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Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

326: Rejection Practice?! It's freaking me out! Part 1 of 2

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

David Burns, MD

Clinical, Therapy, Anxiety, Psychotherapy, Depression, Health & Fitness, Cognitive, Mentalhealth, Mental Health, Behavior, Education, Self-improvement, Psychology, Relationships, Addiction, Happiness, Personalgrowth

4.4856 Ratings

🗓️ 9 January 2023

⏱️ 47 minutes

🧾️ Download transcript

Summary

Featured pic of Cody in one of the small group practice sessions in David's virtual Tuesday training group.

Live Therapy with Cody, Part 1 of 2

I recently treated Cody, a young man wanting help with his fairly severe social anxiety since childhood, during one of our Tuesday evening Stanford training groups. My co-therapist for this session was Rhonda Barovsky, PsyD, the Feeling Good podcast co-host.

The full session will be broadcasted in two parts, starting today and finishing next week.

Part 1

T = Testing

At the start of the session, Cody’s depression score was only 6 out of 20, indicating minimal to mild depression, but his score on the loss of self-esteem was “a lot.”

His anxiety score was 11 out of 20, indicating moderate anxiety, and his anger score was only 2, minimal. However his score on the Happiness test was only 11 out of 20, which is only moderately happy, indicating a lot of room for improvement. If you like, you can review his Brief Mood Survey at this LINK. We’ll of course ask him to take this test at the end of today’s session so we can see what, if impact, we made on his feelings.

E = Empathy

Cody described his shyness like this:

“I’ve been shy for as long as I can remember and feel introverted. It started in middle school. I felt like I never fit in or connected with people very deeply. In middle school, you really want to fit in.

“I wanted my friends to like me, and one day they all started to torment me. Our seats in school were assigned, so I couldn’t get away from them. I cried at recess every day for months. Then, one day, they suddenly went back to being my friends again, and I never understood why.

“When they were tormenting me was the most painful moment of my life. I felt like they were judging me.

“I’ve worked on my own and I’ve gotten over 90% of my social anxiety. At first, I was afraid of answering the phone or even ordering a pizza, so I got a job where I was required to answer the phone and got over it.

“Now I’d like to date, but this has been a problem for me. Also, when I’m treating someone, and this topic of social anxiety comes up, I get uncomfortable. I think if I could overcome the rest of my shyness, it would boost my confidence.

“The podcast you and Rhonda did with Cai on Rejection Practice (LINK) inspired me tremendously, and I managed to do one Rejection Practice. By now I’m chickening out again. I go to the mall determined to do it, but I just keep putting it off. Asking women to reject me seems incredibly frightening, and I’m afraid people will judge me or see me as a predator. I love in a small town, and most people know each other.

“When I was thinking about the session all day today, I felt nervous and my stomach tightened up.

Cody brought a partially completed Daily Mood Log to the session, which you can review at this LINK. As you can see, the Upsetting Event was thoughts of approaching someone at the mall for Rejection Practice.

His negative feelings included the entire anxiety cluster, shame, the entire inadequacy cluster, unwanted, humiliated, embarrassed, the entire hopelessness cluster, frustrated, annoyed, and anger with himself. These feelings ranged from a low of 35% for shame to a high of 100% for foolish and humiliated and 90% for the hopelessness cluster.

And as you can see, many of his negative thoughts focused on the theme of being judged by others who might see him and think he was strange, or a disrespectful jerk, and so on. He was also convinced that women would be annoyed by him, and that the word would spread so that he’d lose the respect of people he cared about.

A = Assessment of Resistance

Cody’s goal for the session was to feel motivated to do the Rejection Practice he’d been avoiding, and to get rid of the negative thoughts that were holding him back.

He said he’d be reluctant, though, to press the Magic Button and make all of his negative thoughts and feelings disappear, so we listed what his fears might actually say about him and his core values that was positive and awesome. Here’s the list we came up with:

Positives

My anxiety

  1. My anxiety shows that I care about peoples’ comfort.

  2. My anxiety protects me from rejection or doing something foolish.

  3. My fears of being seen as a predator show that I want to fit in with the social norms and not be weird or threatening to women.

  4. My fears show that I want to be respectful towards women.

  5. My fears of being judged show that I care about friends and family.

  6. My anxiety shows that I care about my reputation.

  7. My feelings of inadequacy show that I’m aware that I have things I want to work on.

  8. Those feelings also show that I’m humble.

  9. My feelings show that I really care about connecting with others, which is one of the most important things in life!

  10. My negative thoughts and feelings motivate me to work hard on changing.

  11. They also show that I have high standards.

  12. My hopelessness shows that I’ve tried to do Rejection Practice six times and have always chickened out. So I’m being realistic.

  13. My hopelessness also protects me from getting my hopes up and then being disappointed.

  14. My unhappiness gives me greater compassion for my clients.

  15. My anger energizes me and motivates to do something new.

Tune in next week for the exciting conclusion of the live work with Cody!

David and Rhonda

Transcript

Click on a timestamp to play from that location

0:00.0

Hello and welcome to the Feeling Good podcast, where you can learn powerful techniques

0:11.6

to change the way you feel. I am your host, Dr. Rhonda Borovsky, and joining me here in the

0:16.8

Muriata studio is Dr. David Burns. Dr. Burns is a pioneer in the development of

0:22.3

cognitive behavioral therapy and the creator of the new team therapy. He's the author of Feeling

0:27.4

Good, which has sold over 5 million copies in the United States and has been translated into over

0:32.7

30 languages. His latest book, Feeling Great, contains powerful new techniques that make rapid recovery

0:39.3

possible for many people struggling with depression and anxiety. Dr. Burns is currently an emeritus

0:45.2

adjunct professor of clinical psychiatry at Stanford University School of Medicine.

0:51.5

Hello, Rhonda. Hi, David. And welcome to everyone, our listeners around the world and in our own little country here in Canada and Mexico and everywhere else. This is the Feeling Good podcast, episode 326.

1:23.3

And what an exciting follow-up to last week's podcast announcing the two-day anxiety marathon that Jacob and his colleague Michael Luau so wonderfully produced and offered it almost

1:31.3

three of charge a fantastic thing. And now we're going to do our first personal work of

1:38.5

2023, which will be on the same topic of social anxiety, something that so many of us, therapists and

1:48.3

general public alike, have struggled with and can identify with. And what a fantastic two-part

1:55.0

podcast we've got coming up for you. It'll blow you away. Great. Let's take a listen. Your depression score,

2:07.9

Cody, is six, six out of 20, which is just a very mild level of depression. But one thing is very

2:17.0

elevated, and that's the third item, low self-esteem,

2:21.9

inferiority or worthlessness, and you say you're feeling that a lot. So that's pretty strong.

2:28.0

The sadness, the hopelessness, the loss of motivation, loss of pleasure, and satisfaction

2:33.3

life, or just barely elevated.

2:36.0

That one symptom is very strong. There's no suicidal thoughts or urges. The anxiety is 11 out of 20,

2:43.6

so that would be more in the range of moderate anxiety. The anger is only two out of 20, so that's minimal. There's just a touch of

2:55.9

frustration and a touch of irritation. The happiness scale is pretty revealing. It's only 11 out of 20.

...

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