others will be of interest to clinicians and patients alike. And many of these reasons will also apply to individuals using the Feeling Good App who are stuck in their attempts to change the way they think and feel. But what does “stuck” actually mean? The definition, of course, is subjective. I believe that a substantial or complete elimination of depression and anxiety can typically be achieved in five sessions with a skilled TEAM therapist. I use two-hour sessions, and can usually see dramatic change in a single session, although follow-ups may be needed for Relapse Prevention Training or other problems the patients might want help with. In my experience, the treatment of relationship problems and habits and addictions usually takes much longer than the treatment of anxiety or depression. The techniques to treat relationship problems and habits and addictions actually work just as fast as the techniques to treat depression and anxiety, but the resistance can be far more intense. For example, someone may be ambivalent about leaving a troubled relationship or giving up a favored habit for many months or years before making a decision to move in a new direction. And, of course, the treatment of biological problems like schizophrenia and bipolar I disorder will nearly always require a long term therapeutic relationship, often requiring medications in addition to therapy. The problems and errors I've listed below are mostly correctable. And although there are many traps that therapists and patients fall into, the vast majority of therapeutic failure the patient's hidden 'resistance' to change and the therapist's lack of skill addressing it. This is true in clinical practice and in psychotherapy outcome studies, as well. On the one hand, a great many patients will feel ambivalent about change. For example, a patient with low self-esteem may not want to stop being self-critical and accept themselves, as-is, but to have a better version of themselves, first. Or they may want to overcome their fears without facing them. Or they might want a better relationship but would want the other person to do the changing. Unfortunately, most therapists lack the skills to address resistance and, in fact, often make it worse by trying to motivate the patient to change, rather than understand their hesitation to change and discuss it with them. This is one area where TEAM training has a great deal to offer, including over 30 skills therapists can learn to address motivation and resistance. The following list of 37 reasons why therapy fails follows the structure of T, E, A, M. Errors at or before the initial evaluation Patient is just window shopping Patient does not buy into the cognitive model Incorrect conceptualization of type of problem, so you end up using the wrong techniques. To simplify things, I think of four conceptualizations: Individual mood problem (depression or anxiety) Relationship Problem Habit / Addictions “Non-problem”: healthy negative feelings such as the grief you might feel when a love one dies Patient is not in treatment out of choice. For example, a teenager might be brought in by parents to be “fixed,” like bringing in your car to the local garage for a tune up, and you don't have an agenda with your patient. Or a parent might be court-ordered to go to therapy if he wants to have custody of his children. Failure to ask patients to complete the Concept of Self-Help Memo, the How to Make Therapy Rewarding and Successful memo, and the Administrative Memo prior to the start of therapy. These memos fix a great many therapeutic problems that are likely to emerge later on, like homework non-compliance, premature termination, and policies about confidentiality, last minute cancelling of sessions, conflicts of interest (eg patient is seeking disability) and more. Most therapists ignore the use of these memos, only to pay a steep price later on. Failure to mention the requirement for homework and similar issues the at initial contact with the patient. Failure to explore the patient's motivation for treatment. T = Testing Diagnostic errors: not recognizing additional problems which patient may have in addition to the initial complaint, such as drug or substance abuse, psychosis, intense social anxiety, past trauma or abuse, or hidden problems the patient is ashamed to disclose. This is easily solvable by the use of my EASY Diagnostic System prior to your initial evaluation. It screens for 50 of the most common DSM “diagnoses” and only takes ten minutes or so out of a therapy session to review and assign the “Symptom Cluster Diagnoses.” Failure to use Brief Mood Survey before and after each session. This error makes the therapist blind to the severity or nature and severity of the patient's feelings, which cannot be accurately identified by a patient interview or therapy session. As a result, the therapist's understanding will not be accurate, and the therapist will not be to pinpoint the degree of change (or failure to change) during and between therapy sessions. E = Empathy Failure to ask patients to complete the Evaluation of Therapy Session after each session. As a result, it will not be possible for therapists to understand their level of empathy, helpfulness, and several other relationship dimensions critical to good therapy. Failure to use the “What's My Grade” technique while empathizing with the patient. Failure to receive training in the Five Secrets of Effective Communication and the three advanced communication techniques. These techniques are difficult to learn, requiring lots of practice and commitment, but can be invaluable in therapy and in the therapist's personal life. A = Assessment of Resistance (also called Paradoxical Agenda Setting) Failure to recognize and deal with Outcome Resistance: There are four distinct types, corresponding to depression, anxiety, relationship problems, and habits and addictions. Failure to recognize and with Process Resistance: There are four distinct types, corresponding to depression, anxiety, relationship problems, and habits and addictions. The “because” factor: I won't let go of my depression until “I've lost weight,” or “I've found a loving partner,” or “I've achieved something special,” or “I've found a better job / career,” or “I've achieved my goals at X.” This is another type of Outcome Resistance. M = Methods--errors using the Daily Mood Log Patient “cannot” identify any Negative Thoughts The way you worded your Negative Thought. The common errors include thoughts describing events or feelings, rhetorical questions, long rambling thoughts, or thoughts consisting of a few words or phrases, like “worthless.” No Recovery Circle / many need many techniques combined with the philosophy of “failing as fast as you can.” This allows you to individualize the treatment for each patient. It is simply not true that there is one school of therapy or method (like meditation, mindfulness or daily exercise, etc.) that will be helpful, much less “the answer,” for all patients! The way you did the technique / incorrect use of technique. Many of the most powerful techniques, like Interpersonal Exposure, Externalization of Voices, Paradoxical Double Standard, Feared Fantasy, and many more require considerable sophistication and training. They can be fantastic when used skillfully, but they aren't easy to learn! Trying to challenge your negative thoughts in your head / vs on paper or computer. This is associated with Process Resistance for depression—refusing to do the written homework, and it is exceptionally common. Trying to challenge the negative thoughts of someone else or encouraging them to think more positively: won't work! In my first book, Feeling Good, I spelled out the warning that cognitive techniques are for you, and NOT for you to use on other people, including friends, family, and so forth. It is my impression that many people ignore this warning. When they discover that the person they are trying to “help” does take kindly to identify the cognitive distortions in their thoughts, both end up frustrated. Failure to “get” the Acceptance Paradox / using too much self-defense in your positive thoughts, especially Technique when doing Externalization of Voices Using the Acceptance Paradox in a defeatist, self-effacing way Failure to include the Counter-Attack Technique when doing Externalization of Voices. This techniques is not always necessary, but can sometimes be the knock out blow for the patient's endless inner criticisms. Not understanding the necessary and sufficient conditions for emotional change when challenging distorted thoughts. Too much focus on cognitive / rational techniques when far more dynamic techniques are needed, such as the Experimental Technique (e.g. exposure) in treating anxiety or the Externalization of Voices or Hidden Emotion Techniques Not recognizing that the patient's negative thoughts might be valid (I think that my partner is cheating on me) and trying to get your patient to challenge the “distortions” in the thoughts Other therapist errors Codependency: addiction to trying to “help” / cheer up the patient / solve some problem the patient has Need to be “nice” and refusal to hold patients accountable Narcissism: unwilling to be criticized, unwilling to fail, needing to stay in the expert role Difficulties “getting” the patient's inner feelings, due to lack of skill with Five Secrets and the failure to use Empathy Scale Difficulties forming a warm and vibrant therapeutic relationship, which can sometimes result from strong (and nearly always unexpressed) dislike of the patient Commitment to a favored “school” of therapy / thinking you are superior to colleagues and have the one “correct” approach Failure to use assessment tools with every patient at every session Failure to make patients accountable for homework Four types of reverse hypnosis: this is where the patient hypnotizes the therapist into believing things that simply aren't true. Depression: the patient may really be hopeless or worthless Anxiety: the patient is too fragile for exposure Relationship problems: the patient is too fragile for / not yet ready for exposure Habits / addictions: not making the patient accountable or assuming patient isn't yet “ready” to give up the addiction, or the patient needs to have emotional / relationship problems fixed first Unrecognize, unaddressed conflicts with therapist that need to be addressed with Changing the Focus. This error often results from the therapist's fear of conflict or patient anger, and is usually accompanied by a failure to use the Evaluation of Therapy Session, which would send a loud signal to the therapist that something is wrong. Failure to do Relapse Prevention Training prior to discharge. Conceptualization errors. Failure to use or select the most effective therapeutic approach and techniques for the patient's problem. For example, the Daily Mood Log and Recovery Circle are great for depression and anxiety, although there will be some important differences in the choice of methods for depression vs. anxiety. For example, Exposure and the Hidden Emotion Technique are great for anxiety, but rarely useful for depression. The DML has only a secondary role in the treatment of relationship problems (the Relationship Journal is more direct and useful) or habits and addictions (the Triple Paradox and Habit and Addiction Log (HAL) are far more useful. The therapist may be committed to a school of therapy, like Rogerian listening, without addressing resistance or using methods. Or therapist may believe that psychodynamic or psychoanalytic therapy, or ACT, or traditional Beckian cognitive therapy, will be the “answer” for everybody. The schools of therapy function much like cults, causing feelings of competitiveness (our guru is better than your guru) and sharply limiting the critical thinking and narrowing the consciousness of the faithful “followers.” Conflicts of interest. The therapist may subconsciously want to keep the patient in a long-term “talking” relationship due to emotional or financial needs. The therapist may have been taught that therapeutic change is inherently slow, requiring many years or more. This belief will always function as a self-fulfilling prophecy. Thanks for listening! Matt, Rhonda, and David

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!

Anger, Part 1 You suck! Screw you!   Jay asks: Are you EVER going to do a podcast on anger? Dr. Burns, Also are you EVER going to do a podcast on Anger with Rhonda and Matt? You have done many podcasts on depression, anxiety, interpersonal relationships YET there is not one podcast addressing anger. Given the world we live in right now maybe it's time to address Anger from a TEAM-CBT perspective and give it the attention you have given anxiety and depression. All the Best, Jay In today's podcast, Rhonda and David address this important but neglected topic that is perhaps more important than ever in today's angry and violent world. David began by pointing out that in the feeling Good App, anger improved as much as six other negative feeling clusters, with fairly dramatic reductions in just a few days. This was completely unexpected and exciting, and has been replicated in numerous beta tests. Maybe there IS a small glimmer of hope in this troubled, angry world! David pointed out that anger is addictive Depression is not addictive because in depression you are thinking I am no good, and you have negative and painful distortions about yourself. Anger, in contrast, is addictive because you are directing the distortions at other people, telling yourself that they are no good, and they will never change, and so forth. These distortions directed at others trigger feelings of moral superiority and those feelings are intensely addictive. Any group that is at war tends to feel morally superior and sees the “other” as scum, the enemy, and these distortions give you justification for hurting and killing them and feeling good about what you are doing. What makes the treatment of anger fairly challenging is that most angry people are not looking for help. Distortions directed at others are key in conflicts with friends and loved ones as well as racial and religious hatred, and war and violence. How do you treat a patient who is angry? You always start with T = Testing. David's research on therapist accuracy indicates that therapist accuracy is recognizing anger in their patients is incredibly poor. If you want to assess and deal with patient anger,  the Brief Mood Survey at the start and end of every session can be invaluable, and the Evaluation of Therapy session at the end can also help. E = Empathy comes next. However, empathizing with someone who is angry can be challenging because they are often provocative, or want the therapist to align with them in their belief that the person they are angry with is to blame. We want the client to feel accepted, and have a warm relationship with their therapist so the therapist can easily get sucked into the patient's blaming mind-set. David calls this “reverse hypnosis,” and this can sabotage the chance for effective treatment. Empathy can be challenging if the anger is directed at the therapist, or if the client is saying they are so angry they want to hurt someone. That can be ethically challenging because of the Tarasoff duties to warn the victim and notify the police. That is tough because the client can get upset with the therapist. A = Assessment of Resistance comes next, starting with the Straightforward or Paradoxical Invitation. With someone who is angry, we nearly always use the Paradoxical Invitation. Here's an example: You have been talking about person X, and I can see you are pretty fed up with her. You said, you've tried everything and nothing works, and she won't change. I have a lot of tools that could be very helpful if you want to do work on the relationship and turn it around. But I did not hear you saying that, and I am assuming that is NOT what you want. Don't get me wrong, if you want to work on this relationship, I'd love to do that so you can develop a closer relationship, but at the same time, there's no law that says you have to get along or like everyone. I'm assuming you DON'T want to work on your relationship with X, but want to make sure I'm understanding you. Am I reading your right? M = Methods Two invaluable tools are the Straightforward or Paradoxical Cost-Benefit Analysis for anger, blame, or for the relationship. Anger CBA What are the Advantages and Disadvantages of feeling intense anger at the other person. Blame CBA What are the Advantages and Disadvantages of blaming the other person for the problem. Relationship CBA What are the advantages and disadvantages of having a relationship with this person? David provided this example of a Paradoxical Anger CBA. A man was hospitalized involuntarily in Philadelphia who was brought in by the police. He was working at Savings and Loan company with disgruntled customers. A customer came in who was whining and complaining. The patient was a large and powerful man, and he got so angry at the whining customer that he picked him up and threw him against the wall. They called the police who arrested the man, but he seemed psychotic, or in a manic state, so they brought him, instead, to the hospital. He was sent to Dr. Burns' cognitive therapy group shortly after he was admitted to the locked unit, and defiantly stated at the start of the group that he was sent here for “anger management!” Dr. Burns said he never tried to “manage” anger, and instead suggested that they could list some of the advantages and benefits of his anger with the help of the group, and also list what his outburst showed about him that was positive and awesome. Together, the man and the group listed more than a dozen positives on the white board, including: Truth was on his side People are too entitled, making demands on other people. The patient has a strong value system and was willing to put everything on the line for his beliefs He was willing to show his true feelings. And many more. At the end of the group, Dr. Burns reviewed all the really good reasons for his angry outburst, and said he did not see any reason for him to change or to give up his anger. The patient said he totally agreed. At the start of the group, the man's anger had been 100 on a scale from 0 to 100. Dr. Burns asked him how angry he was now, and the patient said zero! The dramatic change came about because of the Paradoxical Cost-Benefit Analysis. That strategy can be tremendously helpful when you are working with an angry patient. You won't get any buy-in by trying to convince the patient to manage their anger. David was actually siding with the patient's resistance, and the patient could sense that David actually liked and admired him. This can form the basis of a trusting and productive therapeutic relationship. But many therapists are afraid of this type of paradoxical strategy and reluctant to let go of their addictions to “helping,” in spite of the high failure rate with that approach. You and your patient have to be on the same team if you want to use tools for effective change. If the patient is motivated and wants help, you can work on the inner dialogue or the outer dialogue, or both. The inner dialogue is the way you are thinking about the situation, and the outer dialogue is the way you are communicating with the other person. Anger always results from your inner dialogue—your thoughts about the other person, and those thoughts will nearly always be distorted. The Daily Mood Log can be very helpful at eliciting and challenging those distortions. The focus with the DML is on the inner dialogue, which will nearly always include a rich mix of positive and negative distortions including All-or-Nothing Thinking: Seeing the other person as a total loser. Overgeneralization: Generalizing from a negative moment or characteristic and seeing them in an entirely negative way based on this one negative habit, or feature they have. We all have features that are not likeable. WE generalize from the person's actions to their SELF. You think the person is bad. Mental Filtering: Noticing and focusing and all the things about the other person that you find offensive. Discounting the Positive: Ignoring the person's positive qualities, or telling yourself that they're fake or don't count. Mind-Reading You imagine the other person's motives. When you feel angry you nearly always attribute malignant motives to them. Sometimes there are some truths and other times there are no truths. Fortune Telling: Telling yourself that the other person will never change. Magnification and Minimization: Exaggerating the other person's “badness” and minimizing their good qualities. Emotional Reasoning: I feel angry at you, therefore, you are scum and I want to get back at you. You must be very bad. Labeling: We label someone as a terrorist as if the person's entire person can be reduced to a label. There are terrorist actions but…a terrorist can be considered a freedom fighter by someone else. Shoulds He shouldn't be like that. She shouldn't have said that. Other Blame: Telling yourself the other person is to blame and that you are the innocent victim or their badness. Once you've identified the distortions in a thought, you can use any of the more than 100 M = Methods I've developed to challenge it, such as Explain the Distortions Externalization of Voices with Acceptance Paradox, Self-Defense, and Counter-Attack Technique Semantic Technique for Should Statements Forced Empathy Positive Reframing of the other persons feelings and behaviors Individual / Interpersonal Downward Arrow Examine the Evidence How Many Minutes Technique Paradoxical Double Standard Many more If our listeners (meaning you) want a Part 2 podcast on anger, we can describe helping the patient with the Outer dialogue, which is how you actually communicate with the person you're feeling angry with. This was not discussed in great detail on today's podcast, but we just touched on a couple points. The first topic is the difference between Attacking with your anger vs Sharing your anger. It's not bad to be angry, but it is how you share and express your anger that's most important. There's a huge difference between healthy and unhealthy anger. If your goal is to hurt and demean the other person, it's unhealthy, destructive anger. You may want to get back at the other person, hurt them, or put them down. Healthy anger is very different. Martin Buber, a 20th Century Jewish theologian, distinguished an “I-It” vis and “I-thou” relationship. Buddhist philosophy is similar. They say that the cause of all evil is the belief that you are separate from an external reality, so you see other person or group you're angry with as the “enemy” or the “it,” that is separate from you, and “different,” as opposed to the “thou.” Then you can rationalizing using, hurting, or even killing them in order to advance your own interests, or so you think! Sharing your anger involves letting the person know directly and openly and respectfully that you are angry with them because of something they DID, and not because of something they ARE. The goal of healthy anger is to develop a deeper and more loving (or satisfying) relationship with the other person. Healthy anger is the decision you make to share your anger, rather than to attack with your anger out of vengeance, frustration or rage. Healthy anger is not the choice that most people seem to make, since unhealthy anger gives feelings of vengeance and moral superiority. A Part 2 podcast on anger might include Forced Empathy Relationship Journal (RJ What did the other person say? What did you say next? EAR Checklist / Bad Communication Checklist Consequences Five Secrets of Effective Communication List of 12 GOOD Reasons NOT to E = Empathize using Listening Skills A = Assertiveness—Sharing vs attacking with your anger R = Convey Respect The RJ Requires insight, communication skill, and the painful death of the “self” Examples: Why does my husband constantly criticize me? Why are men so critical? Why does my wife treat me like crap? Why can't men express their feelings? Thanks for listening! Rhonda, and David

A Strange Paradox-- The Incredible Impact of Compassion + Accountability Featuring Adam Holman, LCSW We want to remind our listeners about the upcoming Mexico City TEAM intensive from November 6 – 9, 2023, organized by Level 5 TEAM therapist, Victoria Chicural, and Level 4 TEAM therapist Silvina Bucci. The Intensive will be held in a beautiful part of Mexico City (Sante Fe) at the Hotel Camino Real. There will be lots of opportunities to practice every aspect of TEAM-CBT along with many excellent, internationally renown TEAM-CBT trainers. I (David) will do a keynote address on Day 1,  On Day 2 Rhonda and I will do a live TEAM demonstration with a volunteer attending the conference. On Day 3 everyone will have the opportunity to practice the TEAM model from start to finish.  And on Day 4 Leigh Harrington and I will answer questions about the TEAM treatment model. This promises to be an Intensive not to be missed!  To learn more and register, please visit their website: https://teamcbt.mx, Today we are joined by Adam Holman, LCSW, whose podcast 288 on April 22, 2022 was a big hit. He shared his strategies for working with kids with video game addictions, and his no-nonsense, patient-focused approach made good sense and resonated with many of our podcast fans. Today, he talks about what he calls a “Strange Paradox,” which is: If you treat people like they're fragile, they act and behave like someone who's fragile. If, in contrast, you hold them accountable, with compassion, they will discover their strengths. He began by commenting on hearing David talk about how therapists often get hypnotized by our clients without realizing it. When that happens, we buy into the clients' beliefs that they're helpless and hopeless. And, I (David) might add, worthless. When that happens, we start to treat them as if the beliefs are true, further proving to them that they're helpless, hopeless, and worthless. This became incredibly evident after Adam had a unusual encounter with a child  while on a hike with his partner near Prescott, Arizona. The child was shrieking in terror at the top of his lungs. As they got approached the child, they saw that he was paralyzed by fear of a swarm of flies near his head. They also realized that his family had already walked past, and were about 45-seconds down the trail, hoping that he would become brave and walk through the flies and catch up with them.  But that clearly wasn't happening. Adam walked past the flies and stood next to him before saying, “I know you're scared, that's okay. I just walked past the flies and it's safe. You can walk through.” Then, the boy immediately stopped crying and walked past the flies on his own. The boy willingly chose to walk past them the moment that his suffering was acknowledged. He heard the message that there was nothing wrong with him or the fear that he was feeling. In other words, the acknowledgement of his fear send the message: “It IS scary, and you can do it. You're capable of doing scary things.” And he immediately found his courage and became capable. Adam continued: My partner and I began thinking about the suffering that the boy had experienced in that moment, and how little he needed in order to become strong and courageous. We felt close to the boy, and talked about our own suffering, and our parents' suffering that was passed on to us. We cried for three hours that day and began to think about all the suffering in the world. It felt incredibly relieving, I felt so connected to all of the people in my life, and naturally began thinking more about the suffering experienced by my clients. I realized that with many of them, I've just given in to listening without holding them accountable. I had been standing next to them, but I was treating them as if they could not walk past the flies.  . . . I loved your podcast on stories from the 60's, especially your experience when you were crying for hours when driving through the Nevada desert. All the same kinds of feelings bubbled up in me. I saw that his parents were just doing what they'd learned to do; to try to discourage the uncomfortable feelings by walking away from them. Unknowingly, this was sending the message that he isn't strong enough and that he is weak for feeling so fearful. Like many of us, they had learned that it's not okay to suffer, that experiencing feelings like fear is not acceptable. This, ironically triggers more suffering because you learn to avoid and fear your negative feelings, and you don't gain the courage to sit with your painful feelings and the feelings of others You can say (to the little boy), it's okay that you're suffering and afraid, and that's not a problem. I related to that boy. My dad was very critical, and would berate me for feeling anything other than happiness. Feelings like fear or sadness were signs of weakness, and eventually I stopped realizing that I was even feeling them. Then my feelings came out in the form of a lot of anxiety that I was avoiding, and the avoidance of that anxiety didn't allow me the opportunity to see that I had strengths. Rhonda, Adam and David discussed the role of tears in healing. Rhonda mentioned the immense value of exposure in recovery from anxiety, as opposed to avoidance, and the importance of making her patients accountable. David mentioned that our field is based on the idea that your negative feelings, like depression, or fear, show that there's something “wrong” with you, like a “mental disorder,” so you need to be fixed, by some pill, or some new school of psychotherapy. But if you're trying to “fix” someone, you're giving them the message that they're “broken.” TEAM, in contrast, is based on the opposite idea, that our negative thoughts and feelings will always be the expression of what's right with us, and not what's wrong with us. “Getting this,” which may not be easy at first, can paradoxically open the door to rapid change, just as we saw with the frightened boy that Adam encountered on the hike. Finally, Adam discussed how he ended up applying what he realized to a client he had been working with. The client was diagnosed with “Treatment-Resistant OCD,” and had years of therapy and medication that had not brought him to much relief. Adam had been working with him for a few months and they were able to recognize some outcome resistance. Outcome resistance is when the client has one or many good reasons not to give up their symptoms. Specifically, this client had an intense fear of rejection, and was making sure that his appearance was absolutely perfect in order to prevent rejection. Adam discusses sadness and frustration over the term “Treatment Resistant”, noting that it often keeps people feeling more stuck. Once the client saw this, he decided that they wanted to go forward and let go of his compulsions and agreed to include exposure in his treatment. This would mean that he would have to let his appearance be imperfect, and allow himself to feel anxious. Thinking back on the treatment, Adam realized that he had been providing listening and support without making the patient accountable and insisting on exposure. The next session, Adam recognized that just like the boy, he needed to treat his client with compassion and accountability. Adam re-invited the client to address the OCD and offered the gentle ultimatum, reminding the client that in order to go forward, we're going to have to do exposure. The client agreed, then started to hesitate as a result of his fear when he realized that the exposure would be taking place right at that moment. Adam messed up his own hair and invited the client to do it along with him. Adam reiterated that getting over it requires the use of exposure. The client then messed up his hair, and expressed feeling anxious for a few minutes before erupting into laughter. Then the client proceeded with his day without fixing his hair. He also decided to do more exposure on his own after session without giving into the anxiety. When he returned for the next session, he explained that his compulsions were gone for the first time in his life. The moment he was treated with compassion and accountability, he also found the strength to recover. So, what's the bottom line? When working with your own fears, or the fears of your clients or friends, two things are required. First, respect and compassion can help you accept your fear without feeling broken, or ashamed, or less than. And second accountability can give you the courage to confront your fears for the first time, and make the magical discovery that the monster really had no teeth! This is one form of enlightenment, going back 2500 years to the teachings of the Buddha on the “Great Death” of the “Self.” Thanks for listening today! Adam, Rhonda, and David

TEAM for Troubled Couples A New Twist! Today we are joined by a favorite guest, the brilliant Thai-An Truong. Thai-An is a Licensed Professional Counselor (LPC) and Alcohol and Drug Counselor (LADC). She is the first Certified TEAM-CBT Therapist and Trainer in Oklahoma. She has found TEAM-CBT to be life-changing professionally and personally and is passionate about training other therapists in this “awesome approach.” In her private practice, Thai-An specializes in the treatment of trauma and OCD. To learn more about her TEAM-CBT Trainings, visit www.teamcbttraining.com Thai-An has been featured on many Feeling Good Podcasts focusing on Depression and social anxiety (Live demonstration, 187) Postpartum Depression and Anxiety ( 218) How to Get Laid (Ep. 264) OCD ( 283) Grief (Ep 344) Now Thai-An adds an important dimension to the TEAM Interpersonal Model—working with trouble couples, as opposed to working with individuals with troubled relationships. She also describes a new way to use Positive Reframing to reduce patient resistance to giving up David's famous list of “Common Communication Errors,” and she adds five new errors to the list. At the start of the podcast, Thai-An described a woman who complained that her husband often “shuts down” when they are communicating about a sensitive topic, and she wondered why. Thai-An decided to invite him to join the session so his wife could find out why. This really opened things up, and the wife discovered that her husband shut down because he was feeling inadequate when she pointed out all the things that were wrong with the house, and he was taking her comments as criticism. However, the more he shut down, the more she complained, and this pushed him away even further since her criticisms intensified his feelings of inadequacy. Thai-An then used Positive Reframing to help her see why he shut down. One of Thai-An's new ideas was to use Positive Reframing to cast our list of “errors” on the “Bad Communication Checklist” in a positive light, just as we do with the negative thoughts and feelings of people who are using the Daily Mood Log. By siding with the patient's resistance and listing all the good reasons NOT to change, nearly all patients paradoxically let down their guard and powerful urges to oppose change. Instead, they open up and become receptive to the many methods for challenging distorted thoughts. Thai-An has observed the same phenomena with troubled couples. When they see the GOOD reasons to why they or their partners use dysfunctional ways of communicating, they paradoxically let down their guard and become more willing to use the Five Secrets of Effective Communication. She says: Positive reframing started to open them up to each other, and helped them see each other in a more positive light. At the same time, they discovered that they shared the same values. Voicing the good reasons to maintain the communication errors as well as the cost of change (e.g., it'll be hard work, I'll have to focus on changing myself, it'll be vulnerable) allowed each partner to melt away their resistance to change. David comment: This is an excellent example of a “double paradox.” Once again, instead of trying to “help,” which often triggers intense resistance, the therapist sides with the resistance, and this paradoxically triggers strong motivation to change! Thai-An reminded us that it's important to go through the TEAM structure before moving forward with tools to help the couple change. For testing, she asks both partners to complete the version of David's Brief Mood Survey that includes the Relationship Satisfaction Scale, and asks both to complete the Evaluation of Therapy Session at the end. She makes sure both partners rate her empathy toward them at 20/20 (perfect scores) before proceeding to the next steps. During the Assessment of Resistance, she begins to work with David's Relationship Journal to get a specific moment in time of conflict. Then when they do Steps 3 and 4, where they identify their own communication errors and their impact on their partners, she does positive reframing of the bad communication errors, which you can see here, along with five new errors that Thai-An has listed below.   The Bad Communication Checklist* Instructions. Review what you wrote down in Step 2 of the Relationship Journal. How many of the following communication errors can you spot? Communication Error (ü) Communication Error (ü) 1.      Truth – You insist you're "right" and the other person is "wrong."   10.   Diversion – You change the subject or list past grievances.   2.      Blame – You imply the problem is the other person's fault.   11.   Self-Blame – You act as if you're awful and terrible.   3.      Defensiveness – You argue and refuse to admit any imperfection.   12.   Hopelessness – You claim you've tried everything and nothing works.   4.      Martyrdom – You imply that you're an innocent victim.   13.   Demandingness – You complain when people aren't as you expect.   5.      Put-Down – You imply that the other person is a loser.   14.   Denial – You imply that you don't feel angry, sad or upset when you do.   6.      Labeling – You call the other person "a jerk," "a loser," or worse.   15.   Helping – Instead of listening, you give advice or "help."   7.      Sarcasm – Your tone of voice is belittling or patronizing.   16.   Problem Solving – You try to solve the problem and ignore feelings.   8.      Counterattack – You respond to criticism with criticism.   17.   Mind-Reading – You expect others to know how you feel without telling them.   9.      Scapegoating – You imply the other person is defective or has a problem.   18.   Passive-Aggression – You say nothing, pout or slam doors.     * Copyright ã 1991 by David D. Burns, MD. Revised 2001.   Thai-An Truong's 5 Additional Communication Errors: Shut down—You shut down and ignore the other person or give them the silent treatment. Avoidance—You hide your feelings and avoid talking about hard topics, or disconnect through some form of escape. Rejection—You make threats to leave – “I'm done with you,” or “I can't deal with this anymore,” or “I want a divorce.” Control—You insist that the other person “needs” to behave or communicate differently, or “should” or “shouldn't” behave the way they do. Invalidation—You tell the other person they shouldn't feel the way they feel. Here's how Thai-An did the Positive Reframing with this couple. First she asked the wife, “Why might your partner suddenly want to “shut down” and stop communicating during a conflicted exchange?” She also asked, “What does this do for the person who is shutting down?” This is the list of positives they came up with. Shutting down . . . Keeps me safe and protects me from more criticism Protects my partner from hurtful comments I might make. Shows that I value our marriage and my partner's feelings. Shows my love for my partner, and for myself. It shows that I'm feeling hurt and want to be appreciated. Guarantees that I won't make things worse. Shows that I want to protect myself from becoming overly vulnerable and getting invalidated again. Shutting down feels less risky than sharing my feelings. Once she saw why he shut down, she realized the negative impact of her complaints, and began to provide more genuine words of appreciation to him. He said that this meant so much to him and made all the hard work worth it. Her common communication errors included “truth” and “making complaints.” He realized, again through positive reframing, that she also wanted validation, that raising children can be hard, and that she ALSO wanted appreciation for how well she was keeping up with the home and the care of their children. So, when she wasn't getting validation and appreciation from him, she was even more likely to complain to try to voice her perspective. Once he was able to stop shutting down, and instead began to make more disarming statements, use feeling empathy, and stroking, she was much less likely to complain. They also realized they had the same values of wanting healthier communication and to provide a safe and happy home for their children. Was this effective? Both went from 10/30 and 11/30 on the relationship satisfaction scale (shockingly poor scores) to 26/30 by the end of the relationship work together (extremely high scores indicating outstanding scores on my Relationship Satisfaction Scale.) Thai-An provided us with a cool Positive Reframing document for all of the communication errors. You can check it out if you CLICK HERE. I (David) pointed out that Positive Reframing can also be used in conjunction with the Relationship Journal in another way. In step one of the RJ, you write down one thing the other person said, and you circle all the many feelings they were probably having, like hurt, alone, anxious, angry, sad, unloved, and many more. In step two you write down exactly what you said next, and circle all the feelings you were having. This would be an ideal time to do Positive Reframing of your partner's negative feelings, so as to shift you perception that the other person is “bad” or “to blame” or some negative interpretations that you may be making. This reframing might be helpful in the same sense that my technique, Forced Empathy, can sometimes cause a radical shift in how you see the person you're at odds with. Announcements On January 4, 2024, Thai-An Truong will be offering a 14-week training program in TEAM couples therapy for mental health professionals. The class will meet weekly from 11:30 to 1:30 East Coast time. To learn more, please go to Courses.teamcbttraining.com/relationships There will be a 4-day TEAM-CBT Intensive November 6-9, 2023, in Mexico City, at the Hotel Camino Real.  To learn more, please go to:  https://teamcbt.mx/welcome Thanks for listening today! Let us know what you thought about our show! Thai-An, Rhonda, and David

Where Do Feelings Come From? Getting Unstuck from Apathy Ancient Stoic Philosophers--and More! Ask David Questions for Today Bystad: Why is it so helpful to write down your negative thoughts when you're upset? Anyinio: Do we have to have a thought every time we have an emotion? What if I see a car coming fast and about to hit me? Would I have to have a fast automatic thought? Raghav: How can I get unstuck from apathy? Anita: What are the necessary and sufficient conditions for emotional distress as well as escape from emotional distress? Louisa: Can you tell us some more about the ancient and modern Stoic philosophers who influenced the development of CBT and TEM-CBT? Answers to today's questions. The following answers were written before the podcast. The information on the podcast may be quite different in some cases, and will typically provide much more information than the brief answers below. David   Bystad asks: Why is it so helpful to write down your negative thoughts when you're upset? Dear David! I have practiced the paradoxical approach where I just write down my thougts / worries without challenging them. I think I learned that approach from your great book «When Panic Attacks». This is something that really works for me, especially for worries. It is almost like I «get the worries out of my head». Can you talk about this approach in your lovely podcast, why is it so effective for some people?? Best regards from Martin David's reply Great question. Will address it the next time we record an Ask David podcast!   Anyinio asks: Do you ALWAYS have a thought before you can experience an emotion / feeling? David's response The word “thought” is just a form of shorthand for perception. Perception can take many forms. When you see a car about to hit you, you already HAVE a negative and alarming thought! If you like, you can check out the railroad track story in my Feeling Good Handbook. It is a story about a man who became euphoric after his car was hit by a train going 60 MPH because of his thoughts about it! When a deer spots a pack of howling wolves, it runs in terror. It does not have a “thought” in English, but it DOES have the perception of being in imminent danger, and it DOES experience intense, sudden fear. However, the deer did NOT feel fear / anxiety until s/he SAW and correctly interpreted the pack of wolves. Thanks, best, david   Raghav asks: How can I get unstuck from apathy? Hi Dr. Burns, I hope you're doing well and thank you so much for all of your incredible work! It has really helped me pull myself out of some of the deepest depressions and anxieties I've had. I wanted to ask for your help with a problem I've been facing recently: I seem to get stuck in depressive cycles at times where I don't want to do a DML even though I know it will make me feel better. When I start doing the positive reframing, it helps melt away this resistance, but I still mope around for a while before I start the positive reframing. My thoughts during this time are generally “There's no point to getting better,” “Doing a DML is like forcing myself to cheer up,” “I should care about getting better more than I do right now,” and “There's no meaning to life.” How would you recommend I go about dealing with this apathetic state? I would greatly appreciate any help in this matter! Thanks, Raghav David's reply: You could perhaps list: All the really GOOD reasons NOT to do a DML. What the procrastination / avoidance shows about you and your core values that positive and awesome. How the avoidance helps you. Something along those lines. I might make this an Ask David question if that's okay with you. Could use your first name only, or a fake name if you prefer. Thanks! Good question, as so many can relate to it! Best, david Raghav's response to David Here's the answers I came up with: Good Reasons NOT to do a DML Doing a DML might be difficult and take a long time. I might not be able to answer some of my thoughts. Even if I do a DML, I might not be able to change my mood. Even if I change my mood, there's no point in being happy. There's no sense of meaning in doing a DML. It feels inauthentic to try to change my mood. Even if I do a DML now, I will return to this state again. Doing a DML is like forcing myself to cheer up and I don't want to be forced to do anything. I want to be able to get better without doing a DML. I might have to confront really negative and distressing thoughts. Core Values it shows about me I care about doing things successfully — I don't want to half-ass it. I want to put my best foot forward when doing tasks — i.e. not do them when I'm tired. I want to be self-reliant and be able to solve all my problems myself. I care about being able to change my mood. I care about having meaning in life. I care about being authentic to my emotional states — I can honor my apathetic/bored side. I can sit with my sadness and apathy rather than trying to escape it. I care about having lasting solutions rather than short-term fixes. I'm my own man — I'm not going to be forced to do something I don't want to do. I care about being able to deal with my emotional problems without “crutches.” How the Avoidance Helps Me It means that I don't have to do the hard work of doing a DML. I don't have to engage in the ups and downs of life if I'm apathetic/avoidant. I can keep engaging in avoidance and distracting myself. It feels like there are no consequences to my actions so I feel more free. I don't have to do the hard work required to build meaning into my life. I can fully engage and honor my apathy and boredom. I'll push myself to search for lasting solutions to my problems. It pushes me to improve my mental capabilities of solving my problems. It helps me avoid the pain and anguish of actually addressing really negative thoughts. It pushes me to find more interesting things to fill my life with. Raghav David's reply Great work, thanks! So now my question is this: Given all these positives, it is not clear to me why you'd want to do a DML. What's your thinking about this? Best, david    Anita asks about the necessary and sufficient conditions for emotional distress as well as escape from emotional distress? Dear David While revisiting Feeling Great I was thinking further about the interplay of necessary and sufficient conditions that are correlated to emotional distress. Necessary condition: You must have a negative thought Sufficient condition: You must believe in the negative thought I was thinking of another sufficient condition that may account for the behavioural component of emotional distress: Sufficient condition: You must act in way that reinforces your negative thought. For me this additional sufficient condition unlocks another philosophical underpinning why exposure is a key to overcoming anxiety. For example, if I have a negative thought I'm going to screw up in a presentation and then I believe it 100%. I can still summon up the courage to go ahead and do the presentation. Thus, I'm behaving in a way that doesn't fulfil the second sufficient condition, and therefore another way to reduce emotional distress. More often than not, the presentation is not as calamitous as I anticipated anyways. Thanks for reading. Warm Regards Anita David's reply Hi Anita, Great question, thanks. I greatly appreciate folks who think more deeply about these things. Exposure is a desirable tool in the treatment of anxiety, for sure, but if you point is “necessary and sufficient” for emotional distress, then the action thing is an unnecessary and erroneous, to my way of thinking, add-on. For example, many people who are severely depressed and believe themselves to be worthless do very little, and others do a great deal, but both feel the same severity of distress. Could we use this for an Ask David, with or without your first name? If so, we could also discuss the “necessary and sufficient” for emotional change. Here the sufficient condition is that you no longer believe  the negative thought, or your belief has gone down significantly. You can respond, too, if you like to my comments. Warmly, david Anita's Response to David Thanks David, sure I'd be pleased if you find any of what I wrote useful for your listeners. Feel free to use my first name. I'm also curious to know more about the depth of belief in a negative thought as a sufficient condition for emotional distress. Is there a particular intensity or tipping point that might lead to the emotional distress? David's Response: The greater you belief in a negative thought, the greater the emotional impact. There's no “tipping point.” I loved the premise of your book: “When you change the way you think, you can change the way you feel” It got me pondering about the possibility other things such as some behaviours in addition to thoughts that could be associated with emotional distress. David's Response: Your own or someone else's behaviour won't have any effect on you until you have a thought, or interpretation, of what's happening. This is the basic premise of CBT, going back 3500 years or more. An example I'm thinking of is workplace procrastination. Let's say I have been given two weeks to tackle a laborious project. I might initially have thoughts there is plenty of time and I can procrastinate for the first week doing things I find more satisfying at work. Towards the end of the second week, panic sets in as I rush through the project so I can still meet the deadline. After the event, I start ruminating and believing self-critical thoughts such as “I shouldn't have been so lazy” and “I'm never able to handle projects well.” Is it to say, the behaviours before the event has little to no bearing on the negative thoughts or belief after the event? And if so why is it really the case that the negative thinking comes into play after the event happens? David's Response: Negative thinking can happen before, during, or after an event. I really have gained much from many of your books. I'm inquiring to deepen and refine my own thought processes. Thankyou Warm Regards Anita David's Response Thanks so much for you kind and thoughtful comments.   Louisa asks: I'd like learn more about the ancient and modern Stoic philosophers who influenced the development of CBT and TEM-CBT. Hello Rhonda and David, I am a Belgium based listener thoroughly enjoying the podcast and sharing it far and wide! I love the TEAM CBT structured approach. I find in particular that many of the methods are (relatively) easy to remember and administering self-help feels much easier than I ever imagined. Well-done, David! I wonder if David could talk one time about the different influences various figures in the development of CBT right from its inception with (it seems to me) the Roman Stoics until this century. Some names that come to mind are Seneca, Epictetus, Marcus Aurelius, to Albert Ellis, Aaron Beck & William Glasser (these last three all since passed away.) Are they any particular names that stick out as having been particularly useful in the development of TEAM CBT and why or how? Do the Roman Stoics still have anything to offer us? Thanks for the great show! Louisa David's Response Hi Louisa, Thanks, will include in the list of questions for the next Ask David, depending on time constraints.  Best, david PS Albert Ellis documents much of the history in his book, Reason and Emotion in Psychotherapy. I believe that Karen Horney, the feminist psychiatrist of the first part of the 20 th century, discuss lots of the current ideas as well, especial the “need” for love, success, etc. and the idea that we have an “ideal” self and a “real” self. We get upset when we realize that the two don't match! David and Rhonda are grateful that Matt can join us often on the podcast.

Menopause-- The End? . . . or the Beginning? Rhonda starts today's podcast, as usual, with a warm endorsement from Sally, a podcast fan who really liked Podcast 355 on the topic of “Relationship Problems: Be Gone!” She said the role-play demonstrations were “incredible” and especially helpful. We'll keep that in mind and see if we can do some more role-playing demonstrations in future podcasts, along with instructions so you can practice at home, as well. This can be extremely helpful if you want to master the techniques we describe. They may sound simple, but they're not! In our recent podcast on free practice groups (put LINK), you can find many virtual practice groups you can join from home to practice many of the techniques in TEAM-CBT with like-minded colleagues and become part of the growing TEAM-CBT community. We now have many excellent and free practice groups for the general public as well as and training groups for shrinks. Today, Mina returns to the show with a new problem—pre-menopausal symptoms that are scaring her and casting a shadow on her future as well as her marriage with her husband, Maurice. Menopause is a topic that freaks many people out, due to feelings of anxiety and shame which can sometimes be intense. Today, menopause will be out in the open and front and center. However, Meina is confused because so many problems and feelings are swirling around in her head, and she doesn't quite know where to start. At the start of the session, Mina's Brief Mood Survey indicated mild depression, severe anxiety, moderate to severe anger, and greatly diminished feelings of happiness and relationship satisfaction, thinking of her husband, Maurice.f If you review Mina's Daily Mood Log. you can see that the Upsetting Event is irregular periods due to menopause. You can also see that Mina is struggling with fairly feelings of depression, anxiety, shame, inadequacy, loneliness, embarrassment, hopelessness, frustration and anger, and she's giving herself some intensely negative messages, like “My body is falling apart,” and “My husband will leave me,” and “I'll get osteoporosis and die in pain like my grandmother,” and more. During the initial Empathy phase of the session, Mina described quite a lot of personal and professional concerns, as well as somatic complaints of various kinds. Sometimes, in the past, Mina has developed numerous somatic complaints that terrify her, because she has interpreted them as possible serious diseases, like multiple sclerosis. However, excellent physical evaluations rarely or never provide any medical evidence or explanation for her symptoms. This pattern of obsessing about somatic symptoms is actually quite common. Many general practice doctors report that as many as a third of their patients complaining of pain, dizziness, and so forth do not have any medical disease that could possibly explain the symptoms. In fact, in his classic book, Caring for Patients, the late Dr. Allen Barbour from Stanford reported that about half of these types of patients experience a disappearance of their somatic symptoms when they identify some conflict or problem that they've been avoiding, and then take steps to express their feelings or solve the repressed problem. Pretty much every time, this has been true of Mina, too. It often turns out that she is upset about something she is sweeping under the rug, and the Hidden Emotion Technique has proved extremely helpful in pinpointing the hidden feeling or conflict. Then, as soon as she acts on this information, and expresses her feelings, the somatic problems immediately disappear. So, our first task in today's session was to see if the same thing was happening. It turned out that she was quite upset with her husband, Maurice, so we did a Relationship Journal to see if we could get a better understanding of what was going on. Her complaint was that Maurice did not want to talk about “difficult feelings.” Instead, he suggests they go for a nature walk or watch a movie. So, she felt sad, anxious, rejected, hurt, frustrated, and alone. But, as is the case nearly 100% of the time, when we examined a brief interaction between them—what did he say and what did she say next—it became clear that she was actually pushing him away and putting him down. This was understandably painful for Mina to see, and a bit embarrassing, but she was super brave, and saw how she could use the Five Secrets to respond to Maurice in a radically different and more inviting manner. As an aside, the person who seeks treatment for a relationship problem will nearly always discover that they have actually be causing the very problem they're complaining about. If Mina's husband had come to us for help, he would have made the exact same shocking discovery—that HE was causing the problem he was complaining about. I call this strange but fascinating phenomenon the “theory of interpersonal relativity.” Mina feared abandonment, but discovered that her real problem was that she was rejecting her husband, and forcing him to reject her! Although this type of sudden insight can be tremendously painful, it is also liberating at the same time. That's because people discover that they have far more power than they thought. Mina felt helpless, but was actually pulling the strings. Once you “see” this, you have the option of moving in a radically new and more rewarding direction. Mina promised to send a follow up once she's had the chance to try a new approach during her interactions with Maurice. We have our fingers crossed! In addition, we worked with Mina's negative thoughts and feelings on her Daily Mood Log, starting with Positive Reframing, which she found helpful. What did her negative thoughts and feelings show about her that was positive and awesome, and how were they helping her? Then we did several rounds of Externalization of Voices and she was quickly able to knock her negative thoughts out of the park, with incredible results that you can see if you examine the emotions goal and outcome columns on her emotions table HERE. As you can see, there was an immediate and dramatic reduction in all of her negative feelings. We publish these TEAM-CBT sessions because we believe that the vast majority of mental health professionals do not know how to trigger rapid and extreme changes in how people think, feel, and interact with others. It is our hope that these podcast live therapy sessions, in conjunction with our weekly training groups, will make mental health professionals aware of what's now possible, and how TEAM-CBT actually works. We try to make it look simple, but it requires tremendous training, practice, and commitment. Rhonda and I have strong, tender feelings toward our dear colleague, Mina, and we are deeply indebted to her for making herself vulnerable in a public forum so that we can all learn and feel much closer to one another. Personal work is one of our finest teaching tools. In addition, feelings of respect, love, and connection are so often missing in our embattled and hostile political and world environment these days. We cannot change the world, but we can definitely make our own small ripples in the pond, and work on changing ourselves. If you'd like, you can take a look at Mina's Brief Mood Survey and Evaluation of Therapy Session at the end of the session.  Thanks so much for listening today! Rhonda, Mina, and David

361: Cultivating Delight Today we feature Dr. Angela Krumm, Clinical Director at the Feeling Good Institute (FGI) in Mountain View, Ca, and Zane Pierce, LMFT, a Level 3 TEAM therapist at FGI, on a novel and arguably controversial tool which is not aimed at reducing negative feelings, but rather boosting positive feelings.  Zane Pierce Rhonda, as usual, starts the podcast with a wonderful email from Andrew who really enjoyed Podcast 357, on what David learned on the streets of Palo Alto in the wild and wonderful latter half of the 1960s.  Then Angela described her Journey to Delight, which may be silly and goofy, or wonderful, or perhaps a little of each. She was inspired by a podcast interview she heard with Ross Gay, who wrote the popular Book of Delight, a book of ultra short essays he wrote every day for a year, starting on his 42nd birthday, describing “common place” things he noticed that were amazing, inspiring, or delightful. An example was noticing a weed with a beautiful flower growing out of a crack in an ugly piece of concrete.  Then Angela noticed that she felt “neutral” during and after a pleasant family hike on a pleasant and beautiful day, with the people she loved. She asked herself, “Why did I only feel neutral? And can something be done to cultivate greater delight and joy in our daily lives?  She asked herself, “I want to be more open to delight in my life—is it possible to cultivate delight? And if so, how?” She reasoned that since we have more than 100 TEAM-CBT to reduce and eliminate negative feelings, like depression, anxiety, shame, inadequacy, and even anger, couldn't we create some methods for boosting positive feelings? Could we focus, for example, not just on how to challenge and crush our negative internal dialogues, but also on how to cultivate more positive self-talk? Can we “elevate” our more neutral moments. In order to set the agenda, she did a Cost-Benefit Analysis during one of her Thursday morning training groups with the therapist at FGI. She asked David, Rhonda and Zane to list some really GOOD reasons NOT to try to cultivate greater delight in our lives, including: People who are hurting and struggling need compassion. It's important to see the truth and reality of the negative realities we confront every day in our personal lives as well as on the news. Negative feelings can motivate us to work hard. Negative feelings and self-criticisms often show that we have high standards and humility. And many more.  She encouraged us to list the reasons to focus on the beautiful and awesome things we sometimes ignore or overlook going on all around us all the time, including: the possibility of feeling more joy, slowing down in life, and being more present in the moment. Angela described an informal experiment she set-up to i see if adding positive self-talk to otherwise neutral activities could increase delight. Forty two therapists participated in small groups of four to do some shared activities, while some completed the activities solo. Participants completed my 5-item Happiness Scale as well as a sixth item measuring feelings of “delight” prior to and after the experiment.  The experiment was simple—engage in a neutral or common place activity. The key variable was to actively add positive self-talk to the activity. And of course there was a requirement that the positive self-talk has to be 100% true (e.g., can't lie to yourself or say fake positive things).  In the small group, Zane and Angela walked through a park and several participants decided to swing on the park's swing set. Their positive self-talk motivated them to try out the swings, which was quite “delightful.” Then they walked separately, adding positive talk to their activities and observations. Zane described his “journey to delight,” noticing a sickly Giant Redwood that was struggling and nearly dead. But, he found green sprouts coming out of it, as the tree was still struggling to grow and survive. Zane also spotted a hummingbird on his walk. Adding positive self-talk to otherwise neutral activities increased his happiness score by 50% (swinging at the park and 20% (observing nature).  This was especially poignant since Zane tragically lost his beloved younger brother to suicide just two months ago. This was devastating, and one of the most difficult periods of his life. He said, “It turned my world upside down.” Our hearts go out to Zane, and we are grateful that you, Zane, could share this special time with us today, given the tragic and horrible circumstances you've had to face.  I have many happy memories with Zane, who used to be a faithful and beloved member of my Sunday morning hiking group. We had to abandon the Sunday hikes during the Covid pandemic, and now I'm limited in my walking due to low back pain. I hope to get the hikes going again one day.  Zane and his wonderful wife, Daisy have appeared on some of the most popular podcast episodes in the past, including # 79: “What's the Secret of a ‘Meaningful' Life? Live Therapy with Daisy.”  Angela shared that folks who participated alone did things like vacuuming up pet hair, commuting in the car, drinking coffee, going for a walk. Angela reported on the results of her experiment. She saw a 39% boost in happiness scores in the group of 42 individuals, and a boost of 75% in feelings of delight, resulting from the efforts to cultivate positive self-talk during the exercises. Examples of positive self-talk might include: “I have a strong pair of legs that allow me to walk.” “What a treat to take a break in my day.” “This tea smells so sweet.” For example, one of the participants generated self-talk while vacuuming dog hair for five minutes, a frequent and fairly unwelcome chore. Here are examples of her positive self-talk:  “I'm contributing to canine diversity by putting up with this shedding…. If there weren't people like me, the world would be all poodles and doodles.” “It's true that the work never gets done…And yet, even a little vacuuming is an improvement.”  “It's fun to see the fur get sucked into the vacuum and to find places, such as under the couch, where it hides.” We talked about some potential uses of “Delight Training,” as well as a few potholes to avoid. For example, when individuals are struggling with strong feelings of depression, anxiety, or anger, encouraging positive self-talk may make the patient feel worse, since it could be experienced as superficial or insensitive to the suffering. In addition, it might seem insensitive as well when working with individuals with genuinely negative or horrific life circumstances, such as homelessness, terminal illness, war, and so forth.  On the other hand, it may play a useful role in heightening positive feelings in individuals who have moved their negative feelings scores to zero, so they can do more than just overcome negative feelings like depression, but have some tools for exploring and enhancing the world of positive emotions. David described a patient vignette of a young woman who sought treatment because she wanted to have “more fun in life.” David asked her to make her therapeutic goals specific and real by asking, What time of day would you like to have more fun? Where will you be then? What would having more fun look like?” This led to a meaningful and challenging homework assignment with an unexpected and funny outcome.  Zane ended the podcast with some tips about positive self-talk. First, the positive thoughts have to be 100% true to be effective. This is also true, by the way, when countering distorted negative thoughts.  He said he is trying to turn this into more of a habit, noticing every day delightful and wonderful seemingly “commonplace” things, like something one of his two children say or do, riding his bicycle, or just taking a bite of a fresh, tasty apple.  He also explained that he is still grieving the loss of his brother, but the excursions into the more positive side of his life has provided a welcome balance.  Thank you for listening today! Angela, Zane, Rhonda, and David  

360: The Story of Indrani “Why can't I get close to my daughter who I love so much?” Today, we present Part 2 of the awe-inspiring work that David and Jill did with Indrani in the Tuesday group at Stanford. Indrani was a mother with a heart-breaking but all-too-common story of a conflict with her daughter. Sometimes, we love someone tremendously, but every time we try to get close, they seem to push us away. The story should ring true and be helpful to so many people, as nearly everyone runs into conflicts at times with our family members, including our parents, siblings and children. And, as usual, the solution often involves attending to your “inner” dialogue, which is the conversation you're having with yourself about the conflict, and the “outer” dialogue, which is what happens when you try to get close to the person you love. And today's session illustrates not one, but two forms of enlightenment. The changes in the inner dialogue involves challenging and crushing the negative messages you've been giving yourself about h problem with the person you love so much. You can see Indrani's Daily Mood Log if you click HERE. As you can see, she's been telling herself that her daughter has shut her out of her life, and that she'll die alone/ That's incredibly sad! And she's also telling herself that all of her friends have wonderful relationships with their daughters “and I don't” and she's blaming herself for the problem: “I deserve this treatment,” and “nothing I do pleases her.” You can also see the intensity of Indrani's negative feelings, including sadness, anxiety, inadequacy, loneliness, embarrassment, discouragement, irritation, and more. You can also see a typical exchange with her daughter if you look at her Relationship Journal (RJ). As you may know, the whole theme of my interpersonal model in TEAM-CBT is that we create our own interpersonal reality at every moment of every day. In other words, we unknowingly create and cause the exact relationship problems that we complain about, but just don't realize this, so we think there's something wrong with the other person. But how can this be? If you look at Step 2 of Indrani's RJ, her response to her daughter seems innocent enough! But stayed tuned, because Indrani makes a shocking and mind-blowing discovery during the session, and that discovery requires the exceedingly painful “death” of the “self.” But this “Great Death” is instantly followed by a “Great Rebirth.!” At the end of the session, a Tuesday group members named Keren, said this to Indrani: “You wowed me!” One of the men, Ed, could barely speak because he was sobbing. You may also be sobbing for joy when you listen to this heart-warming story. In part 1, today's podcast, you'll hear the initial T = Testing and E = Empathy. In part 2, in next week's podcast, you'll hear the M = Methods, including Jill and David's incredible work with Indrani on her R and her rather sudden discovery, in Step 4, of exactly how and why she'd been driving her daughter away—and how to stop doing that and begin to communicate in a way with a far greater chance of enhancing closeness and love. The Jill and David turn to Imani's Daily Mood Log so she can smash her distorted negative thoughts with the Externalization of Voices, and several role reversals illustrating the integration of Self-Defense, the Acceptance Paradox, and the CAT (Counter-Attack Technique.) You can see Imani's initial and final Brief Mood Surveys plus her Evaluation of Therapy Session, We are extremely grateful to Indrani for giving us this very intimate glimpse into her inner life in a way that will illuminate and inspire every person with the good fortune to listen to Indrani's amazing Journey this evening! PS I emailed Indrani this morning to see how she's doing, and recevied this wonderful reply: I'm still feeling great…very light and hopeful. I've listened to the audio. I sound goofy at times but loved re-living the moment when the truth dawned on me and how I felt immediately afterwards. My daughter Soni ( like the Japanese electronic company :) is coming on Thursday. I would've been filled with intense anticipatory anxiety but now I can't wait to give her a big hug and use what I've learnt to connect with her. I'm looking forward to watching the video with Soni. Thank you so much Dr. Burns and Jill! Thanks for listening! Rhonda, Jill, and David