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

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?

Transcribed - Published: 17 March 2025

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!

Transcribed - Published: 10 March 2025

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

Transcribed - Published: 3 March 2025

Overcoming Your Porn Addiction Featuring the Awesome Thai-An Truong! 🎙️ Hosts: Dr. David Burns, Creator of TEAM-CBT and author of Feeling Good Rhonda Barovsky, Co-Host and Therapist at the Feeling Great Therapy Center 🎉 Special Guest: Thai-Ann Truong. Licensed Professional Counselor, Licensed Alcohol and Drug Counselor and a Superb TEAM-CBT Teacher, Trainer, and Super-Shrink who specializes in the treatment of Trauma, OCD, and marital /  relationship dysfunction, including the impact of a porn addiction on couples In this jam-packed episode, of the Feeling Good podcast, David and Rhonda welcome Thai-An Troung, Level 5 TEAM therapist and trainer, licensed professional counselor,  licensed alcohol and drug counselor and expert in addictions, to discuss the complex issue of pornography addiction. Thai-An shares her insights on the rising prevalence of porn use, its impact on relationships, and the psychological and physiological effects of addiction. The conversation delves into the symptoms of porn addiction, the importance of psychoeducation, and the application of TEAM therapy methods to help individuals and couples recover from the negative consequences of porn use. Thai-An emphasizes the need for awareness and understanding of how porn can affect brain chemistry and relationship dynamics, ultimately offering hope for recovery and healing. This conversation delves into the complexities of addiction, particularly focusing on porn addiction and its impact on pleasure and motivation. We discuss the importance of understanding the psychological aspects of addiction, including the loss of pleasure and the role of motivation in recovery. We explore various TEAM tools, such as the triple paradox, to address motivation and cravings, and emphasize the significance of social support in the recovery process. The discussion also touches on the nuances of sexual identity and the importance of abstinence when overcoming porn addiction. Finally, we highlight the need for specialized training for therapists working with couples facing these challenges. Key Topics Covered: * Porn addiction is a growing concern in modern society. * There is no moral judgment on porn use; it can be healthy for some. * Statistics show a significant rise in porn use among young people. * Abstinence from porn can improve relationship satisfaction. * Porn addiction can lead to sexual dysfunction and intimacy issues. * Sexual conditioning can alter attraction to real-life partners. * Psychoeducation is crucial for understanding porn addiction. * Brain chemistry is significantly affected by porn use. * Withdrawal symptoms from porn can include flatlining and social paralysis. * Porn addiction can lead to a depletion of pleasure and joy in life. * Understanding motivation is crucial for overcoming addiction. * The Triple Paradox can effectively address motivation in therapy. * Social support plays a vital role in recovery from addiction. * Abstinence is often necessary for healing from porn addiction. * Therapists should explore the benefits of addiction with clients. * Clients may find deeper connections through shared experiences in therapy. *Therapists need to be aware of the complexities of sexual identity. *Training and resources for therapists are essential for effective treatment. * Therapists can help clients find sustainable satisfaction beyond addiction. Listener Challenge 🌟 Try Out the Feeling Great app! Want to experience TEAM-CBT’s transformative power? Download the Feeling Great App or join an upcoming beta test to see the magic of its AI-driven mood and self-esteem coaching. You'll find it all at FeelingGreat.com! 💬 Feedback: We love hearing from you! Share your thoughts about today’s podcast. Send us your questions for an Ask David diopside 🛠️ Get Involved: Interested in joining a Feeling Great App beta? Reach out to Jason Meno at [email protected] 📚 Resources Mentioned: Feeling Good by Dr. David Burns Learn more about TEAM-CBT and the Feeling Great App TEAM-CBT at FeelingGreat.com. ✨ Don’t forget to subscribe to the Feelinggood.com or Feelinggreat.com YouTube channels, and rate, and review! Thank you for listening! Thai-An, Rhonda and David

Transcribed - Published: 24 February 2025

Swimming in an Ocean of Gold-- The Unique Magic of TEAM-CBT! 🎙️ Hosts: Dr. David Burns, Creator of TEAM-CBT and author of Feeling Good Rhonda Barovsky, Co-Host and Therapist at the Feeling Great Therapy Center 🎉 Special Guests: Jeremy Karmel, CEO of the Feeling Great App Jason Meno, AI Content Lead and Developer of the Feeling Great App Episode Summary In this jam-packed episode, the Feeling Good team dives deep into the groundbreaking elements of TEAM-CBT. From rapid emotional transformations to the app’s jaw-dropping AI breakthroughs, this conversation will leave you inspired and ready to explore how TEAM-CBT can transform lives. Whether you’re a therapist, someone seeking self-help, or simply curious, this episode delivers gold at every turn. Key Topics Covered 🧪 T = Testing: Why measuring emotions and progress at every session is a game-changer. How testing reveals what therapists often miss and ensures rapid results. Hear Dr. Burns' incredible stories, including how testing saved a life. 💛 E = Empathy: Busting myths about cold, clinical therapy. How warmth and deep connections are at the heart of TEAM-CBT. Rhonda shares her powerful story about learning empathy and its transformational effects on her practice and personal life. 🧠 A = Assessment of Resistance: The revolutionary concept of honoring your “resistance to change.” Why it’s essential to embrace the positive aspects of negative feelings. Jason shares how paradoxical agenda setting melted years of stuckness in minutes. 🎭 M = Methods: The unparalleled arsenal of 140+ techniques to tackle every problem. Role-playing methods like Externalization of Voices and Feared Fantasy—how they create breakthroughs in minutes. Jeremy explains why therapists need to match the right tools to the right problems. Fun Highlights Money-Back Guarantee for the Podcast (It’s free!) Jeremy’s hilarious take on “jiggling your eyes into happiness.” The “critic from hell” gets crushed in real-time role-play. Why TEAM-CBT Stands Out Rapid, measurable results – No more endless talking without change. Powerful empathy – A therapy that connects deeply with your emotions. Resistance embraced – Discover the beauty in your struggles. Diverse methods – 140+ techniques tailored to every unique challenge. Listener Challenge 🌟 Try It Out! Want to experience TEAM-CBT’s transformative power? Download the Feeling Great App or join the upcoming beta test to see the magic of its AI-driven mood and self-esteem coaching. Next Week 🎙️ Tune in for Episode 437: Breaking Free from Your Porn Addiction, with Thai-An Truong from Oklahoma City 💬 Feedback: We love hearing from you! Share your thoughts about today’s podcast. 🛠️ Get Involved: Interested in joining the Feeling Great App beta? Reach out to Jason and the team! 📚 Resources Mentioned: Feeling Good by Dr. David Burns Learn more about TEAM-CBT at FeelingGreat.com. 👉 Quote of the Week: "TEAM-CBT isn’t just therapy—it’s swimming in an ocean of gold." ✨ Don’t forget to subscribe to the Feelinggood.com or Feelinggreat.com YouTube channels, and rate, and review!

Transcribed - Published: 17 February 2025

Hypnosomatic Therapy Featuring Erik Burns In this episode of the Feeling Good podcast, we hear from another David Burns—not me (David Dean Burns), but rather David Erik Burns, my wonderful and beloved son. Erik discusses his journey in creating BloomHarmony.org, his new clinical practice that integrates hypnotherapy with somatic work. To kick things off, Erik shares personal stories about his relationship with his father, David, including the story of his birth and struggle to breathe in the pediatric intensive care unit, and how touch has played a significant role in his life and healing journey. He emphasizes the idea that words alone sometimes fall short in attempts to convey love or transmit healing. A loving touch, in contrast, can make an immediate and profound impact. Today’s conversation delves into the mind-body connection and the importance of emotional expression in therapy. Erik calls his innovative approach hypnosomatic healing, which involves a combination of guided hypnotic imagery with massage.  The mind/body connection refers to the dynamic relationship between your thoughts, emotions, beliefs, and attitudes (the mind), and your physical health and bodily functions (the body). Erik emphasizes the transformative power of touch and the need for openness in therapeutic settings, exploring how these elements can lead to a profound healing experience. Erik also discusses the tremendous value of longer therapy sessions as well as the powerful role of trance states in therapy and in life. They also discuss the ethical balance between therapist livelihood (which naturally requires charging for sessions) and the therapist’s genuine commitment to the relief of suffering, regardless of the patient’s financial resources. Both Erik and his dad, David Sr., agree that in an ideal world, health care would be free and available to all, and regret having to charge for treatment. Erik always takes the needs of his clients into account and works for a reduced fee or for free if needed. Erik explains how and why the mind-body connection is so crucial to genuine healing and describes the importance of energy management during sessions Here's how he explains it: Energy management is about showing up with the proper state of consciousness for a session. Transpersonal work relies heavily on the therapist interpersonal relationship, so the state I am in has a huge influence on the outcome. We teach a 3-sided model: emptiness, awareness, and love. "Energy" management would be the preparation I do to both Empty myself from pre-conceived notions (AKA getting out of my own way), to step into observer consciousness, and to become rooted in love. I guess a simpler way to describe energy management would be to become an open unconditional channel and to silence the monkey mind as much as possible. I believe I may have been referring to the inner child dialog I often do before a session to help achieve this state. The dialogue also explores the transformative experiences clients can undergo in therapy and the tools therapists can use to empower clients who feel helpless, hopeless, or defeated. The personal connection between therapists and clients is highlighted as a crucial element in the healing process. While gut problems, such as irritable bowel and chronic abdominal complaints are important targets for hypnosomatic therapy, Erik emphasizes the potential value of his approach for a wide variety of complaints, including Emotional problems Depression, grief, despair Loss of motivation, pleasure or satisfaction in life Anxiety / stress / worry / panic / fear Recent or past trauma Feelings of inadequacy, inferiority, worthlessness Feelings of hopelessness, discouragement, and frustration Interpersonal difficulties Anger Relationship conflicts Loneliness Feeling isolated, unlovable, unloved Blame, bitterness and resentment Physical / somatic complaints Chronic belly pain, back pain, chest pain, headache, etc. Chronic fatigue / exhaustion / burn out Dizziness Spiritual Feeling empty, rudderless and lost Wondering, “Who am I?” Wondering, “What’s the meaning and purpose of my life?” Wondering, “Why am I struggling and suffering?” Here  are Erik’s actual words, from his website, BloomHarmon.org: I Hi, I’m Erik. I believe in your potential to live a pain-free, vibrant life. Why do I believe in you? Pain relief is not just my profession — it's also my personal journey. I've lived with gut disorders for most of my life, including food allergies to wheat and milk, intermittent pain, and ulcers. I sought help from Western doctors but never received much relief. Modifying my diet provided some improvement, but it never fully addressed the underlying issues. Finally, I discovered hypnotherapy, and my life really started to change. As an undergraduate at Stanford University, I studied neurophysiology and  deepened my understanding of the mind-body connection. I also trained in deep tissue and polarity massage, which showed me how treating the mind and body together can maximize the effects of each approach. This holistic understanding led me to develop my primary modality, hypnosomatics, a comprehensive body care treatment that combines elements of massage and hypnotherapy to supercharge recovery. A lot of research has been done into the underlying causes of chronic gut pain. Conditions like IBS, SIBO, and GERD have been studied extensively. Gut-directed hypnotherapy (GDH) is widely considered the most medically effective form of treatment for these types of conditions, with treatment success rates often exceeding 70-80%. This discovery was transformative for me, and it can be for you too. Today, I am mostly pain-free and thriving, and I want to share the tools and techniques that were so helpful for me. My approach to well-being goes beyond reducing pain; it's about empowering you to transform your own life from within and, ultimately, to thrive. Thank you for listening today! Erik, Rhonda, and David

Transcribed - Published: 10 February 2025

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

Transcribed - Published: 3 February 2025

David, Matt, and Rhonda Answer Your Questions! 1. How can I help my depressed son? 2. What can you do on a boring first date? 3. Are depression and anxiety genetic and hopeless? 4. What do scary, intrusive thoughts mean? The answers to this week’s questions were written by David prior to the podcast. The live discussions will add greatly to the comments below. Get consent on first question, or change name. In fact, I’ll just change her name to Henrietta. Henrietta asks how she can help her son who’s been severely depressed for nearly 20 years and rejects all suggestions. Julia asks what to do on a boring first date. Negar asks if anxiety and depression are genetically caused and therefore hopeless . Negar asks about scary intrusive thoughts. 1. Henrietta asks how she can help her son who’s been severely depressed for nearly 20 years and rejects all suggestions. Dear  Dr David I discovered you years ago due to my son’s depression.   I purchased your book for him, but he not reading it.  He thinks he is too far gone for any self help and has been on anti depressants for years. I appreciate all your hard work , the blogs and the app.   I have my hopes up that one day he will listen to you or download the app.   This depression has been going on more than 18 years now. Do you have any ideas on how I could get him to listen to you on You tube?  God bless you and your team.   Keep  up the good work! Best  regards Henrietta David’s reply Hi Henrietta, I’m so sorry he’s struggling. I do have a clear recommendation, clearly spelled out in the podcast of a couple years ago, “How to help. And how NOT to help.” You can easily find it on the list of podcasts on my website. I’m sure that his depression has been heart-breaking for you. But there is a radically different strategy / direction one can pursue when efforts to “help” are 100% rejected. LMK if I can use your question on an Ask David podcast. Then you’ll get input from several of us. Warmly, david 2. Julia asks what to do on a boring first date. Dear David Just saw that you published a podcast about how to give negative feedback, absolutely cannot wait to listen to it. I’m afraid I fall in the category of people who tend omitting opinions and this is going to be of great help! Now to my question: how do I get more excited in dates with guys ? I would like to date more and have a more active sexual life but I find myself getting bored in dates and this affects also my libido. I will have thoughts like: this is boring he is not that attractive I won’t be turned on sex won’t be good I obviously then don’t end up having sex with the guy and try to have a date with someone else. In the date I don’t feel anxious but I’m not excited physically and mentally. The anxiety plays a role before I go to the next scheduled dates, because with time I start thinking this feeling of boredom will never go away. I have tried to work on the thoughts myself with little results and I was wondering if you had any suggestions on how I could be less bored and anxious and enjoy myself. Thanks you for your answer and your amazing work! Best wishes, Julia David’s Reply Great question, and I have an answer. Can we include this in the next Ask David, using your first name or a fake first name? Thanks, Warmly, david You are viewing dating as a shopping expedition, trying to “find” the best item to purchase, and finding your shopping boring, which it is. But you are forcing it to be boring because you are not being open with your feelings. You are foolishly trying to hide your feelings of boredom, whereas they are really the door to fascination and a most interesting and dynamic exchange. Let me show you what I mean. You can, instead, view dating as forming a relationship, being open, and genuine, and a little flirtatious, and seeing how things unfold. So, or example, you might say something along these lines, “You seem like a really neat and interesting person, but I notice that our conversation is not very open, or vulnerable, and that makes it way less interesting. Have you notice that, too? Tell me how you’re feeling.” If you express this, things will instantly get very interesting! You are not trying to hurt their feelings, but rather open up a conversation about feelings, by encouraging them to be real. They may also be feeling bored, or anxious, or whatever. As a psychiatrist, I find that when I explore the feelings and insecurities of my patients, it is always interesting. And when there is tension, including boredom, I acknowledge it to find out what’s up, and how is my patient experiencing the session and our interaction, and that is interesting 100% of the time, without exception. Warmly, david Dear David, Thank you for such an amazing answer! I have listened to the podcasts so many times and I am familiar with the concept of sharing the tensed feelings like boredom, to not force the other person to be boring. However I had never thought to apply it to dating!! It is such a foreign concept to how all my friends approach dating, that I will need first to experiment with it. I’m curious to see if I’m going to be brave enough to take this leap! Cannot wait to hear the podcast! All the best, Giulia 3. Negar asks if anxiety and depression are genetically caused and therefore hopeless . Hello, my kind father🦋💙, I hope you are well💝. I have a question. Many people I see who suffer from panic attacks and experience anxiety and major depression believe that they have a family and genetic background. That is why they do not have much hope that psychotherapy can help them and believe that the defective gene for causeless anxiety and panic is turned on in the nucleus of their cells. What do you think? Is it possible to deactivate these defective genes with psychotherapy sessions, meditation, etc.?!🥲 David’s Reply There is evidence that anxiety is inherited, and my mother had fear of heights, for example. I also got fear of heights and more than a dozen other forms of anxiety: fear of blood, dogs, vomiting, social situations, public speaking, cameras, panic attack once, and much more. But I have found that the techniques I use in therapy have helped greatly. I got over my fear of blood, for example, in twenty minutes working in the emergency room of a hospital and treating a severe trauma patient covered in blood. Everything about humans is genetic. We are born unable to speak a language, and yet we learn. So, to me, the argument is kind of silly and naïve. Just because something is influenced by genetics, and everything is, how does it follow that we cannot grow and learn? The whole notion seems to me to be ridiculous. Now, there are some genetic things that cannot be changed. For example, how tall you are, or the color of your hair (of course you can dye your hair if you want.) So everything has limits. The belief that you cannot change the way you feel will act as a self-fulfilling prophecy, since you won’t try, but that doesn’t make it true! Here’s something that IS true: Your feelings constantly are changing, at every minute of every day from the moment of birth. So anyone who argues that feelings CANNOT change is just wrapped up in a complete delusion! But people are welcome to believe whatever they want, of course. I believe strongly in freedom of thought. I also believe that people have the RIGHT to be WRONG! Best, david Will use as another excellent Ask David question if okay. Thanks for the great photo. Do you want me to include it in the show notes for that podcast episode? PS I will soon publish a video on my YouTube channel showing a 5 ½ minute cure for a woman with ten years of extreme panic attacks every week. Panic is probably the easiest thing to treat. 4. Negar asks about scary intrusive thoughts. Hello my kind father I hope you are in a good mood and continue to be full of energy as always I had a question I see in some people that they say that we have scary and useless thoughts This case is interesting for me too, because sometimes I have absurd and meaningless thoughts But since I meditate and do mindfulness exercises, I came to the conclusion that these are just thoughts. Did you have such an experience?😉 David’s Reply Yes, I have treated many people with frightening, intrusive thoughts and images, common in OCD / intense anxiety. Often, something is happening in that person’s life that is bothering them, but they are not dealing with itself, instead they sweep their feelings, of anger or whatever, under the rug and try to avoid them. Result = obsessions. There’s a whole section on this in my book, When Panic Attacks, and you can look up my podcasts on the Hidden Emotion Technique. Best, david

Transcribed - Published: 27 January 2025

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

Transcribed - Published: 20 January 2025

Overcome Your Screen Addictions! Featuring Dr. Brandon Vance Today we interview Dr. Brandon Vance, the Founder of the wildly popular Feeling Great Book Clubs and many other psychoeducational groups for the general public as well as shrinks. Today, he tells us about his latest group designed for people with the newly named "screen addiction." Dr. Vance formed this group because of many recent research studies suggesting a link between the time spent with social media sites and increased feelings of loneliness and depression in teens and adults. Although correlational studies do not prove causality, many of these studies are compatibles with the hypothesis that excessive time on social media may reduce the quality of moods as well as personal relationships, to say nothing of the potential negative impact on work and productivity. On the podcast he gave examples of how technology has been built into our lives, and how eqsy it is to pick up your cell phone, even in the company of others. However, screen addiction can also involve tlevision binge-watching, video games, and more. We demonstrated an example of the Devil's Advocate Technique, one of many techniques help combat positive thoughts that suck us into screen addictions. For example, Rhonda loves and frequently gets tempted to binge-watch a show on wedding dresses (Say YES to the DRESS), because she tell herself things like this: This is really fun. Would i like that dress? Would it look good on me? Maybe my wedding dress wasn't as pretty. I'll only watch for a minute. I need to relax. This is not hurting anyone. My husband won't mind that I'm gone. I can talk about the dresses to some of my friends. I work night and day and deserve to watch. in the live role-play, 'Rhonda was able to defeat these tempting thoughts "huge." If you think this might describe you, or benefit you, or just be fun and educational, here's the coop about the Screen Addiction Group, as well as his next Feeling Great Book Club and his Five Secrets Deep Practice Group. Free Yourself from Mindless Tech Use (Jan22-Feb26, $180 for 6 hour-long sessions).  Do you get on your phone every time you have a spare second?  Do you think social media will make you happier and yet you feel more lonely or stressed?  Do you stay up late fighting video game zombies and then turn into a zombie the next day because you're so tired? This 6-week online class will teach you powerful Cognitive Behavioral Therapy techniques (such as Self-Monitoring, Triple Paradox and Devil's Advocate) led by Brandon Vance, MD, all within the accountability and support of a group of peers to Free Yourself from Mindless Technology Use. The Feeling Great Book Club (two groups: Feb 24 - May 12 and Feb 26 - May14. $168 for 12 80-minute sessions, sliding scale).  Join together with people all over the world in this popular online class in a book club format, to read the Cognitive Behavioral Therapy book Feeling Great by David Burns, MD, and learn and practice tools to break through depression and anxiety to live a more joyful and relaxed life.  See live expert demos and join smaller breakout groups to practice what you learn in this sliding scale weekly online group. 5 Secrets Deep Practice (Jan 15 - Feb 19th and Mar 5 - Apr 9, $180-480 sliding scale, 6 90-minute sessions).  David Burns, MD laid out 5 key ingredients that make communication highly successful to get closer to each other, even in conflict situations.  Learn to use these 5 Secrets in your own life with expert demos and instruction and 1-1 practice in this 6-week online group. Rhonda and I strongly recommend these groups because active practice is the real key to learning and personal growth The support of others in the group can also lift morale and enhance accountability. If you want to change your life, this is a great option. Dr. Vance is not only a tremendous visionary and teacher, but he also has a huge heart. You'll find that these groups are ridiculously cheep but incredible treasures, and you can also contact him if any group looks appealing but you currently have limited means. Thank you for joining us today! Warmly, Rhonda, Brandon, and David

Transcribed - Published: 13 January 2025

Do Negative Thoughts REALLY Cause Depression? An Answer--At Last!--from Research Featuring David Burns, Jeremy Karmel, Diane Spangler and Rhonda Barovsky Today, David and two dear colleagues--Jeremy Karmel, CEO of the Feeling Great Corporation, and Dr. Diane Spangler--share the amazing results of two types of research on the Feeling Great app that focus on two related and vitally important questions: How effective is the Feeling Great app? Research confirms it triggers incredibly fast and dramatic reductions in seven negative feelings: depression, anxiety, guil7, inadequacy, loneliness, hopelessness and anger. The speed and depth of these effects may substantially outstrip human therapists as well as antidepressant medications. How does it work?  What is the mechanism of action? People have argued intensely about the chicken vs the egg problem for more than 2,000 years. Do negative thoughts REALLY cause negative feelings? Or do negative feelings cause negative thoughts? Or both? Or neither? The answers are exciting! Warmly,. Rhonda, Jeremy, Diane, and David

Transcribed - Published: 6 January 2025

Ask  David With Special Guest Expert, Dr. Matthew May Daily Mood Log: Does it have to be done perfectly? Somatic Complaints: How does TEAM Help?  Passive Aggression: What distortions cause it? Roger, from Australia, asks: Do daily mood logs still work if you complete them ‘imperfectly’? Roger also asks: Based on your clinical experience, what causes a reduction or complete elimination of in symptoms for people who present with somatic complaints or chronic pain? TOZ asks: Does passive aggressive behavior result from All-or-Nothing Thinking? The answers below were written prior to the show, based on correspondence with those who asked the questions. The live answers on the show will be different in many cases.  1, Roger, from Australia, asks: Do daily mood logs still work if you complete them ‘imperfectly’? 2. Roger also asks: Based on your clinical experience, what causes a reduction or complete elimination of symptoms for people who present with somatic complaints or chronic pain? Dear David, Sure, I would love to have my questions be on an Ask David! It would be okay for you to use my real name and my location as being in Australia for the podcast and show notes. I’ve reworded the questions so that they get across what I was actually trying to ask in my previous email. You might now have a slightly different response based on the new questions. I have to apologise as my wording in my previous email was confusing, even for me. Here’s a shorter version of the first question: “Dear David, I’ve got a question about doing daily mood logs as part of my psychotherapy homework. I tend to start a lot of new daily mood logs where I write my negative emotions and thoughts, as well as do positive reframing, but then get stuck when it comes to doing methods for challenging my negative thoughts, as I get caught up on trying to do the exercise perfectly. I get worried that I won’t see as much benefit from the exercise if I don’t do the steps perfectly or in order. Did you see improvements in patients who filled out their daily mood logs imperfectly? Perhaps they may have skipped steps or maybe they couldn’t crush their negative thoughts completely, but continued to move on to working with new thoughts and seeing if they could crush those.” An even shorter version of the question would be: “Do daily mood logs still work if you complete them ‘imperfectly’?” A shorter version of the question about somatic complaints and pain is: “I’ve also got a question on treating somatic symptoms and chronic pain. Some clinicians have seen people improve by doing journalling or expressive writing about life stressors such as past stressors, current stressors, and self-limiting behaviours or beliefs. Other activities which seem to be useful include writing unsent letters to people who’ve hurt you, or doing behavioural changes for self-limiting beliefs like learning how to designate free time for yourself if you have a tendency to take on too much or feel guilty about spending time relaxing and not doing work. I was wondering what you’ve seen in your clinical experience and what you’ve seen patients do which helps them reduce or eliminate their somatic symptoms and chronic pain?" An even shorter version of that question would be: “Based on your clinical experience, what causes a reduction or complete elimination of in symptoms for people who present with somatic complaints or chronic pain?" Regards, Roger He David’s reply Thanks, these short versions are a big improvement. Here are the quick answers: The critical thing is to come up with one or more positive thoughts that are 100% true, and that reduce your belief in the negative thought. If you send a specific example, it would help. There are several rules about getting workable negative thoughts as well. Perfection is never possible in the universe of daily mood logs, but excellence certainly is. A change in belief in neg thoughts is the goal. In my experience, somatic complaints, such as undiagnosed pain, dizziness, fatigue, and more, are often created or magnified by (or the expression of) negative emotions, as well as hidden emotions / problems. The average reduction of pain, for example, will be 50% if there is a dramatic reduction in negative feelings, or if the patient identifies and tackles some unexpressed problem, like anger, or unexpressed grief, or loneliness when the kids go off to college, and so forth. An average of 50% means that some people will experience a complete elimination of the negative symptoms, like pain. Some will experience no improvement. And some will experience some improvement. With regard to how or why this works, I don’t really know, and don’t think that anyone knows. But it seems like negative feelings, like depression, anxiety, anger and so forth have a magnifying effect on negative feelings. On the podcast, I can give a personal example of when I was in the Stanford emergency room, screaming in pain from a broken jaw. I can also give an example of what happens to my low back pain when I am in an especially good mood and I am out jogging. Best, David 3. TOZ asks: Does passive aggressive behavior result from All-or-Nothing Thinking? Hi David, I thought my therapist will tell me once he gets to know me that I'm passive aggressive and therefore I do things particularly anxiety disease as all or nothing black or white.  I was wondering for you not to answer my case but in general does passive aggressive attitudes or approaches result from all or nothing thinking? Thanks, Toz David’s reply. Thanks, Toz. Great question! To find out, you would have to do what I have recommended for nearly 50 years. Write down your negative thought on a piece of paper (can you do that?) and identify the distortions in it, using my lit of ten cognitive distortions. Let me know if you’ve done this. Most people refuse to do it! Warmly, david Toz replies: So I did your exercise. My thoughts were: I'm crashing.  Help I'm scared.  I'm going to die.  Help me laud.  Help me laud. Distortions:  predicting the future.  Magnification How is that? I looked up. Saw that was fine. Felt better. Then I checked my pulse.  Not too fast so okay. Toz. David’s reply to Toz, That, Toz, is totally cool! Way to go! Could also add: Emotional Reasoning. You identified two super important distortions that are always present in fear, paranoia and anxiety. Cool, cool, cool! David's comment: This is why I ask for specific examples when people ask general questions. As you can see, Toz asked about passive aggression, but his specific example turned out to be all about something entirely different: anxiety and panic. He did a great job of testing his negative thoughts with the Experimental Technique. Warmly, Rhonda, Matt,  and David

Transcribed - Published: 30 December 2024

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

Transcribed - Published: 23 December 2024

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  

Transcribed - Published: 16 December 2024

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

Transcribed - Published: 9 December 2024

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

Transcribed - Published: 2 December 2024

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

Transcribed - Published: 25 November 2024

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

Transcribed - Published: 18 November 2024

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

Transcribed - Published: 11 November 2024

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

Transcribed - Published: 4 November 2024

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

Transcribed - Published: 28 October 2024

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

Transcribed - Published: 21 October 2024

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.

Transcribed - Published: 14 October 2024

Podcast 417 Bullying Featuring Manuel Sierra, MD (pictured above) Today, we welcome an old friend, Manuel Sierra, MD, who practices pediatric psychiatry in Idaho, and Dr. Matt May, a familiar and beloved colleague, to discuss bullying. Below you’ll find a great list of questions Dr. Matt May submitted just prior to today’s podcast, along with some links you may wish to explore for more information. We addressed some of the questions, but certainly not all, during the podcast! Manuel described bullying, and said the ¼ of children and adults have experienced bullying. The consequences can be severe, including suicidal urges or completed suicides, along with shame and a severe loss of self-esteem, and more. He pointed out that bullies are good at zeroing in on aspects of ourselves that we feel insecure about, including how we look, our ethnicity, our aptitudes, and more. He provided links to resources on bullying. The bully picks on someone who is weak, so there is a power imbalance, and does the bullying to gain popularity and power, at the expense of the victim. David and Manuel emphasized that the bullying per se cannot cause the depression, shame, and so forth, but rather the victim must buy into the bully’s mean-spirited statements, like “you’re weak,” or “you have an ugly zit on your nose,” “your mother is a dirty whore,” and more. Then, the inner dialogue of the victim often goes like this: I must be a terrible and horrible person to get bullied like this. I’m worthless. All the kids are looking down on me. Everybody hates me! Everyone is laughing at me. I’m just a loser. And that, of course, is the voice of the “inner bully” who does all the emotional damage. Manuel and David both emphasized that the goal of treatment is to help the victim see that the “badness” is not with them, but rather with the kid (or adult) who’s doing the bullying. Because the victims nearly always feel ashamed, they will often suffer in silence, keeping the bullying a secret. David described what he calls the “abuse contract” that many, and perhaps most, humans buy into when being hurt or exploited. It’s really a contract between the abuser and the abused, and there are there parts to the agreement. I get to hurt you for my own pleasure. This might include sexual, physical, financial, or psychological torture or abuse. You, the victim are entirely to blame for this. You are the bad one. I am superior and totally innocent. You deserve what’s happening to you. We have to keep this a secret, even from ourselves. You cannot even hint that I am doing something wrong. If you try that, I will REALLY hurt you. David emphasized that the tendency to “accept” this type of horrible contract is not limited to children, but includes adults as well. He emphasized that sometimes the child who is being bullied will tell parents, who then tell the teacher or school officials, who will tell the bully to stop. This is rarely effective, and often makes the situation worse, since the bully tells the victim that they are a snitch and now they will REALLY get what  they “deserve.” Matt described many types of bullying, including physical, psychological, and cyber bullying. Manuel described some of the signs to look for if you suspect a problem with your child, including: Not wanting to go to school. Saying things like “everyone thinks I’m terrible.” Changes in sleep, eating habits, and energy. Somatic symptoms such as stomach aches and headaches. Manuel emphasized that the goal is not to eliminate negative feelings entirely, but rather to reduce the time you spend feeling anxious, humiliated and upset after being bullied. He also emphasized that ongoing practice talking back to your own negative thoughts is an important key to change, in exactly the same way that athletes must commit to ongoing daily practice to boost their physical skills and stamina. Manuel emphasized the importance of empathy and support, as well as asking victims if they’d want some help combatting their automatic negative thoughts and feelings. He shared that he endured considerable bullying as a kid, and was bullied because he was poor, of Mexican heritage, short, wearing glasses (“four eyes”), and young, and sometimes called “a fag” and other hurtful things. He said that reattribution is one useful strategy, among many, for combatting automatic thoughts and negative feelings. Instead of automatically blaming yourself for the bullying, you can ask questions like this: “What is it in their life that makes them want to do things like this.?” And “They are trying to hurt and embarrass me. Why are they doing that.” The goal is to help the victim see that the “badness” and shame really reside within the bully, and not with them. The bully is trying to tear you down. Ask yourself why? The bully thinks that this is the best way for them to gain popularity, power, and importance. Toward the end of the podcast, I, David, again emphasized that the Outer Bully can hurt us physically, by hitting for example, but only the Inner Bully can make us suffer emotionally. And if you’ve used the Externalization of Voices to crush the inner bully, and you no longer feel intimidated or ashamed when some tries to bully you, it becomes infinitely easier to respond effectively to the Outer Bully, using the Five Secrets, including Disarming and Stroking, as well as humor. To demonstrate this, I invited the other guests to try to bully me as an old person (I’m about to turn 82), and urged them to say the cruelest things they could think of. This is called the Feared Fantasy Technique. I was surprised and pleased at how incredibly easy it was to get “the edge on them. “ I hope you enjoy that aspect of the podcast. We will likely approach this topic again, with a focus on cyber bullying, and will restrict our focus to children and teens. How to Help! Matt once worked with a child who encountered their own 'inner bully' in the form of negative thoughts that would occur when they were unable to assemble LEGO's. The child could express certain thoughts, but was too young to write, so Matt wrote these down: I'll never be able to do it It’s impossible I'm not good at anything There is something wrong with me Matt asked the child if they would like to learn a trick for how to feel better and the child agreed. Matt wrote down some new thoughts for the child to choose from to describe the situation that was upsetting to them. Multiple Choice Positive Thoughts: I really, really want to do this! It's ok if I can't do it, yet Some things take lots and lots of practice I may be able to do it later I can do lots of things really well already I can probably get better with practice People love me and like to help Nobody's good at everything all the time Everybody messes up sometimes It might help to take a break   I can always choose to like myself The child said they really liked #11 and felt better right away and during future 'relapses'! Thanks, Matt Thanks for listening today. Below you’ll find the email Matt sent prior to the show. Manuel, Rhonda, Matt, and David Matt wrote: Just to stir up trouble and make you all sweat, I'm sending a few questions we might address: What is bullying? How are we defining this term? Is it Liberal Propaganda? How dare I say that? What's the difference between bullying and micro-aggressions / gaslighting? Am I crazy, if I think I'm being gaslighted? If I avoid bullying, in-person, including physical, emotional and verbal abuse...am I safe, on the Internet, at least? Is there such a thing as 'Safety'? Isn't that the thing we need, the most? Whose job is it, to make me feel safe? Why do some people think that safety doesn't exist? What is the significance of bullying? Does it matter or have any tangible effects on individuals or society? Link: https://www.ncbi.nlm.nih.gov/books/NBK390414/ What are some common misconceptions when it comes to bullying? Here are some that Matt has seen on DML's: It was all my fault / I deserved it / This happened because I am (insert label: bad/weak/defective, etc.) Bullying is normal, nothing can be done about it. Everyone gets bullied. It builds character. I should just get over it. I shouldn't *still* feel upset. That was a long time ago and I've done a lot of therapy. I can't speak up or talk about it, it's just too disturbing and upsetting. People would judge me and reject me, if they knew what happened to me All conflict is dangerous and must be avoided, at all costs I'm just a loser, a born victim, worthless in every way. This will always happen to me and people who believe #2 are correct I should be more accepting of bullies, they're people, too. Bullies shouldn't be bullies and should be hunted to the ends of the earth, and destroyed. What is the *cause* of bullying behaviors? Why would anyone choose to be cruel, manipulative and selfish? What is the 'Dark Triad'? Which feature of the 'Dark Triad' is most closely associated with bullying? Link: https://en.wikipedia.org/wiki/Bullying What can be done about bullying? How can TEAM therapy help someone who is being bullied? Can TEAM therapy help a bully? What can parents do, if their child is being bullied? Can TEAM help? What can parents do, if their child is bullying? Can TEAM help? What can society do? Other Questions: What is the “Internal Bully”? How does the “Internal Bully” relate to depression? What is the greatest predictor of bullying behavior and thinking? Who's to blame, anyway, here?

Transcribed - Published: 7 October 2024

Podcast 416 Ask David is it reckless to question the existence of the "soul?"' How can I make myself accountable? Do we have a "personality," or is that just another illusion?  Do questions about the "self" and "free will" involve All-or-Nothing thinking? The answers below were prepared prior to the podcast, and simply based on email exchanges. Be sure to listen to the live podcast discussion to get a variety of opinions and comments! Questions for today’s podcast. #1: Weren’t your comments on the self a bit reckless, given that the existence of / or belief in the “soul” is a prerequisite for most religions? #2: How can I make myself accountable for doing the exercises in your books? #3. Holy asks if the concept of having “a personality” is the same as the question of having “a self?” #4. Could questions about the “self” and “free will” involve All-or-Nothing Thinking?   Question #1. (not question, just a comment worthy of a response) Your comments on the “self” were shallow, mocking and restless. The recent episode on ‘Do I have a self?’ (Episode 406) was very shallow and mocking of people who thought there was a soul/self. Given a soul is a prerequisite for most religions, dismissing it out of hand without meaningful discussion seems reckless. David’s response Thanks, there’s a lot of truth in your comment and we’ll definitely include this on an upcoming Ask David! To give a brief response prior to the show, I would say that I am not trying to defend or attack any religion, but don’t want to give up my right to freedom of thought. I, David, am not saying that the “soul” does not exist, but what I am saying is hard to convey, and I probably won’t be successful now, either. But, when you talk about a “soul,” I do not have any idea what you mean by that word, or what you are referring to, if anything. To me, words like “self” or “soul” are simply language that is “out of gear,” as Wittgenstein might say. Meaning can only occur in a specific concept. It is not the case that there are “pure meanings” for abstract concepts. Thinking along those lines was the huge error that Plato and Aristotle made. Now, let’s say I go to YouTube and listen to some really kick-ass music that I totally love. I might say, “Wow, that guy (like James Brown, for example) really has soul!” What I’m saying is that I tremendously admire and appreciate his talent, his energy, and so forth. I am not referring to something metaphysical. My concern about your comment is that it sounds scolding, at least to my ear, like the “morality police,” perhaps. Personally, I have seen a great deal of evil done in the name of this or that religion, and I have no doubt that you have, too! Still, I am sure you have strong religious beliefs, which I respect, and apologize for having offended you. But I admit I am ambivalent, and partially happy that you are offended, and speaking out, because I believe that critical thinking is also tremendously precious, just as your religious beliefs are precious to you. In a selfish way, I have to confess I am also happy for the criticism, because controversy stirs up interest, and I am trying to interest people in our podcasts, which are ultimately dedicated to healing and relief of suffering. Still, I cannot deny the truth in your comment, that my “critical thinking” can be a disguise for a put down. When I wrote Feeling Good, I was very aware already (in the 1970s) that the chemicals categorized as “antidepressants” had few or no clinically significant effects above and beyond their placebo effects, and subsequent research has validated this. But I did not emphasize this in that book because I did not want to pull the rug out from anybody, and hurt anybody’s feelings. After all, if you are getting a nice “placebo effect,” that’s a good thing, at lest to some extent. Now, I’m older, so I’m more willing to speak my mind, and let the chips fall where they may. And you have bravely spoken your mind, too. Kudos to you! And that’s the end of my prayer! Keep those good thoughts rolling along. Amen Best, david (PS I’m sure you’ll get way better answers from the others on the podcast tomorrow!)   Question #2. How can I make myself accountable for doing the exercises in your books? Good to have Fabrice back. Regarding your books I have a question. I have trouble holding myself accountable doing the exercises in the book. Do you have any advice on how to prioritize doing the homework and being disciplined with it? How did other depressed people get better using your books? I already filled out multiple notebooks but appear to be stuck. Any help appreciated! David’s Response Thanks, we will address your question on a future Ask David podcast, if that's ok.   Question #3. Holy asks if the concept of having “a personality” is the same as the question of having “a self?” @HolyLoveQuest  • 1 day ago Thank you for this video on this topic, it was very clear to me! It's a shame that this chapter of your Feeling Great book was removed, because to me this philosophical point is one important tool (among the many techniques that you propose) to get read of negative thinking, and to heal. What you said about the DSM is refreshing, and I agree with it. So, you said schizophrenia and bipolar1 are mental disorders, and you explained why, but what would be the third: psychopathy? It would be nice if you do another video where you dig on this. Your voice on it is really important. What the APA is doing is really concerning. Other psychiatrists disagree with this business of labelling people. And you're right, it's detrimental to human beings. There is another psychological concept that you didn't talk about, but who looks similar to the "self", which is the "personality". What is your take on it, the same or different? Lastly, now in the spiritual domain, is the notion of the soul the same for you than the "self"? Or, in your opinion, could it be a possibility of an essential part of us which links us all to the Spirit, to spirituality? Looking forward to watching the other philosophical videos! David’s Response Will include in next Ask David Podcast!   Question 4. Could questions about the “self” and “free will” involve All-or-Nothing Thinking? Matt send me the following email he received and asked if we could include it in our next podcast, and my answer was “of course!” Hi, I'd like to tell you about my experience with my son. He is 14 years old and despite our honest attempts not to label, he has always been the problem child: selfish, disobedient etc. Recently we started him on Prozac and the changes have been incredible. Things that have been way beyond his best times are now simple, like going to sleep on time or having a good time with his brother. Every night my wife and I tell each other about some new miracle. So, I wonder what you can say about this from the lens of free will. An obvious conclusion would be that the choices he made until now were not "free" because his brain was not presenting him with the same set of choices that other kids experience. On the other hand, if he is acting better now, we could say that it is not his choice, just a pill making the decision for him. I feel like that would be insulting and degrading. I wonder if a lot of resistance to therapy and especially pharmacotherapy is related to anxiety about the question: "If I can be changed by a pill, then who am I?" I had another thought after listening to the episode on "self". The position that self doesn't exist seems extreme to me, maybe like "all or nothing thinking". Maybe we could answer that question with a "magic dial". How much do we agree that there are selves and free wills? I agree that there are problems associated with having a self and free will, but I think there are practical and theoretical reasons on the other side as well. Maybe the golden path is in the middle? David’s Response:  Will include your excellent question in the next Ask David Podcast! I am so happy to hear the good news about your son! At this point I will briefly say that concerns about “free will” might definitely include all-or-nothing thinking in the following sense. There is an awful lot of our thoughts, beliefs, feelings, behaviors, preferences, and so forth that is kind of hard-wired by evolution, genetics, and who knows what. For example, I really love blueberry pie that way my mother made it, but I never cared for pumpkin pie. I cannot “will” myself to like pumpkin pie! So I don’t have free will in that sense. Similarly, I can’t “will” myself to want to stop breathing permanently, or to stop feeling hungry when I haven’t eaten, and I can’t “will” myself to levitate when mediating or being able to high jump over something five feet high. The list goes on and on. And even when I freely chose something, like what type of new shirt to purchase, I have no doubt by genes and innate preferences, and possibly my upbringing, will strongly influence my choices. We all have biases, preferences, and desires that we do not choose, at least not consciously, Like sexual preferences, for example. We’re kind of stuck with what we’ve got. Now we can make free choices, of course, but we cannot be “totally free,” because we exist and are human. A cat can’t “not” get excited by a wiggly piece of string or a mouse that’s running away. But we CAN make conscious choices, obviously, just as I made the decision to print your excellent question and type out this brief response! Warmly, david

Transcribed - Published: 30 September 2024

  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 <[email protected]> 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.

Transcribed - Published: 23 September 2024

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 [email protected] or visit https://angelapoch.com/ to learn about Angela’s many training and treatment programs. You can reach Lorna at:[email protected] or https://www.yestohealth.com.au/ And here is the contact information for TEAM-CBT Australia: https://www.teamcbtaustralia.com.au/

Transcribed - Published: 16 September 2024

Ask David Disturbing Intrusive Thoughts-- where do they come from?  Alone and Liking It--is that Okay? Help with those darned Shoulds, and more! The following show notes were written before the show. The actual live discussions will vary somewhat from the answers you will find here, which simply included David's email exchanges with those who asked the questions. . Rodolfo asks about disturbing and unwelcome intrusive thoughts. Brittany asks if it’s okay to enjoy / prefer being alone. John, from Ireland, asks, “Help! I’m shoulding on myself again! What can I do? Please do another podcast on Should Statements.” Rodolfo asks about disturbing and unwelcome intrusive thoughts.   1. Rodolfo asks about ADHD & Intrusive Thoughts Hello Dr. Burns, my name is Rudy. First and foremost, your writings and podcasts have been life changing for me. You’re AMAZING! I was recently diagnosed with ADHD and I started experiencing intrusive thoughts around November of last year. I thought I had OCD, but apparently intrusive thoughts are a common companion in ADHD. What would be the best course of action in defeating them? How would I apply TEAM to them? David’s Response In all my books, like Feeling Great, I outline a step by step approach to writing down and challenging thoughts. You can also listen to the podcast on the four models for treating anxiety. Can we use your great comment on a podcast, and add your question to our next Ask David podcast? Can you send me an example of the types of intrusive thoughts you’re having? Sometimes writing them down and challenging can be helpful, but need to see what we’re talking about. Best, david Rodolfo responds Thank you for the swift response! Ok, so writing down my intrusive thoughts, regardless of their nature, and challenging them. I don’t, however, know which method/route to challenge them with. I have Feeling Great, so I will read through it again. I will also check out the podcasts. My intrusive thoughts have been disgusting violent acts involving my wife and son. ***I HAVE NO INTENTIONS OR DESIRE TO COMMIT ANY OF THEM***. I’ve had images of my wife getting shot, not necessarily by me. Sometimes I’ll see my arms give out and my son will fall. I’ve seen my wife sitting down, and she gets hit in the back of the head. When they appear, I begin to freak out immensely because they are the complete opposite of who I am and what I want to do, which is protect them. I know I’m not doing something right when it comes to your methods because I still freak out. David Responds Thanks! Although disturbing, this is a very common and often easily treatable OCD type of problem. Best, david Rodolfo responds What a relief. I thought I was going insane here! I would be honored if you all covered it in a podcast. All I listen to in my car now is the Feeling Good podcast! David Responds Often, intrusive OCD thoughts reflect suppressed problems / feelings people have, especially when the person is exceptionally "nice," and used to sweeping feelings under the rug, so to speak. I cannot treat you in this medium, obviously, but I'm wondering if you have some negative feelings, like anger or frustration, toward your wife and child? When these are "squashed," they can come out indirectly, disguised as anxious thoughts and feelings. This is called the Hidden Emotion Technique, which you can look up using the search on my website, if curious, or read about it in my book, When Panic Attacks. Best, david 2. Brittany asks if it’s okay to enjoy / prefer being alone. Hi Dr. Burns, I was listening to your podcast on self-acceptance, and it was really interesting hearing the results. I like how you said that just because we accept something about ourselves doesn’t mean we aren’t still working on it. I think people confuse that a lot. One thing I’ve accepted about myself is that I really do enjoy being alone. I think in the past I would try to find a buddy in uncomfortable situations like the first day of work or orientation or going to a baby shower alone etc. but now I find that I am most comfortable when I’m not included with everyone else. However, I think it can come across as off putting to some. Sometimes I get the feeling they see me excluding myself as rejection to them. That’s not my intention and nobody’s ever actually said that but it’s a thought that pops up. Just wondered if you think this form of acceptance is good or bad? I mean it’s been good for me. Just maybe it’s bad for others? -Brittany David’s response This is a cool question and nice comment, too, about our podcast. Can we read this on a podcast and use it for an Ask David? Personally, I am trying to say "no" more often when asked to do things with other people, and sometimes it's hard. But if I don't say no, I get way too much on my plate and can't keep up! Warmly, david Brittany’s reply That makes perfect sense to me. I’ve kind of taken the position where I don’t really want to make more friends because I feel like I’m already falling short with spending enough time with my cats and everyone else. Let alone time for myself. David’s reply Exactly! Our culture has this myth that's it's somehow impossible or immoral to enjoy just being with oneself! David   3. John, from Ireland, asks, “Help! I’m shoulding on myself again! What can I do? Please do another podcast on Should Statements.” Hi David and Rhonda! Love the podcast and the work you folks are doing! I listen to the podcasts regularly and you are both bringing such great benefits to the world! I would love to hear another podcast on should statements. I've been going through a pretty bad and extended period of anxiety and depression in recent months and have been really trying to challenge my thoughts without much success. I'm addicted to shoulds unfortunately and beat up on myself relentlessly. I've tried to do a cost benefit analysis and the motivation piece is a huge part of the benefits side that is keeping me stuck. I really want to give up my should statements, they are making my life a misery. But I'm finding I don't want to let go of the motivation piece. I have given a sample below. I'd love to know if there were further steps/techniques I could use aside from the CBA to address the benefits and the perceived motivation piece so I can fully let go of the shoulds! Thanks so much both, John from Ireland Negative Thought: “I should have plans on a Saturday.” 99% SHLD, ER, SB, MF, DP. Benefits Lets me know when I’m not performing to the standard I set for myself Shows me my passion/goal in life for doing fun exciting things Motivates me to move to make plans, scolds me until I do so. Keeps me vigilant that I’m aware of my shortcomings Reminds me of the value of being socially connected, meeting and having fun with friends. It’s easy, it’s familiar, it’s such a habit. (process resistance) Costs Emotional Cost. Beats me up relentlessly, makes me feel depressed, anxious and lowers my self-esteem. Reinforces perfectionistic beliefs Counterproductive in terms of motivation, makes me feel so low, Huge interpersonal cost, feel isolated alone. Prevents intimate connections Not able to be present or flow in a conversation, quality of conversation/connection drops Self-fulfilling prophecy, if I’m telling myself that then I ignore other possibilities. Benefits 40 / Costs 60 David’s reply Feeling Great is now available in the app store, and you can try it for free. It also has a class called “Your PhD in Shoulds.” I’ll add your question to our next podcast list for an Ask David. Since you’ve told me you can’t yet get the app in Ireland, I’ll send you the script of that lesson. Thanks! David John continues the exchange Hi David, Thank you so much for taking the time to correspond today and thank you so much for all the work you're doing for free. The world would be a better place with more Rhonda's and Dr. Burns' in the world. One of the things that has brought me some peace in the last few weeks is going for a long walk in the evening after work listening to your podcasts! I have attached a DML that I've been working on to give a bit more context. I made some inroads on that original should statement, however, as you can see from the DML more shoulds keep popping up. I have identified the Self Defeating Beliefs that resonate with me at the bottom of the document. I'm working hard to find healthy acceptance, I know this is key for me. I'm not entirely sure a lot of the time what exactly I should be accepting. That I'm a flawed person with many defects, just like everyone else maybe? To give some further context and without overburdening you with too much detail: I feel my anxieties are one of the main parts of my problem and I would love to get over these. I feel defective that I'm not resilient enough for the challenges of life. I have fears mainly around people, fear of letting people down, fear of being judged or rejected and just feeling different to others I suppose. I've struggled with recurring anxiety and some depressive periods from when I was a young child (likely biological - my dad has the same issue). I have strong feelings of defectiveness and not being up to standard compared to my peers. I have a very busy corporate finance job where I've been working very long hours over an extended number of weeks and months. I don’t' love my job, fell into it really. Could be a hidden emotion thing going on. I started working from home more and more in recent months as my workload increased and my anxiety and mood really started to dip as work took over my life. I started to get really burned out in April. A lot of why I enjoyed the job previously was having fun with my teammates but that has become impossible in recent times due to everyone's workload. I do CrossFit which is probably an extreme form of exercise and between that and work I fell into some kind of perfectionism where I couldn't really find joy out of anything, aiming for higher and higher achievements. This brought on tons of shoulds and all or nothing thinking and self-blame, I think. My dad, who had been doing well for a good few years fell into a deep depression and anxious state around April time too and has been in hospital for a number of weeks and our family is trying to support him through this. We're finding the standard of mental health care in Ireland really really poor unfortunately. I find his issues quite triggering for me a lot of the time and I'll believe I'm defective because he is defective and there is nothing I can do about it. Dad is entirely dependent on medication to get him out of his slump and has a bad case of do-nothingism. He is beating himself up relentlessly too and I gave him a copy of Feeling Good to read but he hasn't looked at it at all. I have just turned 40 and I’m still single, so I feel like I'm letting my family down for not being emotionally able for a relationship or kids or be a better brother/son. I know I'm probably being harsh here as they say the opposite, but I feel I could/should be doing more. I have probably fired way too much detail at you, so I'll stop there! Thanks so much again! John Listen to this podcast for the great discussions and commentary by Rhonda, Matt, and David  

Transcribed - Published: 9 September 2024

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

Transcribed - Published: 2 September 2024

Ask David: What’s Self-Esteem? What’s Self-Acceptance? In today’s podcast we address six common questions about self-esteem, including: What is Self-Esteem? How does it differ from self-confidence? How does it differ from self-acceptance? What’s the difference between conditional and unconditional self-esteem? What’s the best way to develop self-esteem? What do you mean when you say that once you develop unconditional self-esteem, you should get rid of it as fast as possible? Please keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks! Brandon Vance and Heather Clague begin today’s show with a pitch for their upcoming Feeling Great App Group, an 8 week experience that will begin in September. If you use the Feeling Great App, or plan to get it, this group would be an inexpensive and incredible enhancement, so you can meet with like-minded people once a week to schmooze, practice the techniques in the app, and get your questions answered by compassionate and personable experts. For more information go to www.FeelingGreatTherapyCenter.com/appgroup. Feeling Great App Group Sept-Nov 2024 Led by Brandon Vance MD and Heather Clague MD, meets online for 80 minutes for 8 weeks, offered Mondays 4-5:20pm Pacific Time, September 23rd - November 11th. Cost is $12 per session ($96 total) plus the cost of the app ($99 per year after 7 day free trial). Sliding scale for both the group and the app are available. No one turned away for lack of funds. Feeling Down? Try the Feeling Great App for Free! It's now in the IOS and Android app stores, and you can check it out for free. It's works super fast. Let us know what you think! Thanks! Rhonda, Matt, and David appreciate your support. Keep your questions and testimonials coming. They mean a lot to us!

Transcribed - Published: 26 August 2024

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

Transcribed - Published: 19 August 2024

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! Is the Universe One? Is the Universe Real? Is the Universe Real? These two philosophical problems used to seem nonsensical to me, and certainly not relevant to much of anything in my life—or anyone’s! But now the picture has changed a bit! When I was a student at Amherst College, I majored in the philosophy of science. On this show, I’ve often talked about my hero, Ludwig Wittgenstein, who attempted (successfully in my opinion) to “solve” all the problems of philosophy. He wanted to help those of us who were “afflicted” by an attraction to philosophical problems to see through them and understand precisely how and why they were nonsensical. He hoped to provide a “treatment” for philosophers so we could give up the need to obsess about nonsensical philosophical problems. Once you see through the these problems, they become kind of like a joke, and you can use jokes to help other people see through them. For example, here’s a kind of lame joke about the question of whether or not the universe is “real.” Wittgenstein said that before we try to answer questions like that, we might want to ask ourselves if these questions even makes sense! And if it a philosophical problem doesn't make sense, it isn’t a real question, so we won’t need to deal with it. In other words, questions that don’t make sense don’t need to be answered because they’re not real questions. Take the question, "Is the universe real?" You could ask, “Well, what would it be like if the universe weren't real? What would that look like? How would things be different?” If you can't answer that question, the question might not make sense. To most of us, philosophical questions wound nonsensical because we are taking words, like “real,” out of the contexts in which it DOES make sense. For example, we can ask : “Is this painting real? Or is it a fake?” That question does make sense. It has an obvious meaning, since many valuable paintings are copied and are fakes, and they try to pass them off as the “real” thing. But what would a "real" or "fake" universe look like? How would it differ from our universe? Now let’s think about another example that is mildly humorous. Let’s imagine you’re driving through Iowa in the summer, and you spot a farmer working in his corn field. You’re interested in speaking to him because you are writing a story about your travels in Iowa, and want to talk about the lives of farmers. So, you pull your car over to the side of the road and shout, “Howdy! What are you doing in the field?” The farmer seems pleased and grabs a gorgeous stalk of corn and holds it up and proudly shouts, “I’m growing corn, and it is real!” Well, that’s great that he's happily growing corn, but what does the tag-on, “and it is real” mean? It doesn’t actually mean anything, because farmers don’t grow “unreal corn.” So, in this context, the word has no meaning. Now, if you were on a movie set, they might actually be using artificial corn as a prop, so now the contrast between real and unreal corn becomes meaningful. This is a very humble point, but it’s the very heart of what Wittgenstein was trying to make us aware of. Philosophical problems kind of sound meaningful and puzzling, but most of the time, they are simply a kind of nonsensical use of language. Now, in personal relationships, we might also have a notion of when people are being “real” or fake. And we often act fake because we don’t think we’re good enough just the way we really are. So, for example, you may hide your shyness in social situations because you’re ashamed, and telling yourself that your shyness is incredibly weird and abnormal, and makes you “less than” other people. One method of helping people overcome shyness is simply to disclose it to others. This TEAM-CBT  technique is called "Self-Disclosure." Instead of hiding your shyness and feeling awkward and ashamed in social situations, you share your feelings openly. Shame depends on hiding, so when you open up, the feelings of shame will often disappear. For example, in a recent podcast of a dramatic, live therapy session, a man named Chris revealed many troubling things about his teenage years that he’d been hiding for years. When he opened up, he began sobbing intensely, thinking he’d let his father down with his wild behavior when he was a high school student. His grief, he was incredibly compelling, and his courageous self-disclosure was appealing to most of us who were privileged to witness that session. Showing us his “real” self became his path to enlightenment, joy, and deeply meaningful relationships with himself and with all of us who witnessed that amazing session. So, although the question, “is the universe real” is silly and nonsensical, the question, “are we being real with each other,” is definitely NOT silly or nonsensical. Being real and vulnerable is an important key to connecting with ourselves as well as other human beings. Is the Universe One? How about “Is the universe one?” This philosophical question also seemed nonsensical to me for years, although I was intellectually aware that some Buddhists make claims that the universe IS one and that the failure to “see” this is the basic of all evil. That's because if you see other humans, for example, as being "external" to yourself, you may feel you have the right to abuse and exploit them. However, for years I thought the idea that the universe is "one" seemed like sheer nonsense. For example, I am sitting in a chair typing, and there is a cup on the desk. People have never call that cup “David,” and no one has ever called me a coffee cup (although lots of people have sad some pretty bad things about me!) So, I concluded that the cup and I are not “one,” and so the whole thing about the universe being one seemed nonsensical and silly. But when I began to think about it in the context of my work with patients, my thinking suddenly changed. For example, the TEAM interpersonal model I’ve developed was based on research I did early in my career that suggested that Blame was one of the main causes of troubled relationships, and perhaps the most important and powerful cause. And this is certainly true in my personal life and in my work with individuals with troubled relationships who are unhappy in their marriages or people who are angry with their neighbors, or family members, or anyone. We almost always see ourselves as victims, and the other person as the one who is to blame for the problem. This triggers feelings of frustration, anger, and moral superiority, and can easily and often lead to arguments, mistrust, divorce, hostility, and violence, murder, and even war. Now, I’m beginning to see that the idea that we are separate from others, who are doing something TO us, does, in fact, lead to hostility, and arguably to evil. And once you “get it,” the same insight applies to our relationships, not just with loved ones, friends, and other people in general, but also our relationships with animals, with the environment, and with the planet earth. If we think of them as “other,” then we may conclude that it is okay to exploit or use them for our own advantage. In the interpersonal TEAM model, we focus more on circular causality, or interpersonal connectedness and ask the question, how do we actually shape and cause the very behavior in the other person that we complain about so vigorously? I have developed a fast, powerful tool that allows any to pinpoint their own role in a relationship problem very quickly and with reasonable accuracy. It’s called the Relationship Journal (RJ), and we’ve talked about it often on this show. Essentially, it’s simple to use the RJ, but it can be startling and illuminating but incredibly painful. All you have to do is write down ONE thing another person said to you that you found upsetting, and EXACTLY what you said next. Choose an interaction that did not go well; otherwise, it’s a waste of time. Then, the RJ will take you through a step by step analysis of your response, and it's implications. When you discover how you are actually forcing the other person to treat you shabbily, it can hurt. This is one of the four ‘Great Deaths” of the self, and it’s the most painful of all, in my experience. This is the "Great Death" of the angry, blaming "self." I hate this great death! But if you have the courage to use it and take a look, it can be incredibly illuminating and liberating, and can put you on the path to far more loving relationships. As an exercise, I will list a number of common complaints that people have about loved ones, friends, or family that they find irritating. Your job will be to show how you could FORCE them to do the exact thing you are complaining about. The other person could be your partner, friend, son or daughter, etc. Your complaint about that person might be that they Refuse to talk to me. Can’t (or won’t) open up and express their feelings Constantly whine and complain, and ignore and resist my good advice. Constantly argue, and always have to be right. Won’t listen. Are relentlessly critical. Always have to get their way. Doesn’t treat me with respect. In each case, see if you can figure out how you could FORCE the other person to do that exact thing. We will discuss a couple of these on the show and lustrate solutions to give you a feel for how this works. Rhonda’s and Matt shared their wise and interesting thoughts on both of these philosophical questions, and how you can understand them in the context of your own lives, and, if you're a shrink, how you can use them in your work with patients. Thanks for listening today! Matt, Rhonda, and David

Transcribed - Published: 12 August 2024

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

Transcribed - Published: 5 August 2024

Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Podcast Practical Philosophy Month Part 2, Do Humans have “Selves”? This is our second podcast in our Practical Philosophy Month. Last week, in our first episode, we focused on the “free will” question. As humans, we all feel like we have “free will,” but is it just an illusion, especially if all our actions are the result of the physical processes in our brains and the laws of the universe? The Bible certainly dealt with this in the book of Genesis, where we learn that the first humans, Adam and Eve, were given a wonderful Garden of Eden to live in, but they had to choose whether or not to obey God’s rule NOT to eat the forbidden fruit from the tree of knowledge of good and evil. They chose to eat the fruit, implying that humans have free choice. But the philosophical arguments rage on. In today’s podcast, we are joined by two beloved and brilliant colleagues, Drs. Matthew May and Fabrice Nye, as we explore the question of whether or not the “self” exists. We all feel like we have a “self,” but is this real or just an illusion? When you try to define your “self,” you may run into problems. For example, you might think that the “self” has to be the part of us that does not change from moment to moment, and is always ‘the same.” For example, I might think back on my childhood and feel convinced that I was the “same David Burns” then that I am now. And, if you are religious, you might also be comforted by the idea that your “self” is the same as your “soul,” and that you will therefore live on after you die. This concept of a “soul” is a core belief in many religions. But are we fooling ourselves? And what was the Buddha thinking about 2,500 years ago when we talked about enlightenment as resulting from the “Great Death” of the “self.” He seemed to be hinting that something wonderful can happen when you give up the idea that you have a “self.” In the original draft of my book, Feeling Great, I had a chapter on entitled, “Do you need a “self?” Join the Grateful Dead.” I tried to persuade readers that the existence of a “self” is nonsense, based on the philosophy of Ludwig Wittgenstein in his famous book, Philosophical Investigations. But readers found the chapter so upsetting that I decided, on their urging, to delete it from the manuscript, which I did. My goal is not to disturb people, but to provide a path to joy and to loving connections with others. But to this day, I still get emails from people asking me to offer that chapter, or to deal more deeply with this concept of the “self” vs “no self” in a podcast. So, here is my attempt today. I will start with my own take, and then summarize some of the views about the self that were expressed by Fabrice, Matt, and Rhonda during the show. Here’s my thinking. There are many key questions you could ask about the concept of the “self?” including: Do we have a “self?” And if so, what is it? Does the first question even make sense? I’m sure you would agree that if a question doesn’t make sense, then it isn’t a “real” question, and there really isn’t anything to talk about. Then we can just stop feeling frustrated and perplexed, and move on with our lives. That is the precise position that the late Wittgenstein would probably have taken. He stated that words have no ultimate or “true” meaning outside of the various contexts in which we use them in daily life. Most words have many meanings, because they are used in different ways, and you can find most of the meanings in any dictionary. So, if you think of the word, “game,” you will quickly realize that it does not have one “true” or essential meaning. It can mean a sports competition, with two teams competing against each, like soccer. But you can have two teams competing in some way other than a sport. And you don’t even need two teams to have a “game.” For example, some games are played by one individual, like solitaire with a deck of cards. Or you can think about the “dating game,” or refer to “game birds,” or a “game boxer.” In short, there is not some single “correct” meaning to the word, “game.” Some uses have overlapping meanings, and some uses do not overlap at all with other uses. So, there is no point in trying to figure out if “games exist,” or what the ultimate or essential meaning is of the word, “game.” Now, how do we use the word, “self,” and what does it mean in each context? You might tell your child to behave themself. This simply means that they are misbehaving and will be punished if they don’t behave more politely. You do not have to tell the child that their “self” also has to behave better, because that would be meaningless. We already told the child to change their behavior. You could ask friends, as I did this morning, if they are planning to join me on the Sunday hike. Two of them confirmed and said that “they” would join me today on our hike. I did have to ask them if they would be bringing their “selves,” because I just do not know what that would mean! They already told me they’re coming to the hike. (They did come and we had a lot of fun.) In my extremely challenging freshman English class at Amherst College, we had to write two or three papers per week on odd topics. The teachers were relentlessly critical in their feedback, and would nearly always point out that we sounded incredibly phony and need to find our true voices, which came from our real selves, as opposed to the false fronts we often used to try to impress people. Almost every student got dumped on constantly! The professors weren’t referring to some metaphysical “true selves.” They were just referring to the fact that our writing didn’t sound natural, compelling, or vulnerable, and so forth. Our writing was, for the most part, an enormous turn-off. Most of us never could figure out quite what that class was all about, but it was useful as I became more sensitive to the “tone” or “voice” in any writing. I would have to concede that it was a sobering but helpful class. But they were not referring to some mystical “true self” we had to find. They just wanted us to stop writing in such a sucky way! So here is my point, which you might “not get.” When you keep the word, “self,” in the context of everyday life, it is obvious what it means, and it never refers to some metaphysical “thing” that we could “have” or “not have.” It is just a vague, abstract concept that is devoid of meaning when it’s all by itself. A “self,” just like “free will,” is not some “thing” that we might, or might not, have. The question, “Does the self exist,” according to Wittgenstein (or his big fan David) has no meaning and so we can just ignore it. It’s not a real question. It is, as Wittgenstein was fond of saying, “language that’s out of gear.” Now, does this discussion have anything to do with emotional problems, or TEAM therapy? It absolutely does. That’s because nearly all depression results from some version of “I’m not good enough,” including: I’m inferior. I’m a loser. I’m a “hopeless case.” I’m a failure. I’m unlovable. I’m a bad parent. I’m defective. And so forth. If you buy into these “self” condemning proclamations, thinking that they mean something, you’ll probably feel depressed, ashamed, inadequate, hopeless, and more. As you can probably see, all these self-critical thoughts contain tons of cognitive distortions, like All-or-Nothing Thinking, Overgeneralization, Labeling, Mental Filtering, Emotional Reasoning, Self-Blame, Hidden Shoulds, and more And to put it in a nutshell, they ALL involve the belief that you have a “self” that’s broken, or simply not “good enough.” And all of those statements are meaningless. My goal in therapy is NOT to persuade you that you ARE worthwhile, or “a winner,” or a “good” parent, but rather to show you how to let go of these meaningless but painful ways of belittling yourself. I might use techniques like Empathy, Positive Reframing, Explain the Distortions, Let’s Define Terms, Be Specific, the Double Standard Technique, the Externalization of Voices, the Downward Arrow, and many more. That’s because the VERY moment you suddenly “see” that these kinds of statements are both untrue and unfair, and you stop believing them, your feelings will instantly change. So, you could say that TEAM really IS a “Wittgensteinian” therapy. And when people ask me how to develop better self-esteem, I would not try to get them to discover how to have some magical and wonderful “thing” called self-esteem, because that concept is just as nonsensical as the concept of a “self.” You might say that “self-esteem,” if you want to use the term, is more about what you DO. And there are two things you can do if you want to change the way you feel. First, you can stop beating up on yourself with hostile criticisms like the bulleted statements listed above, and talk to yourself in the same encouraging way you might talk to a dear friend or loved one who was hurting. And second, you can treat yourself in a loving way, in just the same way you might treat your best friend who was coming for a visit. In other words, you can do nice things for yourself. The day my first book, “Feeling Good,” was finally published, my editor called me with some bad news. She told me that the publisher, William Morrow and Company, loses money on 9 out of 10 of the books they publish, so they decide which ones are most likely to sell, and those are the only ones they’ll promote. The rest of the books go on a “loser list,” and the company does little or nothing to promote them. She said my book was #1 on their “loser list,” since the president of the company felt it had no commercial potential, and that very few people would be interest in a long book on depression. She added that the one thing they did do was to send my book to ten popular magazines for first serial rights. That means they get to publish an excerpt from your book as an article, so that stirs up some media interest in your book. Sadly, she said that all ten had turned them down. She said that I’d have to be in charge of any further marketing of my book, so I asked what I should do. She said to call all ten magazines right away and persuade them to change their minds. In a panic, I called them all, including Ladies’ Home Journal, Reader’s Digest, and on and on. Every magazine said the same thing—they did not want my book, had turned it down, had zero interest in it, and to please top calling since authors shouldn’t call them and they considered it a form of phone harassment since they’d already made a decision. Yikes! No fun! When I jogged home from the train station that night, I shouted, “You’re a loser, you’re a failure.” That didn’t sound so good so then I shouted, “No, you’re not! You’ll figure out how to make it happen! Just keep plugging away.” That sounded a lot more loving, so when I got home, I told my wife that the book at just been published and that I’d been turned down by all ten magazines for serial rights, and the publisher decided not to spend any money on marketing or advertising, so we needed to go out and celebrate. She why we would celebrate? I said, “You don’t need to celebrate when you win, because you already feel great. But when you lose, that’s when you need to celebrate, because you’re feeling down. So, tonight we’ll celebrate!” We went out for a fancy dinner and celebrated and had fun. And the rest, they say, is history. I just kept trying and getting turned down by newspapers, radio stations, television programs, and more. But eventually, the tide started to turn. To date, Feeling Good has sold more than 5 million copies and it achieved best-seller status. And the reason was that researchers discovered that the book actually had antidepressant properties, so excitement about it spread by word of mouth. I am hopeful that the new Feeling Great App will help even more people. Fabrice made some interesting and wise comments on the notion of the “self.” He said that the idea that we have a “self” is a sense that we nearly all have. Some people feel like the “self” that is located somewhere behind the eyes or in the middle of the head. But, he emphasizes, there is no such “thing” as a “self.” He has quoted someone who has “said it all,” but the statement only makes sense IF you “get it!” Here’s the quote: “No Self? No Problem!” This is actually the title of a book by Chris Niebauer, PhD, and the subtitle is How Neuropsychology Is Catching Up to Buddhism. If you want to check it out, here’s a link to it on Amazon: https://www.amazon.com/No-Self-Problem-Neuropsychology-Catching/dp/1938289978 Fabrice emphasized that the concept of “self” is “nebulous.” He asked, “Is there a ‘David’?” He explained: You wouldn’t be able to prove this in court. Well, you could show ID, but that would not be proof. Where does the information on the ID come from? Birth certificate? Who wrote the information on the birth certificate? Probably some doctor back in 1942. And where did he get that information from? Probably some caregiver said “Write ‘David’ here.” Was that from a credible source? Not at all. That info was made up on the spot! Now, you can say that there’s a “sense” of a David going around, and that there are some patterns that show signs of “David-ness,” but there is no “David.” Matt added that your body is not your “self.” When you break your arm, you don’t say that you have broken a part of your “self.” You just say, “I broke my arm.” Rhonda raised the question of whether the “self” is just the same as “consciousness” or “awareness.” Someone in our group added that the “self” is what we DO, and not what we ARE. And, of course, what we are doing is constantly changing from moment to moment. My understanding of all of this is that once you let go of the notion that you have a “self,” you will no longer worry about whether or not you are “good enough” or “special,” or whoever. You can focus instead on living your life and solving the problems of daily living and appreciating the world around you. If you screw up, you can focus on what specific error you made, rather than obsessing about your inferior or defective “self.” You can actually welcome failure as just another teacher, so you can grow and learn, and simply accept your screw ups, or both. In fact, two of the most popular TEAM techniques for challenging the distorted thoughts in bullets above are called “Let’s Define Terms” and “Be Specific.” These techniques are right out of Wittgenstein’s playbook, and they are prominently featured in the “Learn” section of the new Feeling Great App. If you’re feeling depressed, and thinking of yourself as a “loser” or as being “inferior” or even “worthless,” the goal is NOT to “become a ‘winner,” or more ‘worthwhile,’ but rather to give up these notions as nonsensical. But once again, many people cannot “get it,” or “see it,” and that’s where a caring and skillful therapist can help. Some people wrongly think that letting go of the notion that you could be “worthwhile” would mean a huge loss of something precious. Many people who don’t yet “see” what we’re trying to say are terrified of the “Great Death” because they think that giving up the notion that you have a “self” means giving up all hope for improvement, for joy, for intimacy, and so forth. But to my way of thinking, the truth is just the opposite. When your “self” dies, you and your world suddenly wake up and come to life. When you accept yourself and your world, exactly as they are right now, everything suddenly changes. Of course, that’s a paradox. I believe that leading our patients to the “Great Death” of the “self” is like giving them the understanding and courage they need to throw some garbage in the trash instead of carrying the garbage around with them all the time! I hope some of this makes a little sense, but if not, don’t worry about. Sometimes, it takes a little time before you suddenly “see it!” Thanks for listening today. We love all of you! Rhonda, Fabrice, Matt, and David

Transcribed - Published: 29 July 2024

Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Podcast Practical Philosophy Month Part 1, The Free Will Problem Welcome to Practical Philosophy month. For the next five weeks, we will discuss some of the most popular and challenging problems in philosophy, such as these: Do human beings have free will? Or is free will just an illusion? Do human beings have a “self?” Or is the “self” just another illusion? Is it possible to be more or less “worthwhile?” Are some humans “better” or “worse” than others? Does God exist? Is the universe “real” or “one”? What’s the meaning of life? What is “self-esteem”? How does it differ from self-confidence? What’s the difference between conditional and unconditional self-esteem? What’s the difference between self-esteem and self-acceptance? What do you have to do to experience joy and feelings of worthwhileness? We will try to complete the list in five weeks, so some weeks we may include more than one topic, since many of these topics are related to one another. Rhonda and David will be joined by our beloved Dr. Matt May, a regular on our Ask David episodes, and for the first and second sessions we will be joined by our beloved Dr. Fabrice Nye, who created and hosted the Feeling Good Podcasts several years ago. Each week, you will also hear about the linkage between these philosophical dilemmas, and emotional problems, like depression, anxiety, and relationship conflicts. For example, nearly all depressed individuals believe that they aren’t sufficiently “worthwhile.” I see my goal as a psychiatrist not as helping people feel “more worthwhile,” but rather showing people, if interested, how to give up this notion entirely and become free of certain kinds of damaging judgments of the “self” and others. You will also learn how these types of philosophical problems continue to play a large role in psychiatry and psychology, including the DSM5 diagnostic system. For example, is the diagnosis of “Generalized Anxiety Disorder” a true “mental disorder” that you could “have” or “not have?” And might some or most of the so-called “mental disorders” listed in the DSM be based on faulty philosophical / logical thinking? And if many or most of the “mental disorders” are based on goofy, faulty thinking, is there a more productive and effective way to think about most emotional problems? And how did we get into this mess in the first place? Worrying certainly exists, and we all worry at times. But how much or how often do you have to worry before you develop or have a “mental disorder” called “Generalized Anxiety Disorder” that can be diagnosed like any medical illness and treated with drugs? Or is “Generalized Anxiety Disorder” (and hundreds of other “mental disorders in the DSM” based on a certain kind of nonsensical thinking? And if so, why? What is the goofy, faulty thinking in the DSM? And are there some “mental disorders” that are valid and real? We HAVE touched on all of these themes in previous podcasts, but I thought it would be nice to put them all in one place and bring in a variety of “solutions,” controversies, and experts. I David, will often represent (hopefully, and to the best of my ability) the thinking of Ludwig Wittgenstein, as expressed in his famous book, Philosophical Investigation, published in 1950 following his death. That book consists of a series of numbered brief essays (a few paragraphs each) that were based on notes found in a metal box under his dormitory room at Cambridge University. He’d written these in preparation for his weekly seminars in his dormitory room. Wittgenstein, although now widely regarded as one of the greatest philosophers of all time, did not think he knew enough to teach in a classroom. In fact, because of his feelings of depression and self-doubt, he sadly never tried to publish anything when he was alive. Wittgenstein’s philosophy also played an indirect but significant role in the evolution of several modern psychotherapies. His philosophy created new ways of thinking that gave rise to the work of Dr. Albert Ellis, the famous New York psychologist who created Rational Emotive Therapy during the 1950s. Ellis emphasized that the “Should Statements” that trigger so much guilt, shame, depression, anxiety, and rage are based on illogical thinking. He might often say, “Where is it written that people or the world “should” be the way you want them to be?” Of course, this idea actually traces back to the Greek Stoic philosophers like Epictetus and Marcus Aurelius. Wittgenstein’s thinking also seems to have played a role in the thinking of Dr. Aaron Beck, who adapted the work of Ellis and called his version of the “Cognitive Therapy.” Beck emphasized many thinking errors, like All-or-Nothing Thinking, and Overgeneralization, that trigger depression, anxiety, and more. Sadly, Wittgenstein struggled with severe depression and loneliness throughout his life, and three of his four brothers tragically died by suicide. Wittgenstein also had prolonged periods of time when he considered suicide. It is also sad that he did not know how to apply his brilliant philosophical breakthroughs to his own negative thinking, but that application of his work did not develop at the time he was still alive. Part of Wittgenstein’s depression was related, I believe, to the fact that very few people, including the most famous philosophers of Europe, could understand his thinking when he was alive. From time to time, I think he glimpsed the enormous importance of his work; but I believe that he also had prolonged moments of self-doubt when he thought his work was of little value at best. To be as correct as possible, Wittgenstein did write a manuscript called Tractatus Logico Philosophicus as a young man, although he never tried to publish it. He wrote it when he was a prisoner of war. He thought this book solved all the problems of philosophy, which had plagued him since he was a child, and he felt great relief. He sent a copy of his manuscript to Bertrand Russell, who was a famous British philosopher. Bertrand Russell was incredibly impressed with the Tractatus and distributed it to many European philosophers. Bertrand Russell thought it might be the greatest book in the history of philosophy, and a number of the 20th century philosophical movements including Logical Positivism, were inspired by that book. However, Wittgenstein left the field of philosophy, thinking that his work was done, and that he’d found the solutions he was looking for. He tried teaching grammar school for a while, but was fired because he became frustrated and violent toward some of his students. He also tried to survive as a fisher in a Norwegian fishing town, but was not successful at that, either, because he didn’t know much about fishing, much less supporting yourself through fishing. One day, he learned that a brilliant Swedish economics student had found a flaw in his Tractatus, and his inner turmoil about the puzzling problems of philosophy flared up again. He decided to return to the study of philosophy. He applied to be an advanced undergraduate at Cambridge University, but when someone in the admissions office spotted his application, they recognized his name and showed his application to Bertrand Russell, who had been wondering what had become of the young man who once sent him such a brilliant manuscript. Russell, who was the chair of the department of philosophy, said to being Wittgenstein to his office immediately for an interview. Russell explained that he would have to reject Wittgenstein’s application to be an undergraduate at Cambridge University. Deeply disappointed, Wittgenstein asked why. Russell told him it was because he was already recognized as the greatest philosopher of the 20th century. Bertrand proposed that if Wittgenstein would agree to skip college and graduate school, they would immediately award him a PhD for the manuscript he’d sent to Russell years earlier. Russell also offered him a full professor ship in the department of philosophy. Wittgenstein protested and said he needed to study philosophy again, because of the error in Tractatus, and that he didn’t know anything, and definitely could not teach in a classroom. Bertrand Russell insisted, and they finally struck a deal where Wittgenstein would agree to be a professor of philosophy but all he would have to do was to have a conversation session with anybody who wanted to talk to him at his dormitory room once a week. Wittgenstein accepted and met for years with students and famous philosophers who came from around Europe to crowd into his dormitory room for his weekly seminars, and he began to shape a radically different philosophical approach from the one he’d described earlier in his Tractatus. He was determined to find a new way to solve all the problems of philosophy. And, to my way of thinking, along with those few who really understand him, he was successful. But he was often frustrated because, so few understood him. This was unfortunate, because what he was saying was incredibly simple and basic, and it was pretty similar to, if not identical to, the thinking of the Buddha 2500 years earlier. The Buddha apparently had the same problem—almost nobody could understand what he was trying to say when he was still alive. They couldn’t “get it” when he was talking about the so-called “Great Death” of the “self,” or talking about the path to enlightenment. The Buddha’s frustration resulted from the exact same problem Wittgenstein encountered 2500 years later. The Buddha was saying something that was extremely simple, obvious, and basic—and yet, it was rumored that of his more than 100,000 followers when he was alive, only three actually “got it” and experienced enlightenment. When I read Philosophical Investigations my senior year in college, it was rumored that only seven people in the world understood what Wittgenstein was trying to say. Wittgenstein’s dream was that philosophy students would “get” his thinking and give up philosophy when they realized that most if not all philosophical problems are sheer nonsense. He wanted them to do something practical and real in the world instead of studying philosophy. He was verry disappointed when his favorite student, Norman Malcolm (one of the seven who “got it,”) pursued an illustrious career teaching philosophy in America at Cornell University. I always wished I could have known Wittgenstein when he was alive, so I could have told him this: I loved you, too, and I got it after several months of confusion, trying to understand your Philosophical Investigations, but eventually understood it with the help of your student, Norman Malcolm. His book about you was very inspiring. And that’s why I left philosophy for something more practical in the world. I decided at the last minute to go to medical school to become a psychiatrist instead of philosophy graduate school. Hopefully, I am doing something that you might be proud of! But oddly enough, your thinking has also influenced my approach to people who feel depressed and worthless. They are also under a kind of destructive “enchantment,” thinking that there is some such “thing” as a more or less worthwhile human being! And this is a major cause of depression and anxiety and feelings of worthlessness and hopelessness. I wonder if you, Wittgenstein, ever felt that you weren’t “good enough” when you were feeling down. hopeless and suicidal? I sure wish I could have helped you with that! If you want to understand Wittgenstein’s work, the best book in my opinion is Norman Malcolm’s moving and affectionate tribute to his beloved teacher, entitled “Ludwig Wittgenstein: A Memoir.” It’s a short moving tribute to his beloved teacher, and tears go down my cheeks every time I read it, or even think about it. If you ever visit my office here at home, you’ll find that memoir proudly sitting on my bookshelf, with a handsome photo of Wittgenstein on the cover. Toward the end of his life, Wittgenstein appears to have become more or less homeless, and he died from prostate cancer. His doctor said he could live in his home, where he was befriended by the doctor’s wife in his final days. His dying words were, “Tell them that I had a wonderful life.” He died on April 29, 1951, just a few hours before my wife was born in Palo Alto, California. Surprisingly, she is the only person I’ve ever met who understood Wittgenstein’s thinking entirely the first time I explained it to her. She “already knew” what Wittgenstein, the greatest philosophical genius of the 20th century, spent a lifetime figuring out! Reincarnation is pretty “out there,” and fairly silly, to my way of thinking, but sometimes it can be fun to think about it! Here is my understanding of how the thinking of the “later Wittgenstein” actually developed. His first book, which is nearly impossible to understand, was called the Tractatus Logico Philosophicus. It is a series of numbered propositions, which he compared to climbing up a ladder, rung by rung, as you read the book until you got to the roof at the top of the ladder. Then you could throw your ladder away and give up philosophical thinking, since he thought his book contained the solution to all the problems of philosophy that had tormented him since childhood, as mentioned previously. The philosophy of language in the Tractatus is based on the thinking of Aristotle and Plato, who thought that the function of language was to name things that exist in the real world. Plato’s idea was that our real world consists of imperfect examples of a “Platonic Reality” which consisted of “perfect” representations of everything. So, for example, Plato believed there could be a perfect “table,” a perfect “lamp,” and so forth. In other words, he thought there was an ideal essence to the concept of a “table.” And, I suppose, there might also be a “perfect” version of you! The early Wittgenstein also thought that the logic inherent in our sentences reflected the logic inherent in an external reality. If that doesn’t make much sense to you, join the club! But that’s kind of what Plato and Aristotle were promoting, at least in my (David’s) understanding. When Wittgenstein’s Tractatus was debunked, he was devastated, and desperately wanted to find another way to solve the problems of philosophy, since they started tormenting him again. It was much like a relapse of OCD or some other emotional problem. In fact, he thought of philosophy as a kind of mental illness that needed treatment. Here’s an example of the types of philosophical problems that tormented him. Do human beings have free will? Do we have a “self?” Is the universal “real?” Of course, we THINK we have free will, and it SEEMS like we make “free decisions” all day long, but is this just an illusion? For example, some people would argue that we cannot have “free will” because we “have to” follow the laws of science that govern everything, including how the brain works. So, since we “have to” do what we are doing at every moment of every day, we must not have free will! Here is an argument that we do NOT have “free will.” When a powerful storm or hurricane destroys a portion of a city, and people die, we see this as a tragedy, but we don’t get angry at the hurricane because it does have “free will.” It is just obeying the laws of physics that govern the forces of wind, air pressure, heat and cooling, and so forth. A storm cannot behave in any other way. So, the argument goes, we are also following the laws that govern the functioning of our bodies and brains, and so we cannot do other than what we do, so we, too, have no “free will.” We THINK we are acting freely but it is an illusion, so our brains are obeying the laws of the universe at every moment! For hundreds of years philosophers have struggled with this puzzle, and many people still wrestle with this problem today. It was one of the problems that drew me to philosophy. Impractical for sure, but still tantalizing. Another way to express the free will puzzle is via religious thinking. I was taught when I was growing up that God is omnipotent (all powerful), omnipresent (present everywhere) and omniscient (all knowing.) So, God knows the past, present, and future. And if God knows the future, then God knows what we will do at every moment of every day, and we are helpless to do otherwise. Therefore, we have no “free will,” even though we “think” we do! This free will problem can definitely be unsettling, with troubling moral consequences. If we do not “free will,” then are serial killers really responsible for, or guilty, or accountable for their actions? If we do not have free will, then wouldn’t that give us license to do whatever we want whenever we want? Clever arguments for sure! We may “feel” like we have the freedom to do whatever we want at almost any moment of any day, but are we fooling ourselves and living in some gigantic hoax, or illusion? Are we total slaves with the delusion that we are actually acting “freely?” How do we resolve this problem? Well, one day Wittgenstein was walking past a soccer game at the park, and the soccer ball hit him on the head. He wasn’t hurt, but had the thought, “What if the function of language is NOT to name things (like trees, or lamps, etc.) that exist in some “external reality,” like Plato and Aristotle thought? What if language actually functions as a series of “language games,” with rules, just like the game of soccer? Then the meaning of any words would simply be the many ways the word is used in different real world situations. In fact, that’s what you find in the dictionary when you look up the meaning of a word. The dictionary doesn’t ever give you some “correct” or ”pure” meaning, since most words have many meanings. This would be the opposite of the philosophy of Aristotle and Plato who argued that there were “true” meanings for every word, noun, or concept. What if, instead, words had NO true or essential meanings, and their meanings were simply embedded in the context in which they are used in ordinary, everyday language? If so, this might mean that philosophical problems emerge when we try to pull words out of their ordinary meanings, which are always obvious, and put them into some metaphysical realm where philosophers argue about “ultimate truth.” Let’s say we wanted to find out if humans have “free will.” Well, not being sure if there is such a “thing” as “free will,” we could look up “free” and “will” in the dictionary. (I know this sounds incredibly obvious and almost ridiculous.) What does “free” mean? Well, we could talk about the many ways we use “free.” Political freedom means that in some countries you cannot contradict the leader (the dictator) without the danger of being thrown in prison or even murdered. But in other countries, you are, In fact, free to express your own ideas and opinions, without fear of punishment. Free also means getting something without having to pay for it, like a seventh bottle of soda is free at the local grocery store if you purchase a six pack. Free can also mean “available.” I am starting up my Sunday hikes again, and I might say, “If you are free this Sunday morning, meet at my front door at 9 and we’ll go for a hike and have a dim sum feast afterwards at a Chinese restaurant on Castro Street in Mountain View, California, Now notice that when you talk about “free will” you have taken this word, “free,” out of the familiar contexts in which we find it, and given it some type of metaphysical “meaning.” But in this metaphysical, philosophical arena, it has no meaning. So, instead of trying to “solve” the so-called “free will” problem, we can dismiss it as nonsensical, and ignore it as having no practical meaning, and move on with our lives. We can say, “I just don’t understand that problem! I don’t know what you’re talking about when you ask the general question of whether we have something called ‘free will.’” That either works for you, or it doesn’t work for you! Your choice. It does work for me, but it took me months of thinking until I suddenly “got it.” My way of describing this philosophical error is “nounism.” You think that nouns always refer to things that could “exist” or “not-exist,” just like Plato and Aristotle thought. So, you ponder and try to figure out if this notion of “free will” exists or does not exist. But it’s arguably a meaningless question. That’s why I say, and Wittgenstein might say, I have no idea what you’re talking about. Today we’ll discuss the free will problem and how it might relate to our field of psychotherapy. Next week, we’ll deal with another thorny problem: Do we have a “self?” Or is that also just some kind of illusion? I (David) wrote these show notes before the show, and we have had fairly extensive email exchanges, with a variety of points of view on whether or not we have something we can call “free will.” First, I’ll put a great email by Matt, followed by a comment by Fabrice. Here’s Matt’s email first: Subject: Re: question Yes, that's getting very close to what I'm trying to communicate. I don't believe you are 'slow' or 'super lame', either. In fact, quite the opposite. I suspect I'm failing to do an adequate job of disarming your claims that 'free will' and 'self' are words taken out-of-context and, therefore, can't be shown to exist or not-exist. I apologize, as I am pretty excited about the potential to help people, suffering with self-blame and other-blame, by realizing that we and others don't have a 'self' or 'free will'. I believe we have a brain that makes decisions and creates experiences, including the experience of having a 'self' and 'free will'. I believe that the experience of 'making' a decision is an illusion, as is the idea of a static, unchanging 'self' that controls decision-making. I asked you to pick a movie and you said, 'Green Mile'. You acknowledged that this movie title simply 'popped into my head'. That's correct. Your 'self' didn't control what you selected, using 'free will'. Your brain just came up with that movie title. There was no 'self' that made a decision to choose that word. I agree that we have a brain which is incredibly powerful. I'm claiming that we don't have an auxiliary 'self', with extra super powers, controlling our brain. We can make decisions, but we don't have 'free will', meaning, the ability to control those decisions. I do think you have some resistance to seeing through the illusions of 'self' and 'free will', all of which say awesome things about you, e.g. morality and justice. I'm not trying to convince you, one way or another, and I don't expect to. I'm more interested in the listening audience, as many people are significantly relieved when they realize that we are more the victims of our biology and circumstance rather than defective 'selves' lacking 'willpower'. To put a slightly finer point on the subject, when people say they have 'free will', they don't mean that 'decisions are made'. Obviously, decisions are made. You decided to keep reading this email, for example. Or you didn't. I'm not sure. Either way, a decision was made. When people say they have 'free will', they are saying that they (really, their 'self') are/is free to decide whether to continue reading this email, and that this power goes above and beyond what their brain is doing, according to the laws of physics. I am claiming that this is a ridiculous and dangerous thought, for which there is no evidence. You're saying these terms haven't been defined. I'm pointing out that they already have been, intuitively, by anyone who thinks, 'I shouldn't have done that', or 'they shouldn't have done that'. These thoughts require a belief that they 'could have' done something different, that they had free will. Aside from rage and guilt, let's examine the narcissism and excessive sense of confidence a patient might have, if they believe that they can simply 'decide', through sheer 'willpower', not to beat up on themselves anymore. Or a patient who believes they can simply 'decide' to always use the 5-Secrets, rather than criticize and blame. Can they? I've never seen that happen. That's why I assign homework. I know that the goal is to rewire the brain so they can feel and perform better, later. We can't simply decide to feel good all the time. We all drift in-and-out of enlightenment. If we want to increase the likelihood that we will be able to set aside self-criticism or communicate more effectively, we have to practice new thoughts and behaviors. If we do, we will develop greater skills at defeating negative thoughts and communicating effectively. Otherwise, our brains will do, in the future, what they are programmed to do, now. It's because we lack 'free will', that we must do homework. Similarly, you couldn't simply 'decide' to be the world's best ping-pong player. You realized you would have to work hard to re-wire your brain, if you wanted to have a chance at that. Let's use the murderer/cat example: A cat tortures and kills mice for the same reasons that a murderer does: their brains are programmed to do so. Murderers don't have a defective 'self' that is failing to express 'free will' adequately, when they murder. They're doing precisely what the atomic structure of their brain caused them to do, according to the laws of physics, in that moment, when presented with those precise stimuli. We don't have to judge or punish the cat or the murderer's 'self' and insist they should have used their 'free will'. We can accept that neither creature had the ability to decide differently from what their brain decided, in that moment. That is where the therapeutic element of this realization comes into play. I think it's important on a lot of levels, to stop blaming cats for being cats and murderers for being murderers. Similarly, if a patient doesn't want to do homework, will it do any good to blame them and think they're bad and should decide differently? No, it helps to accept them where they are, and to accept ourselves where we are, with open hands. Realizing nobody has a 'self' operating their brain and making decisions that are better than their brains' decisions doesn't mean we have to let all the murderers go or trust our cat with a new mouse companion. We can still be aware that their brains are programmed to murder. We would still be motivated to do whatever is necessary to protect society and mice. The difference is the attitude towards the murderer. We aren't trying to 'punish' or 'get vengeance' but to protect and, instead of 'labeling' them as having a 'bad self' or even being a 'murderer', but someone who has murdered and, left to their own devices, likely to do so again.  Instead of judging and demanding vengeance, we would see a murderer as the victim of their biology and environment. Instead of condemning them as permanently evil and bad, we could recognize that their brain is currently wired to do bad things and they might still learn new ways to interact with others. Perhaps they're not hopeless cases, after all. From the other side, if I ever committed murder, and sentenced to death, I wouldn't want to be feeling defective, thinking what a bad self I have and guilty/ashamed for not flexing my 'free will' in the heat of the moment. Instead, I might feel a sense of relief, purpose and meaning, that I was protecting others by being put to death. Alright, enough out of me! Thanks, Matt And now, the response from Fabrice: Matt’s thinking is exactly in line with mine. I don’t know if the topic came up in your discussion, but some people argue that actually someone could have done something differently than they did, because there is some randomness in Nature. But that argument doesn’t hold water because even if the decision “made” by their brain is different, it has nothing to do with their will but only with the Heisenberg principle. Cheers! Fabrice Nye [email protected] David’s wrap up comment. Matt and Fabrice have quite a different view of “free will” and the “self.” They are arguing, very thoughtfully and persuasive, that we do not “have” a “self” or “free will.” People have been involved in this debate, as I’ve mentioned, for hundreds of years, taking one side or another. My own thinking is different, and reflects my understanding of Wittgenstein’s thinking. They have take these words out of the contexts in which they exist in everyday language, (which is a huge temptation) and involved in a debate about abstract concepts which have no meaning. Very few people, it seems, were able to grasp this idea when Wittgenstein was alive, or even today. So, if what I’m saying makes no sense to you, be comforted, since it seems likely that 99% of the people reading this, or listening to the show, will agree with you! And that’s still a puzzle to me. It is not clear to me why so many people still cannot “see” or “get” this idea that words do not have any pure or essential “meaning” outside of the context of everyday use of language. The best psychotherapy example I can use is the fact that nearly all depressed individuals are trying to figure out, on some abstract or philosophical level, whether they are “worthwhile” or “good enough,” or whatever. This seems to be a “real” problem, and so they believe that they are not sufficiently worthwhile. This belief can be so convincing that many people commit suicide, out of a sense of hopelessness and self-hatred. But there is not such thing as a human being who is more or less “worthwhile.” Of course, your actions can be more or less worthwhile at any moment, and we can evaluate or judge our specific behaviors. Yesterday, we had our first recording session in a video studio we have set up for our Feeling Great App. We had a lot of fun and recorded some (hopefully) interesting stories we’ll publish on our two new YouTube channels. I really appreciated the colleagues who made this possible. It was a relief for me because I tend to have performance anxiety, which impairs my ability to speak naturally and with emotion. But this time, there was no anxiety at all, so it was fun. Did this make me or my colleagues more worthwhile human beings? No! But it did show that we’d become a bit more effective and communicating messages that will trigger healing and understanding in our fans, and hope that includes you! When you “see” this, perhaps for the first time, it can be incredibly liberating, since you no longer have the need to have a “self” that’s “special” or worthwhile. And, as some of you know, my beloved teacher and cat, Obie, taught me that when you no longer need to be “special,” life becomes special. When your “self” dies, you inherit the world! There’s no funeral, only a celebration! Feel free to contact us with your thoughts, ideas and questions! Thank you for listening today! Rhonda, Matt, Fabrice, and David

Transcribed - Published: 22 July 2024

Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. Special Announcement #2 Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it Today's Ask David Podcast 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 [email protected]. Ask David Questions for Today Bosley asks: My father can be very critical of my plans for the future. What’s the best way to respond to him? Willie asks: I have a dating questions. Why do women keep ghosting me? Should they be more willing to work out differences with the Five Secrets of Communication? 1. Bosley asks: My father can be very critical of my plans for the future. What’s the best way to respond to him? "To explain somewhat concisely, I just want to move to the nearest major city (Seattle) since I feel really really happy there. I also love volunteering for a specific organization and have some community there that I care about, and I feel very isolated having been away from for months. I'm willing to carry the load of all the work I would need to do to make it happen, and do a business training my dad wants me to complete. He has other thoughts. He looks down on volunteering and his thoughts on friends are simply that I can make new ones anyway. He is very aggressive and intimidating in his arguments, full of insults and many factually incorrect statements that are difficult to disarm on the fly. He shoots down the idea upon mention, so it's difficult to collaborate to find mutually beneficial solutions. He is a successful businessman, despite recent financial issues, and has a sort of strict plan for me that he has wanted me to follow, although I really don't feel this conflicts with his goals to have me run things in the future. I'm just worried since he has a long past of being emotionally abusive and of going back on his word. Plus, I just want some autonomy. In the end, it's his way or the highway. He says “You keep scheming and going down a twisted path instead of doing what I tell you.” David’s reply I suggested he might complete the first four steps of the Relationship Journal so we could see how he’s communicating with his dad. Here is Bosley’s partially partially completed Relationship Journal (showing steps 1 to 4, but not 5.)   Step 1 – S/he said: Write down exactly what the other person said. Be brief: You keep scheming and going down a twisted path instead of doing what I tell you! Step 2 – I said: Write down exactly what you said next. Be brief: What? Circle or bold the emotions S/HE might have been feeling Circle or bold the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated Angry, mad, resentful, annoyed, irritated, upset, furious Angry, mad, resentful, annoyed, irritated, upset, furious Other (specify) Other (specify)   Step 3 – Good Vs. Bad Communication: Was your response an example of good or bad communication? Use the EAR Checklist to analyze what you wrote down in Step 2 Step 4 – Consequences: Did your response in Step 2 make the problem better or worse? Why? It probably made things worse. I came off dismissive, which probably confirmed for him that I automatically ignored any advice or direction that he gave me. I wasn’t assertive in fear of escalating anger or just being shut down anyway, but that also maintains the status quo. I didn’t, and typically don’t, show a caring respectful attitude. This, I think, allows his anger to continue snowballing into more intensity. 2. Willie asks why women he’s dating “ghost” him instead of working out the problems in the relationship using the techniques in your book, Feeling Good Together. Good morning, Dr. Burns! I hope you are doing well! I want to start off by saying that I love your books and they've played a massive role in changing my personality for the better. However, there is a question I struggle with. In feeling good together, you say that one can keep status quo, solve their problem, or walk away from a relationship. I lean very strongly on the side of always wanting to solve problems. However, at my age, most of girls I date err on the side of just walking away and this opens me up for unnecessary headache and pain. I don't know where to draw the line? My heart says that any two reasonable adults can always make a relationship work given that at least one wants to make things better and, unfortunately, this does not seem to be the case in my experiences. Your insight would be greatly appreciated! Thank you for taking the time! Best Regards, Willie David’s reply Thank you, Willie, I’d love to use this as an Ask David question for one of the podcasts, if that’s okay, using your first name or a fake name if you prefer. Here’s the super short answer. I wrote a book on that exact topic called Intimate Connections. Essentially you probably need to learn a little more about how to “play the game” when dating. You’ll see what this means when you read the book. Warmly, david Willie's Response: Good morning, Dr. Burns! Frankly, I was not expecting a response at all, much less as quick as it was. For this, I truly want to thank you for taking the time to do so. Secondly, it will be my honor if you do bring it up to your podcast. Please don't use my first name - I'd prefer staying anonymous. Please do let me know which podcast this will be so I can give it a listen as well. Lastly, thank you so much for referring me to your book. That will be my next read so I am super excited. If you have any other books which you believe are worth reading which will be beneficial in the dating world, corporate world, etc., please point me to those. I absolutely love your books and their effects on me have been immeasurable. Thank you! Willie I wrote back and suggested we could use the fake name Willie, as he wanted to remain anonymous, and he responded: Now that you say, Willie is definitely sexier! Question: when are you planning on doing the next episode with this question in it? I wouldn't want to miss it.   Here was my response to “Willie.” We’ll just read your question, and then provide opinions. My career in private practice has a majority of single individuals who were trying unsuccessfully to connect in the dating world. That’s why I wrote that book, which is intensely personal as I was the biggest loser of all for a long time because I was a minister’s son and never learned how to “play the game” or be a “bad boy.” But I learned from a friend who was a “hustler” when I was in medical school. I learned a tremendous amount, including that there is a game-playing phase in dating, and a time to be more serious, open and vulnerable. The biggest mistake men make is trying to get too serious when they should be playing the game. What’s the game? Well, you’d know if you ever had or loved a cat. If you chase them enthusiastically, you force them to run away. You have to learn how to make them chase you. Many men are stubborn about this, and lamely insist, “But I shouldn’t have to play the game!” My answer would be, “You don’t! Especially if you don’t want to get laid and have lots of ladies chasing you!” Warmly, david Willie’s response This is extremely valuable to me. I never knew that you come from a religious background and I do too so I do want to ask you some more questions / share my experience. One pattern I am noticing is that either Muslim ladies have a lot of religious trauma or they have very strict conservative values - usually a combination of both. In the modern world, I try using dating apps and might get matched with someone 2-3 states away so usually we would hop on a FaceTime and the topic of religion almost always comes up. And, due to differing opinions, they just walk away which deeply upsets me because they make the false assumption that humans are snapshots in time i.e., opinions / perspectives don't change. In fact, a personal experience I would like to share with you. I was in a relationship for 1.5 yrs (long distance) and it just ended 1-2 months ago. Our intention was always to get married. However, a few weeks before breaking up with me, she basically said "oh you don't pray and I cannot even imagine my future husband not praying etc etc" and she ended things with me on that. I even tried using the 5 methods of effective communication to acknowledge and validate her opinions while simultaneously sharing mine but she was dead set and did not even want to think about working on problems. How could I "play the game" in such instances or over long distances?   David’s response Hi Willie, The principles of dating are the same in all cultures for the most part, and one rule is “Never chase a distancer.” So, when she switches to religion, you could use the listen skills subset of the Five Secrets, and buy in to what she’s saying, WITHOUT arguing or presenting your own thinking. You can admire her, urge her to tell you more about her religious feelings and spiritual life, using liberal Thought and Feeling Empathy, and lots of Disarming Techniques, and Stroking, with Gentle Inquiry. You would NOT chase, or try to persuade, or argue, or defend yourself. Be totally admiring and other-centered at those times. If she says she wants to break up, you might say that you’ve been sensing some distance, and are relieved that she is doing that, because you, too, would like to date other women, but that the two of you can still be friends if she promises not to get romantically involved with you, and that you will be on the lookout for some really great guys she might want to date. This is a paradoxical approach, and it is an art form. And I can also tell you to date other women immediately, and the moment you find one you like better than her, she will find out, even if no one tells her, and she will likely want you back again. That’s because of the Burns rule, which states: “People NEVER want what they CAN have; they ONLY want they CAN’T have!” Now, if you tell me this approach is phony, I would tell you that you’re 200% right! And it’s not only incredibly phony, it’s amazingly effective! And a kinder word that “phony” might be to say that when someone starts pulling away, you have to switch into this style and strategic approach, and stop trying to be loving and sincere or logical, etc. Do NOT chase, simply open your hands and let go. It’s the exact same strategy you might use to get close to a cat! Best, david Hi Willie, If you’d like, you can send me an example of what one of the Muslim ladies said to you, and exactly what you said next. Please select an interaction that didn’t go well. Then I can analyze your response and suggest some alternative ways to respond in a dating situation. In fact, if you like, you can record it on the Relationship Journal that I’ve attached. Please fill in steps 1 through 4. Please do this right away as we record tomorrow. Best, david   Hi Dr. Burns, I cannot even tell you how much these emails are already changing my outlook. I truly want to thank you for taking the time and responding to these. One thing that caught my eye is the paradoxical approach. I never thought about it. In my mind, I feel you should work on relationships / never let go but if letting go is working on it, then that is something I really need to do. I am attaching two copies of the Relationship journal. One dealing with the topic of drugs and one with prayer. One thing I will tell you is that I usually bring these topics up myself because, in my mind, I don't want to deceive anyone and get these big topics out of the way as early on as I can and I think I am making a mistake somewhere here. Thank you, again, for taking the time and responding to these emails! Looking forward to what you think about the topics of conflict I have been having! Best Willie 😉 Willie’s Relationship Journal #1 Step 1 – S/he said: Write down exactly what the other person said. Be brief:   Religion is super important to me. As a Muslim, I want my partner to pray 5x a day. Step 2 – I said: Write down exactly what you said next. Be brief:   Religion is super important in today’s day and age. It is a part of our culture and I definitely want to introduce my kids to it.   However, I don’t think that prayer in and of itself makes you religious - if anything, the more external your religion means the higher likelihood of hypocrisy. In my mind, everyone’s religion is between them and god so the best you can carry is one that no one else even knows of - kind of like charity. Circle the emotions S/HE might have been feeling Circle the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated Angry, mad, resentful, annoyed, irritated, upset, furious Angry, mad, resentful, annoyed, irritated, upset, furious Other (specify) Other (specify) Taken for granted, unappreciated   Willie’s Relationship Journal #2 Step 1 – S/he said: Write down exactly what the other person said. Be brief:     All kinds of drugs are bad and I don’t want to date anyone who does them.   Step 2 – I said: Write down exactly what you said next. Be brief:     I strongly agree. Any kind of drug that can open you up to addiction can have a lot of negative effects and that’s one of the reasons why I don’t even drink coffee.   On the other hand, latest research does suggest that drugs like hallucinogens can have positive effects on people so even though I don’t do them, I have tried once and keep an open door for them primarily because they are not addictive. Circle the emotions S/HE might have been feeling Circle the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated   David's Reply to Willie's RJs This is the analysis of his initial RJs Thanks good start. You might have time to redo them a bit. You failed to circle the feelings she might be having (or use bold face) as well as your own feelings. This will help you with the E and A of the EAR Checklist. You got the general idea, but you’re missing some crucial details. Also, your responses are both argumentative, all about you, and not using any real disarming or empathy / inquiry to draw her out. You are trying to “win” an argument, which is a a 100% guarantee that you will lose! And you are trying to persuade, which is a 100% guarantee to push her way and force her to reject you. Best, david In the show, We analyzed Willie’s responses to the two examples from the Relationship Journal. Rhonda, Matt, and David agreed that Willie was not acknowledging her feelings or empathizing with her at all. She likely had many feelings that we listed on the show, along with his. We focused on how he might respond with Other- rather than Self-Centered conversational skills. It was clear how he was “forcing” the ladies to reject him, and how could respond in a radically different and far more appealing manner. Both Matt and Rhonda did a superb job of role-playing and teaching in this podcast segment!! After the podcast was recorded, Matt had some thoughts about how his response (when playing the role of Willie during the podcast) could be improved. Here's his commentary: Hi Rhonda and David, I had some follow-up thoughts on the role-play with Willie, which I hope are potentially helpful for him. If you agreed, maybe they could go into the show notes? I had given myself a B, but wasn’t sure why. I think I have a better understanding now. First, I agree with Rhonda that suggesting I simply fulfill her request to pray five times per day and that that would mean my dreams come true if it might lead to being with her was an error. I think it was probably problem-solving, as well as an agenda-setting error with Willie, who will likely want to stick to his decisions around what’s right for him in terms of practicing his faith. Instead, I think my error might have been “chasing”, and the missing ingredient was probably “Open Hands”. While Rhonda really appreciated my empathic response, it is also possible that such a response would backfire, at the “intensity matching” level, especially if what willies ex is saying is that she doesn’t want to be with him. It would then be an error to push her towards talking more about her feelings. Something like (in addition to other 5-Secrets)… “On the other hand, it would make sense if you didn’t want to talk about those feelings with me.  Perhaps you’re just letting me know that this isn’t going to work for you.   That would be sad, but also totally understandable and we could just end the conversation, here.  I’d be sad if that were the case because I really like you.  On the other hand, prayer is very important to you and it’s perfectly valid that you wouldn’t want to be with a guy who doesn’t pray”. This would have better demonstrated the paradoxical element of being a “bad boy” or just interpersonally effective, than what I had said. Thanks again for having me in the podcast!! Fondly, Matt And here is Rhonda's response to Matt: Hi Matt:  Now your response jumped from A+++ to A++++.  I think acknowledging their differences is so respectful.  The conversation may indeed have ended there, but it would have ended with respect and understanding and good feelings instead of the confusion, betrayal and other challenging feelings we mentioned on the podcast. Thank you for following up, Rhonda Thanks for listening today! Next week we will start Practical Philosophy month. We will provide solutions to the five most popular puzzles in philosophy, and will also show how they related to emotional problems as well as The DSM and how we think about and diagnosis so-called "mental disorders." Rhonda, Matt, and David

Transcribed - Published: 15 July 2024

A Riveting Story of Raw Emotion. . . “Dad, I let you down!" Part 2 of 2   Special Announcement  The long awaited Feeling Great App is now available in app stores. IOS and android! Check it out. Take a free ride! And now, on with the exciting conclusion of the personal work Dr. Jill Levitt and I did with Chris, along with a fabulous followup interview you will hear at the end of the session. I hope you enjoyed the session with Chis, and hope you found it inspiring. His message of hope and joy could be helpful and inspiring to any of you who may be struggling, and feeling, as he was, that you're just "not good enough." His work is, of course, important from a psychological perspective, because it illustrates the powerful steps of TEAM in a sequence that brought Chris from the depths of despair to the peaks of enlightenment. However, as you will hear in the postscript dialogue, the work for sure takes on a spiritual and mystical quality for sure! When you hear Chris live during the follow-up interview at the end of Part 2 of this two-part podcast, you will not be disappointed! Postscript As I mentioned earlier, I was overjoyed when I learned that Chris had unexpectedly changed his mind and offered us the chance to publish his personal work and provide a follow-up recording of how he’s doing now. Here’s my email to him just prior to the follow-up recording. Hi Chris, I’m assuming that Rhonda will coordinate this and she has us scheduled for this Friday, I believe. When it is 4 PM in your time zone, what time is it in our time zone? Are you two hours later? I just reviewed my chart notes from a year or so ago, and it will be terrific to reconnect with you. I deeply appreciate the chance to share your session with our many listeners, as it is full of raw emotion and is riveting. You are making a super strong statement to the world, to my way of thinking, and it takes incredible courage to say, “This is me! I am very real, and sometimes very raw!” I think many people suffer due to thinking that everyone else is somehow “better” than they are, and that they are somehow “not good enough.” That is perhaps the main theme I hear when doing clinical work, and that includes my work with mental health professionals who are equally vulnerable to this kind of thinking. What triggered your decision to go public, so to speak. And how might this impact your students, and their parents, and so forth? Hopefully, we can chat this Friday about those and any other questions or topics that touch or interest you. It will be great to get caught up on your past year! If Jill or Rhonda want to add your thoughts, please do! To me, this is a very significant occasion to have the chance to connect with you, Chris, again! The work you did is among the most powerful and impactful ever in my memory, although every time we do live work it is pretty incredible to my way of thinking, especially when people become “real,” whatever that means! Humans have a dark side, to be sure to my way of thinking, but something incredibly beautiful and amazing can emerge. I am babbling so will stop. But I am so excited to talk to you again, Chris! Warmly, david Thank you for listening, and please let us know what you think. if you are a therapist, and want to learn how to do this, consider attending the summer intensive from August 8 to 11, on line, or in person at the South San Francisco Conference Center (ten minutes from the SF airport.) See the details and a link below, or go to www.cbtintensive.com. Chris, Rhonda, Jill, and David Click for registration / more information!

Transcribed - Published: 8 July 2024

A Riveting Story of Raw Emotion. . . “Dad, I let you down!"   Special Announcement  The long awaited Feeling Great App is now available in app stores. IOS and android! Check it out. Take a free ride! And now, on with today's podcast! Part 1 of 2 Our work with Chris started with this email: Hi David and Jill, I am 40 years old and have never been in a relationship. I've only had a handful of sexual experiences. I used to carry a lot of shame around this, but have done some work on myself, have more or less come to terms with where I'm at, and actually really enjoy my life and am pretty happy most of the time. However, I recently developed some strong feelings towards a coworker, and this led me to re-evaluate my stance on being single. The DML (LINK) details an incident from last week concerning this coworker. I haven't had extensive interactions with her and she works at a different site. Our clinical team meets twice monthly for online zoom meetings. She recommended a book to the team a few months ago, I read the book and enjoyed it, and was hoping to meet up with her and talk about it sometime. I was feeling a little terrified and didn't know if it was the right thing to do, but ultimately sent her an email asking if she'd like to speak with me about the book sometime. She politely declined the invitation. The daily mood log documents the hour or two immediately after I sent the email, as well as some of the thoughts that happened after I received her reply. There were a lot of negative thoughts, so I only included a few. There were also a number of hidden thoughts/beliefs that occurred to me over the last few days, which I have not included. It seems worth noting that for 2-3 hours after I sent the email, I experienced a lot of emotional turmoil. However, at 4pm when I got off work, from the long drive home until I went to bed, I was in a euphoric state. I was happy about what I did, how I responded to the rejection, and was optimistic about my future. I was working out at the gym and had a hard time keeping a smile off my face. I went to bed feeling great, but woke up in the middle of the night and felt terrible again, the painful sting of rejection kept me from sleeping. Since then, I've mostly felt just fine about it, only a few brief moments of really feeling that sting and they don't last long. My goal isn't to necessarily get into a relationship or have more sex; it's to feel more confident in my interactions with women. After being rejected, I think 15 seconds of agony is enough, no need for more than that. In the past, when I've developed strong feelings towards a woman, I notice that I am prone to both negative and positive distortions, some version of: "It's the end of the world if she isn't attracted to me," or "She's perfect for me; there is no one else like her," or "Sex with a beautiful woman will complete my life, or completely fulfill me". I think I'd be better off without these distortions, but find the positive distortions to be somewhat addictive. They also make it hard for me to let go and move on. I still feel somewhat attached to this woman and haven't been able to let go and move on. Also, I want to note that there are a few experiences from high school that really impacted my sexuality, relationship with women, and probably inform some core beliefs on these subjects that have recently come to surface. I'm not sure how much to share about this or whether it's even necessary to, but I suppose that could be addressed in the empathy phase on Tuesday. One other thing that I didn't include in the DML, is when I'm in that negative state, sometimes I have intense thoughts directed at me that come in the form of the second person, like You're a piece of shit. I fucking hate you. Cut your throat You don't deserve to be alive. I'll fucking kill you. I don't really believe these thoughts, but they do make me sad. Hope this all makes sense, let me know if you have questions or if I'm missing something. Looking forward to working with you. Thanks, Chris This email led to personal work with Chris in our Tuesday TEAM-CBT training group, roughly one year ago. Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California, was my co-therapist. It was one of the rawest and most riveting sessions that I can recall. Here is the Daily Mood Log he sent, along with his Daily Mood Log: Daily Mood Log Due to the intensely personal, explosive revelations Chris shared with us during his session, he decided he did not want us to publicize his work as a podcast, which was totally understandable. Our highest priority is always the peace, safety, confidentiality, and well-being of the people we work with. However, roughly a year later, Chris contacted us and said he’d changed his mind, which was fantastic news. He said he’d changed his mind because he had a relapse, and decided to listen to the recording of the work you’re about to hear. He said it was extremely helpful, and so he decided to let go and share it with the world. I think you will find his personal work, published as usual as two consecutive podcasts without editing, to be mind-blowing, jaw-dropping, intensely inspiring and moving. One word of caution is that his voice is soft and at times difficult to hear. We decide to publish it in spite of this because of the overwhelming power of his work. We are now setting up a professional quality recording studio and hope to record more sessions for you in the highest possible video and audio quality so we can bring you more inspiring Feeling Good Podcasts as well as live therapy sessions. In the meantime, here is part 1 of our work with Chris. Next week, you’ll hear part 2. Thanks so much for listening today! Chris, Rhonda, and David End of Part 1 Thank you for listening. Tune in next week for the exciting conclusion of our work with Chris! Chris, Rhonda, Jill, and David

Transcribed - Published: 1 July 2024

Ask David Unfairness Worthwhileness Erasing Depression with Lasers TEAM in the UK What's the Most Powerful Technique? We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes. We love your questions. Remember to send them to [email protected]. Special Announcement Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information! Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend. But there's some good news, too! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out! Today’s Questions Kiernan asks about “unfairness” and the connection between worthwhileness and achievement. Brittany asks: Can you “erase” feelings of sadness and depression by shining lasers in the patient’s eyes? James asks about the use of TEAM methods in the NHS in the UK Brian asks: Is positive reframing the most successful technique you have used with your patients? 1. Kieran asks (slightly edited for clarity): How would you talk back to negative thoughts like this one: “It's not fair that I can't afford quality food when there are millionaires that will have access to better food and a healthier lifestyle which has an effect on overall health and longevity'”? Or what if you feel like it’s unfair that you should have to pay a lot of money for an expensive dental treatment that you can’t afford? Kieran also asks (slightly edited by david): What if worthwhileness is not based on achievement but there are still things you would like to have and enjoy? They would buy and own things that they happen to like and not to impress others. Hi David and Ronda, and if Matt is on I have been listening to your wonderful podcast for about the last 3 years as I drive to work. It has really opened my eyes about how your thoughts create your interpersonal reality. Loved the podcasts on jealousy addiction, perfectionism, achievement addiction and many more. My questions would be: What about if someone wants to achieve more but it isn't based on worthwhileness? They would buy and own things that they happen to like and not to impress others. Let's say they wanted to be able to afford a nice house, healthier higher quality food and water. As the quality does have an effect on health especially in the US as the regulations are not the greatest. However, the fact that they couldn't afford to buy these upsets them? Thoughts: 'It's not fair that I can't afford quality food but there are millionaires that will have access to better food, lifestyle which has an effect on overall health and longevity' Or if someone has to pay for unexpected expensive dental treatment. Thoughts: 'It's not fair that I have to pay £14,000 for this treatment'. 'It should be more affordable to lower income households, as it is essential to have functional teeth' I hope I have explained this well, I would love to hear your thoughts. Keep doing what you are doing and all the best. Kieran   David’s response Sure Kieran, if you like I will make this an Ask David question for a podcast. LMK if that’s okay, and if it is okay to use your first name. Great question, and has to do with the theme of acceptance: should I or shouldn’t I? Here are the quick versions, but we can discuss in more detail on the live podcast. First, I do not find it useful to base my worthwhileness on my achievements or on my failures. I do work hard and like creating things that are helpful to people, and I enjoy earning money to support my family. I can be motivated to work hard to get things we want or need, but I don’t base anyone’s worthwhileness on how much money they have, or anything, to be honest. In fact, I could also easily accept wanting to buy something really cool, not just because I like it, but because it might impress others, or because they might find it fascinating, too! I don’t try to regulate my life with a lot of shoulds and shouldn’ts, and find that I am happier and more peaceful without lots of shoulds. In the Feeling Great App I have created a class called “Your PhD in Shoulds.” You might enjoy it! Second, you can say that it is unfair that some people have more money and resources than other people if you like. And you have every right to feel angry if that’s what you want, as well. Acceptance is more of a decision than a technique. Take the fact that lions kill deer when they are hungry. You can say, “they should not do that. It’s unfair!” But that won’t stop a hungry lion. You don’t have to LIKE seeing a lion kill an innocent deer, but you can accept it. Again, that’s a choice. The behavior of a lion is dominated by millions of years of evolution. Humans are no different. One thing that sometimes helps is to make a list all the REALLY GOOD reasons NOT to accept the “unfairness” in the world. I’ll bet you could come up with at least ten to fifteen strong reasons. Then you can ask yourself, “Given all those good reason NOT to accept the fact that some people have more and some people have fewer resources, maybe I should just stay good and angry! Why in the world would I want to change?” Also, when you find an injustice, you can use your energy being good and angry, and complain about it, or you can use your energy to do something about it. Or, you can also work to change yourself, instead of complaining about the world. I also have a new class on acceptance. It’s called, “Accept this shit? Hell NO!” You might like it as well. I am babbling so will stop. Warmly, david   2. Brittany asks: Can you “erase” feelings of sadness and depression by shining lasers in the patient’s eyes? Hi David, My husband’s boss was telling him she’s going to be doing some laser therapy to “cure” her depression. She had to undergo 9 hours of testing to see if she’d be a candidate. Apparently, they plan to shine lasers in her eyes to “erase” her sadness. Obviously, I assume this is a load of garbage. But have you ever heard of such a thing? Is this just hypnosis? Best, Brittany David’s Reply Hi Brittany, Probably. As they say, follow the money! There is a placebo effect if you believe something will help, so tons of garbage gets served up as costly gourmet food. You can read up on this on the internet I suspect. Let me know what you learn! Best, david Brittany responds to David Love your answer! I was looking into it and read they use a cold laser in the eyes which allegedly releases endorphins. I already know from you that just like with exercise and that study about the endorphin blockers, it made no difference. People just feel better because they think they are doing something good for their body by exercising. They also allege that the lasers aid damaged neurological tissue. They claim it has helped many patients but there is no data backing it up that I see. They really lost me when I read that lack of activity, stress, and maternal deprivation cause depression in the first place. Thanks! Brittany David adds As it turns out, I know two laser experts who are regulars on my Sunday hikes. Dr. Alexander Makowski is a brilliant scientist who is involved in the research and development of lasers and their marketing. Here is his email, along with some terrific links to articles about the hype of “low light lasers.” Hope you enjoy the email and links from Alex: Hi David, I'll chime in too! From a different angle. Zak knows some great doctors who are doing real work, but the general field of low-level laser/ light therapy (LLLT) for medical issues has been fraught with charlatans for some years. (David note: Zak is a laser expert at the Stanford Medical School and is currently preparing a blog on the topic of LLLT. I will include a link to her blog when it is published, likely in a couple weeks. She is awesome and also often joins our Sunday hikes!) Dr, Alex Makowsy continues Good work by Tiina Kaaru (https://www.spiedigitallibrary.org/profile/Tiina.Karu-8010) and Juanita Anders (https://www.usuhs.edu/profile/juanita-anders-ms-phd) on mechanisms behind using light to stimulate our mitochondria or deactivate infectious bacteria are well documents However, the good work done by the few was overshadowed and worse, was perverted for many years into crackpot devices using bad stats and poorly designed studies. Or sometimes just straight preying on vulnerable people. It is the great shame of the laser industry. Worse yet, some of these devices were actual lasers that led to people getting hurt. I can't recommend in good conscience that lasers be shone into eyes at any time other than diagnostic devices meant to diagnose the eye itself. It may be that some day soon a good scientific body of evidence changes my stance but not yet... The story starts in the origin of my journey into light and lasers. I got involved in this field in 2005 while taking an elective class on optics and lasers when I got a call from my mom that she was seeking a laser therapy for her fibromyalgia. My mother's desire to get her fibromyalgia treated with a "cold laser" pulled me into this field since I was taking a class with a professor who later became my doctoral mentor. A full semester of my free time disappeared as I tried to source out of print articles and do a deep dive on whether this was real or garbage. A research term paper and a conference visit later I could finally see the same trends you saw with medication. I talked her out of the potentially dangerous unproven device usage. [As you may have suspected, In fact my mom was having significant issues in her marriage and life and a very good doctor set her straight. My mom divorced and is now happily remarried, about 95 pounds lighter, no fibromyalgia or serious insomnia. If only we had known you back then she would have recovered in a session or two rather than 3 years] However, in the process, I dug into some of the real research that small doses of light can affect our bodies in ways we don't understand fully due to lack of research. Fast forward several decades and some of the best researchers survived the public scandal of LLLT and found a scientific mechanism (cytochrome c oxidase activation) to explain observed changes in mitochondrial activity. However, the scientists don't claim to cure everything or anything. Then they published this mitochondrial activation and suddenly: This, of course, proves that blogablum does in fact exist and now the truth about the panacea is available for all!! David note: “blogablum” is a fake nonsense word I made up that refers to nothing meaningful. Now continuing with the Alex email: This is a good review of the history and current evidence about it : https://www.mcgill.ca/oss/article/medical-critical-thinking/hype-around-photobiomodulation But if you want the real goods, the hard truth about cold lasers has been out there for over 15 years: Introducing the New Low Level Laser Treatment! youtu.be The following search on YouTube will reveal the secrets of the universe: "cold laser before:2009" Warmly, Alexander J Makowski, Ph.D. Dr. Matt May’s reply Hi David, Thank you for forwarding this question to me.  I am very concerned and wonder if this may fall under the category of 'malpractice'. For one, I am unaware of any FDA approved treatment for depression that involves shining lasers into people’s eyes to erase their sad memories.  For a list of FDA approved treatments for depression, you could refer to: https://www.ncbi.nlm.nih.gov/books/NBK559078/ It's possible that there is new evidence I'm not aware of, but I searched online for studies of light in treatment of depression and was unable to find any placebo-controlled trials.  This is a problem because placebo responses can be so high in the case of depression and anxiety.  There were some studies on light therapy, but nothing fitting the description of 'shining lasers into eyes to erase sad memories'. Other concerns I have relate to the high cost of such an extensive “evaluation”, as well as possible risk of shining lasers into someone’s eyes.  In the absence of evidence supporting the treatment, it seems like a high cost, and potential risk, to the patient, hence my concern for malpractice. It's pretty common for people with depression to feel a sense of desperation, especially after many failed efforts to address their symptoms.  This group of individuals are likely to be extremely susceptible to scams and purveyors of 'snake oil' (sham treatments). It's also concerning to me because the theory behind the idea of shining light into people's eyes to erase sadness doesn't make logical sense to me.  It's a potentially-testable hypothesis, but it's such an absurd hypothesis that I don't see it as worth testing or entertaining. If we are defining depression as some combination of worthless, hopeless, ashamed and guilty feelings, then the hypothesis that such feelings could be meaningfully addressed by such a crude instrument as a laser or a pill or an electrical impulse is absurd. This is because our feelings arise from our thoughts/perceptions.  I've never met a single person or patient who was suffering from depression but had healthy positive thoughts about themselves.  I've also never met someone who had patterns of negative thinking, but felt fine, up-beat and positive. The idea that a pill, a laser, a magnetic pulsation or electrical current could selectively alter the specific thoughts that cause depression doesn't make sense with what we know about the brain and thoughts and feelings.  How could a pill, for example, which crosses the blood-brain barrier and impacts every neuron in the brain, selectively target only the neurons that give rise to depressed thinking?  It's like imagining that we could carpet-bomb a city but only kill the murderers and rapists. I'd encourage all potential clients who are receiving treatment for depression or other conditions to ask their providers for literature that documents the effectiveness of the treatment and to get a second opinion if they are unsure. These are my 2-cents on the topic and I could be completely wrong about it all.  Hoping to hear from others what they think. Also, David, I saw several other people included in the invitation to respond to this question but I didn't see them cc'd.  Perhaps they were bcc'd? Wishing you the best, fondly, Matt David’s reply to Matt Thanks, yes, I have a fantastic response already in the show notes from Dr. Alex Makowski who does research and development of lasers with valid medical applications. His thrust is similar to yours. Our field is littered with junk “scientism” intended to fool and exploit people, similar to the snake oil salespeople who use to go from town to town in America selling magical “elixirs” that “cured” just about everything! But people are endlessly gullible, and con artists are still in endless abundance these days, it seems! Best, david Will add your kind and thoughtful comment to the show notes!   3. James asks about the use of TEAM methods in the NHS in the UK. Hi Rhonda, I hope you are well. I had a couple of questions for an 'ask David' on the podcast if that's okay. A bit of background.... I am Level 1 Team and have attended David's training in Atlanta. I live in the UK and have recently changed career to work in the NHS delivering CBT interventions for patients because David's work inspired me so much. The NHS uses specific interventions for particular diagnoses and because I am in training I have to try and stick to this. I do use the TEAM materials and approach when I can and have already seen some great results. The NHS uses 'Behavioural Activation' for certain patients with Depression and I just wondered what David thought about the effectiveness of this (perhaps compared to Cognitive Restructuring). I believe Beck introduced this into the CBT model as he thought it was useful. Another question was regarding treatment of GAD and whether dividing worries between hypothetical and practical, and then using a certain time to actually worry rather than letting the worries dominate throughout the day was something he thought was useful or had heard about. Thanks so much for all the great work you are all doing and inspiring people all over the world! Kind Regards James Bibby. David’s response Hi James, Thanks for the great questions. In today’s recording of an upcoming Ask David podcast, we can address: The history of “Behavioral Activation,” including the pros and cons of this approach. The history and pros and cons of “Worry Breaks.” The idea of matching a “technique” to a “diagnosis,” as opposed to learning to treat the whole patient with TEAM. The results of our latest research with the Feeling Great App, and whether it might have some value for patients struggling with depression and anxiety disorders in the UK. Best, David Matt’s Thots: Great question! I’m looking forward to discussing. There are certainly some techniques that are more effective, than others, for addressing specific negative thoughts. Meanwhile there are a number of problems that come up when we are, as clinicians, throwing solutions at diagnoses, rather than treating the human being who is suffering. Studies on the treatment of PTSD at the VA, for example, showed veterans often got worse after this approach, in which their diagnosis was matched with a method, ‘prolonged exposure’, without any agenda-setting. This just retraumatized lots of veteran! Similarly, if someone is secretly blaming, and haven’t experienced the ‘death of the blaming self’, they might be assigned ‘communication skills training’, only to see this backfire, because their intent is still to try to change someone, rather than accept them. You might tell a patient with depression that they should go exercise, only to cause them to resist you, ‘you don’t understand, I can’t even get out of bed!’. In short, most therapy fails or even makes patients worse because it doesn’t consider the good reasons to continue to blame, give up, criticize ourselves, etc. 4. Brian asks: Is positive reframing the most successful technique you have used with your patients? I can see how it would cure someone in 2 hours! Feel free to use my question and do and use my name if you wish. I'd be honored. Best, Brian David’s reply Hi Brian, Thanks. Great question! It’s one of the latest powerful techniques, but Ext of Voices might still be the “champion.” Using them in the T, E, A, M sequence is especially powerful. Positive Reframing often gets them closer, but not quite all the way to enlightenment. Externalization of voices (EOV) often gets them over the finish line, especially if you know how to use it skillfully, incorporating Self-Defense with the Acceptance Paradox and Counter-Attack Technique! In fact, you can incorporate many of my > 100 techniques when using EOV, such as Be Specific, Semantic Technique, Examine the Evidence, and a host of other. Best, david Matt’s comments I agree, Positive Reframing and Externalization of Voices are incredibly powerful and it’s often what we’re doing when we see recoveries. What works for a given individual, however, is quite hard to predict, in advance and there’s a ‘process’ to therapy, such that we can’t really skip steps, except in some unusual circumstances. Some other super-powerful methods include Externalization of Resistance, Double Standard, Flooding, Feared Fantasy, and the Hidden Emotion Technique. I’m probably forgetting some. Thanks for listening today! Matt, Rhonda and David

Transcribed - Published: 24 June 2024

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 [email protected]. 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!

Transcribed - Published: 17 June 2024

#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!      

Transcribed - Published: 10 June 2024

 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

Transcribed - Published: 3 June 2024

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

Transcribed - Published: 27 May 2024

Ask David, Rhonda and Matt Assertiveness, Suppressing your Feelings, and the "Miracle Cure" question Questions for today’s Ask David podcast. Chris asks if I have a book about assertiveness. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Matt asks about the “Miracle Cure” question in the Assessment of Resistance portion of a TEAM therapy session. Rhonda began with a lovely endorsement and a cool reminder of the classic book, Robinson Crusoe, who created cognitive therapy (the double column technique) when he was stranded on a deserted island! I believe I wrote about it in one of my books, possibly Feeling Good. It’s pretty cool! You will hear Matt playing the role of the “evil” thoughts, like, “I am stranded alone on a deserted island,” and Rhonda will play the role of the “good” thoughts, like, “Yes, but my life was spared, and all of my shipmates died.” Here's what it looks like in the novel: Evil. Good. I am cast upon a horrible, desolate island, void of all hope of recovery.     But I am alive; and not drowned, as all my ship’s company were. I am singled out and separated, as it were, from all the world, to be miserable.     But I am singled out, too, from all the ship’s crew, to be spared from death; and He that miraculously saved me from death can deliver me from this condition. I am divided from mankind—a solitaire; one banished from human society.     But I am not starved, and perishing on a barren place, affording no sustenance. I have no clothes to cover me.     But I am in a hot climate, where, if I had clothes, I could hardly wear them. I am without any defence, or means to resist any violence of man or beast.     But I am cast on an island where I see no wild beasts to hurt me, as I saw on the coast of Africa; and what if I had been shipwrecked there? I have no soul to speak to or relieve me.     But God wonderfully sent the ship in near enough to the shore, that I have got out as many necessary things as will either supply my wants or enable me to supply myself, even as long as I live. I know this novel is a couple hundred years old, so it certainly deserves nomination of the earliest cognitive therapy! Now, for the answers to today’s Ask David questions. Keep in mind that these answers were written BEFORE today’s recording, so the actual live answers will differ in some regards from the written answers below.   1. Chris asks if I have a book about assertiveness. Hi Dr. Burns, I hope you're doing well. Do you have a book on assertiveness training? I've used your books to help me with my hidden "should" statements, which has enabled me to be less angry or anxious whenever someone treats me less than satisfactorily. While this has helped immensely, I realize it's still in my interest to reduce the behavior I disagree with. For example, my sibling scheduled an early morning shift after I had a long day of work. Because they can't drive, they expect me to take them to work, which means I'll only get about 5 hours of sleep; this in itself isn't a bad thing... except this is the 3rd time in a row they've done this. After using your techniques, I'm less angry and anxious, but I still want to address the behavior to reduce the likelihood that they do something like this again, which is why I'm reaching out. Thanks for your help. Kind regards, Chris David’s Reply Sure. I like my own book, Feeling Good Together, and have often recommended Manuel Smith’s When I Say NO I Feel Guilty. There is a LOT to be said about assertiveness training, including the fact that it doesn’t always work! I can give a great personal account of that! Sometimes, or always, skillful listening is also effective. Assertiveness without listening makes it sound like only your own feelings are important, which is obviously pretty self-centered. One of the most helpful things to me is the difference between healthy and unhealthy anger, and how to express tough messages in a loving, respectful way. Can discuss more on the show. For example, what are the problems with the assertiveness movement? And where can it be helpful? And what mistakes do unassertive individuals make when trying to be more assertive? Do they sometimes overdo it? Warmly, david   2. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Thanks!! David’s reply. Thanks, Brian. Great question! You can listen to the podcasts on the Hidden Emotion Technique, or read about it in my book, When Panic Attacks. Will make this an Ask David question if that’s okay!   3. Matt asks about the “Miracle Cure” question in the Assessment of Resistance portion of a TEAM therapy session. Hi David, I've noticed that when I ask the 'miracle cure' question or 'magic wand' question, I'll sometimes get a response that isn't all that useful and I might waste time trying to figure out what the person is really asking for. An example might be, 'I want to be able to support and understand my husband, who is addicted to video games and spends a lot of our money on games'. I've found it helpful, in such situations, to ask, 'let's imagine you could achieve that goal, you were perfectly understanding and supportive, at all times, of your husband, who is addicted to video games and spends a lot of your money on games...what would change, in your life, if all your dreams came true?' I think this might help in a lot of cases where the agenda is a bit fuzzy and unclear. Wishing you the best! Matt   David’s response Matt and I exchanged several emails we’ll discuss on the podcast. Essentially, I don’t think this woman is asking for understanding why her husband is addicted to video games and spends money on them. Instead, she is secretly blaming him and is probably angry with him for not spending time with her! She wants to change him. Matt agreed with this and has proposed a new tool therapists can use when setting the agenda. I, David, also raised the problem of “hearing the music” behind the patient’s words. This is incredibly important—but hard for therapists to learn—when using the Disarming Technique. They have a tendency to agree with the patient’s words in a literal way without “hearing” what the patient is really trying to say. If you use any form of therapy literally, with really grasping the patient’s feelings, your treatment will not be effective or helpful. There is a human art to therapy, and following rigid formulas simply won’t come across as compassionate or genuine most of the time. That’s why I am dubious about testing different therapies with outcome studies with human therapists. You are actually testing the impact of a miscellaneous group of therapists with potentially widely divergent skill sets. This is one of the many reasons why psychotherapy outcome studies for depression all come out about the same—somewhat better than placebos, but not much better. And there’s been no one winner when using human therapists. Dr. Paul Crits-Christoph from the University of Pennsylvania Department of Psychology once published a study showing that the differences between therapists within each arm of an outcome study were grater than the differences between the two schools of therapy! That’s why I’ve been so excited about analyzing data from our beta tests with the Feeling Great App. Each “patient” gets the exact same shrink! This makes the “dose” of the TEAM done by the computer the same for each patient, much like an outcome study of a medication. TEAM is a actually series of metaphors! If you don’t “get” the metaphors, and try to apply TEAM in an overly literal way, you’ll have a lot of trouble learning TEAM! David   Matt’s Musings: David is incredibly gifted when it comes to ‘hearing the music’ behind what folks are saying, verbally. I suspect this is partially an innate gift, like someone who’s a prodigy at math, only for emotional states and understanding people. After years of practice, I’m not quite as good as David. However, I think there were specific forms of experience that helped me improve my skill ‘hearing the music’. In addition to using measurement and processing feedback with my patients, one thing that helped me a lot was using a lot of ‘uncovering techniques’. These include the ‘What If’ technique, to expose hidden fears, the ‘Individual Downward Arrow’, to expose hidden insecurities, the ‘Interpersonal Downward Arrow’, to expose hidden assumptions about how we ‘should’ act in our relationships. Seeing several thousand of these has helped me with ‘pattern recognition’, which I think is related to ‘hearing the music’. I’m proposing that beginning therapists might also benefit from an ‘Uncovering Technique’ for agenda-setting, following the ‘Miracle Cure Question’, which keeps asking, ok, let’s say you got that, what would you hope for, if you got absolutely everything you wanted? Ok, and let’s say you also got that, what would you hope for, in your wildest dreams? This might expose hidden agendas which can be super important if we want to be able to anticipate resistance and identify the ‘cost of recovery’. Thanks for listening today! Rhonda, Matt, and David

Transcribed - Published: 20 May 2024

Incredible Voices from the Past! Plus: David's Amazing Summer Intensive Returns August 8 - 11, 2024 Today, David and Rhonda are joined by Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mountain View, California, and two incredible voices from the past: Dr. Karen Radella, a clinical psychologist who volunteered to do personal work at the 2013 summer intensive at the South San Francisco Conference Center, and Jacqueline Ong, LCSW, who volunteered to do personal work at the 2019 summer intensive. That was the last summer intensive, due primarily to the Covid pandemic. Karen Radella, PhD But here’s some fantastic news. The intensive returns again this summer, from August 8 to 11, 2024, at the same location. And Karen and Jacqueline give testimonial today, along with Rhonda, to the magic of the intensive, by describing the phenomenal impact of the personal work they did years ago, and the tremendous impact that work has had on their personal and professional lives. Both Karen and Jacqueline had been suffering from the devastating emotional impact of severe personal trauma for many years. Nine years earlier, when Karen’s daughter was 12, she asked Karen if she could go out to play after dinner. She’d done this for years, but Karen had the thought that it was late and cold outside, but gave in and let her daughter go out to play. Minutes later, some neighborhood boys snuck up on her and shot her in the mouth with a high-powered pellet rifle that blew out one of her teeth and did considerable damage to her mouth which triggered PTSD and required many dental surgeries to correct. Both Karen and her daughter had been suffering emotionally for the nine years since that incident. Karen was telling herself that she was a bad mom, that she “shouldn’t have” let her go out to play on that particular night, and that her daughter’s horrific trauma was her fault. She was also convinced that other people, including the 100+ in the audience that evening, would be judging her as harshly as she was judging herself, and her feelings of fear and despair were palpable at the start of her live work. Karen described the techniques that were so helpful to her in her fantastic recovery that evening during her two hour session with Jill and David, including the Survey Technique, which she said was the “coolest experience of my entire life.” She was also helped by other techniques, including Explain the Distortions, the Double Standard Technique, and the Externalization of Voices. Jacqueline had suffered a different but equally severe traumatic event of a personal nature, but also disclosed it and worked it through with great courage in front of an audience of the same size in 2019. Like Karen, she experienced a complete elimination of her symptoms in the 2 hour session with Jill and David. She describe the keys to her suffering and recovery involved perfectionism (the need to be flawless) and perceived perfectionism (a term David coined that refers to the belief that others expect us to be perfect in order to be loved and respected.) Jacqueline emphasized that “failing as fast as you can” is one of the keys to the rapid recovery we so often see in TEAM. Instead of meeting once a week for an hour, which sets you up for very slow progress with relapses between sessions, you use technique after technique in one session until you find the one that works. Of course, following “recovery,” your negative thoughts will return over and over throughout your life, because no one is entitled to be—or would even want to be—happy all the time. But once you’ve experienced your own enlightenment, you know the tools that work for you, so you get better and better at heading off the relapses at the pass. Jacqueline and Karen both said they’d heard that the personal work at an intensive can be life-changing, but they “wouldn’t have believed it” until they experienced it. Rhonda said, “I saw both live demonstrations. My first intensive was also the 2013 intensive when Karen did her personal work and saw Jackie's work at the 2019 intensive. I cried my eyes out with both of you at those intensives. After watching David and Jill's personal work with Karen at the 2013 intensive, I decided that TEAM was the therapeutic method I wanted to learn, and that’s why I’ve dedicated my life to learning, practicing and teaching TEAM.” David, Jill and Rhonda hope YOU can attend the magical intensive this year. To learn more, you can just go to www.CBTintensive.com. This year you can attend in person OR online, since the program will be live-streamed. In the past, David has done all the teaching, but this year, David and Jill will do their dynamic “tag team” teaching made famous by their weekly free training group at Stanford. It is now online and is free for therapists around the world. It is Tuesdays from 5 to 7 PM west coast time. If you are interested in joining, contact Ed Walton, [email protected]. You could also join Rhonda’s Wednesday TEAM training group that meets over zoom from 9-11:00 am. The timing of this group is more convenient for therapists from many parts of the globe. If you are interested in the Wednesday group, please contact Ana Teresa Silva, [email protected]. We hope to see you on August 8 at the South San Francisco Conference Center. But move fast if you want to attend in person, since seating will be strictly limited for those who wish to attend in person. Click here for further Summer Intensive information Best, rhonda, jill and david Thanks for listening today!

Transcribed - Published: 13 May 2024

Ask David, Rhonda and Matt More on Insomnia; Porn Addiction Guilt; Rage Questions for today James asks for help with insomnia. Arjun Asks: How can I stop blaming myself for my porn addiction as a teen? Stephan asks: How do you treat feelings of rage? And what if you are simply very angry, but you don’t have any thoughts?   James asks for help with insomnia, Hi Dr. Burns, I enjoy your newsletter and have experienced moments of clarity with your book. However, my current struggle is that I have developed terrible sleep anxiety. I feel nervous tension in my stomach and trembling limbs as nighttime approaches. Some nights I can put these feelings aside and dose off and others I just cannot stop dwelling on the negative body sensations and it does not allow me to sleep. I wonder if you can offer some advice on how to get over this fear and accompanying sensations. Best, James David’s reply Thanks, James. Sorry you’re struggling with trouble sleeping. Yes, a Daily Mood Log can help, to find out what you are telling yourself that makes you so anxious about not sleeping. Also, the Hidden Emotion Technique may be important to find out if there’s a problem in your life that’s bugging you. There are also the typical sleep hygiene tips that can be useful for some folks, too! You can find these with an internet search. Can I use this as an Ask David question for a podcast, with your first name or a fake name? Best, david   Arjun Asks: How can I stop blaming myself for my porn addiction as a teen? Hi Rhonda, I Really appreciate the work that you guys do and I listen to most of the feeling good podcasts. I'm 27 and have struggled with depression and anxiety since my teens. I'm currently in therapy with a TEAM certified professional from India, but I'm still grappling with feelings of being stuck in my past. During my pre-teen years, I battled a porn addiction for about a year, which has left me with ongoing feelings of anxiety, guilt, and depression. Despite trying various therapies, I haven't found relief. I keep fixating on the thought: "I shouldn't have indulged in porn addiction in the past. It's led me to develop anxiety and depression." How do I debunk this thought, reduce its hold on me, and cope with the regret it brings? It feels like I'm trapped in my past. and constantly blaming myself for that one mistake. because that indulgence in porn really did change my life. I wasn't the same as before. and never could go back to being who I was. How do I put the lie to this thought? Any methods you'd recommend putting in the recovery circle? Your insights would be invaluable in helping me move forward. Thank you, Arjun David’s reply: The key concept is that the problem is perfectionism, plus the beating up on yourself in the here and now, and not the behavior or misbehavior in your past. In the live podcast, we can discuss the importance of T = Testing (with DML), E = Empathy and A = Assessment of Resistance, and M = Methods, like explain the distortions, Perfectionism / Self-Blame CBA, D. Standard, EOR, EOV, etc. etc. The issue, as I see it, is that you are looking for a technique to help you accept yourself, but in reality, it is a decision for you to make. The choice is to accept yourself with compassion or continue to beat up on yourself. There are many really GOOD reasons to beat up on yourself, and we can perhaps outline some on the podcast. You would then have to explain why you’d really want to accept yourself, given all the good reasons to keep beating up on yourself, and given all the positive things your self-criticisms show about you. Also, I will try to remember to tell one of my favorite Buddhist stories that relates to this problem.   Stephan asks: How do treat feelings of rage? And what if you are simply very angry, but you don’t have any thoughts? Hello Mr. Burns, I hope this email finds you in good spirits. I’ve just begun your book “Feeling Good” and I have just reached the point where you begin to speak about cognitive distortions and how to get over your thinking. I’ve been doing your exercise on the days that my thoughts are heavily saturated in my mind and I’ve realized something within doing this exercise. A lot of my thoughts do focus on the cognitive distortions that you’ve outlined in your book, but the other 75% of my thoughts focus on pure trauma of past situations and experiences that channels pure hate, anger and rage that pours out of my thoughts about the past situations. For example, one situation was someone purely scamming and taking advantage of me for years. And while doing your exercise, my hate and rage for that situation really comes out to where I wrote down “F*** that stupid a** b***** I hope she continues through her life being scammed as the fraud she is”. A lot of my thoughts surround things like this with situation that I’ve been in. Or another example “This stupid a** girl gonna be married and divorced five times before I get married once And I went the wrong path. Ha.” Most of my thoughts are like this surrounded past relationships, friendships, and coworkers. And honestly, I don’t think it has anything to do with the list of cognitive distortions that you’ve provided. Not saying that I don’t have those thoughts, but the majority of my thoughts surround different topics. I would love your input in your thoughts on what is going on in my head, and possibly even the name to the type of cognitive distortion, that these thoughts could fall under, if any. In the meantime, I will continue reading your book. Hopefully the answer is in there, but if not, I graciously await your response and I also thank you for your time. Best regards, Stephan   David’s reply Hi Stephan, Anger always results from thoughts, and those thoughts are often extremely distorted. This thought, for example, contains Labeling, and many other distortions: “F*** that stupid a** b***** Sorry you’ve been taken advantage of by someone acting fraudulently and scamming you, as I understand from your note. Anger is totally understandable. The first treatment tool would be a paradoxical Cost-Benefit Analysis, which we could illustrate on a podcast, if you are interested. Your questions touch on many important topics! Best, david Matt’s Reply Thanks for the question, Stephan, like David is saying, getting out of rage and into peace and harmony, which is part of ‘enlightenment’, requires identifying the motivational elements that are pushing you away from, as well as pulling you into, that emotion. For example, David has identified, over 30 Good Reasons to Blame Others and has a handout on this. Here's an example of a reason to keep rage: You’ll be protected, from being taken advantage of, again, if that person is labeled as ‘bad’. This keeps them, and others like them, at a distance. Another motivator for rage is that revenge fantasies can be pleasant, feel powerful, just, and gives us a sense of moral superiority. Also, sometimes we’re not quite ready to just ‘let go’ and ‘move on.’ There might be things we really liked about the relationship that we don’t want to lose and we might not want to grieve the loss of that person, or the loss of our own time. We want our time back and for them to change! Lots of other good reasons, again there’s a list of 30 Good Reasons to Blame, created by David. Please bear in mind that rage can get you into lots of trouble, so if you’re at risk of acting out your anger, it’s a good idea to get professional help, not something we can provide, here. Thanks for listening today! Rhonda, Matt, and David

Transcribed - Published: 11 May 2024

Featured photo is Dr. Jacob Towery Report on the 2nd Annual Social Anxiety Marathon Finding Humans Less Scary 2.0 Led by Jacob Towery, MD  (above) and   Michael Luo, MD (below) Today, Drs. Jacob Towery and Michael Luo report on the second annual “Finding Humans Less Scary” 2-day marathon in March of this year. As you all know, I am partial to offering valuable experiences for therapists and the general public for free, and my website (feelinggood.com) and life are focused pretty strongly on this goal, although I realize it isn’t always possible since we all have to support ourselves and our families. That’s why Rhonda and I are so proud of our colleagues, Jacob and Michel, who have now completed their second annual social anxiety marathon, which was open to therapists and the general public alike—in fact anyone struggling with shyness, public speaking anxiety, and other forms of social anxiety. And the total cost of admission both years had been a simple, $20 tax-deductible contribution to one of the charities listed on the FHLS website. That’s pretty darn cool, since the leaders are among the world’s top experts in the treatment of social anxiety, and there were, in addition, numerous highly trained TEAM therapists providing small group supervision and mentoring as well! They described a number of highlights from the event, including group exercises, both within the auditorium and also outside, on the streets of Palo Alto, doing exercises designed to help participants overcome fears and build feelings of confidence and self-esteem, including, but not limited to: Smile and Hello Practice Talk Show Host Rejection Practice Shame Attacking Exercises Feared Fantasy The Vulnerability Ladder Primary vs Secondary Characteristics Self-Compassion Enthusiastic Verbal Consent Internalizing a Compliment Flirtation Training Cost-Benefit Analysis of Maintaining Social Anxiety Exposure (public speaking on stage) And many more Michael explained that the program was sold out, and that participants came from a wide variety of backgrounds, and many had life-change experiences. Many provided testimonials on what the experience meant to them, including: “I grew as a person and experienced a dramatic increase in vulnerability and genuineness in my interactions with others.” “My son attended Jacob Towery's two-day social anxiety workshop, Finding Humans Less Scary, and found it life changing. He asked me to come along for moral support, which meant I witnessed the transformation in real time. I have never seen anything like it in my life! Quite literally, one person went into the conference room that morning and a different person came out at the end of the day. He was elated. He met amazing people and had transformational conversations. He walked down the street hooting like a bird. He looked and acted like he had thrown off some old moldy coat. “Day two seemed to deepen and solidify the gains. On our drive home he taught me what he had learned (I got some trickle down wisdom!) and he was able to trace how the roots of his social anxiety got started and grew. He reflected on the fact that some people in the room were nearly 70, and that he felt lucky to be learning this stuff at 23. “I can highly recommend this experience to other people who are struggling with social anxiety and want to try a novel approach to breaking the pattern.” I’m of the belief that, in a sense, we’re all one. That means that you can’t bring joy to another person without bringing joy to yourself. And Jacob and Michael both seemed to be on a high from their efforts to touch so many people. If you’re also excited, make sure you register next year well ahead of time so you, too, can have this life-transforming experience, which is (almost) totally free! Thank you for listening today! Rhonda and David

Transcribed - Published: 29 April 2024

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  

Transcribed - Published: 22 April 2024

392 The Empty Nest Cure Featuring Jill Levitt, PhD   Plus BIG NEWS! The Magical Annual Intensive  Returns this Summer  at the South San Francisco Conference Center August 9 -13, 2024 You can Review the Exciting Details Below Or click this link!   Today we are proud to feature our beloved Dr. Jill Levitt. Jill is the Director of Clinical Training at the Feeling Good Institute in Mountain View, California, and co-leader of my Tuesday evening psychotherapy training group at Stanford. She is a dear friend, and one of the world’s top psychotherapists and psychotherapy teachers. Today, Jill joins us to discuss the so-called “Empty Nest” syndrome. According to Wikipedia, this is the “feeling of grief and loneliness parents may feel when their children move out of the family home, such as to live on their own or to pursue a higher education.“ Jill emailed Rhonda and me to explain why she thought a podcast on this topic might be of some value. She wrote, Recently, I was working with two different women around the same age who were having similar feelings of guilt and shame about the choices they made around parenting versus working. Jane is a 60 year old high level executive with two boys who was super successful and is now retired. She is telling herself, “ I did not do enough for my boys. I should have worked less. I should have spent more time with them. I was selfish, and worked because I enjoyed it. I should have done more for them. I’m a terrible mother. Stephanie, in contrast, is a 60 year old stay-at-home mom of four adult kids, and now that her last kid has left for college, she is telling herself: I should have had a career. I have done nothing with my life. I am a smart woman so I should have done more. I am inferior compared to other women who have contributed to society in some way. Jane and Stephanie both struggled with feelings of guilt, shame, sadness and inferiority, and they were both telling themselves that they should have made different choices. I’m sure your life is very different from their lives, but you may have also looked in to the past and beaten up on yourself for what you should or shouldn’t have done. Or, you may be beating up on yourself right now with shoulds, telling yourself that you should be better, or smarter or more successful or popular than you are. In fact, according to the late Dr. Albert Ellis, these “Should Statements” are responsible for most of the suffering in the world, and there are several different types, including: Self-Directed Shoulds, like “I shouldn’t be so klutzy and shy in social situations. These self-directed shoulds trigger feelings of depression, anxiety, inadequacy, inferiority, guilt, shame and loneliness, to name just a few. Other-Directed Shoulds, like “So and so shouldn’t be such a jerk!” Or, “You have no right to feel the way you do!” These other-directed shoulds trigger feelings of anger, blame, resentment, irritation, and rage, and can easily escalate into violence, and even war. I’m sure you can see that both women were struggling with Self-Directed Shoulds. What can you do about these shoulds and the unhappiness they trigger? Jill explains how both women experienced rapid recovery when she used simple TEAM methods systematically, including empathy and Positive Reframing as well as other basic techniques like the Double Standard Technique and the Externalization of Voices, and more. I, David, then described a woman he treated who fell into a depression when her two daughters went off to college. And she was perplexed, because she’d always had a super loving relationship with them, just as she’d had with her own mother when she was growing up. When I explored this with her, a Hidden Emotion suddenly emerged, as you’ll hear on the podcast, and that also led to a complete recovery in just two sessions. Then Jill had a sudden “eureka” moment and realized that the Hidden emotion phenomenon was also central to the anxiety that one of her two patients was experiencing. One of the neat things I (David) really like about TEAM is that we don’t treat people with formulas for “disorders” or “syndromes.” These three woman all had the same “Empty Nest Syndrome,” but the causes and the cures for all of them were unique, as you’ll understand when you listen to this podcast. Our 400th podcast is coming up soon, and we want to thank all of you in advance for your support and encouragement over the past several years, which we all DEEPLY appreciate! We’ll be joined by a number of our podcast stars from the past 100 shows, as well as our beloved founder, Dr. Fabrice Nye! And we have one VERY special event coming up this summer that might interest you if you’re a shrink. I (David) have done very few workshops over the past five years because of the pandemic as well as the intensive demands of developing our Feeling Great App which will be available soon. The most fantastic work of the year was always the summer intensive at the South San Francisco Conference Center. Well, guess what! We’re bringing it back this year. The dates will be August DATES, and it will have the same magic it has always had, but with some cool innovations. It will be Thursday to Sunday noon, 3 ½ days instead of four, but it will include two fantastic evening sessions, so you will get a MASSIVE amount of teaching. It will be sponsored by the Feeling Good Institute in Mountain View for the first time, Jill and I will teach together, just as we do in the Tuesday group. Of course, Rhonda will be hosting the event as well! There will be many expert helpers from the FGI to assist you in the small group exercises throughout, so you will LEARN from actual practice with immediate expert mentoring and feedback. There will be a live demonstration with an audience volunteer, as in earlier years, plus your chance to do live work in small groups on the evening of the third day. This is always the top rated event during the intensive. You can attend in person if you move fast (seating will be limited to around 100 or so) or online (for half price or so.) That will give people from around the world the chance to attend without the extra cost and time to come in person. The online people will have leaders guiding you in the same exercises we will do with the in-person group. You’ll get intensive TEAM training in the high-speed treatment of depression and anxiety, so you can really “get it” all at once and see how all the pieces of this amazing approach fit together. You’ll also have the chance to do your own personal work and healing, which is arguably the most important dimension of professional training. There’s a whole lot more but I’m running out of steam. For more information, click this link! Here are the details: High-Speed CBT for Depression and Anxiety— An Intensive Workshop for Therapists with Dr. David Burns and Dr. Jill Levitt Join in person or online! Dates (3 ½ days) Thursday, August 8: 8:30am-8:30pm Friday August 9: 8:30am-4:30pm Saturday August 10: 8:30am-9:00pm Sunday, August 11 8:30am-12:00pm PT Location South San Francisco Conference Center (10 minutes from SF Airport) Cost In Person $895* Early Bird Price (only 100 seats) Online $495* Early Bird Price To receive the online price, you must enter the discount code: OnlineOnly when purchasing The $100 price increase for live and online starts on 6/3/24  Rhonda, Jill, and I hope to see you there! And thanks for listening today!

Transcribed - Published: 15 April 2024

Evolution of TEAM from CBT Porn Compulsive Liars Angry Patients Who Resist Where's the App? and More! Note: The answers below were written by David prior to the podcast, just to give some structure to the discussion. Keep in mind that the actual live discussion by Rhonda, Matt and David will often go in different directions with different information and opinions. So, please listen to the podcast for the more complete answers! Today's live discussion was especially fun and lively, so make sure you listen to the actual live podcast. Questions for this Ask David Podcast Stan asks if any of my early methods have been abandoned by newer and more effective methods as CBT evolved into TEAM. Stan asks if mild porn is harmful or helpful. Rima ask how you can deal with compulsive liars. Pretika asks what to do with patients who angrily resist positive reframing. Anonymous asks several questions about the Feeling Great App.   1. Stan asks about new approaches in TEAM for habits and addictions, as well the evolution of TEAM, as compared with the much earlier classical CBT. 2. Stan also asks if mild porno is helpful or harmful. Hi David. I read in the eBook (I think it was) that you have radically changed your approach and have many new methods for Habits and Addictions. I actually have many of your books such as: Feeling Good Feeling Good Handbook When Panic Attacks Intimate Connections Feeling Good together Feeling Great eBook I wonder if you could please tell us in one of your Ask David podcasts which methods described in your earlier books you no longer recommend, because they have been superseded by more effective ones described in Feeling Great for example. I am sure there must be a lot of material that is still valid in those earlier books and which is not mentioned in Feeling Great. It would be great to know which ones you no longer recommend for the general public. I also want to ask you about Porn Addiction. Do you think occasional mild porn use is harmful or beneficial? I read in a BBC article that porn probably isn’t harmful for most men, and can even be positive for couples. For example, some couples start to engage in oral sex after seeing it on the internet. Porn seems a bit like alcohol, if you abuse it it will be bad for your health but if you don’t go for the strong stuff and don’t over use it, it could be OK. I think some people might misinterpret your references to porn addiction as being any kind and intensity of porn use.  Maybe these people feel anxious and shameful for using it as a result. I would welcome your clarification on this issue. Finally, even though I know you have heard it thousands, or hundreds of thousands of times, your work is having a really positive effect on my life. I am truly grateful for all that you do. Thank you, David. Warm regards Stan David’s Reply Hi Stan, I can turn this into a couple Ask David questions for the podcast if you like. There have been many upgrades of the therapy ideas and techniques over the years, as we develop greater understanding of how people change, and what works and what tends not to work. In addition, I would say that we develop new methods and ideas on a weekly basis. The TEAM models lends itself very nicely to evolution, perhaps one of the strong points. I can speak in more detail on the podcast, but here are two ideas. First, I have come to appreciate more and more that all change in emotions comes from a reduction in belief in the negative thoughts that trigger negative feelings with few, if any, exceptions. In addition, any reduction in belief in negative thoughts will case an immediate reduction in the negative feelings that thought causes. This insight angers many people who don’t really “get” it, so I don’t push it. I find that people sometimes do not take kindly to statements that challenge their sacred beliefs. A simple example would be jogging, or aerobic exercise. Some people believe on faith or personal experience that exercise has a mood elevating effect due to release of endogenous “endorphins” in the brain, and many even claim that exercise is the most effective antidepressant known. While some people do experience a mood lift after strenuous exercise, I believe this is due to the change in their thoughts, telling themselves and believing that this is going to be good for the health and outlook. So that thought can have potent effects on mood. I can describe some experiments on exercise and mood. Second, I have tilted much further in the direction of appreciating the existence and power of resistance in all emotional and behavioral problems, and the often magical power of the new resistance-melting techniques I’ve developed in opening the door to the possibility of rapid and dramatic change. I’m also very aware of the therapy wars, predicated on the belief that our group as THE answer and your group consists of fools! And typically, one or both of those who are arguing have never measured anything in their patients on a session by session basis to see if things are working or not. This is just the tip of the iceberg, however! You can find a free offer of two free chapters on Habits and Addictions on every page of my website in the right-hand panel. You will find a strong emphasis on powerful new techniques that focus on motivation, such as the Triple Paradox, the Decision-Making Tool, the Devil’s Advocate Technique, and more. Most of the techniques I developed in the early days of CBT still have a lot of power and I use almost all of them, sometimes with various modifications and upgrades. For example, I have added the CAT to the Acceptance Paradox and Self-Defense Paradigm in the Externalization of Voices (EOV), and now there are two versions of the CAT, one of them created just last week! On the porno question, I am not an expert in sociology research, so I don’t know, and I try to avoid giving expert answers on things I don’t have expertise in. My goal is not to proclaim what people should or shouldn’t do, but rather to help people who come to me asking for help. It is tempting to assume your own views are straight from God, but I find that my own narcissism just gets me into trouble most of the time! I do like your thinking, though, that much of the time there are no absolute answers, rather personal preferences, and the impact will often depend on how things are used. As you say, a glass of wine could add to your meal. A bottle of wine daily might get you into trouble with your health and habits! Warmly, david 3. Rima asks about compulsive liars How do you deal with people who are compulsive liars? I found that even when using the five secrets, they either get really angry and start on the offensive or completely deny no matter what you say. If you have a client or someone in your personal life that you have deal with that lies a lot even when faced with facts and proof, what is the best way to handle it? On another point, I know that we all tell lies to a certain extent but I’m wondering whether you can impart some wisdom on why some people are compulsive liars. David response: I have a policy of NEVER answering general questions. If you want help with a relationship problem, please fill out the first four steps of a Relationship Journal. That way, we can see what the other person said, and what you said next. Otherwise, you might frame it as wanting help figuring out how to “handle” this other person who is “to blame,” or behaving badly, and so forth, without pinpointing your own role in the problem, which is the whole key to interpersonal therapy. Then we will have some dynamite to play with, as opposed to bullshit which tends to be too gooey in my experience! Certainly, people who lie compulsively can be challenging and irritating for sure, but let’s take a look at the whole picture so we can also answer this question: Are you responding in a way that reduces the likelihood that they’ll be honest? I’d LOVE to answer this question again once you send an RJ partially filled out. Thanks!  4. Preetika Chandna asks about patients who angrily resist Positive Reframing My client was offended by the positive reframe questions (any benefits and values for anxiety). She was unable to 'see' any benefits to her anxiety despite 'priming the pump' and gathered evidence from friends to emphasize her point. She ultimately dropped out of therapy. I'm wondering if we can move forward without positive reframing and circle back later, or is an open hands with empathy the best option when a client refuses to reframe and is actually offended by the suggestion? David’s Take Sometimes you can do effective work without the A = Paradoxical Agenda Setting step in a highly motivated patient. However, I suspect a more fundamental problem is occurring here. Whenever you’re stuck with an angry patient, immediately go to E = Empathy, and don’t use any methods until you get an A, and have really re-established a warm, trusting relationship with the patient. I have emphasized the importance of using the BMS and EOTS with every patient at every session. Have you been doing this, and have you been getting a perfect score on the Empathy and Helpfulness Scales? This seems unlikely to me. Often anxious patients feel shame, especially if they have social anxiety, but this is also common with panic attacks and some other forms of anxiety. If she’s ashamed of her anxiety, it would make sense that he might get defensive when asked to positively reframe it. At this point, I can only speculate, since I don’t know the details of this case. Sometimes, it makes sense to pay a colleague for a couple consultation sessions to get “unstuck.” These are always extremely productive learning sessions. Positive Reframing, or Assessment of Resistance, is an art form, and sometimes you just can’t “see” the reasons for the resistance at first. You might recall, or want to listen to, our live session with Sunny, who developed a sudden relapse of intense anxiety when he decided to change his approach to work, or non-work. (see podcast # X). The traditional positive reframing was not effective, but then when we started on methods, I suddenly “saw” something none of us had seen before during the session. His “anxiety” was actually a sign that something wonderful was happening! You can always start with M = Methods, and then when you run into resistance, you can revisit resistance with a Paradoxical CBA, or Externalization of Resistance, or some other approach. But the crucial thing is to get on the same page, and stay on the same page, with your patient. David 5. From a therapist who wishes to be anonymous I have a question, I think that habits and addiction (including the online additional chapters) are very important. I wonder if they will ever get their own book and app? David’s take: Eventually we hope to include that dimension in our Feeling Great App. The Feeling Great book is designed for self-help. I wonder if you have suggestions regarding using the different role-playing techniques (such as externalization of voices) for patients or individuals that works on their own? David’s take: Yes, we use these role-playing techniques in the Feeling Great App. When are we expecting the app? David’s take: First quarter of 2024. Thank you ! Thanks for listening today!  

Transcribed - Published: 8 April 2024