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

David Burns, MD

21 episodes

Jan 11, 2021

224: Ask David: TEAM Treatment for Stress, Severe OCD, "General" Depression, and more! 

Podcast 224 Ask David January 11, 2021

Ask David featuring more challenging and interesting questions.

  1. Josh asks: What are the most effective types of psychotherapy homework assignments?
  2. Hassam asks: How would you treat my severe OCD? Exposure doesn’t seem to be working! And Joe asks: Would you say that the secret to overcoming OCD is willpower?
  3. Ted asks: Does any psychiatric disorder result from a chemical imbalance in the brain?
  4. Brian W. asks: Burns, could you do a video on how to use CBT for stress? Thanks.
  5. Clarity asks: Is it too late to be a beta tester for your app?
  6. Simon asks: Is there a podcast that you can recommend for general depression, and how to find out what is wrong?
  7. Stephanie asks: My patients don’t recover as rapidly as your patients. Am I doing something wrong? I’m feeling a lot of anxiety and self-doubt!
* * *
  1. Josh asks: What are the most effective types of psychotherapy homework assignments?

Hi David, thanks for all your work. It has been very helpful.

You mention That doing homework is essential to recovery from anxiety and depression. Any homework you recommend? I am going to buy a few of your books and have the worksheets from the Neil Sattin podcast. Anything else that will benefit?

Josh

Hi Josh,

It depends on the type of problem you are working on. I can work up an answer, perhaps, if you want to tell me!

I did not hear from Josh, but Rhonda and I summarize the best kids of psychotherapy homework for:

    • depression
    • anxiety
    • relationship problems
* * *
  1. Hassam asks: How would you treat my severe OCD? Exposure doesn’t seem to be working!

Hi David,

I love your work on the podcast. I have not yet found a copy of any of your books in Lahore (where I live), but I have grown to understand your philosophy through your podcasts.

Episode 162 disturbed me a little. I suffer from severe OCD and its cousin, depression.

And the "high-speed cure" in the title really attracted me.

But I had buyer's remorse.

Why? Because it does not work like that for most people. The guest on your show, had a few exposures, and BAM, cured.

I have tried exposure many many times, and it very minimally helps in lowering the threat of the obsessions.

I feel that this was a Magic Pill kind of account, and at the risk of judging a person's pain, I think your guest had a relatively mild (as compared to me) OCD.

I would really love it if you could talk about Pure OCD (the type I have), and how it can be resistant to exposure. The intrusive thoughts/obsessions continue to be extremely, EXTREMELY, painful. This "high speed cure" idea seems dismissive of the seriousness of my condition.

Please keep up the great work. And I hope to read your books one day.

Thanks

Hassam

(Therapist in training)

Thanks Hassam, sometimes, therapy is much harder, as you say! Good point.

I often get slammed when I present patients who recover rapidly, especially patients who have had incapacitating symptoms for years or even decades of failed therapy. This is disappointing to me, as my goal is to bring hope to people that rapid and meaningful change IS possible.

To be honest, I don’t like it when I get slammed for presenting cases of rapid recovery. Some people think I am a con artist! Yikes!

Of course, everyone is different, and some people will be more challenging to treat. One thing I learned when I was in private practice is that you can never tell ahead of time who will recover rapidly and who will take much more time.

I’ve had patients I thought would be super easy to treat who responded much slowly than I predicted, and many who I thought would be nearly impossible to treat who responded almost overnight.

You’ve mentioned that exposure has been of limited value for you. I totally agree and saw that early in my treatment of anxiety that exposure alone is often quite ineffective.

That’s why I argue so strongly that exposure is not a treatment for OCD or for any form of anxiety. It is just one tool among many I use in the treatment of anxiety. I use four very different treatment models with every anxious patient:

    1. The Cognitive Model
    2. The Motivational Model
    3. The Hidden Emotion Model
    4. The Behavioral (Exposure) Model

Unless you understand and use all four models, the prognosis might be somewhat guarded, as you’ve discovered. In contrast, when you use all four strategies, your chances for success increase tremendously. For example, prior to using Exposure in the episode you listened to, I spent about 25 minutes with Sara using the motivational and cognitive models, which really helped.

Focusing on one method alone will often not be terribly effective, especially if you’re looking rapid, complete, and lasting recovery. However, occasionally one method will work, so therapists and patients alike get focused on some single approach they’ve learned, thinking they’ve found “the answer.”

There’s a great deal of information on the treatment of anxiety disorders using these four models on my website, www.feelinggood.com.

I often urge listeners to use the search function on my website, and everything will be served up to you immediately. You can learn all about these four powerful models.

In addition, if you were looking for more techniques, you might want to take a look at my book, When Panic Attacks, which describes 40 potent anti-anxiety techniques. You can order it from Amazon.

My psychotherapy eBook, Tools, Not Schools, of Therapy, might also be helpful for therapists who want to learn more about the treatment of depression and anxiety with TEAM. It is an eBook, and order forms are available on my website, www.feelinggood.com, in the resources tab, and also in my store.

Thanks for your excellent question!

david

And Joe asks: Would you say that the secret to overcoming OCD is willpower?

In reply to Joe.

I use four treatment models in the treatment of all anxiety disorders, including OCD. Certainly, the willingness to use Exposure is required, but Exposure is only one of many helpful methods for OCD. You can search for anxiety treatment on my website, and you’ll find many good podcasts. Also, there is a free anxiety class on my website. My book, When Panic Attacks, is another great resource with more than 40 techniques to combat all forms of anxiety, including OCD. You can find all my books on AMAZON, or on the books page on my website.

david

* * *
  1. Ted asks: Does any psychiatric disorder result from a chemical imbalance in the brain?

Hi Dr. Burns,

It says in your book, When Panic Attacks, p. 49, 3rd paragraph, you said that there's not a shred of evidence that there's any chemical imbalance for any psychiatric disorder. Does that include schizophrenia or bipolar or OCD?  Haldol works for me for schizoaffective....controls dopamine in brain?

Ted

Hi Ted,

There are likely one or more biological factors that contribute to schizophrenia as well as full blown bipolar disorder (with true manic episodes.) We do not yet know what those causes are.

However, the brain is not a hydraulic system of chemical balances and imbalances, or perhaps more like a supercomputer. I am not aware of any neuroscientists who believe in the crude “chemical imbalance” theory. We simply don’t know what the causes are.

Meds can definitely help with the symptoms of schizophrenia and mania as well. This tells us nothing about causes. Aspirin can help with a headache, but headaches are not due to an “aspirin deficiency” in the brain. Computers often crash, but I’ve never heard of a computer problem that was caused by a “silicon imbalance” in the chips.

Hope that helps. Psychotherapy can definitely help with feelings of depression and anxiety, but is not a cure for schizophrenia or mania. I would hate to have to treat any psychiatric problem with drugs alone! I like to treat humans, not “diagnoses,” but it can helpful to be aware of diagnoses like schizophrenia, or schizoaffective, or bipolar I, for example.

Hope that is helpful! And just my thinking, too, not “written in stone.”

david

* * *
  1. Brian W. asks: Burns, could you do a video on how to use CBT for stress? Thanks.

Hi Brian, Thanks!

One point is that people are often looking for “formulas” or general solutions to buzzwords like “stress.” The key to TEAM is to focus on one specific moment, and to work with it in an individual way, never using non-specific solutions like exercise, meditation, deep breathing, dietary changes, and so forth.

But as you can see, this is tough for many people to grasp. The failure to understand the importance of specificity is one of the big problems in our field, and it is a problem for therapists and patients alike. There are no very good solutions in the clouds of abstraction, because we are all unique.

I asked Brian for specific examples, and he wrote: “Work pressure, obnoxious bosses, nagging family members, drug addicted family members, and inability to pay bills are a few.”

I responded,

Thanks, these are all totally unique with different solutions. Perhaps you can focus on one and provide a couple details. david

Brian responded,

Thanks. Whichever one you think is best. Stressful thoughts. Also how to change stressful thoughts when they're automatic.

Hi Brian, There an infinite variety of "stressful thoughts," and they all have unique, non-overlapping solutions. Could you tell me about one thought you had at one specific moment?

david

During the podcast, I made some additional comments on dealing with stress using TEAM:

  • Stress is a fairly non-specific word for feeling upset or distressed. I like to use and measure specific emotions in my patients, like depression, anxiety, guilt, shame, inadequacy, hopelessness, frustration, anger, and so forth. But for some people, “stressed” may be more acceptable than words like “depression,” which may carry more stigma.
  • However, there is a somewhat specific meaning to stress, which means overwhelmed by having too much to do and not enough time to do it all. This can sometimes result from taking on too much, and having trouble saying no. Reasons for this difficulty being assertive include:
    • Conflict Phobia
    • Excessive Niceness
    • Submissiveness / Pleasing Others
    • Fear of missing out on something cool and exciting to do
  • NY TV story on “stress” and my ten distortions
  • General tools for dealing with patients who feel “stressed out.”
    • Daily Mood Log
    • Relationship Journal
    • Brief Mood Survey
  • You can take a thought on a DML and do a downward arrow—you will typically come to several common Self-Defeating Beliefs, such as
    • Perfectionism
    • Perceived Perfectionism
    • Approval Addiction
    • Submissiveness
    • Worthlessness schema
    • Conflict Phobia / Anger Phobia
    • Superman / Superwoman
  • Specific Tools
    • Positive Reframing
    • “No” Practice
* * *
  1. Clarity asks: Is it too late to be a beta tester for your app?

Hi Clarity, Thanks! You can sign up at www.feelinggood.com/app

* * *
  1. Simon asks: I have a question for you. I am very depressed at the moment, and I don't know what is wrong, or I have difficult to find out what thought is giving me the down-feeling ☹ Is there a podcast that you can recommend for general depression, and how to find out what is wrong?Thanks for the sooooo great in inspiration.

Thanks Simon. I will include your question in an upcoming Ask David, but here’s a start. Focus on one moment you were upset, and tell me how you were feeling and thinking at that specific moment, and record the information on a Daily Mood Log. If you listen to live therapy on the Feeling Good Podcasts, or read one of my books, like Feeling Good or Feeling Great, you will get a step by step introduction to TEAM therapy. Thanks! d

PS There is at least one podcast on how to identify your negative thoughts and generate a Daily Mood Log. You can use the search function on the website to find those or podcasts on any topic, but here’s the link since the search function is not working properly at the moment so I’ll have to fix it. (https://feelinggood.com/2018/03/05/078-five-simple-ways-to-boost-your-happiness-5-you-can-change-the-way-you-feel/)

PS PS I want to thank Simon for creating time codes for all 50 techniques on podcasts 93 (https://feelinggood.com/2018/06/18/093-fifty-ways-in-fifty-minutes-part-1/) and 94 (https://feelinggood.com/2018/06/25/094-50-methods-in-50-minutes-part-2/) entitled, “Fifty techniques in fifty minutes.” His time codes allow you to find the description of any techniques of interest.

* * *
  1. Stephanie asks: My patients don’t recover as rapidly as your patients. Am I doing something wrong? I’m feeling a lot of anxiety and self-doubt!

Hi David,

I hope this is the right address to which to send an "Ask David." I am a huge fan of your work and cannot thank you enough for making your therapy techniques so accessible. And thank you for taking audience questions!

I am in the process of learning TEAM and notice myself getting more skilled, slowly but surely.  There are times I hear you help patients recover in a single session. So far, I have not found myself able to help patients that quickly. I've felt disappointed about this, and it's led to anxiety and self-doubt ("I need to learn TEAM faster so I can help my patients as quickly as possible," "This should be happening quicker.").

I am wondering how logical it is for me to expect myself to help patients recover in a single session. Is it reasonable to assume I may have to practice TEAM for some time and go through several training experiences before I can help patients change that quickly?

Thank you again!!

Stephanie

David and Rhonda discuss ways of improving over time and reducing the pressure on yourself if you are a therapist.

Jan 4, 2021

223: The Jealousy Addiction: What Can You Do When Good Things Happen to Bad People? 

The Jealousy Addiction! What Can You Do When Good Things Happen to Bad People?

Hi podcast fans! Thanks for your wonderful support in 2020. You helped us hit our three millionth download. I wanted to give a shout out to my fantastic hostess, Dr. Rhonda Barovsky, who has brought magic to the Feeling Good Podcast!

This is our first podcast of 2021. It is a really good one, I think. A tremendous amount of work has gone into it, both in the weeks prior to the podcast, as well as in the creation of the detailed show notes for those who want to study and understand exactly how TEAM therapy works for the thorny and almost universal problems of jealousy and anger. Much violence in the world, especially in couples, results from these feelings.

I want to thank Bridget for her tremendous courage in giving us all this wonderful gift to kick off the new year! For therapists and therapy students, this show, with the show notes, should be a rich source of learning.

David

And, I, Rhonda wants to thank Dr. Burns for the incredible contribution he has made to the field of mental health treatment and for the honor of being part of the Feeling Good Podcast!

Rhonda

Bridget asks: Can you help me with my feelings of intense jealousy?

Hello David & Rhonda,

I’ve had this issue for a while now, and I’m wondering if others deal with it as well. If I find out that someone I dislike has something good happen in their life, I get extremely upset, frustrated, angry, jealous, & resentful. It will eat away at me, sometimes for weeks.

The thing is I’m happy with my life & wouldn’t actually want to trade places with these other people, but it’s like just the fact that they get to be happy when they are a “bad person” & don’t deserve it upsets me. By “bad person” I mean people who are manipulative, liars, cheaters, etc.

I’ve always been a person who is big on justice. I don’t want to focus on these other people anymore. I don’t want to care. Any help would be greatly appreciated.

Thank you,

Bridget

David's Comment

I was pleased to receive this email, as jealousy IS a big problem, and one I have not focused on specifically in my books or podcasts. I exchanged several emails with Bridget who graciously gave me permission to feature her work in today’s podcast.

When people share their vulnerabilities openly, it is a gift to the rest of us, since the teaching and learning potential is great. In addition, most of us feel close to people who open up and share the inner feelings and insecurities that most of us hide. This is an action that requires great courage, and often results in even greater rewards.

Bridget is also interesting because some fans have criticized me for featuring mental health professionals when I’m doing personal work. I do that because I’m no longer in private practice, and do not carry liability insurance. When I do personal work with therapists, it is in the context of their training, and is not considered an ongoing therapeutic relationship.

But today, I have decided to bring you some really challenging work with someone who is not a therapist, but a married woman who works as a product manager for a high-tech company. Of course, I have disguised her identity. The emotions she is asking for help with, jealousy and anger, are the toughest emotions to challenge, far harder than depression or anxiety. That’s because the thoughts that trigger depression and anxiety involve Self-Blame and self-criticism, so you tend to feel worthless or inferior. Crushing self-critical thoughts leads to relief and joy.

But the thoughts that trigger jealousy and anger typically involve Other-Blame and other-criticism, which is far tougher to defeat, because blaming others can be associated with exciting feelings of moral superiority.

(You will notice below that I am embedding the PDFs of Bridget's work in the show notes, as opposed to linking to them as I usually do. Let me know which format you prefer. Thanks! david)

STEP 1: Record your negative thoughts and feelings at a specific moment

Here was my response to Bridget:

Thanks, Bridget!

On the attached DML, fill out the event, circle and rate emotions, and record and rate belief in negative thoughts.

Scan back to me, and then I'll have further instructions.

d

Hi Dr. Burns,

Here is my DML. Thanks!

Bridget's DML at the beginning of the intervention.

Notice that the belief in the NTs are all high, and the negative feelings are intense.

STEP 2: Positive Reframing

Hi Bridget,

You’re moving fast! Way to go! Great example!

Now list answers to these two questions about every category of negative feeling.

    1. What does this negative feeling show about you and your core values that’s’ positive and awesome?
    2. What are some benefits, or advantages, of this negative feeling?

You can also do this with a couple of your negative thoughts.

david

Hi Dr. Burns,

Some of these were difficult to find positives, but I do truly believe everything I wrote.

This is Bridget's Positive Reframing Table. The items in caps were suggested by David, and she endorse these as well.

Hi “Bridget,”

You did great work on Positive Reframing. I have added several more things in caps in the right-hand column. Delete or edit that are not valid or don’t ring true. Would love to see your edited version.

Once you are done, use the % Goal column at top of emotions table to do the following. Imagine you had a Magic Button, and if you pressed it, all your negative thoughts and feelings would vanish, and you’d be euphoric with no effort. However, all these benefits and beautiful things about you would go down the drain at the same time.

So, answer this question: Why in the world would you want to do that?

Then, answer this question for each negative feeling: “Given that there are many genuine benefits of this feeling, would there be some level I could dial this feeling down to if I had a Magic Dial? For example, my unhappiness is at 100%. Would there be some ideal level of unhappiness that would be less painful, but would still allow me to have the benefits and positives associated with this feeling? Would 40% be enough, for example? Or maybe even 20%”

If this makes sense, fill in the %Goal column for each negative feeling.

Thanks! david

STEP 3: Magic Dial

Hi Dr. Burns,

Thank you! I actually really liked & agreed with everything you added. Those all seem true to me, so I left them on there and did not change it. I put in percentages for my goals on the daily mood log. I think it's good to keep quite a bit of those feelings after seeing the benefits.

Bridget's DML with Goal column filled it 

STEP 4: Positive Thoughts

Hi Bridget,

Perfect, and you are moving fast. So cool!

Now I want you to choose one thought to work on first. Identify the distortions in it with abbreviations in the Distortion column.

Then see if you can generate a positive thought with the help of the attached booklet, which is for your eyes only. Please do not send to anyone!  It is written for therapists but will be great for you, too, hopefully!

Please note the Necessary and Sufficient Conditions for an effective and helpful Positive Thought:

    1. It has to be 100% true.
    2. It has to reduce your belief in the Negative Thought.

Reach out if you need help or if something isn’t clear.

david

Hi Dr. Burns,

I was able to reduce the belief in the thought to 50%. Just because she lives in a nice house in a warm location doesn't mean that's guaranteed happiness. There's a lot of factors involved that could change at any moment.

Bridget's DML with first Positive Thought.

As you can see at the link, she believes the PT 100%, and this reduced her belief in the NT to 50%.

Hi Bridget,

Well done! If 50% is low enough, we can move on to another thought. Another distortion in the thought is Mind-Reading, since our assumptions about how other people feel are rarely valid. My research has shown that shrinks cannot even know how their patients feel, even at the end of a therapy session. So, we don’t actually know how she feels most of the time, or at any specific time.

In addition, you are saying that it’s unfair that people with poor character can have lots of money and nice things, and this is a source of anger. That’s the “should” telling yourself this “should not” happen. It is so EASY and ENTICING to feel this way. And we certainly see lots and lots of ugly, repulsive, mean-spirited people with tons of money and stuff! It’s unfortunate.

Albert Ellis used to point out that we may not like certain things, but it’s not true that they “should not” happen. For example, we don’t like the fact that our cats like to capture, play with, and kill little creatures. But it’s not true that they “should not” do that because it’s their nature.

For myself, I’d rather hang out with people I like and respect and feel comfortable with, as opposed to these “hot shot” types. I’ve treated some very wealthy narcissistic individuals, one in particular, and it was incredibly unpleasant. I had no longing at all to live his lifestyle—in a mansion in Southern California filled with priceless antiques and stuff—but miserable relationships with other people he was trying to control since it seemed like his only thing—brag and try to manipulate people. I prefer people who are more on the humble side!

Just some babbling.

If 50 is good enough—since there IS truth in the thought, time to tackle another. You’re doing great!

david

Hi Dr. Burns,

I worked my way through all my negative thoughts, & I ended up surpassing all of my goals for my negative emotions. Some of the thoughts were hard to challenge. I think the "shoulds" do get in the way a lot for me. And I also do a lot of fortune telling I noticed.

I did some cognitive flooding and imagined her being hand fed grapes by the pool, her husband telling her how wonderful she is, her saying "I just love my life", and it all seemed so ridiculous then. There's no way that's how the majority of anybody's days are. I feel much better about it now. Let me know if you have any other thoughts.

Bridget's completed DML

Notice that she believed all of her PTs 100%, and there was a nice reduction in her belief in the NTs, along with a reduction in her negative feelings.  But was this enough? Had we gone far enough. Only Bridget can answer this question!

Hi Bridget,

This is fantastic, thanks! Can I use all this great work in an Ask David? We might record it Friday, tomorrow.

Are you satisfied with where you’re at now? If you want to bring feelings down further, we can attack a couple of the thoughts that are still at 50%, but not necessary.

The question will be how many of the negative feelings you want to retain, and it’s cool that you have surpassed your goals! Very cool, and might be helpful to others. let me know if you give permission to use this personal but terrific material in a podcast. Tons of jealousy in the world!

David

Hi Dr. Burns,

Yes, you can definitely use everything we did here. I think it will help others. I think I’m ok with leaving the thoughts at 50% for those 2.

Bridget

STEP 5: Additional Methods

Hi Bridget,

While jogging, I realized that I forgot to comment on your creative use of flooding. I had thought of that also as another useful technique, and there you went and did it before I had the chance to suggest it!

You are probably the first person in the world to use flooding for jealousy—usually it is for anxiety, as you likely know. I’ve attached a flooding flowsheet if you do more. The goal would be to see if you can work your jealousy up to higher and higher levels, and keep it as high as possible.

I also thought of a ton of additional techniques we could use in challenging any of your negative thoughts, like the Individual and Interpersonal Downward Arrow, to get at the core beliefs underneath the jealousy, and lots more cool techniques. But we may not need any more techniques! Like scheduling time each day to make yourself as jealous as possible, say for one minute, or five minutes, or whatever.

I was also curious about your prior experiences with this woman. I’m sure there’s a story behind your negative feelings

David

Hi Dr. Burns,

I actually haven't ever met this woman personally. I guess I've seen her as the enemy ever since I started dating my husband. I saw all their old pictures on Facebook & messages between them, & I had this intense rage about it. My husband told me that she had not been faithful to him throughout their entire relationship, but he kept sticking it out with her.

So anyways, I had this intense desire to find out more information constantly. I was looking her up online all the time, trying to find out more. It was an obsession at times. At first I thought I just needed to know what it was about her that he liked so much that he was willing to be with her all those years despite everything she had done.

Eventually I realized I was doing it to prove to myself that she was not better than me, that her life was not better. But then it's like I was finding out the opposite. I found out about her marrying into that rich family, saw pictures of her and her husband traveling the world together, then buying this big beautiful home. I was filled with jealousy and rage. I thought here she strung my husband along for years and stole his prime years from me, and now she's living it up! Never paying the price. So yeah I suppose that's the long back story behind it.

Wow thanks, Bridget, I really appreciate your candor! It all makes sense now. I’m so sorry she has been haunting you and making your life unhappy at times.

She sounds, to me, like a pretty unhappy person, bitter and tortured and maybe trying to impress people with her “things.”. Not my kind of folk at any rate!

When I was in grammar school, someone asked me if I was going to any Halloween parties, and I said I hadn’t been invited to any. I told my mother, if memory is correct, and she said why don’t I have a Halloween party?

So, the next day at school I said if anyone hadn’t been invited to a Halloween party, they can come to my Halloween party.

I had an older sister who helped prepare it to be this really neat party, but I didn’t know if anyone would come as I didn’t feel like I was one of the “popular” people. I might have been more of an intellectual nerd or something like that, and I wasn’t very attractive. But I was really happy when practically the whole class came, and we had the best party ever.

Ever since then, I think I’ve kind of preferred the “unpopular” people, and to this day it is the same. I have tons of friends I totally love in low places.

Anger and jealousy are, to my way of thinking, by far the hardest emotions to get rid of. It can be done, as you’ve shown, but it ain’t always easy. And what you’re doing totally rocks! Kudos! It was hard for me to shake it in the early days of my career. Now, these emotions never bother me, although I am joyfully angry from time to time!

And thanks, too, for such rapid responses!

I love the humorous imaging you created of her sitting around the pool being fed grapes, exotic wines, and rare chocolates by her dutiful slave husband, and perhaps a couple servants as well!

Happy Thanksgiving, and thank you for giving of yourself!!

David

Hi Dr. Burns,

That is a great story. I hope I can one day rid myself of those emotions like you were able to. I really appreciate you taking the time to work with me & spend so much time on this issue. I am just so grateful! I look forward to the podcast.

Happy Thanksgiving!

Hi Dr. Burns,

Thank you! I actually got the idea by using that cheat sheet for the recovery circle from your new book Feeling Great, which by the way I love. It's like the Bible of cognitive therapy. I have so many spots bookmarked and go back to it all the time.

I did the Downward Arrow technique, & it helped reduce my beliefs in the thoughts even more. I don't think that I made the wrong choices in life just because I have to work hard to get by. If I had made other choices, then I might never have met my husband or adopted my cats or maybe I would've never even discovered your books and connected with you which changed my life. I was able to reduce my belief in the thought "It’s not fair I have to work so hard just to get by" to 20%.

For my other thought "She gets to live this happy life after how she’s manipulated and treated people poorly for years" I also did the Downward Arrow. That made a big difference as well. Just because she is happy doesn't mean that me doing the right thing has been for nothing. I'm glad I can confidently say I believe I'm a good-hearted, caring person. Her happiness will never change that about me. That thought is also now reduced to 20%.

I'm feeling pretty dang good right now! I think I will take your advice and continue to do the cognitive flooding a little each day until the thought has no merit anymore.

Link to her downward arrow work

Hi Bridget,

Thanks for all the positive feedback and hard work. I have more ideas, a lot more actually, if you want to push things further at some point, but doesn’t hurt to take a breather when you have climbed to the top of a mountain! Warmly, david

Hi Dr. Burns,

I’m always open to more ideas to try. Wouldn’t hurt. Maybe I could even get my belief in the thoughts to 0 eventually.

* * *

I offered to send Bridget a copy of my video, “Overcoming Toxic Shame,” since she was feeling some shame about carrying this burden alone.

* * *

Hi Dr. Burns,

Yes, you are the only person I’ve ever told this to. I definitely fear being judged & rejected in this situation. I feel like I shouldn’t care so much what everyone else is doing in their lives & just focus on my own life. I feel ashamed & embarrassed of my online stalking too. The thing is that when I “play detective” & find out new information about her online I get this sort of high off it. It can be exciting, but then it always just ends up leading to me feeling bad about myself. So, as you can see there are advantages & disadvantages to doing it.

I have done online stalking with other people too & told my husband about it when I would find out something upsetting or just interesting information. Sometimes he would make a face & say why would you be looking them up. And then I’d feel ashamed. I just feel like he does not approve of that behavior, & I can’t blame him. If the roles were reversed, it might make me a little suspicious of his intentions. Maybe even a little concerned.

I do have a DVD player & would be very interested in seeing that video you mentioned.

STEP 6: A New Idea: Is this actually a habit / addiction?

Hi “Bridget,”

Your video is ready for shipping, and the next mail package pick up at our house will be tomorrow or Wednesday. It will come express mail, so you should get it later this week.

I had one other thought. If your habit of checking up on people gives you a high, but also leads to negative feelings, one could view this problem in the context of habits and addictions. You would have to think about that and see if it is valid or not. I don’t know for sure.

But if it is, then abstinence might be helpful, too, since continually re-engaging with your checking up on people might keep fueling your feelings of jealousy.

So, giving up this habit might be a price you’d have to pay to escape completely from this problem. Again, just speculation.

At any rate, two chapters on habits were not included in my new book due to length, but they are available for free on the home page of my website. It offers one unpublished chapter, but there are actually two.

If you are interested in this approach, download the chapters and see what you think, and maybe do some of the written exercises like the Triple Paradox, for example, and let me know what you think, too!

Sincerely,

David

Hello Dr. Burns,

I read the extra chapters, and they are great. It's too bad they couldn't have been included in the book because I bet they would help so many people. I did all of the exercises & found them very helpful. I especially loved using the decision-making tool for this. I would never think to compare disadvantages of 2 situations like that. I was actually surprised at how much of a "slam dunk" the option of "stop checking up on people entirely" was. I didn't expect that.

I want to change because I'm tired of comparing myself & my life to other people. I also don't want to sit around waiting for justice then getting upset when the opposite happens. I spend too much of my free time thinking about these people I don't even like. I'm letting them win by caring. I also don't want to feel like I'm keeping secrets from my husband. The less I know, the better. All signs point to stopping the behavior. I just hope I can do it!

Attached are the exercises I did. Would love your thoughts/feedback.

Bridget

You can link to Bridget's Triple Paradox and work with the Devil's Advocate tool. If you're interested, you can also review her work with the powerful Decision-Making Tool that I created 40 years ago. For more information, you can download the two free unpublished chapters on Habits and Addictions that I omitted from my new book, Feeling Great, due to length. You will find those chapters for free on the homepage of my website, www.feelinggood.com.

Hi Bridget,

Forgot to write back, I thought all your work was awesome! Incredible. Thanks, and kudos!!

Hope you got or soon get the Melanie video.

Apology for slowness. We adopted an incredibly 6-year old cat at the Humane Society, but ran into some temporary complications and now all is well. Plan to integrate her with our 3-year old feral cat, Miss Misty, at the end of a week keeping them separated. The new lady is a purring machine!

Her owner died, and then she was adopted and returned, so she is terrified that she’s not “good enough” and fearful that we’ll send her back. We are totally in love with her, but had to take her back for a check-up for ring worm as the Humane Society called and said she had an accidental interaction with a ring worm cat.

But they didn’t find anything. It was super-traumatic, since we had to put her back in the carrying cage, and she was desperate, thinking we were returning her. It was heart breaking, once of the worst experiences of my life!

But now she’s back with us and looking forward to meeting her new “sister,” Miss Misty. Fortunately, she gets along really well with other cats. But we don’t know about Miss Misty!

David

Hi Dr. Burns,

Aww poor kitty! That is so awesome you decided to take in another cat. I love how passionate you are about them. I loved your story of Obie in your book and how you dedicated it to him. I could really identify with it.

We took in a feral kitten this past fall, and it went from him running away from us if we were within 10 feet of him outside to him being a permanent inside cat. Just last night he hopped on the couch next to me and laid on me purring while I put my arms around him like a teddy bear. It was so special!

I haven't gotten the Melanie video yet, but I will definitely let you know once I receive it and watch it!

-Bridget

Hi Bridget,

Thanks! Congrats on your kitten! Heaven!

d

Commentary

Here are my random comments / observations.

  1. Bridget got a really rapid and fairly dramatic response. This was due, in large part, to the fact that she did all of her homework, and she did everything right away. When I worked with individuals when I was I private practice, doing homework was required, not optional. Many people want to just come and talk to their shrink once a week, but, at least in my experience, this has never once been effective.
  2. Bridget was motivated. She asked for help, and worked hard to get that help. Motivation is the key to overcoming depression, anxiety, relationship problems, and habits and addictions. Most religions have the concept of “ask and ye shall receive.” Without the asking, there will be little or no “receiving!”
  3. Bridget conquered two of the most challenging of all emotions on her own. I did provide some guidance via email comments, but she did the heavy listing.
  4. Over time, new insights develop. Therapy and self-help are fluid in this regard. The idea that this problem could be viewed as a habit or addiction suddenly popped into my mind and clicked, and provided another powerful tool for defeating this problem. Rigid formulaic treatment is less effective, but many therapists and many people in general are looking for “formulas” and secrets of overcoming this or that problem. Methods and tools are great, but formulas leave a lot to be desired.
  5. I don’t think that Bridget’s response was any slower than when I do live personal work sessions with therapists. It took longer, since we had to exchange a series of emails. But the total contact time was still in the range of an extended (two hour) therapy session. This demonstration may not satisfy the doubters, but it might at least help a little. The effective ingredient is TEAM, applied systematically with warmth and compassion.
  6. I am incredibly indebted to Bridget, and hope you also appreciate her brave contribution! It is not easy to bare your soul to the world, but the world deeply appreciates this type of openness, because most of us suffer in secret, adding loneliness to the equation. When you open up, your worst part sometimes gets magically transformed into your best part. It is a little like emotional alchemy, turning your emotional mud into gold!

I hope you enjoyed today's podcast, and a got a feel for how a TEAM therapist might treat someone struggling with intense jealousy and anger. These are topics not often discussed in the psychotherapy world, so hopefully this podcast will be a useful contribution to a challenging topic!

Rhonda, Bridget, and David

Dec 28, 2020

222: Ask David: Personality Disorders, Buddhism, the "Great Death," the Magic Button, perfect empathy, and more! 

Podcast 222 Ask David December 28, 2020

Ask David featuring five challenging questions.

  1. Jay asks: How do you treat individuals with personality disorders using TEAM-CBT?
  2. Jeff asks: Can you talk more about the “great death” of the therapist’s “helping” or “rescuing” self? This was really helpful to me!
  3. Darkmana asks: Hey David, are there any books about Buddhism you would recommend? I can see you’re a fan of it from Feeling Great!
  4. Angela asks: What’s a perfect score on your empathy test?
  5. Margaret asks: What can you say to a patient who doesn’t want to push the Magic Button?
* * *
  1. Jay asks: How do you treat individuals with personality disorders using TEAM-CBT?

Dr. Burns

Have you considered doing a podcast on using TEAM-CBT or CBT for Borderline, Narcissistic and Histrionic Personality Disorders? The interesting thing is those with personality Disorders seem to blame everyone and everything for their problems but themselves

Also, what if anything could individuals do to not get attracted or quickly eject when they encounter these folks. One theory is that folks with abusive or neglectful parents are vulnerable. Because the chaos and drama is familiar.

I think many therapists avoid folks with pd no? Particularly patients with Borderline PD. It's interesting in that kids have years of relating to parents with personality disorders.

So how would TEAM-CBT help?

Just curious what your experience and Rhonda too

Jay

Rhonda and David talk about how TEAM-CBT developed out of David's treatment of large numbers of individuals with Borderline Personality Disorder, and what some of the treatment strategies are.

* * *
  1. Jeff asks: Can you talk more about the “great death” of the therapist’s “helping” or “rescuing” self? This was really helpful to me!

Hi Dr. Burns,

I loved what you've taught on the death of the selves - and recently read the Four Great Deaths of the Therapists Ego in your new book, Feeling Great. One part that I found so helpful was the death of "The Helping, Rescuing Self."

I think I've believed that's my purpose. That's why I'm there. I'm there to "help" the client feel better and live a full, rich, meaningful life. That's something I've struggled with - because if I'm not there to help, what am I there for?

And if I don't FEEL like I've helped, then I've failed the client. I'd love to hear this concept expanded on. I think many therapists, coaches, etc. would benefit from seeing how they can work with clients without thinking they have to help or rescue them. Thank you, Dr. Burns.

P.S. Your new book is a goldmine. Enjoying it immensely.

* * *
  1. Darkmana asks: Hey David, are there any books about Buddhism you would recommend? I can see you’re a fan of it from Feeling Great?

Hi Darkmana,

Thank you for your question. I'm sure there are many great books out there, but I have never studied Buddhism or read anything about it. I just sort of make things up!

David will tell his Buddhism story when eating in a noodle house with his son Erik.

Rhonda has invited the Dalai Lama to appear on a Feeling Good Podcast. It seems like a long shot, but it would be delightful to have the chance to chat with him, as there is so much overlap between Buddhism and TEAM-CBT! I would guess that he likely has a good sense of humor, since humor and laughter can be such great ways of grasping certain ideas and achieving enlightenment.

I have heard that the Buddha talked about the “Great Death” of the self. In Feeling Great, I talk about four “great deaths” that correspond to recovery from depression, anxiety, relationship problems, and habits and addictions. I’d love to hear the Dalai Lama’s thoughts about this. There may be large numbers of “Great Deaths,” I suspect.

To me, “reincarnation” is something that happens when we are alive, and not something that happens after our bodies die! However, I think most Buddhists might fiercely oppose my thinking in this regard.

I think that “literalism” is one of the problems with most organized religions. Stories that are intended to convey wisdom and insight are taken as literally true.

* * *
  1. Angela asks: What’s a perfect score on your empathy test?

Hello David,

In the weekly practice group that I host, the question came up today “what does Dr. Burns mean by no less than 20?  Is it the first section titled “Therapeutic Empathy” which is 20 points total, or the entire survey which is 20 questions?

Warmest blessings,

Angela Poch, RPC-C

Hi Angela,

Thanks, yes that is correct. 20 on the empathy scale is the lowest passing grade. A score of 19 and below indicate some significant failure in the therapeutic relationship / empathy.

Since we are hoping for failure, I try to make failure as easy as possible! That’s part of my “anti-perfectionism” philosophy. I encourage the four “great deaths” of the therapist’s ego, and this is the first of the four deaths.

* * *
  1. Margaret asks: What can you say to a patient who doesn’t want to push the Magic Button?

Hi Dr. Burns,

I attended your intensive in Atlanta and am working on my level 3 certification. TEAM CBT has transformed my life personally and transformed my practice professionally. I will be forever grateful to your hard work and dedication in developing this approach.

My burning question is about the magic button / magic dial. After the positive reframe, when we ask, " With all these awesome things your negative emotions show about you and all the benefits you get from them, why would you want to press this button?"  Ninety five percent of the time my clients argue for change and that is great.

My problem is when they say, "I guess I wouldn't want to press that button."  I feel like I am cheating them by not offering the magic dial. It seems like all or nothing thinking. If you press the magic button, "all" of these positive things will go away.

They never get the chance to even learn about the magic dial and then may never get the chance to learn about cognitive distortions and all of the other cool methods you and others have created. My clients always benefit from the positive reframing. How much do they have to argue for change? How critical is this?

Maybe I am thinking about this all wrong. I can really use some guidance.

Thank You so Much,

Margaret McCall

I just realized my pun with "Burn"ing question- that was not intentional, lol

Hi Margaret,

Great question! Will add it to an Ask David.

Quick answer: you can agree that it is not a good idea to press the Magic Button,  and ask them what their NTs and feelings show about them that is positive and awesome, and also ask them why they might NOT want to push the Magic Button, and then once again paradox them.

All you have to do is say “Good thinking. Let’s list all the really GOOD reasons NOT to press that button.” Then you go right into Positive Reframing, followed by the Magic Dial.

Also, if they do not want help, which is often the case with relationship problems as well as habits and addictions, you can just ask if them if there is anything they DO want help with!

It is not my job to persuade the patient to work on something. It is the patient’s job to persuade me to help him or her!

Rhonda and David

Dec 21, 2020

221: Ask David: What's Your Definition of a Violent Person? Five Cool Questions from Listeners Like You! 

Podcast 221 Ask David December 21, 2020

Today’s Ask David features five challenging questions submitted by listeners like you!

  1. Sumaya asks: I recently bought Feeling Great and can’t find the chapters on Habits and Addictions in the book. Could you please clarify?
  2. Jay asks: Can you provide more specific information on the contrasts between Feeling Good, The Feeling Good Handbook, and Feeling Great?
  3. Rizwan asks: How would you use the Five Secrets to respond to a truly irate patient?
  4. Casey asks: How do you treat resistant autism patients with All-or-Nothing Thinking?
  5. Debby asks: What’s your definition of a violent person?

Today’s podcast begins with season greetings for people of all (or no) religious faiths. Rhonda reads a moving email submitted by a listener who was helped by the recent two-part Sunny series on the Approval Addiction. David gives a plug for his upcoming workshop with Dr. Jill Levitt on “Defeating the Beliefs that Defeat You and Your Patients” on February 28. 2021 (include link.)

We also give a shout for Sunny’s recently opened private practice, which offers super rapid treatment and a user-friendly fee schedule.

Sunny can be reached at: Sunny Choi, LCSW sunny@bettermoodtherapy.com Better Mood Therapy

rhonda's exciting new Feeling Great Treatment Center is now open for business as well. She can be reached at rhonda@feelinggreattherapycenter.com.

And now—your cool questions!

* * *
  1. Sumaya asks: I recently bought Feeling Great and can’t find the chapters on Habits and Addictions in the book. Could you please clarify?

David explains that the two “lost” chapters on habits and addictions are available for free on the homepage of www.feelinggood.com. I had to cut about ten chapters from Feeling Great due to length, but put them on the homepage since the techniques for treating habits and addictions are new, innovative and powerful, and may help some folks.

* * *
  1. Jay asks: Can you provide more specific information on the contrasts between Feeling Good, The Feeling Good Handbook, and Feeling Great?

Dr Burns

Is it possible for you and Rhonda to do a podcast about Feeling Great book and Feeling Good and Feeling Good Handbook? I sat down to hear the similarities and differences and target audiences etc. Very in depth etc but podcast 213 seemed to me to get derailed into the four ego deaths of the therapist and the four ego deaths of the patient.

I am not minimizing the value of discussing Ego deaths. But it seems like you never really addressed the similarities and differences in the three books.

One thing I have not heard you discuss is that powerful section in Feeling Good on preventing setbacks. Love addiction etc. Addressing the core beliefs that trigger recurrent depression in some people.

Also the expectations of doing a two-hour session vs doing the daily mood log for 15-20 minutes per day over a few months ( in the Self Esteem section of Feeling Good.)

I thank you

Sincerely

Jay

Thanks, I DO meander! Both a curse and a blessing, as my mind works like that, with new ideas popping in all the time.

First, here are the differences between the three books:

Feeling Good is a beautiful presentation of the basics of cognitive therapy, including how to crush distorted thoughts and modify self-defeating beliefs like the Achievement, Love, and Approval Addictions, as well as Perfectionism and Perceived Perfectionism. The books focuses on depression, including suicidal urges. This book was published in 1980 and has sold more than 4 million copies worldwide. It has received a number of awards and has been named the top depression self-help book, from a list of 1,000 books, by American and Canadian mental health professionals.

The Feeing Good Handbook has more exercises and a broader range of topics, including depression, anxiety, and relationship problems, as well as a special section for therapists on how to help challenging, difficult patients. This book was published in 1988 and has sold roughly two million copies.

Feeling Great was published in September of 2020. It updates all the tools and techniques in the prior two books, but also includes powerful new techniques to overcome therapeutic resistance. It also includes a section on more spiritual (but still practical) techniques, including the four “Great Deaths” of the self.

Feeling Great has a special section on how to crush each of the ten cognitive distortions, plus many real case examples with links to the actual therapy that you can hear online in my Feeling Good Podcasts. This is important because some readers may not believe that people with chronic and severe depression and anxiety can recover more or less completely in a single, two-hour therapy session.

Toward the end there of Feeling Great there is a special chapter by the famed neuroscientist, Professor Mark Noble from the University of Rochester, on how TEAM quickly modifies specific circuits in the brain to achieve ultra-rapid recovery.

The stance of the therapist has changed significantly in Feeling Great, as compared with the earlier books. Instead of trying to “help,” the therapist becomes the voice of the patient’s subconscious resistance, and makes the patients aware that their symptoms of depression and anxiety are not the result of what’s wrong with them, like a “chemical imbalance in the brain,” or a “mental disorder” described in the DSM, but rather what’s right with them. And the moment the patient suddenly “sees” this, recovery ill be just a stone’s throw away.

Feeling Great was based on 40 years of research on how psychotherapy actually works and more than 40,000 hours of therapy with depressed and anxious individuals, including many with severe and chronic problems. TEAM is not a new school of therapy, but a structure for how all therapy works.

* * *
  1. Rizwan asks: How would you use the Five Secrets to respond to a truly irate patient?

Dear David

I suggest one imaginary statement from an irate patient: “Your therapy is not working. In last one year I paid you $1500. And I am nowhere near completing the therapy successfully with you. I am broke. I can’t pay you anymore. I need to quit. How you could you do such a thing to me?”

How would a therapist reply to this using 5 secrets?

Rizwan

David and Rhonda emphasize the importance of session by session testing so this unfortunate situation does not develop, and role play how to respond effectively using the Five Secrets. The importance of the Disarming Technique is highlighted, and training methods are illustrated, along with the philosophy of "learning through failure" or "joyous failure."

* * *
  1. Casey asks: How do you treat resistant autism patients with All-or-Nothing Thinking?

I am a behavior support specialist working with people with Autism, all across the spectrum of the diagnosis, as well as with people with intellectual disabilities, cerebral palsy and down syndrome. Not to be confused with an ABA therapist, I am more of a traditional therapist who uses eclectic strategies and methods to help the people I support. I also work mainly with adults because, sadly, the system often forgets them and they do not have as many services as children.

Because I work on helping people change their behavior, it is a logical conclusion that I have to help them work to change their thoughts first. Thankfully my graduate school program was very CBT focused (Go IU School of Social Work!). Since then I have found your podcasts and books immeasurably helpful in enhancing my practice and use the methods you teach whenever possible.

When working with people with Autism I often run into All or Nothing thinking, catastrophizing, and unfortunately a lot of treatment resistance because most of the people I support are “Involuntary” clients who have been sent to therapy by their family members.

I have two questions: First, what is the most powerful method for defeating All-or-Nothing Thinking?

Second: I know you talk a lot about agenda setting to combat treatment resistance. How do you balance the wishes of the parents (or guardians) vs. the willingness on the part of the patient to change? I struggle with this daily and could use some advice.

Thank you and Rhonda so much for the amazing podcast, the books, and the wealth of information about TEAM-CBT. I have also attended several of your trainings and plan to attend more this year because our annual conference was cancelled, so I’m left to get 10 CEUs on my own and your trainings have been very helpful in fulfilling this need!

Also, Rhonda: You are amazing and I hope you know it!

Casey

P.S. I also promoted you a lot on my Instagram channel @passionplanhappiness when I did a series on unhelpful thinking styles. I couldn’t find an Instagram page for the podcast so I just mentioned it by name. Do you have an Instagram channel?

Hi Casey,

Thanks, I can include this in an Ask David, and you might also want to try out one of the introductory 12 week TEAM classes sponsored by FGI, feelinggoodinstitute.com, as a lot of practice is usually needed to grasp and implement techniques and ideas that might seem simple. I do not ever treat people against their will, who are involuntary. This is not treatment in my opinion, and is rarely or never effective. However, I would offer to treat the parents if they wanted help with parenting skills for the child.

Also, you might want to check out the podcast on the best techniques to treat AON! Use search function on my website.

All the best, david

David D. Burns, M.D.

David and Rhonda talk about techniques to combat All-or-Nothing Thinking as well as how to set the agenda and sit with open hands with patients who are in therapy involuntarily.

* * *
  1. Debby asks: What’s your definition of a violent person?

Hi Doctor Burns,

I have a question on what you consider a” violent person” to be. For example, If someone feels like punching someone out, doesn’t does that make them a violent person just for feeling it? I would say no because they never acted on it.

Debby

Hi Debby,

You may be trying to define something that does not exist. Violent urges exist in varying degrees at varying times in all human beings. Violent thoughts, feelings, urges and actions exist. But a “violent person” does not exist. My thinking only, and many will undoubtedly “violently” disagree, and not even comprehend, perhaps, what I am saying. Humans have a dark side, and the extent is on a bell-shaped curve.

The denial of the dark side is arguably worse than the dark side, since violence is generally carried out in the guise of some religious principle, or some kind of “truth.”

david

Hope you enjoyed today's podcast!

Rhonda and David

Dec 14, 2020

220: An Interview with Dr. Steven Hayes, Creator of ACT! 

Today’s podcast features Dr. Steven C. Hayes, the founder of ACT (Acceptance and Commitment Therapy), and author of 46 books, including his most recent book, The Liberated Mind, which is available on Amazon. We are joined by Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California.

Dr. Hayes began by describing ACT, a form of psychotherapy aimed at increasing something he calls “psychological flexibility.” He defines psychological flexibility as the ability to stay consciously in contact with the present moment, including the difficult thoughts, feelings, memories, and bodily sensations you may be experiencing. At the same time, you direct your attention toward actions and behaviors based on your personal values.

I think it is fair to say that Rhonda, Jill and I had a more than a little difficulty understanding what Dr. Hayes was saying at times throughout the interview, particularly when he was describing the six dimensions of his concept of psychological flexibility. This is unfortunate, because Dr. Hayes has a great personal story to tell, and he has done a tremendous amount of interesting and important research as well.

Dr. Levitt did a tremendous job in tracing some overlap between ACT and TEAM in several areas. One is the idea that feelings like depression, anxiety, shame, and even anger are not bad but are actually good. These feelings can be telling us things that are tremendously valid and important about our core values as human beings. In TEAM, we call this Positive Reframing.

Another overlap between ACT and TEAM-CBT has to do with what Dr. Hayes calls “cognitive defusion,” a concept that has to do with the capacity to realize that your negative thoughts, like “I’m a loser,” or your anxious thoughts, like “I’m about to go crazy,” are simply thoughts, and not statements that are literally true.

This is consistent with one of the goals of TEAM-CBT, which is to recognize that these kinds of thoughts are nearly always distorted, and the moment you stop believing them your negative feelings will diminish or disappear. ACT suggests that you need to simply “defuse” from your thoughts, while TEAM-CBT utilizes many techniques to help you crush the distorted thoughts that trigger negative feelings, since everyone is different, and you can rarely predict which approach will be effective for a particular individual.

I sadly have to confess that after this face-to-face interview with Dr. Hayes, I still have extremely limited understanding of ACT, and apologize that I can’t be a more effective translator of his many excellent ideas and methods!

A touching moment came at the end of the interview when Dr. Hayes spoke about his own journey into a dark place in 1981, and why the ineffective therapy that he received at that time inspired him to create ACT. We all felt really close to him at that very human and vulnerable moment.

If you would like to contact Dr. Hayes, you can reach him at stevenchayes@gmail.com or visit his website at www.stevenchayes.com. You can also link to his new book A Liberated Mind.

Thanks for joining us today!

Rhonda, Jill, and David

Dec 7, 2020

219: Meet the Incredibly Inspiring Dr. Cai Chen! 

Today’s podcast features a most unusual and incredibly inspiring guest, Dr. Cai Chen. Cai is a fourth-year general psychiatric resident at the University of Texas Health Science Center in Tyler, Texas. He’s also currently enrolled with Mike Christensen’s “Live Online CBT Training Courses for Therapists.” Cai has told me that Mike Christensen is a “friggin’ amazing teacher” and that everyone who is interested in starting their journey in TEAM owes it to themselves to take his class.

My first contact with Cai was an email he sent me after listening to Podcast #187 on the live work I did with Dr. Michael Greenwald and Thai-An Truong at the Atlanta intensive about a year ago. Cai wrote:

Hi David, Michael, and Thai-An,

This podcast episode helped me truly change my life. I thought I had things figured out before, but man! The work you three did that day crystallized my own social anxiety issues and gave me the courage to finally do some very hefty self-disclosure. I was in tears throughout the podcast and well after even waking up in the middle of the night crying, knowing that I had to do the exact same thing that Michael had done. So I finally told all the people I knew on social media that I struggled with social anxiety and that my deepest fear was my negative feelings inconveniencing people, hurting them, and showing how I was being selfish by taking the spotlight. I also told everyone how all of these fears led to a lifetime of loneliness, rejection, and helplessness. I cried writing it all out because it finally felt like I was letting all of that go for the first time in my life.

The response I received from so many on social media, including people I hadn't heard from in years, was astonishing and so supportive! My social anxiety was completely shattered! Now I see the truth: that our feelings are an expression of our humanity and the most honest, loving thing to do is to share them with people! I'd be damned if I'm going to tell myself anymore that my negative feelings "inconvenience" or "hurt" people. Screw whether I'm being "selfish"! I finally understand what you mean, David, that the problem was NEVER that I have been inconveniencing, hurtful, or selfish. It's that I'm telling myself that these things about me are WRONG and that I SHOULDN'T be that way.

I share my feelings all the time now! The constant feelings of nervousness/unease, OCD, and panic attacks I had before are gone 99% of my days! I feel more human and myself than I've ever felt for the last 20 years.

You should call it "re-learning how to be human" therapy! God bless you David, Thai-An, and of course yourself Michael! I'm truly in your debt, Michael. You're my own personal hero and I wish I was there at the intensive to give you a big hug! I'm grateful, honored, overjoyed, and just so happy for the help you've all brought me it's making me tearful again. I love the work you've done and I love you all! I'll remember this for the rest of my life.

Regards,

Cai

Today, Rhonda and I were thrilled to meet with Cai face to face for the first time to get an update on what’s happened since that time. Cai emphasized that his intense feelings of depression, anxiety, crippling shyness and loneliness have vanished because of the intense effort he put in learning and using TEAM-CBT entirely on his own.

He described how he first became acquainted with the podcasts. He felt a lack of clinical training in his residency program on how to do psychotherapy, so did a google search for therapy training, and came up with two podcasts, one of which was ours. So, he flipped a coin and the Feeling Good Podcasts won.

He listened to the first podcast on measurement and testing, and said he was immediately excited about testing the idea that you could see exactly how effective or ineffective you were in every session with every patient. He was also excited by the idea that rapid changes in depression and anxiety really are possible, and that long term treatment is often not necessary.

He describes his determination to use TEAM-CBT in his clinical work, after a tremendous amount of practice based on what he’s been learning in the Feeling Good Podcasts. He stressed:

The importance of T = Testing, and how helpful and challenging it was at first because, as I had predicted, he initially got failing scores on the Empathy and Helpfulness scales from nearly all of his patients. But this led to opportunities to deepen his relationships with them while processing their feedback from the previous session. He said that he was initially embarrassed about handing his patients the Brief Mood Survey and asking them to fill it out before and after each session.

This was helpful, but very challenging, both from a technical and emotional perspective, since it was painful to have to view his failures. I mentioned that it has been the same for me, and described a recent extreme failure with a patient who was livid with me after a session I had thought was great. But talking it over with that individual subsequently led to a tremendous breakthrough, confirming the idea that “your worst therapeutic failure is often, or always, your greatest therapeutic success in disguise.” Of course, you have to have the willingness and skill to talk it over with your patient in a respectful, non-defensive, and genuine way.

My patient’s Achilles heel was perfectionism and a fear of anger. I believe it was helpful to her to see that it was absolutely okay to be angry with me, and to express feelings that she so often avoided, and to see that my failure did not have to be “awful,” but presented genuine opportunities for growth and a deepening of our relationship.

Cai also emphasized the value of the Five Secrets of Effective Communication, since these tools showed him HOW to be empathic with his patients. Prior to that, he thought that empathy was something you just kind of acquired spontaneously, on your own.

He also said he now realizes the incredible importance of doing your own personal work if you are a therapist.

Cai was so determined to learn and to do his own personal healing that he did tons of Daily Mood Logs, every time he was upset in fact. He also did many Relationship Journals to improve his skills with the Five Secrets of Effective Communication, and even role-played with himself! He unearthed many of his own Self-Defeating Beliefs with the use of the Downward Arrow Technique, including Perfectionism and the Achievement and Love Addictions, as well as the Conflict and Anger Phobias, as well as a kind of underlying “worthlessness” schema, thinking of himself as an inherently “useless person.”

Cai described his struggles with shyness, described in his email above, and identified with one of my podcasts about a young man I treated for shyness who “froze” with anxiety when in line at a Safeway store and seeing an attractive young lady checking groceries who seemed to be looking at him and smiling. Similarly, Cai froze when seeing a cute young lady and similarly felt “mortified.”

He describes how he overcame his own shyness, and how he did the “What-If Technique,” while working on a Daily Mood Log, and discovered his belief that “If I open up to people about my feelings, I’ll just be wasting their time.” He decided he also had to take action, and begin forcing himself to use Self-Disclosure with strangers, as well as all the people he knew on social media, plus patients, and colleagues, telling them about his shyness instead of hiding it.

He says that the positive responses he got blew his mind. He can now share his honest, vulnerable feelings with complete strangers in public and talk with them without shame or anxiety, something he never thought would be possible in the last 20 years.

He also described using a two-and-a-half-hour TEAM CBT session with a woman with decades of failed treatment for incredibly severe depression, including several series of electroconvulsive therapy that had minimal effects. Althought the shock therapy worked for several months, she relapsed when she remembered why she was depressed and became miserable again).

But when he did Positive Reframing, she was astonished to realize for the first time that her symptoms were actually the expressions of what was most awesome and beautiful about her, and when he used the Externalization of Voices during the M = Methods portion of the session, her symptoms not only disappeared completely for the first time, but she became euphoric.

He described this personal rule: anytime he becomes upset: He immediately does a Daily Mood Log or Relationship Journal ASAP, and sometimes spends two to three hours a day doing this. He would also stubbornly skip out on meals to finish a session with himself, something he doesn’t recommend other people do! I am in awe of his commitment, not only to defeating his own demons, but also to learning to become, not just another “shrink” who prescribes drugs, but a true “healer.”

Of course, Rhonda and I were pretty happy when he described the free assets on feelinggood.com, especially the podcasts, as “freaking amazing!” He mentioned how convinced he is that with dedication, time, the courage to face a lot of pain, and a lot of homework, anyone can learn how to heal themselves and better heal other people through TEAM just with the podcast and other self-learning material. He feels strongly that this is the case even if you don’t have access to any readily available teachers or trainers in your immediate area.

At the end of the podcast, to bring his story to life, he shared three of his negative thoughts after seeing a woman’s new relationship status on Facebook. At the time, he previously believed all three thoughts 100%, but now no longer believed them at all.

  1. This proves that I’ll never find anyone special.
  2. There must be something inherently wrong with me because I haven’t found a lifelong partner.
  3. There’s no point in trying anymore because I keep screwing things up.

I’m sure that many of our listeners, including maybe you, have had thoughts like this at some time in your life!

We demonstrated Externalization of Voices, using his first thought, and Cai blew it out of the water. This was his response: “This one’s a real tear-jerker for me. I dated someone a couple of months back and it was one of the best moments of my life. It didn’t last long, but I really loved her. She wasn’t special, but that’s the exact reason why I loved her.”

And then, when thinking back on the women he loved, he said, “none of them were special, but I loved all of them tremendously,” and broke into tears—showing us the beautiful and awesome human being he is.

Cai was so inspired by this short session that he went back to his Daily Mood Log and came up with some more killer, emotional responses. For another of his negative thoughts “Everyone else is succeeding more than I could ever hope to”, he responded: “It’s not in my interest to believe in success and accomplishments anymore. To live is to fail because being human means being defective, flawed, and imperfect. We’re all human and we’re all failing fantastically every day. It’s time for me to join the rest of the human race by letting my success and accomplishments die. Luckily there’s not very much there so I don’t think it will be too painful to let it all go.”

He mentioned how this brought on a lot of tears as well because it finally felt like he could let go of what he “needed” and still be ok.

Hey ladies, I’m going to post his photo with this podcast! Go for it! This incredible young doctor is—believe it or not—available!

Cai (Dr. Chen) plans to start his clinical practice in Dallas next summer following his graduation. He plans to be certified in TEAM-CBT, and will join one of our weekly free training TEAM-CBT training groups. If you would like to contact Dr. Chen, you can do so at: fontatlas42@gmail.com or cai.chen@uthct.edu.

David  and  Rhonda

Nov 30, 2020

218: Causes and Cures for Postpartum Depression and Anxiety--An Eye-Opening Interview with--Thai-An Truong 

Do Negative Thoughts or Hormones Cause Postpartum Depression and Anxiety? And What’s the Best Treatment? TEAM-CBT or Pills?

We begin today’s podcast with a lovely endorsement, and an announcement that Rhonda’s new free Wednesday TEAM therapy training group will be open to therapists from around the world and will start on December 2, 2020 at 9 to 11 AM west coast (pacific) time. Rhonda will have many fine trainers working with her, including the incredible Richard Lam, and the magnificent Leigh Harrington, to make your training experience stellar. If you are interested, contact Rhonda right away, as slots will be strictly limited. You can also fill out this form to confirm your interest!

Today, Rhonda and I are proud and excited to interview our brilliant and delightful guest, Thai-An Truong, from Oklahoma. Thai-An is an accomplished TEAM Therapist (the first in Oklahoma) and popular TEAM trainer for therapists who want to learn about these new techniques.

Thai-An, her husband, and two children on Halloween, the day after this podcast was recorded. Her daughter was born earlier this year.

Thai-An’s niche is unusual and extremely interesting—she specializes in the treatment of women with post-partum depression with TEAM therapy, and usually without medications. This is extremely interesting since the world is currently focused on the belief that post-partum depression is a 100% biological disorder that results from hormonal changes, needs treatment with medications, and typically requires a year or more of treatment before improvement can be expected.

Of course, this message can unfortunately function as a self-fulfilling prophecy. And is it even valid?

No, says Thai-An. Although she sees a role for medications in some women with severe post-partum depression and anxiety, she says that the vast majority of the women she treats recover quickly without drugs. I was so happy to hear this, since my experience has been the same. In fact, Chapter 2 of my new book, Feeling Great, features my treatment of a woman struggling with severe post-partum depression who recovered in a single TEAM therapy session.

Thai-An begins by describing her own horrifying and totally unexpected battle with post-partum depression after her first child was born 4 ½ years ago. She had a wonderful pregnancy and was excited about the prospect of giving birth to her daughter, but immediately after delivery, “it suddenly felt like the rug was pulled out from under me.” She went into a state of self-loathing and struggled with extreme depression and anxiety. She says, “I could barely sleep, woke up in a state of panic, and wondered ‘can I feed my baby?’”

It got so bad that Thai-An began to think that her family and daughter would be better off without her. She said, “I even asked my mother if she’d be willing to raise her.” I felt incredibly sad to hear that, and I could barely even grasp the intensity of her suffering. The suffering of extreme depression is almost beyond human understanding, especially if you’ve never been there yourself.

Thai-An was treated with medications, including antidepressants, but they didn’t help and made her more anxious. Then was told that these side effects are “expected” and advised to “wait it out.” She said, “I saw how devastating post-partum depression is—it robs you of joy.” They told me it was biological.

One theme of Thai-An’s depression was her belief that moms are supposed to bonded to their children and loving at every moment, so “I asked myself, ‘did I make a mistake? Am I a monster? Why don’t I feel that way?’”

Fortunately, Thai-An recovered after 3 months, and decided she wanted to work with other mothers with similar problems. She now has a thriving practice in Oklahoma. Rhonda asked how other doctors view her work, since Thai-An’s treatment approach—TEAM—is so radically different from current treatments that emphasize biology. Thai-An said the doctors have become extremely supportive when they see fabulous results in the patients they refer to her.

Thai-An emphasized several components of TEAM-CBT that have been especially helpful to the women she treats.

  • Positive Reframing. She says that this method is super powerful. Traditionally, woman are told (and think) that they need to “calm down,” but this makes the symptoms worse, especially the anxiety. Positive Reframing, in radical contrast, honors their negative feelings, and the effect is often “mind-blowing.” She says, “It heals a lot of the symptoms”
  • Anxiety is even more common in post-partum depression than depression, including OCD symptoms. For example, many women have horrific intrusive thoughts that their child may suffocate, or that they’ll throw their child down the stairs, or other gruesome scenarios that they try to control and suppress.

Of course, that never works and always makes the symptoms worse. Exposure, techniques like Cognitive Flooding—leaning into the fantasies and surrendering to them—can often be rapidly curative, but requires great courage on the part of the therapist, as well as the patient. Sadly, 80% of American mental health professionals avoided Exposure, wrongly thinking it will be “too dangerous” or that the patient is “too fragile.”

Therapists like Thai-An, with expertise in Exposure and the courage to use it, are treasures, or “healers,” because they can often cause almost unbelievably rapid recovery and freedom from horrific fears.

  • The Hidden Emotion Model. Nearly all anxious individuals are overly “nice,” and often suppress forbidden negative feelings, like feeling angry or annoyed. Bringing the hidden feelings to conscious awareness, and helping the patient express them, using the Five Secrets of Effective Communication, can also have fantastic and rapid healing effects.

I, David, resonated with all of these themes, having seen nearly identical scenarios in many patients I’ve treated with post-partum depression, as well as their husbands or partners. Rhonda and I both share Thai-An’s enormous enthusiasm for TEAM-CBT, and greatly admire her incredible dedication to healing.

Thai-An said that although post-partum depression is a bit more common among African-Americans as well as poor and underprivileged populations, it really affects everyone from a wide variety of social and economic backgrounds. No one is immune to this debilitating and demoralizing disorder.

Thai-An emphasized that while hormones may play some kind of role, the real and surprising culprit is perfectionism, and the expectation that things should or should not be a particular way. In other words, telling yourself that “I should not feel angry or sad,” and “I should be flooded with love and joy,” can set you up for a painful fall. These are the unrealistic expectations that trigger intense feeling of inadequacy, anxiety, and worthlessness, not only in women with post-partum depression, but all of us. I can attest to that personally!

Thai-An emphasized that recovery is not just a psychological phenomenon, but involves a deep and spiritual transformation of the patient. I definitely resonate with this theme.

Thai-An attributes her fantastic therapy skills to her many mentors—teachers she’s learned from at the Feeling Good Institute (FGI) in Mt. View, California, including Matthew May, MD, Angela Krumm, PhD, and many others. But she especially wants to honor her hero and mentor, Mike Christensen, who teaches introductory TEAM-CBT classes at the FGI. I want to second that, since I also love and admire Mike, and all of our amazing teachers and colleagues at the FGI.

Thai-An’s parents emigrated from Viet-Nam, a culture where psychiatry and psychology are practically unknown. Thai-An was “supposed” to go to medical school, but found psychology classes way more interesting than pre-medical classes. But her mom didn’t understand. She said, “Are you going to sit around and talk to crazy people al day?”

Fortunately, Thai-An stuck to her guns and went to graduate school in a mental health field rather than medical school, and the rest is history. We are SO LUCKY to know Thai-An. She is a diminutive and beautiful woman with the brain and heart of a giant! Rhonda and I both feel extremely honored to have her testimony on today’s podcast!

If you would like to contact Thai-An for training, please visit TEAMCBTTraining.com. If you are in Oklahoma and looking for treatment, you can contact Thai-An at LastingChangeTherapy.com.

Thanks for tuning in today. Next week, it looks like we’ll have another amazing guest, Cai Chen, who will also blow your mind.

Warmly,

David  and  Rhonda

Nov 23, 2020

217: Ask David: Is human "worthwhileness" worthwhile? Why am I always the the last to find out about anything? A Daily Gratitude Log, Positive Reframing and more! 

Today's Ask David features four terrific questions.

  1. Kevin asks: Why is the concept of worthwhileness and worthlessness so important to people and their emotional health?
  2. Vallejo asks: Does the statement, "WHY AM I ALWAYS THE LAST ONE TO FIND OUT ABOUT ANYTHING?” correspond to overgeneralization, or self-blame? I’ve been listening to the early podcasts on the ten positive and negative cognitive distortions.
  3. David P asks: Do you think there is anything to be gained from a daily gratitude log, to go along with the daily mood log?
  4. Harvey asks: I don’t see how Positive Reframing actually contributes to the therapy.
  1. Kevin asks: Why are the concepts of worthwhileness and worthlessness so important to people and their emotional health?

Hi David,

I have a quick question about the concept of being a worthwhile human being. Suppose a person believes they are unconditionally worthwhile, what are the implications of this? Why are the concepts of worthwhileness and worthlessness so important to people and their emotional health?

Best Regards,

Kevin

Hi Kevin,

Thanks! That’s a very important question. However, it is abstract and philosophical. I have found that philosophical discussions tend to go on endlessly with resolve. In contrast, when someone asks for help with a specific moment when she or he was upset, then I can usually show that person how to change the way she or he is feeling. And when that happens, the person generally suddenly “sees” the solution to some very profound philosophical or spiritual questions.

All that being said, I’ll take a crack at it. The goal of TEAM therapy is not to go from thinking that you’re a worthless human being to thinking that you’re a worthwhile human being, but to give up these concepts as nonsensical. Specific activities, talents or thoughts can be more or less worthwhile, but a human being cannot be more or less worthwhile. We can judge specific events, actions, and so forth, but not humans. At least I am not aware of how to validly judge a human being, or a group of humans. We can only judge their actions, attitudes, thoughts, and so forth.

Unconditional self-esteem is definitely better than conditional self-esteem, since you don’t have to be perfect or a great achiever or a great anything to be “worthwhile,” but you are still focused on being "worthwhile."

I'm not sure what that means, but there is a downside, to my way of thinking. If you think you are worthwhile because you are a human being, does that mean that you are more worthwhile than animals? Lots of people abuse animals, hunt animals, and so forth, which many people find immensely disturbing. These are some of the consequences of thinking that animals are less worthwhile, for example.

Not sure that helps, but like your line of questioning!

David

Kevin follows up: What is the implication then of giving up these concepts at all? I assume that thinking that you have unconditional worthwhileness because you are alive or to drop these concepts entirely have the same emotional implications for people. What are these implications? For example, if I think that worthwhileness and worthlessness are meaningless concepts, so what? What’s the point? What do I gain?

Hi Kevin,

Let me start by saying, once again, that I am not an evangelist spreading the “gospel,” so to speak. My goal is simply to help people who are struggling with feelings of depression, anxiety, and self-doubt. So, if your way of thinking about things is working for you, there’s no reason to change.

But my focus is always on someone who is suffering, and that’s where these concepts can sometimes be important.

I can tell you what I gained by giving up the idea that I could be, or needed to be “worthwhile” or “special.” I gained a great deal of joy. It was a lot like escaping from a mental prison. It freed me to find incredible joy in the “ordinary” events of my daily life. It also freed me from fears of “failure” or not being “good enough.”

Depression always results from Overgeneralization--you generalize from failing at something specific to thinking you are a failure as a human being. Without Overgeneralization, I think it is safe to say that it is impossible to be depressed.

For example, if you measure your worthwhileness based on your achievements and success, you may feel excited when you succeed and devastated or anxious when you fail, or when you are in danger of failing. I'm not sure if this addresses your excellent question!

A young woman told herself that she was "unloveable" when she and her boyfriend broke up after two years of going together. Can you see that she thinks she has a "self" that can be "loveable" or "unloveable?" This thought was very disturbing to her, as you might imagine.

Relationships do not break up because someone is "unloveable," but because of specific factors or events that drive people apart. Once you zero in on why the relationship failed, or more correctly, why the two of you broke up, then you can pinpoint the causes and learn and grow so you can make your next relationship even better. There are tons of specific reasons why people break up!

But if you think that you’re “unloveable,” or tell yourself that the relationship was “a failure,” then you may get stuck in a morass of negative feelings. But it’s not even true that the relationship was a failure.” That’s All-or-Nothing Thinking, since all relationships are a mixture of more or less successful aspects. You could even tell yourself that a “failed” relationship was a partial success, since you successfully learned that this isn’t the person you’re going to spend the rest of your life with.

What’s in it for you to give up Overgeneralization and All-or-Nothing Thinking, as well as the concepts of being a “worthwhile” or “worthless” human being? That’s a decision each person can make. There are benefits as well as problems with these ways of thinking.

For example, let’s say you’re depressed and think of yourself as “defective.” This is a common negative thought, and it is based on the idea that a human being could be more or less worthwhile, or thinking that your "self" can be judged or rated.

So, you could do two Cost-Benefit Analyses.

    1. First, you could list the advantages and disadvantages of thinking of yourself as a “defective” human being. Then balance the advantages against the disadvantages on a 100-point scale, assigning the larger number to the list that seems more important or desirable.
    2. Second, you could list the advantages and disadvantages of thinking of yourself as a human being with defects, and once again balance the list of advantages against the disadvantages on a 100-point scale.

This is just a subtle change in semantics, but the emotional implications can sometimes be pretty powerful.

As I mentioned at the top, philosophical debates are just debates. Fun, perhaps, but not terribly useful.

I’m more interested in magic, or miracles. That’s what happens at the moment of profound change, which can ONLY happen by focusing on one specific moment when you felt upset and needed help. When you do that, everything becomes radically different, and real change can occur. And at that magic moment of change, the solutions to all of the problems of philosophy will often suddenly become crystal clear. Or, to put it differently, the philosophical debates will suddenly become, without meaning to sound harsh, almost a waste of previous time.

Our current semi-feral cat loves my wife, but is only starting to trust me, so I’ve been working at gaining her trust and learning to understand her non-verbal and somewhat complex efforts to communicate. Yesterday she roller over on her back and stretch out her front and back paws to expose her tummy to the max, and she let me pet her tummy for quite a long time, purring loudly the whole time.

I don’t care if she’s “worthwhile,” or if I’m “worthwhile,” and have no idea what those terms could even mean. But petting her tummy—now, that’s something that’s REALLY worthwhile!

david

Hi David,

You and Albert Ellis are my heroes. Without your books, I always wonder what path I would have taken in life! Thank you.

I had a quick question about self-acceptance. One of the reasons I feel that I’m fully unable to embrace it (and I think this is common) is that I’m afraid that I will lose out on motivation to work hard towards my goals. I think this partially true because my conditional self-esteem has caused me to work hard on a lot of things including CBT!

Do you have any good ways to combat this exact notion, that if I accept myself I will simply become complacent and therefore I can’t?

Looking forward to Feeling Great!

Best Regards,

Kevin

Hi Kevin,

There’s a lot of truth in what you say. Early in my career I also had a tendency to base my self-esteem on my achievements and productivity, both in my research and in my clinical work as well. I did accomplish quite a lot, but things were a bit of a roller coaster. When I thought I was doing well, I felt terrific, but when I thought my research was failing, or when I was stuck with a patient, I got quite anxious and frustrated. These feelings didn’t always foster positive outcomes.

Now I no longer feel that my “worthwhileness” as a human being depends on my successes. In fact, I don’t even have the concept anymore.

Now, I think my writing skills are very good, especially my skills in explaining complex ideas in fairly simple terms. But I do not think this makes me “more worthwhile.” Sometimes my writing, or my interactions with people, or my jogging, and many other things I do aren’t very good. But I don’t think these problems and flaws make me any less “worthwhile.”

Take our little adopted feral cat, Miss Misty, that I mentioned in my last email. Misty does not care how “worthwhile” I am. However, she’s totally delighted if I pet her, let her out in the back yard to explore, or give her a piece of cat candy, or if I play with her.

She is enlightened because she judges what I “do,” not what I “am.”

Will you become less productive or unmotivated when you give up these concepts of “worthwhileness?” That has not been my experience. I am the busiest and most productive now than at any previous time of my life. I’m now 78, and life is a ball. I have tons of fabulous colleagues to collaborate with and we’re working on all kinds of super-exciting and challenging projects.

When we don’t have “selves” that we need to protect, or feelings of “worthwhileness” that we need to defend, we can listen to criticisms and collaborate without feeling threatened, and use the information to improve what we’re doing!

Hope that makes sense!

david

* * *

  1. Vallejo asks: Does the statement, "WHY AM I ALWAYS THE LAST ONE TO FIND OUT ABOUT ANYTHING?” correspond to overgeneralization, or personalization cognitive distortion? I’ve been listening to the early podcasts on the ten positive and negative cognitive distortions.

Hi Vallejo,

Rhetorical questions are technically not considered Negative Thoughts because they contain no distortions. However, this question is actually a Hidden Should Statement, and a great example of Other Blame as well.

You need to change rhetorical questions into statements, like: “It’s unfair that I’m always the last one to find out about anything. This shouldn’t happen all the time!” And, as you point out, it is also a gigantic Overgeneralization.

Thanks, Vallejo!

On the podcast, David will talk about some of the rules for generating Negative Thoughts.

* * *

  1. David P asks: Do you think there is anything to be gained from a daily gratitude log, to go along with the daily mood log?

Dr. Burns, I'm a big fan of your work, and have now finished "Feeling Great" and loved it. I know you approach depression from a clinical background, but do you think there is anything to be gained from a daily gratitude log, to go along with the daily mood log? It seems like my negative thoughts are automatic, and I have to work to counter them. Maybe, if I have to force myself to think of a few things I really am grateful in my life, instead of only focusing on countering the negative automatic thoughts, it would be beneficial? Also, is there a role for altruistic volunteering in alleviating depression? Thank you.

david p

Hi David P,

Anything that works for you is strongly recommended. I do a lot volunteer teaching, and also treat therapists and students for free, and i enjoy that a great deal!

So go for it and let me know if it is effective! I often feel grateful for a lot of things, and people, and animals, like our cat, who "almost" loves me!

As for me, I never use non-specific, formulaic approaches that one practices over time, hoping some good will come from it. So I never prescribe meditation, a daily gratitude log, prayer, aerobic exercise, dietary considerations, vitamins, and so forth. You can do these things if you like, but they are not “therapy” to my way of thinking. I only use specific techniques to crush a patient’s unique negative thoughts of dysfunctional ways of communicating with others during conflicts.

Therapy is a lot like learning to play the piano, or going to a tennis coach to improve your game. Specific practice is needed, not prayer, gratitude journals, or the like. And my focus is on high speed, total and lasting change right now, if possible.

david

* * *

  1. Harvey asks: I don’t see how Positive Reframing actually contributes to the therapy.

Hi Dr Burns:

Thank you for this great podcast.

I was particularly impressed by and related to the idea of “Beating Up On Yourself.” I think it is so easy to fall into that trap.

My question is that I don’t see how the positive reframing aspect of TEAM actually contributes to the therapy.

Once you did the reframing with Neil, you didn’t seem to go back to it. So why is that a necessity thing to do?

I understand that the positive side of negative thoughts could cause resistance to give up the negative thoughts, but that didn’t seem to be dealt with.

Thank you so much for these podcasts and I have just started to read “Feeling Great”.

Maybe you go into the positive reframing aspects and benefits more in the new book.

Thanks,

Harvey.

Hi Harvey,

The session you are referring to was a while back, but by memory my thinking was that the Positive Reframing was not a particularly powerful tool for Neil, and I think he thought that also. It is not the case that any one tool--and I have created / learned more than 100 methods--will be effective for everyone.

That's why it's so great to have a huge palette of tools and techniques, so you can find the path forward for many patients, and not just a few! Some people think that if a technique is not helpful for one patient, then it is no good.

Some people also think that one technique, like meditation, or exercise, or medication, should be "the answer" for everyone. My experience is radically different, and it is hard for me to even comprehend how people can get sucked into some of these notions--but they do!

Positive Reframing is one of the great breakthroughs in TEAM-CBT, and it opens the door to ultra-rapid recovery. In fact, I usually (but not always) see a complete or near-complete elimination of negative feelings in one extended (two-hour) therapy session.

Here are some reason why Positive Reframing can be helpful:

      • When you see that your negative feelings are the expressions of your core values, rather than your defects, this reduces feelings of shame, so you might feel a little better right away.
      • You don’t have to shoot for perfection, or complete recovery, but rather a reduction in your negative feelings. This is pretty sensible, and more realistic and relaxing than shooting for total change. In addition, you are no longer fighting against your negative thoughts and feelings.
      •  Your resistance to change will diminish because you can honor your negative thoughts and feelings, and work to reduce them rather than thinking you have to change completely.
      • You’re in control—the therapist is not trying to “sell you” on something. “Selling” nearly always triggers fairly strong resistance.
      • You may suddenly see the benefits of many of your negative thoughts and feelings, so you no longer feel so “broken” or defective.
      • When you "listen" and finally hear what your negative thoughts and feelings are trying to tell you, the volume and intensity of your negative thoughts and feelings will suddenly diminish, like a balloon with a hole in it.

Thanks for listening today!

Rhonda and David

 

Nov 16, 2020

216: Cool Questions about Should Statements! 

Ask David featuring four terrific Should questions, and more questions about “asinine, stupid, narcissistic, self-serving humans! “

  1. Oliver asks: Can a thought be thought as moral or immoral?
  2. Vincent asks: I have suffered from depression for about 3 years and say to myself, "I should have gotten better sooner." Isn't this "should" appropriate?
  3. Charles says: Your concept of “no self” shot my anxiety way up and made me feel hopeless. . . . It makes me feel worse than before!
  4. Michelle asks: How is your requirement that new patients must agree to not make any suicide attempts for the rest of their lives any different to a “suicide contract” which you mention are not effective?
  5. Brian asks: I’ve done a few things that made me feel intensely guilty. . . . The knowledge that I didn’t do what I should have done led to a lot of guilt and shame, and eventually depression. Just wondering your thoughts on this
  6. Carrel asks: I'm a Democrat in Texas. How can we use disarming to heal the political rifts in our country?
  7. Natasha asks: How do I stop the dark thoughts of wishing harm to come to stupid humans who do asinine, narcissistic, self serving, irresponsible things—like driving massive, loud pickup trucks around the neighborhood, honking incessantly as they wave their 20 ft political flags; or bringing the family for a paddle boat ride in the local pond, taking delight in teaching their human offspring to paddle the boat as quickly as they can to chase after the beautiful, innocent geese and ducks trying earnestly and fearfully to swim to safety. and more.

 

Dear Dr. Burns,

Can a thought be thought as moral or immoral?

In many podcasts and articles, you use "Thou Shalt Not Kill" to demonstrate morally should statement, which is one of the 3 valid should statements in English. I'm still somewhat confused about this concept. To tell you where I get stuck, I come up with three thought experiments.

Imagine the following situations in which a should statement may come to mind:

Situation 1

Lisa stole some money from a grocery store. When arrested by police, Lisa said with tears, "I shouldn't have stolen money. I feel ashamed for what I have done."

In this case, it is obvious that "I shouldn't have stolen money" is a morally should statement, and also a legally should statement, because Lisa did something that violates the law and her moral principle.

DAVID’S COMMENT: YES, YOU ARE CORRECT. LISA’S STATEMENT CAN BE CLASSIFIED AS A LEGAL SHOULD AND A MORAL SHOULD.

Situation 2

One day, Bob went to Walmart to buy a suit. When he was passing by a shelf, a thought appeared in her mind. "What would happen if I steal this suit? I really want it, but I have very little money." When he came back home, he talked to himself," I shouldn't have felt the urges to steal things. And I shouldn’t have thought about stealing the suit."

DAVID’S COMMENT: THESE WOULD NOT BE CONSIDERED VALID SHOULD STATEMENTS BY MOST PEOPLE, SINCE WE HAVE FREEDOM OF THOUGHT. HUMAN BEINGS HAVE ALL KINDS OF FANTASIES AND URGES ALL THE TIME—AT LEAST I KNOW THAT I DO! AN URGE ONLY BECOMES IMMORAL OR ILLEGAL WHEN YOU ACT ON IT.

HOWEVER, ALTHOUGH I DO NOT THINK THESE ARE VALID SHOULDS, BUT I TRY NOT TO IMPOSE MY VALUES ON OTHERS FOR THE MOST PART. I AM A SHRINK, SO I WORK WITH PEOPLE WHO ARE ASKING FOR HELP.

FOR EXAMPLE, PEOPLE WITH OCD OFTEN PUNISH THEMSELVES JUST FOR HAVING “FORBIDDEN” THOUGHTS, FEELINGS, OR URGES. THE FIGHT TO CONTROL THEM IS THE ACTUAL CAUSE OF THE OCD. THE SHOULDS TYPICALLY MAKE THE PROBLEM WORSE, NOT BETTER. SELF-ACCEPTANCE CAN BE ONE OF MANY HELPFUL TREATMENT STRATEGIES.

RELIGION CAN SOMETIMES BE A SOURCE OF OPPRESSIVE SHOULDS, ESPECIALLLY THE MORE FUNDAMENTALIST TYPES OF RELIGION. RIGIDITY MAY BE A PARTIALLY INHERITED TRAIT. FOR EXAMPLE, MANY RELIGIONS AROUND THE WORLD PROMOTE THE IDEA THAT HOMOSEXUALITY IS “WRONG” AND THAT PEOPLE “SHOULDN’T” HAVE URGES AND ATTRACTIONS TOWARD PEOPLE OF THE SAME GENDER. THIS IS AN AREA WHERE “SHOULD STATEMENTS” BECOME HIGHLY CONTROVERSIAL, AND ARE OFTEN A SOURCE OF HORRIFIC HATRED AND VIOLENCE, SOMETIMES IN THE NAME OF SOME “HIGHER POWER.”

Situation 3

Lucy was buying fruits in a grocery store when she found that a man was taking an apple off the shelf and hiding it in his clothe! Obviously, the man was stealing an apple. Lucy was very angry and said, "the man shouldn't steal things from the store. It's not right!"

In this case, Lucy didn't steal apples, the man did. But Lucy made a moral judgement about the man's behavior, not Lucy's behavior. Then is this should statement valid for Lucy?

DAVID’S THINKING. TO MY WAY OF THINKING, YES THESE ARE VALID LEGAL SHOULDS AND MORAL SHOULDS, SINCE OUR CIVILIZATION (AND ALL CIVILIZATIONS) HAVE DECIDED THAT STEALING IS ILLEGAL, AND IS ALSO CONSIDERED MORALLY WRONG IN MOST RELIGIONS: “THOU SHALT NOT STEAL” IS, I THINK, ONE OF THE TEN COMMANDMENTS.

THE GOAL IS NOT TO CLEAN UP YOUR SPEECH SO THAT YOU NEVER USE SHOULD STATEMENTS THAT DO NOT FIT INTO ONE OF THE THREE VALID CATEGORIES OF LEGAL SHOULDS, MORAL SHOULD, AND LAWS OF THE UNIVERSE SHOULDS. AT LEAST I HAVE NO INTEREST IN THAT. MY GOAL IS TO HELP PEOPLE WHO ARE SUFFERING BECAUSE OF SHOULD STATEMENTS.

sincerely

Oliver

 

Hi David,

What is it with "shoulds" related to recovery from depression? I suffer from depression for about 3 years and say to myself "I should have gotten better sooner." Isn't this "should" appropriate? Because who really wants to suffer through this agony?

Greetings from Geneva.

Vincent

Hi Vincent,

"I wish I had gotten better sooner." This is a correct statement without the "should." This simple shift in language is called the Semantic Technique, and it was developed by Dr. Albert Ellis who kind of gave birth to cognitive therapy in the 1950s, along with Dr. Karen Horney about the same time. Instead of using a should, you use “it would be preferable if” or “I wish X was true.”

In addition, it isn't actually true that you "should" have gotten better sooner! The universe does not always conform to our expectations. Just because we want something, it doesn't follow that it "should" happen. I'd love to have a new Tesla sports car, at least in fantasy, but it isn't true that I "should" have one. It would be “great” if you had gotten better sooner, that’s absolutely true.

“I should have gotten better sooner.” That’s totally false.

In addition, although one might think that no one would "want" depression, my research and new clinical work indicate that resistance is nearly always the key to recovery. In other words, people do cling to depression, anxiety, troubled relationships, and habits and addictions, but don’t realize why they are resisting change. Once you suddenly see why you are resisting, your resistance paradoxically disappears, and recovery is then just a stone’s throw away.

You can learn more about this in my new book, Feeling Great, available now on Amazon. Thanks! PS let me know if you like the new book, and if you find it helpful!

All the best,

David

 

A new comment on the post "108: Do You Have a "Self?"" is waiting for your approval

Author: Charles

Dr. Burns,

First off I want to say thank you. Your work has been helping me through my anxiety. However, I really struggled with this podcast. The concept of no self shot my anxiety way up and made me feel hopeless. It made me feel almost as if I was not real or that there is nothing worth striving for. I love helping people. But I feel like I don’t have a purpose if I don’t have a self. It makes me feel worse than before.

David’s answer.

Hi Charles,

The “great death” of the self is a challenging concept, and while it is incredibly liberating, lots of people—most, in fact—don’t “get it.” Some get angry. Some struggle with trying to understand what this could possibly mean. And some find the concept very threatening. That’s why I deleted the chapter from my book. In fact, a couple extremely brilliant and interested colleagues totally couldn’t grasp it, and felt frustrated by my writing on the concept.

sometimes, ideas are so simple and basic that people cannot grasp them. The Buddha ran into this problem 2500 years ago. People thought he was fantastic, but almost none of his followers experienced the enlightenment he was so excited to teach them.

The 20th century philosopher, Ludwig Wittgenstein, ran into the same problem. He solve all the problems of philosophy, but when he was alive, it was rumored that only seven people in the world, including one of his favorite students, Norman Malcolm, could grasp what he was saying. He went in and out of intense depression and loneliness during his life, in part because of his frustration with trying to teach the obvious.

In my book, Feeling Great, I teach that there are actually four “Great Deaths” for the patient, corresponding to recovery from depression, anxiety disorders, relationship conflicts, and habits and addictions. There are also four “Great Deaths” for TEAM therapists. Those sections might be helpful for you!

In addition, I focus on the fact that people can never judge your “self,” only something specific that you think or do. Depression cannot exist on the specific level, only up in the clouds of abstraction. For example, Overgeneralization is one of the ten cognitive distortions I described in my first book, Feeling Good. When you Overgeneralize, you see a negative event as a never-ending pattern of defeat, and you might also Overgeneralize from some specific flaw or defect to your “self.”

You will read about an attractive and vivacious young professional woman who had the thought, “I’m unloveable,” when her boyfriend of two years broke up with her. This is classic depression thinking, and “self” thinking. She thinks she has a “self” that can be loveable or unloveable. But this is simply not true, and it’s not productive, because she’ll spend all her time ruminating and feeling worthless.

An alternative is to focus on why the (overall excellent) relationship didn’t work out, and what she can do to change and learn and grow, so as to make the next relationship even better. You can pick up on the details in the chapter on Overgeneralization if you’re interested!

As I point out in Feeling Great, the “death of the self” is not like a funeral, it’ like an incredible celebration of life. Death of your old concept of what you are is liberating, and leads to instant rebirth.

My teachings cannot make you happy or unhappy. Your thoughts about what I’m saying create all of your feelings, positive or negative.

At any rate, thank you for a most important question that most of my audience will definitely related to.

As an aside, I lost my “self” years ago, and what a relief that was. Sadly, it comes back to life from time to time, and then I struggle again, until I realize what’s happening.

One day, what I’m saying may make sense! In the meantime, please accept my apologies concerning the “self!”

If it gives you comfort to believe you have a “self,” no problem. But the “self” is just a concept, and not a “thing” that could exist or not exist. When you lose your precious and protected “self,” you lose nothing, because there was never anything there in the first place! But while you lose nothing, you do inherit the earth, as nearly all great religious leaders—Buddha, Jesus, and others—have taught us.

David

 

Hi Dr. Burns,

I’ve just listened to your podcast episode on suicide and found it really interesting and useful but I have a few questions.

Firstly, how is your requirement that the patient agree to not make any suicide attempts for the rest of their life any different to a ‘suicide contract’ which you mention are not effective?

Also, you talk about doing this assessment at the intake and making non-attempts a condition of therapy. If the patient/client agrees to this, why then do you continue to monitor suicidal thoughts in each session in the BMS? Presumably because the agreement is no guarantee of cessation of thoughts. Surely if you’ve told them it’s a condition of therapy with you to not make any attempts then they’d be likely to not tell you about them even if they occurred, and don’t see how setting the initial ground rule resolves the problem.

And lastly, when suicidal thoughts, urges, or fantasies do come again in the BMS how do you handle it then? Do you tell them you’ll end therapy, say “but you promised”?

Looking forward to your reply.

Thanks, Michelle.

Hi Michelle,

I have scheduled your email for an upcoming ask david episode, and will use your first name unless you prefer that i use some other name. Here is a brief reply. Most patients with borderline personality disorder will become enraged by the gentle ultimatum at the initial evaluation, and if they decide this is not the type of therapy they want, so be it. The techniques I use will not be effective with patients who continue to threaten suicide. TEAM therapy requires TEAM work.

Most, nearly all, patients will "get it" and will decide to continue with the therapy. They can have suicidal thoughts and urges, and we can work on them together in therapy. However, to my way of thinking, it is important that they therapist and patient be protected, in a safe environment.

If the patient starts threatening to make a suicide attempt, then they will need another form of more intensive treatment like hospitalization, day care, or intensive outpatient treatment. These are options I cannot personally provide for them.

I monitor suicidal urges before and after each session with every patient with no exceptions to protect the patient and to protect myself as well. Thanks!

PS the suicide contract is an agreement not to attempt suicide "while we are working together." This is very weak, as the patient can suddenly decide he or she is dropping out of therapy and making a suicide attempt. And this often happens.

My contract is more demanding, and intentionally so. Patients must also agree to do psychotherapy homework, too. Some patients want to make the therapist a hostage with suicide threats, which can and so work as a form of manipulation and hostility. Then the therapist is in an almost constant state of agitation, anxiety, and frustration. If I allow a patient to make my life miserable, how can I teach that patient how to be happy? We are all ONE—we go up and down together. If I allow you to make my life miserable, then I am allowing you to make your own life miserable, too.

David

 

Hello David,

Thank you so much for everything you do. I’ve listened to all of your podcasts, and read most of your books, and am very grateful for the changes you, Rhonda, Fabrice and the rest of the team have made to my life.

I’ve just listened to this episode, and there’s one thing I’m struggling with, which is the concept of the moral should.

I’ve done a few things that made me intensely guilty – one in particular was not standing by and supporting a friend who needed people when he was going through a particularly hard time. He was angry and disappointed with me, and, in hindsight, rightly so. He has since forgiven me but I still struggle with it.

I feel that supporting him was a moral should. The knowledge that I didn’t do what I should have done led to a lot of guilt and shame, and eventually depression. You say that a moral should is valid; so therefore, I feel that my negative thoughts on this are not misguided but valid – I did something morally wrong and deserved to feel bad for it.

Just wondering your thoughts on this.

Thanks again, and keep up the good work!

Hi Brian, thanks!

Would love to include this on an Ask David, using just your first name, or even a fake name if you prefer. A quick response might be to ask how many minutes per day would you like to dedicate to feeling guilty? And for how many days, months, or years?

In your spiritual or religious beliefs, is a person supposed to feel intensely guilty forever? Most of us have done things we are ashamed of, or feel guilty about. How much guilt and shame would you recommend for me, for example? And what is the goal of the guilt and shame? And how guilty would you recommend I feel, between 0% and 100%?

That's one approach. Another approach would be A = Assessment of Resistance, listing what the guilt shows about you that's positive and awesome, and then asking yourself why in the world you'd want to let go of the guilt, given all the many real positives.

Then you might validly decide to “dial it down” to some more acceptable level. For example, if you now feel 90% guilty, perhaps 15% or 20% would be enough. In addition, you could also decide how many minutes of guilt you would recommend. If you now feel guilty about eight hours a day, would 10 minutes be enough? If so, you could schedule your “guilt periods” ahead of time, and then really work hard at feeling guilty during those ten minutes.

Then, when you’re done with your “guilt work,” you can return to joyous and loving living!

Also, instead of one ten minute daily guilt binge, you could schedule, for example, three guilt binges, each three minutes long, in the morning, at lunch time, and in the evening, like three pills the doctor prescribed!

David

In reply to Dr. Burns.

Hi Dr Burns,

Thanks so much for your quick response! I really appreciate your advice; I will dedicate a bit of time today to approaching it the way you say.

And also, I’d be delighted if you included it on a podcast! You can use my first name by all means.

Thanks again!

Brian

 

Comment from Carrel

I'm a Democrat in Texas. How can we use disarming to heal the political rifts in our country? How does one find agreement across that ever-widening divide?

Carrel

David’s reply

Hi Carrel, It’s really tough, for sure! Have you listened to my podcast on this topic? There is a search function on my website. If you type in “political divide,” this podcast will pop right up: “127: How Can We Communicate with Loved Ones on the Opposite Side of the Political Divide?”

Let me know what you think! David

David emphasizes the value of the search function. Often you can find your questions have already been addressed.

In addition, the many podcasts on the Five Secrets of Effective Communication could be invaluable (links), and the emphasis would be on using the Disarming Technique to find some truth in what the other person is proclaiming and arguing for.

But first, you have a decision to make, and this is always based on ONE person you may want to interact with. First, ask yourself if you do actually want a better relationship with person X, Y, or Z. There is no rule that says we have to get along better with everyone.

I think that Joe Biden is doing a pretty good job of promoting unity, and not diverseness in our country. Hopefully, the forces of love and unity will win out over the forces of hatred and war, but it’s not at all clear what direction our country is heading for. And we’re seeing now that at times the tensions are become so intense, and the hatred so strong, that violence is once again on the increase.

In the next Ask David we'll have a really cool session devoted to the intense anger that many of us feel when confronted by human behavior that strikes us as narcissistic, vicious, self-serving, and aggressive. This topic should appeal to lots of people! And we have a wonderful question from a woman who's feeling pretty darn enraged!

David and Rhonda

 

Nov 9, 2020

215: The Approval Addiction: Live Therapy with Sunny, Part 2 

Last week, you heard part 1 of the live work with Sunny. Today, you will hear the dramatic conclusion of that session. My wonderful co-therapist is Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California. Jill also co-leads our Tuesday training group at Stanford. This session took place between 5 and 7 PM at a recent Tuesday group because we feel that personal healing is a critical part of psychotherapy training.

We will begin with a summary of A = Assessment of Resistance.

David will summarize  Sunny’s Positive Reframing list, as well as the “turning point” when David challenged Sunny’s first negative thought, telling himself that he shouldn’t be getting anxious again. Once again, the moment he saw that he actually should be getting anxious, and that this was a good thing, and not a bad thing, the dam kind of broke open, and Sunny suddenly saw everything in a radically different perspective.

This is one of the core principles and goals of TEAM—helping the patient suddenly see that his or her suffering is not the expression of what’s wrong with you, like a “chemical imbalance” in your brain, but what’s most beautiful and awesome about you, and your core values as a human being.

During this phase of the session, Sunny expressed anger about parents who tell their children they SHOULD do X, Y, and Z, and thus sowing the seeds of low self-esteem and the need for approval.

We continue and conclude the M = Methods, using:

  1. Identify the Distortions
  2. The Enhanced Cost-Benefit Analysis (Enhanced CoBA)
  3. The Externalization of Voices, with Self-Defense and the Acceptance Paradox
  4. The Hidden Emotion Technique
  5. The Five Secrets of Effective Communication

Final T = Testing.

You can see Sunny’s end of session mood ratings on his completed Daily Mood Log, as well as his end of session scores on the Brief Mood Survey and Evaluation of Therapy Session.

Here is Sunny’s follow-up email to the Tuesday group:

Hi folks.

Just want to give you an update of what happened after our group meeting. I was exhausted after our session. But I felt very good - even different than other times when I did self disclosure and deep-down part of me was looking for some validations from others. This time, I came out feeling very confident about myself and my ability to swim without the floating bubbles (approval from others). Most importantly enjoy life now. In fact I didn’t think talking with my mom was necessary because I was not angry with her the next day. Somehow I wasn’t blaming her anymore because I know she changed since then. And I was thankful because I wouldn’t be where I am without that push. But I did chat with her tonight.

I told her how I was hurt when I felt a lot of pressure from her when I was young. And that I love her very much and now am happy that I am confident about my own life decision without needing approval from others. And she told me that she is happy that I am happy. And when we were young, she And she will always love me and support me. And she is happy that I am doing whatever I love so I don’t regret in life. And on and on... lots of loving languages that we don’t use together usually :)

Net net: it was an awesome chat and we are closer. But as importantly, I wasn’t looking for any validation from her - more like giving her some good news about my personal growth. And I felt more confident and equal but loving when I talked with her. So it’s all good :)

I do have an insight on self disclosure. From my experiences, there is a fine line between self disclosure vs approval seeking type of sharing. Both can have similar Immediate results - feeling good and emotional. So make sure our clients are clear of the objective of the self disclosure. And that there is no approval seeking hidden inside - if that’s not the objective.

See you all next Tuesday

Sunny

And here is some of the feedback from members of the Tuesday group:

What did you like the least about today’s Tuesday group?

Nothing comes to mind

Sunny was fabulous!

This isn't something I disliked, but a question... I'm trying to figure out how David and Jill are able to get through the process so quickly and yet have it not feel rushed.. I suppose a lot of practice! Also curious about how Sunny will talk to his mom- thinking about doing this with my mother, I'd be worried that she'd feel like I was blaming her for something and become defensive and close down (which she typically does when anyone tries to bring up their feelings or even when they ask about hers), so I'd be curious about the specific details of the 5-secrets approach here

Nothing — I loved everything about our session tonight

Please describe what you specifically liked about the training? What was the most helpful?

Agree with David that the learning which takes place via live personal work may be the most powerful of all. Helpful to review the various steps and methods while also watching the masters weave the art and science of It all together. Thank you to the brave Sunny for sharing this work with us tonight. This Session was also an awesome dose of relapse prevention for myself, as while I have made major strides with approval addiction this year, I still drift in and out of enlightenment, as is expected!

I appreciate that Sunny's courage to share his vulnerability. His cultural background and parenting style are very similar to mine.

I enjoyed the masterful use of empathy from David and Jill

I share Sunny's approval need without being told by a parent, at least not obviously. The 'talking back to distorted thoughts' helped me a lot. Also, watching the flow of the therapy by David and Jill was educational in my interactions in similar situations.

I loved seeing the whole process of TEAM being modeled with Sunny. I especially liked the positive reframing and empathy stages the best, but it was all so blow away to experience. I'm so grateful to be able to be a part of this group.

I loved watching the whole session unfold. It was a powerful positive reframe and Jill really honed in on the hidden emotion which seemed to really resonate with Sunny.

I love the live sessions. It went so deep, and was so moving and beautiful. I appreciate Sunny's courage and authenticity, and the skill of David and Jill.

Feeling so grateful to be able to see the live demo of TEAM by David & Jill on Sunny. It feels like watching the very painful but beautiful grief process of letting go of this infamous approval addiction, which I relate to so much as a Chinese woman. Watching how the enhanced CBA is a very magical, powerful & dynamic uncovering tool to address outcome resistance & change his mood rapidly.

I loved being able to walk patiently through each step of the therapy. I am frequently amazed at how quickly the work goes once the TEA is managed fully and effectively. I love this stuff! Thanks for allowing me to be an observer and participant in this group.

I like seeing the richness of live work. It was uplifting to hear group members share with Sunny how the session affected them and how they think about their parent-child relationships.

It's always great to watch a full session.

This has been a wonderful session and also a surprise. I see clients and do not get to check emails before we start and was not aware we were heading for another individual work - what a treat! This has been an amazing session. Sunny is a very bright and sensitive guy and admire his eagerness to work though his challenges and open up to the group. I have learned so much from his insights and felt most honored to be an invisible participant in this process. Thank you Sunny! Jill and David you were wonderful! This has been a particularly powerful session. Thank you.

It was great to see the shift in thinking and feeling in session. Sunny was so open to talk about his past and his pain; he had been reflecting about his approval addiction for some time. It seemed that through the positive reframing he was able to see his "addiction" from a different perspective.

Approval addiction is something I have struggled with myself over the years and I felt so grateful toward Sunny for his vulnerability. Also really appreciated Jill's pausing to address the anger that came up in the Externalization of Voices, and David's teaching point about how important it is for the patient to really "SEE" something during the positive reframing.

Loved that Sunny was willing to be truly vulnerable and authentic. I always love seeing the model from start to finish.

Session tonight was exceptionally awesome. Thank you, Sunny for your willingness to work on something so painful and deep in front of the whole class. This has been one of my favorite classes. You touched my heart because you were genuine,, honest, and very very humble. Thank you! And thank you to David and Jill for their superb teaching. As always, I learn so much from them when they do live. With immense gratitude – Sara

Demonstration by David and Jill. It was such an amazing opportunity for us to witness how T.E.A.M works and get through the process. Approval addiction is something I have wanted to work on myself..... I need to listen to the recording and review!

I enjoyed seeing the ease in which the TEAM method was used

Jill's way of connecting some dots and inquiring with sunny about his mother’s understanding of his experience. Jills ability to do this always blows my mind because I'm still trying to tap into that deep level of listening.

Thank you for sharing Sunny! Love the cultural aspect that was brought in

This live session was moving, insightful, and very instructive for me. It gave me insights into my own approval addiction, it moved me to see how Sunny went through his internal conflict throughout the session, and it was beautiful and very instructive to see two master therapists like David and Jill at work. Thank you so much Sunny, David, and Jill!

Thank you Sunny, David and Jill. I was moved and touched by the therapy. I like David and Jill asked Sunny his feeling at an appropriate moment during the therapy instead of only at the beginning and the end. For instance, David asked, "You are opened up to us. How are you feeling now?" Jill asked how angry he was when he expressed his feeling of anger to his mom. It is very powerful. I liked how David asked Sunny to communicate with his mom. Although I am learning the Five Secret skills, it is still hard to use them in daily life. I need to practice it.

Sunny can be reached at: Sunny Choi, LCSW sunny@bettermoodtherapy.com Better Mood Therapy

Thanks for listening today!

David and Rhonda

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