389: The Story of Amy, Part 2 of 2

25 Mar · Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

01:28:05

Featured Photo is Dr. Amy Huberman The Amy Story, Part 2: The Joys of Doing the Laundry!

Amy and her exuberant son, Sasha, and wife, Alena

Last week you heard Part 1 of the Amy session, which included T = Testing, E = Empathy, and A = Assessment of Resistance. Today, you will hear Part 2 of Amy's exciting journey from perfectionism to JOY.

M = Methods

We used a variety of Methods to help Amy challenge her negative thoughts, starting with the first, “I’m failing my patients.” We started with Identify and Explain the Distortions, then went to the Double Standard Technique, and ended up with the Externalization of Voices.

As a reminder, you can see Amy's Daily Mood Log at the start of her session here..

As an exercise, see how many distortions, or thinking errors, you can find in her first Negative Thought, “I’m failing my patients,“ using the list of cognitive distortions on the bottom of her Daily Mood Log. You’ll find the list of the ten cognitive distortions if you click here. After you’ve identified each distortion, see if you can explain two things about it:

Why is this distortion in Amy’s thought unrealistic and misleading? Why might it be incredibly unfair and hurtful?

You’ll find my list of the distortions in this thought at the end of the show notes. But don’t look until you’ve made your list!

These techniques we used were effective , as you’ll hear on the podcast, especially the Externalization of Voices. You’ll hear us doing role-reversals with Amy, and the method that “won the day” was the CAT, or Counter-Attack Technique, combined with the Acceptance Paradox. The Acceptance Paradox involves finding truth in a negative thought with a sense of peace or even humor. The CAT involves confronting the hostile voice in your head and tell it to go fly a kite, or other gentle but firm message

You’ll enjoy seeing some striking changes in Amy, as her tears and feelings of intense self-doubt are suddenly transformed into joy and laughter.

Those changes created strong feelings of joy for Jill and me as well. We both have incredibly fondness and admiration for Amy, and feel great joy as well when she feels joy.

Here are Amy’s final scores at the end of the session.

Emotions % Now % Goal % After Sad, blue, depressed, down, unhappy 80 25 0 Anxious, worried, panicky, nervous, frightened 80 20 0 Guilty, remorseful, bad, ashamed 90 5 0 Worthless, inadequate, defective, incompetent 100 15 5 Lonely, unloved, unwanted, rejected, alone Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing 90 5 0 Frustrated, stuck, thwarted, defeated 80 5 5 Angry, mad, resentful, annoyed, irritated, upset, furious Other

The Joyous Dr. Amy!

Sudden and dramatic change is pretty trippy, but it isn’t much good if it doesn’t last. And it won’t! Negative thoughts and feelings will always return, because no one can be happy all the time. That’s why some relapse prevention training and ongoing practice and refinement of what you’ve learned can be vitally important.

In our follow-up session with Amy one week later she said she’d felt way better during the week, but did, in fact, have some relapses and had to challenge her negative thoughts again. She’d been helped a lot by the idea that it was okay to fail, to seek consultation, and learn, and that failing with patients gave us endless opportunities to learn and grow as therapists. And it was also okay not to have to listen so intently to the attempts of the negative self to put her down.

In fact, our misery almost never results from our failures, but from telling ourselves that we “shouldn’t” ever fail, and from punishing ourselves mercilessly when we do.

One of her most exciting statements in our follow-up session was that she discovered that even something as humble as putting the dirty clothes into the washing machine could be a joyous experience without that negative voice in her brain constantly hollering at her that she wasn’t good enough!

Teaching points

It was hard, at first, for Amy to “see” how distorted and unfair her negative thoughts were. She is an extremely intelligent, accomplished, and beloved colleague, and yet most of us cannot “see” or really “grasp” that we can be pretty mean to when we’re feeling down and anxious.

I have often said that feeling anxious and depressed is a lot like being in a deep hypnotic trance, telling yourself and believing things that just aren’t true. For example, Amy is doing beautiful work with the great majority of her patients, and is doing the exact same thing with the patients who are responding beautifully as she is with the two who are stuck. So, when she tells herself she’s a failure, she’s clearly involved in All-or-Nothing Thinking. In other words, she’s thinking that if she’s not perfect, she’s a complete failure and a fraud.

She also seems to have many Hidden Shoulds (e.g. I SHOULD be able to help every single patient quickly) and Mental Filtering (focusing only on the negatives) and Discounting the Positive (ignoring the positives, as if they didn’t count.)

The techniques that were the most helpful for Amy were Positive Reframing: that’s where we pointed out the positive aspects of Amy’s Negative Thoughts and feelings. The Externalization of Voices with Self-Defense, the Acceptance Paradox, and the CAT. Be Specific: Amy was Labeling herself as a “fraud” and a “failure,” and she was Overgeneralizing from two patients to her entire self and career. Jill emphasized Be Specific. In other words, focus on and accept what’s real. What’s real is that Amy has been valiantly struggling to help two patients who are stuck. She can just accept that, and get some consultation and guidance from a colleague, which would probably help her get unstuck.

So, instead of labelling yourself as “a failure” and “a fraud,” which are just mean, vague words, you can tell yourself that you have a specific problem—in Amy’s case, getting stuck with two very anxious patients. Then you can focus on getting some help in solving that specific problem—for example, by seeking consultation from a colleague.

Jill said that’s what she does when she gets stuck. I used to do that every week, especially when I was first learning cognitive therapy. Getting stuck, then, can simply be an opportunity for growth and learning cool new tools.

If we never got stuck, we’d never learn anything new!

The very moment Amy stopped believing her negative thoughts, her feelings instantly and dramatically changed. That change happened suddenly, over the course of about 30 seconds, and you can SEE it in her face and hear it in her voice. But it won’t last forever! Jill pointed out that the belief at the root of Amy’s problem was Perfectionism, and the idea that “I should know exactly what to do with all of my patients.” That may be a pleasant fantasy, and it might even motivate us to work hard and achieve, but it’s also a recipe for misery!

Follow-up

Rapid recovery is great, but will it stick? You will hear excerpts from our brief follow-up session one week later for Relapse Prevention Training. The idea is that none of us can feel happy forever, and negative thoughts will creep back into our minds sooner or later.

However, you can anticipate this and prepare for it by challenging your negative thoughts with the same techniques that helped you the first time you improved. That’s because the details will usually be different every time you’re upset, but the pattern of self-critical negative thoughts will usually be the same.

And this DID happen to Amy, just as it will happen to you. But this was an opportunity for her to deepen her understanding of perfectionism and to refine and enhance her ability to respond to her negative thoughts.

During the weeks following the recording of this podcast, Amy found that she experienced some resistance to using the counterattack technique. She began to feel like she was relating to her perfectionism as an enemy and attacking it—and in doing so, was discounting all the good in it, including the values that came shining through during the Positive Reframing. She found that a better fit for her, instead of the counterattack, was to disarm her perfectionistic thoughts by seeing the truth in them. In fact, you could view this as yet another form of acceptance. When she did this, the perfectionistic voice in her head naturally backed down and gave her the space to do what matters to her unencumbered by self-criticism.

I thought it was cool when she described experiencing waves of joy while doing the laundry—an activity that had always felt like a chore to her before, when it was accompanied by thoughts like “I should have finished this laundry days ago.” She discovered that without beating up on herself, something as humble as doing the laundry could be incredibly rewarding!

After our follow-up meeting, I got a lovely email from Amy about the joys of giving up the need for perfection, and sent this follow-up reply to Amy:

Thank you, Amy, you are the BEST!

I did a four-day intensive in San Antonio years ago with a small group of about 25 therapists. As you know, I always BS and say “As the Buddha so often said . . . “ followed by something goofy or quasi-mystical or whatever, and most people seem to kind of like that and see it as fun or humorous or whatever.

Well, I was doing that at the workshop, and at one of the breaks a woman approached me and said she was interested in my Buddhist remarks because she had been raised as a Buddhist in an Asian country where Buddhism is prominent. I panicked and thought I’d been found out and exposed as a fraud.

She went on to say that their family gave up Buddhism, however, and she was sad. I asked why they gave up Buddhism, and she explained that her mother suffered from severe depression, and the Buddhists taught that’s because you think you “need” things, and if you’re a good Buddhist you won’t think that way and you won’t ever suffer. Since she suffered, she felt like a failure as a Buddhist, so the family gave up Buddhism.

I told her that she might not be aware that there are actually two schools of Buddhism. There’s low-level Buddhism and high-level Buddhism. In low-level Buddhism, you’re not allowed to want or need anything, and you’re not allowed to suffer. That’s sounds like that was the school of Buddhism your family was raised in.

But there’s another type of high-level Buddhism. In high level Buddhism you’re allowed to suffer and struggle, and screw up, and fail, and all sorts of stuff.

She got animated and said, “I didn’t know that. Thank you so much. You’ve restored my faith in Buddhism, and I can’t wait to tell my mother!”

Aside from my being elderly and half-demented, I hope that makes some sense in light of our work together with Jill!

So, if you need any translation or explanation, Amy, I’m inviting you to join the high-level Buddhist therapist group where you’re allowed to screw up with some of your patients, or even many!

Warmly, david

Subsequent Follow-Up

I forgot to tell you what happened to Amy’s two “stuck patients.” Well, she got some consultation about why these patients might be stuck, which is nearly always an Agenda Setting problem—the therapist is working harder than the patient due to the need to “help,” and this plays into the patient’s ambivalence.

This struck a chord, and Amy was very excited to see her patients again, and both suddenly got “unstuck,” although in somewhat different ways. And that is why I call it the Acceptance Paradox. The moment YOU change, and accept yourself, your world will also change!

Or, to put it differently. We often see the world as “different” or as “other,” thinking we are separated. The Buddhists see the world as “one,” and that is certainly true in therapy as well.

Answers to the Quiz Question

David’s list of Distortions in Amy’s Negative Thought:

“I’m failing my patients.”

1. All-or-Nothing Thinking. This is not realistic because Amy is not stuck with all of her patients. And even though she's still far short of her hopes for these two patients, they may feel they are getting lots of TLC and support from Amy. 2. Overgeneralization. This is misleading because she’s overgeneralizing from her two failures to her “self,” and labeling herself as “a fraud and a failure.” She also overgeneralizing to the future, thinking things will never change or improve so she should get a new career. 3. Mental Filtering. She only focusing on the two patients who are stuck. 4. Discounting the Positive. She’s overlooking the fact that she’s going excellent work with a great many people, and has tremendous integrity, skill, and commitment to her patients. 5. Magnification and Minimization. She’s kind of blowing things out of proportion, although it’s always good to focus on patients who aren’t yes improving. 6. Emotional Reasoning, She FEELS like a failure so thinks she IS a failure. 7. Hidden Should Statement. She thinks she SHOULD be perfect! 8. Labeling. Same as Overgeneralization. See above. 9. Self-Blame. She’s blaming herself instead of loving herself and focusing on getting she help she needs and deserves!

Thanks for listening today!

Rhonda, Amy, and David

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Episodes

414: All About Coaching: What Is it? Is it Different from Therapy?
16 Sep· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Feeling Down? Try the Feeling Great App for Free!
The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com!
Life Coaching: A New Dimension in Counseling
Today we discuss the recent upsurge in life coaching, and feature one of the leaders in this emerging field, Angela Poch, and one of her wonderful students, Lorna Bird.

Lorna Bird

Angela Poch (see featured photo) is a Registered Professional Counsellor (RPC) with the Canadian Professional Counselling Association, certified Master Life Coach, and TEAM-CBT Level 4 Advanced Therapist and Trainer. She has been teaching health and wellness for over 30 years and was Vice President of Education with the Adventist Association of Health & Wellness Coaching. She has written several articles and books on health and wellness including, “The Truth Will Set You Free.” She has a YouTube channel (@talkingteamcbt) interviewing clinicians about their journeys with TEAM-CBT. She also has a channel on psychology and health (@bodymindhealth4u).

Lorna Bird holds a Diploma of Counseling from Australia and is a certified Life and Health Coach. She is also a Level 3 certified TEAM-CBT therapist https://www.yestohealth.com.au/

Angela and Lorna will give us the true scoop on coaching. To get started, what IS coaching, and how does it differ from psychotherapy?

I am aware that our podcast goes worldwide, so the answer may differ depending on the country or state where you live. According to AI,

“In California, the term "psychotherapist" is defined in the Civil Code to include a number of mental health professionals, including psychologists, psychiatrists, and clinical social workers. In general, anyone who provides psychotherapy or counseling in California, whether in person, by phone, or online, must be licensed.in California.”

Coaching is quite different. Again, according to AI,

“In California, there are no specific state-mandated requirements for individuals to use the term "coach" or practice life coaching, meaning anyone can technically call themselves a coach without obtaining a specific license.”

Angela Poch resides in Canada, and she has been a leading and beloved member of the TEAM-CBT community. She emphasized several differences between a “coach” and a licensed mental health professional:

Diagnosis: A coach does not diagnose clients into the familiar DSM categories of “mental disorders,” such as “Major Depressive Illness,” “Bipolar Disorder,” “Schizophrenia,” or any of the hundreds of “mental disorders” listed in the DSM. In the same vein, licensed mental health professionals will typically screen for suicidal thoughts and urges, and will treat suicidal individuals, but this is forbidden territory for coaches.

Purpose / aims of coaching: The purpose or aims of coaching do not, as a rule, involve delving into your past to search for the “cause(s)” of your problems, such as adverse childhood experiences or traumas. Instead, the focus of coaching is primarily on making changes in the here-and-now in how you think, feel, and relate to others. This might involve learning to challenge distorted negative thoughts so you will think and feel more positively about your life, as well as how to relate to others more skillfully. Coaching is goal-oriented and forward-moving rather than dwelling on the past. Of course, good counsellors and licensed mental health professionals may also provide tools to move forward as well, so there can be overlap.

Training / credentialing: Because coaching is so new, there are not yet any widely accepted standards or requirements for calling yourself a “coach.” There is a varying degree of training to be “certified,” which might just consist of watching a couple videos to 100’s of hours of supervision with the ICF (International Coaching Federation), and everything in between.

Here’s a generalized diagram Angela created to help with further clarification. NOTE: many TEAM-CBT therapists also are client/goal focused as well as and will often use coaching-style tools.

Angela described a 20-hour “Feeling Great Coach” certification program she has developed. Her program is based almost entirely on TEAM-CBT and includes a final exam you must pass to get certified.

She also offers a TEAM-CBT Masterclass & Mentoring Program for both coaches as well as therapists that includes live training twice a month, online practice groups, case consultation in small groups, one-on-one mentoring sessions, and personal work as well. She said this integrates seamlessly with FGI’s Fast Track program, any of David’s intensives, or the Tuesday group for those who want more individualized support and training.

Lorna enthusiastically described her experiences learning from many of Angela’s training programs. I (David) have had the pleasure of knowing and working with Angela for many years now, starting with her attendance at a number of my intensives and two-day TEAM-CBT training programs in Canada. Lorna is really enjoying the Masterclass Mentoring Program and recommends you take Angela’s free workshop called “Effective Compassion.” You can check it out at

www.teamcbt.ca/effectivecompassion

How do I, David, feel about coaching? I am, for the most part, enthusiastic, but with a few reservations. I would have to confess that I spent 5 years in medical school, four more years in psychiatric residency, plus two years in post-doctoral research training at top institutions, but did not learn much at all, if anything, that has really helped me treat human beings who are hurting. Of course, I did learn how to prescribe drugs for those with severe difficulties, like Bipolar I Disorder, or Paranoid Schizophrenia, but that definitely did not require years and years of intensive medically oriented training.

All I ever really wanted to do was psychotherapy. In my last year or so of post-doctoral psychiatric training, I discovered cognitive therapy, although it was not a part of the required curriculum, and learned quite a lot that has been really helpful in working with patients.

But for the most part, all of the extensive medical training I received had very little, at best, to do with how I now work with patients, and an awful lot of what I do was things I had to figure out for myself. I do have great respect for psychology training (either clinical psychology or PsyD training), because of the emphasis on research and critical thinking, but I do think there is lots of room for new approaches such as coaching to emerge and evolve, and it seems to be the case that more people than ever are still struggling with depression, anxiety, addictions, rage, and more.

Like any field, I think coaching is vulnerable to misuse by narcissistic individuals who wish to deceive or exploit the general public, and individuals who are naïve or unaware of the background or training of their therapists are perhaps at great risk of abuse. But I would also say that this problem is in no way limited to coaching, since a great many licensed mental health professionals have been charged and convicted of all manner of unethical conduct and as well as malpractice over the years as well.

That’s why I’m enthusiastic about responsible leaders who, like Angela Poch, are blazing new trails and setting the bar high for those who wish to enter the field of life coaching. I’m also delighted to see that for years now, the Feeling Good Institute (FGI, feelinggoodinsititute.com) has included coaches in their superb training programs as well, and many high profile individuals you may be familiar with, like our beloved Professor Mark Noble, have taken and benefit from TEAM-CBT certification via the FGI.

To learn more, contact Angela at [email protected] or visit https://angelapoch.com/ to learn about Angela’s many training and treatment programs.

You can reach Lorna at:[email protected] or https://www.yestohealth.com.au/

And here is the contact information for TEAM-CBT Australia: https://www.teamcbtaustralia.com.au/
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413: Intrusive Thoughts; Alone and Liking It; Shoulds, and More
9 Sep· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Ask David Disturbing Intrusive Thoughts--
where do they come from? Alone and Liking It--is that Okay? Help with those darned Shoulds, and more!
The following show notes were written before the show. The actual live discussions will vary somewhat from the answers you will find here, which simply included David's email exchanges with those who asked the questions. .
Rodolfo asks about disturbing and unwelcome intrusive thoughts. Brittany asks if it’s okay to enjoy / prefer being alone. John, from Ireland, asks, “Help! I’m shoulding on myself again! What can I do? Please do another podcast on Should Statements.” Rodolfo asks about disturbing and unwelcome intrusive thoughts.
1. Rodolfo asks about ADHD & Intrusive Thoughts

Hello Dr. Burns, my name is Rudy. First and foremost, your writings and podcasts have been life changing for me. You’re AMAZING!

I was recently diagnosed with ADHD and I started experiencing intrusive thoughts around November of last year. I thought I had OCD, but apparently intrusive thoughts are a common companion in ADHD. What would be the best course of action in defeating them? How would I apply TEAM to them?

David’s Response

In all my books, like Feeling Great, I outline a step by step approach to writing down and challenging thoughts. You can also listen to the podcast on the four models for treating anxiety.

Can we use your great comment on a podcast, and add your question to our next Ask David podcast?

Can you send me an example of the types of intrusive thoughts you’re having? Sometimes writing them down and challenging can be helpful, but need to see what we’re talking about.

Best, david

Rodolfo responds

Thank you for the swift response! Ok, so writing down my intrusive thoughts, regardless of their nature, and challenging them. I don’t, however, know which method/route to challenge them with. I have Feeling Great, so I will read through it again. I will also check out the podcasts.

My intrusive thoughts have been disgusting violent acts involving my wife and son. ***I HAVE NO INTENTIONS OR DESIRE TO COMMIT ANY OF THEM***. I’ve had images of my wife getting shot, not necessarily by me. Sometimes I’ll see my arms give out and my son will fall. I’ve seen my wife sitting down, and she gets hit in the back of the head.

When they appear, I begin to freak out immensely because they are the complete opposite of who I am and what I want to do, which is protect them. I know I’m not doing something right when it comes to your methods because I still freak out.

David Responds

Thanks! Although disturbing, this is a very common and often easily treatable OCD type of problem. Best, david

Rodolfo responds

What a relief. I thought I was going insane here! I would be honored if you all covered it in a podcast. All I listen to in my car now is the Feeling Good podcast!

David Responds

Often, intrusive OCD thoughts reflect suppressed problems / feelings people have, especially when the person is exceptionally "nice," and used to sweeping feelings under the rug, so to speak. I cannot treat you in this medium, obviously, but I'm wondering if you have some negative feelings, like anger or frustration, toward your wife and child? When these are "squashed," they can come out indirectly, disguised as anxious thoughts and feelings. This is called the Hidden Emotion Technique, which you can look up using the search on my website, if curious, or read about it in my book, When Panic Attacks.

Best, david

2. Brittany asks if it’s okay to enjoy / prefer being alone.

Hi Dr. Burns,

I was listening to your podcast on self-acceptance, and it was really interesting hearing the results. I like how you said that just because we accept something about ourselves doesn’t mean we aren’t still working on it. I think people confuse that a lot.

One thing I’ve accepted about myself is that I really do enjoy being alone. I think in the past I would try to find a buddy in uncomfortable situations like the first day of work or orientation or going to a baby shower alone etc. but now I find that I am most comfortable when I’m not included with everyone else. However, I think it can come across as off putting to some.

Sometimes I get the feeling they see me excluding myself as rejection to them. That’s not my intention and nobody’s ever actually said that but it’s a thought that pops up.

Just wondered if you think this form of acceptance is good or bad? I mean it’s been good for me. Just maybe it’s bad for others?

-Brittany

David’s response

This is a cool question and nice comment, too, about our podcast. Can we read this on a podcast and use it for an Ask David?

Personally, I am trying to say "no" more often when asked to do things with other people, and sometimes it's hard. But if I don't say no, I get way too much on my plate and can't keep up!

Warmly, david

Brittany’s reply

That makes perfect sense to me. I’ve kind of taken the position where I don’t really want to make more friends because I feel like I’m already falling short with spending enough time with my cats and everyone else. Let alone time for myself.

David’s reply

Exactly! Our culture has this myth that's it's somehow impossible or immoral to enjoy just being with oneself!

David

3. John, from Ireland, asks, “Help! I’m shoulding on myself again! What can I do? Please do another podcast on Should Statements.”

Hi David and Rhonda!

Love the podcast and the work you folks are doing! I listen to the podcasts regularly and you are both bringing such great benefits to the world!

I would love to hear another podcast on should statements. I've been going through a pretty bad and extended period of anxiety and depression in recent months and have been really trying to challenge my thoughts without much success. I'm addicted to shoulds unfortunately and beat up on myself relentlessly.

I've tried to do a cost benefit analysis and the motivation piece is a huge part of the benefits side that is keeping me stuck. I really want to give up my should statements, they are making my life a misery. But I'm finding I don't want to let go of the motivation piece.

I have given a sample below. I'd love to know if there were further steps/techniques I could use aside from the CBA to address the benefits and the perceived motivation piece so I can fully let go of the shoulds!

Thanks so much both, John from Ireland

Negative Thought: “I should have plans on a Saturday.” 99% SHLD, ER, SB, MF, DP.

Benefits
Lets me know when I’m not performing to the standard I set for myself Shows me my passion/goal in life for doing fun exciting things Motivates me to move to make plans, scolds me until I do so. Keeps me vigilant that I’m aware of my shortcomings Reminds me of the value of being socially connected, meeting and having fun with friends. It’s easy, it’s familiar, it’s such a habit. (process resistance)
Costs
Emotional Cost. Beats me up relentlessly, makes me feel depressed, anxious and lowers my self-esteem. Reinforces perfectionistic beliefs Counterproductive in terms of motivation, makes me feel so low, Huge interpersonal cost, feel isolated alone. Prevents intimate connections Not able to be present or flow in a conversation, quality of conversation/connection drops Self-fulfilling prophecy, if I’m telling myself that then I ignore other possibilities.
Benefits 40 / Costs 60

David’s reply

Feeling Great is now available in the app store, and you can try it for free. It also has a class called “Your PhD in Shoulds.”

I’ll add your question to our next podcast list for an Ask David.

Since you’ve told me you can’t yet get the app in Ireland, I’ll send you the script of that lesson.

Thanks!

David

John continues the exchange

Hi David,

Thank you so much for taking the time to correspond today and thank you so much for all the work you're doing for free. The world would be a better place with more Rhonda's and Dr. Burns' in the world. One of the things that has brought me some peace in the last few weeks is going for a long walk in the evening after work listening to your podcasts!

I have attached a DML that I've been working on to give a bit more context. I made some inroads on that original should statement, however, as you can see from the DML more shoulds keep popping up. I have identified the Self Defeating Beliefs that resonate with me at the bottom of the document. I'm working hard to find healthy acceptance, I know this is key for me. I'm not entirely sure a lot of the time what exactly I should be accepting. That I'm a flawed person with many defects, just like everyone else maybe?

To give some further context and without overburdening you with too much detail:
I feel my anxieties are one of the main parts of my problem and I would love to get over these. I feel defective that I'm not resilient enough for the challenges of life. I have fears mainly around people, fear of letting people down, fear of being judged or rejected and just feeling different to others I suppose. I've struggled with recurring anxiety and some depressive periods from when I was a young child (likely biological - my dad has the same issue). I have strong feelings of defectiveness and not being up to standard compared to my peers. I have a very busy corporate finance job where I've been working very long hours over an extended number of weeks and months. I don’t' love my job, fell into it really. Could be a hidden emotion thing going on. I started working from home more and more in recent months as my workload increased and my anxiety and mood really started to dip as work took over my life. I started to get really burned out in April. A lot of why I enjoyed the job previously was having fun with my teammates but that has become impossible in recent times due to everyone's workload. I do CrossFit which is probably an extreme form of exercise and between that and work I fell into some kind of perfectionism where I couldn't really find joy out of anything, aiming for higher and higher achievements. This brought on tons of shoulds and all or nothing thinking and self-blame, I think. My dad, who had been doing well for a good few years fell into a deep depression and anxious state around April time too and has been in hospital for a number of weeks and our family is trying to support him through this. We're finding the standard of mental health care in Ireland really really poor unfortunately. I find his issues quite triggering for me a lot of the time and I'll believe I'm defective because he is defective and there is nothing I can do about it. Dad is entirely dependent on medication to get him out of his slump and has a bad case of do-nothingism. He is beating himself up relentlessly too and I gave him a copy of Feeling Good to read but he hasn't looked at it at all. I have just turned 40 and I’m still single, so I feel like I'm letting my family down for not being emotionally able for a relationship or kids or be a better brother/son. I know I'm probably being harsh here as they say the opposite, but I feel I could/should be doing more.
I have probably fired way too much detail at you, so I'll stop there!

Thanks so much again!

John

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412: Ask David: Give-Get Imbalance; Best Anxiety Treatment; Externalization of Voices; and more
2 Sep· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Feeling Down? Try the Feeling Great App for Free!
The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com!
What's a Give-Get Imbalance? What's the Best Treatment for Anxiety and Dysthymia? Can you do Externalization of Voices on Your Own?
The show notes for today’s podcast were largely written prior to the show. Tune in to the podcast to hear the discussion of these questions by Rhonda, Matt, and David.

And keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks!
Suzanna asks: What’s a “Give-Get” imbalance? And how can you get over it? Martin asks: What’s the best treatment for anxiety and dysthymia? Eoghan (pronounced Owen) asks: Can you do Externalization of Voices on your own?
1. Suzanna asks: What’s a “Give-Get” imbalance? And how can you get over it?

Description of Suzanna’s problem.

Suzanna is a woman with a grown daughter with severe brain damage due to a severe brain infection (viral encephalitis) when she was an infant. Suzanna was constantly giving of herself and catering to her daughter. She explains that her daughter can be very demanding and throws tantrums to get her way, and kind of controls the entire home in this way.

She can only talk a little and has the vocabulary of about a two-and-a-half-year-old. She can mostly express the things she wants or doesn`t want on a very basic level. She mostly understands what I want from her, but mostly does not want to do what I ask her to do. She can be very stubborn. And I cannot reason with her because she has her own logic and, in her eyes, only her logic is valid. Maybe all a little bit like a two-and-a-half-year-old.

Suzanna struggles with negative feelings including guilt, anxiety and depression, because she is constantly giving, giving, giving and feeling exhausted and resentful. And she tells herself, “I should be a better mum.” Can you spot any distortions in this thought?

Put your ideas in the text box, or jot them down on a piece of paper, and then I’ll share my thinking with you!

What are the distortions in the thought, “I should be a better mum”?

There are many distortions in this thought, including All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Magnification and Minimization, Emotional Reasoning, Self-Directed Should Statements, and Self-Blame. There may be one or two more, too!

The first step in change nearly always includes dealing with motivation and resistance. Suzanna decided to do a Cost-Benefit Analysis, as you can see below, and a revision of her Self-Defeating Belief, as you can see below.

Another helpful step might include “No Practice,” which simply means saying “no” so you don’t constantly get trapped by “giving,” as well as “giving in.”

A third critically important strategy involves the mom and dad making the decision to work together as a loving team in the management of a troubled child, rather than fighting and arguing with each other, as we've discussed on previous podcasts. However, in many, or possibly most cases, the parents are not willing to do this. They are more concerned about being "right" and so they continue to do battle with each other, as well as the child who needs a more loving structure.

David
Cost-Benefit Analysis Self-Defeating Belief: I should be a better mum to my daughter
Advantages of this belief
(How does believing this help me?)

Disadvantages of this belief
(How does believing this hurt me?)

This thought motivates me to:
Put myself out. Push myself to give what I have. Find ways to advance her development. Find ways to involve her in everyday life. Invest myself into her and her life as much as I can, physically, emotionally and time wise. Try to find ways that my daughter can have a fulfilling life. Try hard to connect to her, her pain, her needs, her sadness and her frustration. Try to make her life as easy as possible. Try my hardest to see her world through her eyes and gain deeper understanding of how she feels. Try to understand what is upsetting her when she throws a tantrum. Stay healthy and fit to have energy for her. Try to make her life rewarding and meaningful. Fulfill my duty as a mum to my daughter who needs my support. I can feel good about myself. I satisfy other people’s expectations of me. Protects me from criticisms from my husband I am a prisoner to my daughter. No matter how hard I try I don`t seem to make a meaningful difference to her life and to her development. I am a “Siamese Twin” to her. I cannot move or do anything if she doesn`t want to. I reason with my emotions instead of thinking rational at times. I let my daughter get away with “murder”. I find excuses for her behaviour. I find excuses for her why she cannot behave differently. I beat up on myself when I feel I failed her. I take all responsibilities away from My daughter and make them my own. I blame myself when I cannot motivate her to do something. I blame myself when she is bored and unhappy. I feel guilty doing my own things. I feel guilty when I do not involve her in my activities. I feel guilty when I expect her to do entertain herself for a while. I cannot live my own life. I cannot be myself at times. She rules my life, and she lives my life. I feel trapped and frustrated. I feel I need to constantly entertain her. I feel responsible for her happiness. I feel responsible when My daughter is sad and frustrated. I feel exhausted and overwhelmed at times. I feel unhappy and unfulfilled. Advantages: 20 Disadvantages: 80
Semantic Method: Re write your personal value

I want to be a mum to My daughter and help her along and invest myself into her. But I also want to treat myself the way I treat her. She has a “right” to live a happy and fulfilling life, but so do I. Our needs and desires are equally important and deserve the same attention and care. I can only continue to look after My daughter well if I look after myself too and take myself and my needs and desires as seriously as I do hers. There needs to be a give-get balance so that both of us can be healthy and happy and stay healthy and happy. I want to help her to slowly take new steps into independence and support her lovingly along the way.
2. What’s the best treatment for anxiety and dysthymia?
Hello Dr. Burns,

What method of treatment would you suggest for GAD and dysthymia? 3rd wave CBT, ACT? What is best based on science?

Can you recommend some books please?

thank you

Martin

David’s Reply

My books are listed on my website, FeelingGood.com. They all describe my approach, which is a bit like CBT on steroids. But every patient is treated individually and uniquely, following a structured and systematic approach that facilitates rapid and dramatic change.

I don’t recommend “methods of treatment” or “schools of therapy” based on so-called “diagnoses,” but treat the individual with TEAM. Every session with every patient is an experiment, with precise measures at the start and end of every session.

The new Feeling Great App, now available, gets a mean of 50% or more reductions in seven negative feelings, such as depression, anxiety, and more, in 72 minutes of starting to use the bot. You can check it out for free! Anxiety and depression often co-exist, and the app targets both.

My book, When Panic Attacks, describes my approach to anxiety, based on four models of treatment: the Motivational, Cognitive, Exposure, and Hidden Emotion Models. If you use the search function, you can find podcasts describing those models. Also, there's a free anxiety class on this website.

Thanks, Martín, for your excellent question!

Best, david
3. Can you do Externalization of Voices on your own?
Hi David,

Long time listener of your great podcast and huge fan of your book Feeling Great.

I’ve often heard you mention that “externalization of voices” is one of, if not the most powerful CBT techniques. I am just wondering if it is still almost as effective when done solo without a therapist i.e. the person takes on both the roles of positive and negative by recording themselves talking or similar?

Also, have you any data comparing the efficacy of TEAM CBT work carried out solo using Feeling Great/your podcast as a guide vs. TEAM CBT performed with a trained TEAM therapist?

I am very much looking forward to the Feeling Great app launch in the UK as hopefully that will be a much more effective way to do personal work without a therapist.

Many thanks,

Eoghan (pronounced Owen)

David’s reply

Thank you, Eoghan! Appreciate your support and thoughtful question.

I don’t have any data on the use of EOV on your own. One could use a recording device, like your cell phone, and record your negative thoughts in second person, “you,” and try to defeat them when you play them back, one at a time.

But in my experience, people nearly always need an experienced role player to do role reversals to show them how to get to a “huge” win. People almost never get a huge win when doing it for the first time, because the therapist (in the role of positive self) can model unfamiliar strategies for the patient.

Generally, a hugely successful response involves a combination of self-defense, self-acceptance, and the CAT, or counter-attack technique. And sometimes other methods as well, like Be Specific, for example

Radical new learning is definitely the key to success with EOV.

Now, thanks to the app, everyone can practice, since we’ve trained our Obie Bot to role-play with users, do role reversals, give feedback, and so forth.

Great question that I will include in the next Ask David if that’s okay!

We are also exploring the combination of the Feeling Great App plus a trained TEAM therapist from the Feeling Good Institute in Mountain View, California.

We are hoping that 1 + 1 may equal 3. Wouldn’t that be awesome?

What I’ve found when doing research is that the results are virtually always wildly unexpected! Somethings come out great, and some things come out dismally. I always tell myself that “the Lord giveth, and the Lord taketh away!”

Seems to be the rule in research! Especially when you’re wanting to be guided by the truth, and not so much by your hopes and expectations.

Best, David
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411: Ask David: What’s Self-Esteem? What’s Self-Acceptance? Do We "Need" Them?
26 Aug· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Ask David: What’s Self-Esteem? What’s Self-Acceptance?
In today’s podcast we address six common questions about self-esteem, including:
What is Self-Esteem? How does it differ from self-confidence? How does it differ from self-acceptance? What’s the difference between conditional and unconditional self-esteem? What’s the best way to develop self-esteem? What do you mean when you say that once you develop unconditional self-esteem, you should get rid of it as fast as possible?
Please keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks!

Brandon Vance and Heather Clague begin today’s show with a pitch for their upcoming Feeling Great App Group, an 8 week experience that will begin in September. If you use the Feeling Great App, or plan to get it, this group would be an inexpensive and incredible enhancement, so you can meet with like-minded people once a week to schmooze, practice the techniques in the app, and get your questions answered by compassionate and personable experts.

For more information go to www.FeelingGreatTherapyCenter.com/appgroup.
Feeling Great App Group Sept-Nov 2024
Led by Brandon Vance MD and Heather Clague MD, meets online for 80 minutes for 8 weeks, offered Mondays 4-5:20pm Pacific Time, September 23rd - November 11th. Cost is $12 per session ($96 total) plus the cost of the app ($99 per year after 7 day free trial). Sliding scale for both the group and the app are available. No one turned away for lack of funds.
Feeling Down? Try the Feeling Great App for Free!
It's now in the IOS and Android app stores, and you can check it out for free. It's works super fast. Let us know what you think! Thanks!

Rhonda, Matt, and David appreciate your support. Keep your questions and testimonials coming. They mean a lot to us!
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410: What's the Meaning of Life?
19 Aug· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Feeling Down? Try the Feeling Great App for Free!
The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com!
What's the Meaning of Life?
Before we start today, I have a special shoutout to Max Kosma, our new colleague, friend and brilliant technical guru who helped make our new video studio possible! Next week, we’ll see if we can pipe him in to say hello to all of you. His spirit is joyous, infectious, incredibly generous and supportive.

Thanks, Max!

Rhonda opened today’s podcast with a vibrant and inspiring endorsement from Jeff, a podcast fan who was raving about the Feeling Great App. Thank you Jeff, and please check out our new app at FeelingGreat.com.

Important Announcement

Rhonda, along with a group of dedicated TEAM Therapists, including Amy Berner, Brandon Vance, Leigh Harrington, Mariusz Wirga, and Mark Noble, has just created a new non-profit organization called TEAMCBT International (TCI). TCI will provide seed money in the form of no-or-low-interest loans for groups around the world who want to offer TEAM-CBT intensives for therapists in your country. Rhonda has been instrumental in the organization of successful intensive workshops in India, Poland, Mexico, England and Ireland. They have been well received, but can be somewhat costly to produce, so Rhonda’s new group is ready to provide a helping hand.

I’ve had the honor of presenting keynote addresses, live therapy demos, and Q and A sessions in many of those programs, and have totally enjoyed them. A big hug and THANKS to Rhonda once again! To learn more, just go to TEAMCBT.International.

Today, Matt joins us for a discussion of the meaning of life, something young people often worry about, but people of any age can be concerned. So, today, you may finally find the answer to that lofty question!

But first, I (David) mentioned a little about one of last week’s questions, “Is the universe real?” I provided the type of answer the famed philosopher, Ludwig Wittgenstein, might have provided. Namely, that the question is nonsensical, it is language “out of gear.” So, we can dismiss the question, as opposed to trying to answer it.

HOWEVER, the question DOES make a ton of sense when we ask if human beings are “real.” And I am not referring to some metaphysical nonsense, but rather the tendency of many people to present a happy or confident false front, all the while feeling empty, lonely, anxious and ashamed inside.

Two of the now more-than-140 TEAM techniques include Self-Disclosure and the Survey Technique, where you take the chance of opening up about some of the secrets you’ve been hiding, and ask others what they think about you. Although this takes tremendous courage, it often results in tremendous warmth and connection to others.

I provide a description of a young man who disclosed a tremendous amount he’d been hiding in our recent Tuesday group at Stanford, and he was convinced the group would judge him and look down on him. But just the opposite happened. He encountered a flood of warmth, admiration, and respect from the people in our group.

A small miracle, perhaps, but a real and meaningful miracle at the moment when his universe suddenly became “real” and radically different from the dangerous and critical world he’d feared and imagined.

Then we tackled today’s philosophical question: “What’s the Meaning of Life?” As usual, our brilliant and beloved Matt May began with a description of an extraordinarily depressed patient he once treated who’d been hospitalized for 180 days with no improvement, including a very dangerous suicide attempt.

Matt was worried for the patient’s safety, so told the referring doctor that he’d been willing to talk with the patient while the patient was still in the safe environment of the hospital. The patient called Matt and, after some listening and empathy Matt said he would like to help and that there would be committed to helping the man and thought he could help him make a complete recovery, work with this man, and thought there was an excellent chance for significant progress, perhaps even complete recovery, but the patient probably wouldn’t want to work with him.as long as he’d be willing to give Matt what he needed in order to work together effectively. Matt suggested the patient give him a call.

On the call, Matt told him he might not be able to afford treatment, since part of the “cost” of therapy was that the patient had to make a commitment to life, and that he must agree never to attempt suicide no matter what, for the rest of his life.

After a couple days of reflection, the man convinced Matt that he WOULD make that commitment.

Then Matt described the man’s problem. Both of his parents were world famous, successful scientists, and during his upbringing, his parents emphasized how fantastic and rewarding a career as a scientist could be, and he was convinced that his parents expected him to follow in their footsteps. He had "learned that doing science was the "meaning of life" and would inevitably result in his feeling satisfied, joyful and proud.

So. sure enough, this young man, who was extremely bright, pursued a scientific career, and eventually one of his papers was accepted for publication in one the world’s most prestigious research journals.

There was a big party at his laboratory, and everyone congratulated him and sang his praises.

But there was one big problem. He felt nothing!

Of course, he smiled and didn’t let on that he felt nothing. He tried to act happy, but simply WASN’T. He said, “I faked it.”

He concluded that he must be defective, since he’d done what he was supposed to do, in order to feel joyful and happy, but he felt nothing, even though he had fulfilled his parents dreams and expectations for him. This plunged him into his severe depression, with the familiar theme of “I’m not good enough. In fact, I am deeply flawed and defective, incapable of feeling joy or happiness. There must be something terribly wrong with me!”

Sound familiar? Did you ever feel like YOU weren’t good enough?

During an early session, Matt asked his patient what he really enjoyed, what he’d really LIKE to do with his life.

The patient confessed, after much resistance, that he felt that his fantasies were totally ridiculous, but what he really loved were trains, photography, and painting. He said his dream job would be to be a conductor or engineer on a train where he could take pictures of the scenery and especially, the people on the train.

BUT, he said, that would be meaningless, since he wouldn’t be contributing to science and would be letting everyone down., etc. etc. etc.

I bet you can guess what followed! If you were his shrink, what would you say or do?

Put your ideas here, into the text box, and then I’ll tell you!

If you took a guess, thanks! If you didn’t, no problem.

Matt suggested he do those very things—take a train somewhere, start snapping photos, and do some painting. Predict how satisfying each thing will be (0 to 100) BEFORE you do it.

Then do it, and record how satisfying each activity actually was on the same scale of 0 to 100.

He exclaimed, “I’d LOVE to do that,” and started crying. His depression score immediately fell to zero.

The next week he brought a large cardboard box to his session. It was filled with books on ancient philosophy and how to find the “meaning of life.” He said, “I don’t need these anymore, so they’re a gift to you!”

Matt said, “I don’t need them either!”

Now you know about the “meaning of life.”

We discussed some of the many meanings in this story, including:
Rhonda pointed out what Kurt Vonnegut said on the meaning of life. He said, “We’re all here to fart around!” David discussed the basic idea that it’s not what we’re doing, but our thoughts, that trigger ALL of our feelings. And at the moment you learn to turn off that critical voice in your brain, you will experience your own “enlightenment. David has also said, over and over, that when you discover that you no longer need to be “special,” you can experience the “Great Death” of the “self,” but it’s not like a funeral. It’s more like a celebration, because when you lose your “self,” and discover you didn’t “need” the things you wrongly thought you needed (like love, achievement, perfection, etc.), at that moment you’ll experience enlightenment and you’ll inherit the world, and life, and deeper connections with the people you love. There’s not one “meaning” to life. There are many meanings every day. And today, for Matt, Rhonda and David, it is VERY meaningful and joyful just to hang out with each other, and with you, so we can shoot the breeze together! Or, as Kurt Vonnegut said, so we can "fart around" together.
Please keep your wonderful questions and comments flowing, and be sure to catch us in our new video version on my feeling good YouTube channel.

Warmly,

Rhonda, Matt, and David
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409: Is the Universe One? Is the Universe Real?
12 Aug· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Feeling Down? Try the Feeling Great App for Free!
The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com!
Is the Universe One? Is the Universe Real? Is the Universe Real?
These two philosophical problems used to seem nonsensical to me, and certainly not relevant to much of anything in my life—or anyone’s! But now the picture has changed a bit!

When I was a student at Amherst College, I majored in the philosophy of science. On this show, I’ve often talked about my hero, Ludwig Wittgenstein, who attempted (successfully in my opinion) to “solve” all the problems of philosophy. He wanted to help those of us who were “afflicted” by an attraction to philosophical problems to see through them and understand precisely how and why they were nonsensical. He hoped to provide a “treatment” for philosophers so we could give up the need to obsess about nonsensical philosophical problems.

Once you see through the these problems, they become kind of like a joke, and you can use jokes to help other people see through them. For example, here’s a kind of lame joke about the question of whether or not the universe is “real.” Wittgenstein said that before we try to answer questions like that, we might want to ask ourselves if these questions even makes sense! And if it a philosophical problem doesn't make sense, it isn’t a real question, so we won’t need to deal with it. In other words, questions that don’t make sense don’t need to be answered because they’re not real questions.

Take the question, "Is the universe real?"

You could ask, “Well, what would it be like if the universe weren't real? What would that look like? How would things be different?” If you can't answer that question, the question might not make sense.

To most of us, philosophical questions wound nonsensical because we are taking words, like “real,” out of the contexts in which it DOES make sense. For example, we can ask : “Is this painting real? Or is it a fake?” That question does make sense. It has an obvious meaning, since many valuable paintings are copied and are fakes, and they try to pass them off as the “real” thing.

But what would a "real" or "fake" universe look like? How would it differ from our universe?

Now let’s think about another example that is mildly humorous. Let’s imagine you’re driving through Iowa in the summer, and you spot a farmer working in his corn field. You’re interested in speaking to him because you are writing a story about your travels in Iowa, and want to talk about the lives of farmers.

So, you pull your car over to the side of the road and shout, “Howdy! What are you doing in the field?”

The farmer seems pleased and grabs a gorgeous stalk of corn and holds it up and proudly shouts, “I’m growing corn, and it is real!”

Well, that’s great that he's happily growing corn, but what does the tag-on, “and it is real” mean? It doesn’t actually mean anything, because farmers don’t grow “unreal corn.” So, in this context, the word has no meaning.

Now, if you were on a movie set, they might actually be using artificial corn as a prop, so now the contrast between real and unreal corn becomes meaningful.

This is a very humble point, but it’s the very heart of what Wittgenstein was trying to make us aware of. Philosophical problems kind of sound meaningful and puzzling, but most of the time, they are simply a kind of nonsensical use of language.

Now, in personal relationships, we might also have a notion of when people are being “real” or fake. And we often act fake because we don’t think we’re good enough just the way we really are. So, for example, you may hide your shyness in social situations because you’re ashamed, and telling yourself that your shyness is incredibly weird and abnormal, and makes you “less than” other people.

One method of helping people overcome shyness is simply to disclose it to others. This TEAM-CBT technique is called "Self-Disclosure." Instead of hiding your shyness and feeling awkward and ashamed in social situations, you share your feelings openly. Shame depends on hiding, so when you open up, the feelings of shame will often disappear.

For example, in a recent podcast of a dramatic, live therapy session, a man named Chris revealed many troubling things about his teenage years that he’d been hiding for years. When he opened up, he began sobbing intensely, thinking he’d let his father down with his wild behavior when he was a high school student.

His grief, he was incredibly compelling, and his courageous self-disclosure was appealing to most of us who were privileged to witness that session. Showing us his “real” self became his path to enlightenment, joy, and deeply meaningful relationships with himself and with all of us who witnessed that amazing session.

So, although the question, “is the universe real” is silly and nonsensical, the question, “are we being real with each other,” is definitely NOT silly or nonsensical. Being real and vulnerable is an important key to connecting with ourselves as well as other human beings.
Is the Universe One?
How about “Is the universe one?” This philosophical question also seemed nonsensical to me for years, although I was intellectually aware that some Buddhists make claims that the universe IS one and that the failure to “see” this is the basic of all evil. That's because if you see other humans, for example, as being "external" to yourself, you may feel you have the right to abuse and exploit them.

However, for years I thought the idea that the universe is "one" seemed like sheer nonsense. For example, I am sitting in a chair typing, and there is a cup on the desk. People have never call that cup “David,” and no one has ever called me a coffee cup (although lots of people have sad some pretty bad things about me!) So, I concluded that the cup and I are not “one,” and so the whole thing about the universe being one seemed nonsensical and silly.

But when I began to think about it in the context of my work with patients, my thinking suddenly changed. For example, the TEAM interpersonal model I’ve developed was based on research I did early in my career that suggested that Blame was one of the main causes of troubled relationships, and perhaps the most important and powerful cause.

And this is certainly true in my personal life and in my work with individuals with troubled relationships who are unhappy in their marriages or people who are angry with their neighbors, or family members, or anyone. We almost always see ourselves as victims, and the other person as the one who is to blame for the problem. This triggers feelings of frustration, anger, and moral superiority, and can easily and often lead to arguments, mistrust, divorce, hostility, and violence, murder, and even war.

Now, I’m beginning to see that the idea that we are separate from others, who are doing something TO us, does, in fact, lead to hostility, and arguably to evil. And once you “get it,” the same insight applies to our relationships, not just with loved ones, friends, and other people in general, but also our relationships with animals, with the environment, and with the planet earth. If we think of them as “other,” then we may conclude that it is okay to exploit or use them for our own advantage.

In the interpersonal TEAM model, we focus more on circular causality, or interpersonal connectedness and ask the question, how do we actually shape and cause the very behavior in the other person that we complain about so vigorously? I have developed a fast, powerful tool that allows any to pinpoint their own role in a relationship problem very quickly and with reasonable accuracy. It’s called the Relationship Journal (RJ), and we’ve talked about it often on this show.

Essentially, it’s simple to use the RJ, but it can be startling and illuminating but incredibly painful. All you have to do is write down ONE thing another person said to you that you found upsetting, and EXACTLY what you said next. Choose an interaction that did not go well; otherwise, it’s a waste of time.

Then, the RJ will take you through a step by step analysis of your response, and it's implications.

When you discover how you are actually forcing the other person to treat you shabbily, it can hurt. This is one of the four ‘Great Deaths” of the self, and it’s the most painful of all, in my experience. This is the "Great Death" of the angry, blaming "self."

I hate this great death! But if you have the courage to use it and take a look, it can be incredibly illuminating and liberating, and can put you on the path to far more loving relationships.

As an exercise, I will list a number of common complaints that people have about loved ones, friends, or family that they find irritating. Your job will be to show how you could FORCE them to do the exact thing you are complaining about. The other person could be your partner, friend, son or daughter, etc. Your complaint about that person might be that they
Refuse to talk to me. Can’t (or won’t) open up and express their feelings Constantly whine and complain, and ignore and resist my good advice. Constantly argue, and always have to be right. Won’t listen. Are relentlessly critical. Always have to get their way. Doesn’t treat me with respect.
In each case, see if you can figure out how you could FORCE the other person to do that exact thing. We will discuss a couple of these on the show and lustrate solutions to give you a feel for how this works.

Rhonda’s and Matt shared their wise and interesting thoughts on both of these philosophical questions, and how you can understand them in the context of your own lives, and, if you're a shrink, how you can use them in your work with patients.

Thanks for listening today!

Matt, Rhonda, and David
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408: Do You Believe in God? Does God Exist? The Spiritual Dimension in TEAM-CBT
5 Aug· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Special Announcement #1 The Legendary Summer Intensive Starts on Thursday of this week! Featuring Drs. David Burns and Jill Levitt August 8 - 11, 2024 Click for registration / more information!
This workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Special Announcement #2
Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it
Today's Podcast #408-- Does God exist?
We started today’s podcast with a beautiful testimonial and a shout out for the intensive from August 8 to 11, 2024 at the South San Francisco Intensive in person or virtually if you prefer. To learn more, contact www.CBTintensive.com. Act fast because the intensive is on Thursday of this week when today’s podcast will be published.

Today, we tackle another popular and intensely debated philosophical / religious puzzle: Does God exist? People have very heated views, one way or the other. I (David) will start with a brief explanation of a Wittgenstein answer to this question, and then for the most part, we will focus instead on the question of how we all incorporate spirituality into TEAM-CBT.

Wittgenstein emphasized that philosophical problem exist when we debate about the meanings of words or terms that are vague, or poorly defined. Traditionally, we think there are three positions one could take:
Theism: You believe that God exists. Atheism: You do not believe in God. Agnosticism: You say that you do no know whether or not God exists.
My own thinking, which is strongly influenced by Wittgenstein, would be that I don’t understand any of those three stances because I have no idea what you mean by your use of the word, “God.” What is it, exactly, that I’m supposed to believe in, or not believe in?

To me, the question, “Do you believe in God,” is nonsensical, so I simply do not deal with it. All of the three positions listed above are based on the idea that the word, “God,” has some kind of clear meaning that we can all agree upon. But it clearly does not.

You might define “God” as the “creator of the universe.” Well, there is certainly something magical and mysterious about the existence and creation of the universe (assuming it did begin with some kind of “big bang.”) Some questions might include “Where did all the energy come from all of a sudden?” Or “Are there many universes?”

These are valid questions, and physicists are pursuing the answers, which is very exciting and fantastic. But they are generally not invoking the concept of a “God,” although some undoubtedly would say that they do “believe in Gad.”

Regardless, I cheer them on and find every new discovery about the nature of the universe, and how the universe works, endlessly fascinating!

For today, we will ask a much simpler question of whether and how we include some kind of spiritual dimension into our work as shrinks. This is a topic that is equally exciting, and definitely meaningful.

Rhonda got us started by explain that she sees the belief in God as a matter of faith, and is not something that can be tested empirically, which is certainly true. She says she does believe in God, or some “higher power,” but does not believe in a God who “rules over things.”

She was raised in the Jewish religion, and says that many Jews believe that God exists in everyone . This sounds a little like Hinduism, which traces back at least 2500 years ago, and possibly as early as 5000 years ago. I believe that the Hindus believe that God exists in everything.

The practical impact of the belief that God exists in all of us, is that we will treat each other with love and respect, since we are all an expression of God. She also said that we can “create God among us as a community.”

Matt said that he was raised as a Christian and that when he was growing up he had heard about miracles, like Jesus raising Lazarus from the dead in the New Testament on the Gospel according to John. He said that he views our work with individuals who are severely depressed as a kind of spiritual healing, even though we are working with purely secular methods. This is especially true when we are working with individuals who appear to be paralyzed by depression, claiming they are unable even to get out of bed, people who bombard themselves with harsh criticisms, and feel hopeless and ashamed.

Matt said that self-acceptance (accepting ourselves exactly as we are) is one of the many tools we use, and that he (Matt) loves to think about the ripple effects of our work, which not only transforms the lives of individuals who awaken from their depressive trance, but this also has enormous positive effects on their friends and family as well.

He asks, “How do we achieve this?”

I (David) loved hearing from Rhonda and Matt on spirituality in TEAM, and pointed out many areas of overlap between TEAM and the Christian theology I was raised on, since my dad was a Lutheran minister. For example,
The TEAM concept that you do not, and cannot, earn genuine feelings of worthwhileness or self-esteem through achievement. In other words, your worth is not your work, but something you give yourself unconditionally. In Christianity, we are sometimes taught that you cannot get to “heaven” through your good works. Enlightenment is a gift, a decision, and not something you have to earn. We also teach that humans are not purely good, but have a mixture of positive and negative motives, and that many people suffer because of guilt and regret about past errors or sins. When we are teaching the Acceptance Paradox, we are teaching a “letting go” of the inner abuse we endure from that relentless, critical voice in our brains, labeling us and telling us that we aren’t good enough, we’re “bad,” we’re “losers,” and so forth, using powerful tools like the Externalization of Voices.
In Christianity, this message is delivered in my ritualized ways, including the act of communion, confessing your sins and accepting the blood and body of Christ who “died for your sins.” This is just another way of sending the message that it is okay to accept the fact that you are flawed and fallen, and yet still worthy of God’s love—and your own love!
In the interpersonal TEAM model for troubled relationships, the entire emphasis on pinpointing your own role in a problem with a friend, colleague, loved one, or stranger, instead of casting blame on the other person and feeling angry and morally superior. My Relationship Journal is a tool designed to facilitate this process very rapidly.
In Christianity there are many messages about taking out the moat in your own eye, as well as the idea that when you blame others, and cast judgment, you condemn yourself.
There is a strong emphasis on humility and accountability in TEAM-CBT. This often comes up during positive reframing; we talk about how the patient’s self-criticisms are often an expression of high standards, honesty, and humility, and that these are beautiful qualities that are real, important, and powerful.
And this similar, it seems to me, to the Sermon on the Mount, where Jesus talked about “blessed are the meek, for they shall be called the Children of God.”

There are many, many additional areas of overlap, and many books have been written on this subject. During the podcast I provided examples of how the spiritual and psychological realms can meet and reinforce each other at the moment the patient recovers and discovers their own enlightenment. I am proud to have developed TEAM-CBT, and it is clearly infused with many spiritual dimensions, even though it is entirely secular.

I mentioned that I was born on a Sunday morning, and my dad said it was the only time he was unable to preach his sermon. He was too excited, especially since my parents had become reconciled to the notion that they could not have children. He called me David Dean Burns, and hoped that someday I would become D.D. Burns, D.D. DD is an honorary degree in theology, and he (and everyone) assumed that I would one day be a minister, like was. He was L.C. Burns, DD. (Lyle Charles Burns)

I went in a different direction, but have kind of returned to my original calling, though threw an unexpected route, and hope you have all enjoyed our “sermons” this morning.

I would add that I would never impose my beliefs or spiritual orientation on any patient, and only ask about the integration of their successful recovery with their own religious beliefs AFTER they have recovered, so as to add a deeper level of meaning to the work and transformation that they experienced. We only emphasized the Jewish and Christian approaches to spirituality because that was our upbringing, but the spiritual “discoveries” during TEAM treatment are actually compatible with nearly all, if not all, religions and spiritual paths.

Warmly,

Rhonda, Matt, and David
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407: Do You Have a "Self?"
29 Jul· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information!
Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Special Announcement #2
Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it
Today's Podcast Practical Philosophy Month Part 2, Do Humans have “Selves”?
This is our second podcast in our Practical Philosophy Month. Last week, in our first episode, we focused on the “free will” question. As humans, we all feel like we have “free will,” but is it just an illusion, especially if all our actions are the result of the physical processes in our brains and the laws of the universe?

The Bible certainly dealt with this in the book of Genesis, where we learn that the first humans, Adam and Eve, were given a wonderful Garden of Eden to live in, but they had to choose whether or not to obey God’s rule NOT to eat the forbidden fruit from the tree of knowledge of good and evil. They chose to eat the fruit, implying that humans have free choice. But the philosophical arguments rage on.

In today’s podcast, we are joined by two beloved and brilliant colleagues, Drs. Matthew May and Fabrice Nye, as we explore the question of whether or not the “self” exists. We all feel like we have a “self,” but is this real or just an illusion? When you try to define your “self,” you may run into problems.

For example, you might think that the “self” has to be the part of us that does not change from moment to moment, and is always ‘the same.” For example, I might think back on my childhood and feel convinced that I was the “same David Burns” then that I am now. And, if you are religious, you might also be comforted by the idea that your “self” is the same as your “soul,” and that you will therefore live on after you die. This concept of a “soul” is a core belief in many religions.

But are we fooling ourselves? And what was the Buddha thinking about 2,500 years ago when we talked about enlightenment as resulting from the “Great Death” of the “self.” He seemed to be hinting that something wonderful can happen when you give up the idea that you have a “self.”

In the original draft of my book, Feeling Great, I had a chapter on entitled, “Do you need a “self?” Join the Grateful Dead.” I tried to persuade readers that the existence of a “self” is nonsense, based on the philosophy of Ludwig Wittgenstein in his famous book, Philosophical Investigations. But readers found the chapter so upsetting that I decided, on their urging, to delete it from the manuscript, which I did. My goal is not to disturb people, but to provide a path to joy and to loving connections with others.

But to this day, I still get emails from people asking me to offer that chapter, or to deal more deeply with this concept of the “self” vs “no self” in a podcast. So, here is my attempt today.

I will start with my own take, and then summarize some of the views about the self that were expressed by Fabrice, Matt, and Rhonda during the show.

Here’s my thinking. There are many key questions you could ask about the concept of the “self?” including:
Do we have a “self?” And if so, what is it? Does the first question even make sense?
I’m sure you would agree that if a question doesn’t make sense, then it isn’t a “real” question, and there really isn’t anything to talk about. Then we can just stop feeling frustrated and perplexed, and move on with our lives.

That is the precise position that the late Wittgenstein would probably have taken. He stated that words have no ultimate or “true” meaning outside of the various contexts in which we use them in daily life. Most words have many meanings, because they are used in different ways, and you can find most of the meanings in any dictionary.

So, if you think of the word, “game,” you will quickly realize that it does not have one “true” or essential meaning. It can mean a sports competition, with two teams competing against each, like soccer. But you can have two teams competing in some way other than a sport.

And you don’t even need two teams to have a “game.” For example, some games are played by one individual, like solitaire with a deck of cards.

Or you can think about the “dating game,” or refer to “game birds,” or a “game boxer.” In short, there is not some single “correct” meaning to the word, “game.” Some uses have overlapping meanings, and some uses do not overlap at all with other uses.

So, there is no point in trying to figure out if “games exist,” or what the ultimate or essential meaning is of the word, “game.”

Now, how do we use the word, “self,” and what does it mean in each context?

You might tell your child to behave themself. This simply means that they are misbehaving and will be punished if they don’t behave more politely. You do not have to tell the child that their “self” also has to behave better, because that would be meaningless. We already told the child to change their behavior.

You could ask friends, as I did this morning, if they are planning to join me on the Sunday hike. Two of them confirmed and said that “they” would join me today on our hike. I did have to ask them if they would be bringing their “selves,” because I just do not know what that would mean! They already told me they’re coming to the hike. (They did come and we had a lot of fun.)

In my extremely challenging freshman English class at Amherst College, we had to write two or three papers per week on odd topics. The teachers were relentlessly critical in their feedback, and would nearly always point out that we sounded incredibly phony and need to find our true voices, which came from our real selves, as opposed to the false fronts we often used to try to impress people. Almost every student got dumped on constantly!

The professors weren’t referring to some metaphysical “true selves.” They were just referring to the fact that our writing didn’t sound natural, compelling, or vulnerable, and so forth. Our writing was, for the most part, an enormous turn-off. Most of us never could figure out quite what that class was all about, but it was useful as I became more sensitive to the “tone” or “voice” in any writing.

I would have to concede that it was a sobering but helpful class. But they were not referring to some mystical “true self” we had to find. They just wanted us to stop writing in such a sucky way!

So here is my point, which you might “not get.” When you keep the word, “self,” in the context of everyday life, it is obvious what it means, and it never refers to some metaphysical “thing” that we could “have” or “not have.” It is just a vague, abstract concept that is devoid of meaning when it’s all by itself. A “self,” just like “free will,” is not some “thing” that we might, or might not, have.

The question, “Does the self exist,” according to Wittgenstein (or his big fan David) has no meaning and so we can just ignore it. It’s not a real question. It is, as Wittgenstein was fond of saying, “language that’s out of gear.”

Now, does this discussion have anything to do with emotional problems, or TEAM therapy? It absolutely does. That’s because nearly all depression results from some version of “I’m not good enough,” including:
I’m inferior. I’m a loser. I’m a “hopeless case.” I’m a failure. I’m unlovable. I’m a bad parent. I’m defective.
And so forth.

If you buy into these “self” condemning proclamations, thinking that they mean something, you’ll probably feel depressed, ashamed, inadequate, hopeless, and more. As you can probably see, all these self-critical thoughts contain tons of cognitive distortions, like All-or-Nothing Thinking, Overgeneralization, Labeling, Mental Filtering, Emotional Reasoning, Self-Blame, Hidden Shoulds, and more

And to put it in a nutshell, they ALL involve the belief that you have a “self” that’s broken, or simply not “good enough.” And all of those statements are meaningless.

My goal in therapy is NOT to persuade you that you ARE worthwhile, or “a winner,” or a “good” parent, but rather to show you how to let go of these meaningless but painful ways of belittling yourself. I might use techniques like Empathy, Positive Reframing, Explain the Distortions, Let’s Define Terms, Be Specific, the Double Standard Technique, the Externalization of Voices, the Downward Arrow, and many more.

That’s because the VERY moment you suddenly “see” that these kinds of statements are both untrue and unfair, and you stop believing them, your feelings will instantly change. So, you could say that TEAM really IS a “Wittgensteinian” therapy.

And when people ask me how to develop better self-esteem, I would not try to get them to discover how to have some magical and wonderful “thing” called self-esteem, because that concept is just as nonsensical as the concept of a “self.” You might say that “self-esteem,” if you want to use the term, is more about what you DO.

And there are two things you can do if you want to change the way you feel. First, you can stop beating up on yourself with hostile criticisms like the bulleted statements listed above, and talk to yourself in the same encouraging way you might talk to a dear friend or loved one who was hurting.

And second, you can treat yourself in a loving way, in just the same way you might treat your best friend who was coming for a visit. In other words, you can do nice things for yourself.

The day my first book, “Feeling Good,” was finally published, my editor called me with some bad news. She told me that the publisher, William Morrow and Company, loses money on 9 out of 10 of the books they publish, so they decide which ones are most likely to sell, and those are the only ones they’ll promote. The rest of the books go on a “loser list,” and the company does little or nothing to promote them.

She said my book was #1 on their “loser list,” since the president of the company felt it had no commercial potential, and that very few people would be interest in a long book on depression. She added that the one thing they did do was to send my book to ten popular magazines for first serial rights. That means they get to publish an excerpt from your book as an article, so that stirs up some media interest in your book. Sadly, she said that all ten had turned them down.

She said that I’d have to be in charge of any further marketing of my book, so I asked what I should do. She said to call all ten magazines right away and persuade them to change their minds.

In a panic, I called them all, including Ladies’ Home Journal, Reader’s Digest, and on and on. Every magazine said the same thing—they did not want my book, had turned it down, had zero interest in it, and to please top calling since authors shouldn’t call them and they considered it a form of phone harassment since they’d already made a decision.

Yikes! No fun!

When I jogged home from the train station that night, I shouted, “You’re a loser, you’re a failure.” That didn’t sound so good so then I shouted, “No, you’re not! You’ll figure out how to make it happen! Just keep plugging away.”

That sounded a lot more loving, so when I got home, I told my wife that the book at just been published and that I’d been turned down by all ten magazines for serial rights, and the publisher decided not to spend any money on marketing or advertising, so we needed to go out and celebrate.

She why we would celebrate?

I said, “You don’t need to celebrate when you win, because you already feel great. But when you lose, that’s when you need to celebrate, because you’re feeling down. So, tonight we’ll celebrate!”

We went out for a fancy dinner and celebrated and had fun. And the rest, they say, is history. I just kept trying and getting turned down by newspapers, radio stations, television programs, and more. But eventually, the tide started to turn. To date, Feeling Good has sold more than 5 million copies and it achieved best-seller status. And the reason was that researchers discovered that the book actually had antidepressant properties, so excitement about it spread by word of mouth.

I am hopeful that the new Feeling Great App will help even more people.

Fabrice made some interesting and wise comments on the notion of the “self.” He said that the idea that we have a “self” is a sense that we nearly all have. Some people feel like the “self” that is located somewhere behind the eyes or in the middle of the head. But, he emphasizes, there is no such “thing” as a “self.”

He has quoted someone who has “said it all,” but the statement only makes sense IF you “get it!” Here’s the quote:

“No Self? No Problem!”

This is actually the title of a book by Chris Niebauer, PhD, and the subtitle is How Neuropsychology Is Catching Up to Buddhism. If you want to check it out, here’s a link to it on Amazon: https://www.amazon.com/No-Self-Problem-Neuropsychology-Catching/dp/1938289978

Fabrice emphasized that the concept of “self” is “nebulous.” He asked, “Is there a ‘David’?” He explained:

You wouldn’t be able to prove this in court. Well, you could show ID, but that would not be proof. Where does the information on the ID come from? Birth certificate? Who wrote the information on the birth certificate? Probably some doctor back in 1942. And where did he get that information from? Probably some caregiver said “Write ‘David’ here.” Was that from a credible source?

Not at all. That info was made up on the spot!

Now, you can say that there’s a “sense” of a David going around, and that there are some patterns that show signs of “David-ness,” but there is no “David.”

Matt added that your body is not your “self.” When you break your arm, you don’t say that you have broken a part of your “self.” You just say, “I broke my arm.”

Rhonda raised the question of whether the “self” is just the same as “consciousness” or “awareness.”

Someone in our group added that the “self” is what we DO, and not what we ARE. And, of course, what we are doing is constantly changing from moment to moment.

My understanding of all of this is that once you let go of the notion that you have a “self,” you will no longer worry about whether or not you are “good enough” or “special,” or whoever. You can focus instead on living your life and solving the problems of daily living and appreciating the world around you. If you screw up, you can focus on what specific error you made, rather than obsessing about your inferior or defective “self.” You can actually welcome failure as just another teacher, so you can grow and learn, and simply accept your screw ups, or both.

In fact, two of the most popular TEAM techniques for challenging the distorted thoughts in bullets above are called “Let’s Define Terms” and “Be Specific.” These techniques are right out of Wittgenstein’s playbook, and they are prominently featured in the “Learn” section of the new Feeling Great App. If you’re feeling depressed, and thinking of yourself as a “loser” or as being “inferior” or even “worthless,” the goal is NOT to “become a ‘winner,” or more ‘worthwhile,’ but rather to give up these notions as nonsensical.

But once again, many people cannot “get it,” or “see it,” and that’s where a caring and skillful therapist can help. Some people wrongly think that letting go of the notion that you could be “worthwhile” would mean a huge loss of something precious.

Many people who don’t yet “see” what we’re trying to say are terrified of the “Great Death” because they think that giving up the notion that you have a “self” means giving up all hope for improvement, for joy, for intimacy, and so forth. But to my way of thinking, the truth is just the opposite. When your “self” dies, you and your world suddenly wake up and come to life. When you accept yourself and your world, exactly as they are right now, everything suddenly changes. Of course, that’s a paradox.

I believe that leading our patients to the “Great Death” of the “self” is like giving them the understanding and courage they need to throw some garbage in the trash instead of carrying the garbage around with them all the time!

I hope some of this makes a little sense, but if not, don’t worry about. Sometimes, it takes a little time before you suddenly “see it!”

Thanks for listening today. We love all of you!

Rhonda, Fabrice, Matt, and David
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406: Do Humans Have "Free Will?"
22 Jul· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information!
Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Special Announcement #2
Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it
Today's Podcast Practical Philosophy Month Part 1, The Free Will Problem
Welcome to Practical Philosophy month. For the next five weeks, we will discuss some of the most popular and challenging problems in philosophy, such as these:
Do human beings have free will? Or is free will just an illusion? Do human beings have a “self?” Or is the “self” just another illusion? Is it possible to be more or less “worthwhile?” Are some humans “better” or “worse” than others? Does God exist? Is the universe “real” or “one”? What’s the meaning of life? What is “self-esteem”? How does it differ from self-confidence? What’s the difference between conditional and unconditional self-esteem? What’s the difference between self-esteem and self-acceptance? What do you have to do to experience joy and feelings of worthwhileness?
We will try to complete the list in five weeks, so some weeks we may include more than one topic, since many of these topics are related to one another.

Rhonda and David will be joined by our beloved Dr. Matt May, a regular on our Ask David episodes, and for the first and second sessions we will be joined by our beloved Dr. Fabrice Nye, who created and hosted the Feeling Good Podcasts several years ago.

Each week, you will also hear about the linkage between these philosophical dilemmas, and emotional problems, like depression, anxiety, and relationship conflicts. For example, nearly all depressed individuals believe that they aren’t sufficiently “worthwhile.” I see my goal as a psychiatrist not as helping people feel “more worthwhile,” but rather showing people, if interested, how to give up this notion entirely and become free of certain kinds of damaging judgments of the “self” and others.

You will also learn how these types of philosophical problems continue to play a large role in psychiatry and psychology, including the DSM5 diagnostic system. For example, is the diagnosis of “Generalized Anxiety Disorder” a true “mental disorder” that you could “have” or “not have?”

And might some or most of the so-called “mental disorders” listed in the DSM be based on faulty philosophical / logical thinking? And if many or most of the “mental disorders” are based on goofy, faulty thinking, is there a more productive and effective way to think about most emotional problems?

And how did we get into this mess in the first place?

Worrying certainly exists, and we all worry at times. But how much or how often do you have to worry before you develop or have a “mental disorder” called “Generalized Anxiety Disorder” that can be diagnosed like any medical illness and treated with drugs?

Or is “Generalized Anxiety Disorder” (and hundreds of other “mental disorders in the DSM” based on a certain kind of nonsensical thinking? And if so, why? What is the goofy, faulty thinking in the DSM? And are there some “mental disorders” that are valid and real?

We HAVE touched on all of these themes in previous podcasts, but I thought it would be nice to put them all in one place and bring in a variety of “solutions,” controversies, and experts. I David, will often represent (hopefully, and to the best of my ability) the thinking of Ludwig Wittgenstein, as expressed in his famous book, Philosophical Investigation, published in 1950 following his death.

That book consists of a series of numbered brief essays (a few paragraphs each) that were based on notes found in a metal box under his dormitory room at Cambridge University. He’d written these in preparation for his weekly seminars in his dormitory room. Wittgenstein, although now widely regarded as one of the greatest philosophers of all time, did not think he knew enough to teach in a classroom. In fact, because of his feelings of depression and self-doubt, he sadly never tried to publish anything when he was alive.

Wittgenstein’s philosophy also played an indirect but significant role in the evolution of several modern psychotherapies. His philosophy created new ways of thinking that gave rise to the work of Dr. Albert Ellis, the famous New York psychologist who created Rational Emotive Therapy during the 1950s.

Ellis emphasized that the “Should Statements” that trigger so much guilt, shame, depression, anxiety, and rage are based on illogical thinking. He might often say, “Where is it written that people or the world “should” be the way you want them to be?” Of course, this idea actually traces back to the Greek Stoic philosophers like Epictetus and Marcus Aurelius.

Wittgenstein’s thinking also seems to have played a role in the thinking of Dr. Aaron Beck, who adapted the work of Ellis and called his version of the “Cognitive Therapy.” Beck emphasized many thinking errors, like All-or-Nothing Thinking, and Overgeneralization, that trigger depression, anxiety, and more.

Sadly, Wittgenstein struggled with severe depression and loneliness throughout his life, and three of his four brothers tragically died by suicide. Wittgenstein also had prolonged periods of time when he considered suicide. It is also sad that he did not know how to apply his brilliant philosophical breakthroughs to his own negative thinking, but that application of his work did not develop at the time he was still alive.

Part of Wittgenstein’s depression was related, I believe, to the fact that very few people, including the most famous philosophers of Europe, could understand his thinking when he was alive. From time to time, I think he glimpsed the enormous importance of his work; but I believe that he also had prolonged moments of self-doubt when he thought his work was of little value at best.

To be as correct as possible, Wittgenstein did write a manuscript called Tractatus Logico Philosophicus as a young man, although he never tried to publish it. He wrote it when he was a prisoner of war. He thought this book solved all the problems of philosophy, which had plagued him since he was a child, and he felt great relief. He sent a copy of his manuscript to Bertrand Russell, who was a famous British philosopher.

Bertrand Russell was incredibly impressed with the Tractatus and distributed it to many European philosophers. Bertrand Russell thought it might be the greatest book in the history of philosophy, and a number of the 20th century philosophical movements including Logical Positivism, were inspired by that book.

However, Wittgenstein left the field of philosophy, thinking that his work was done, and that he’d found the solutions he was looking for. He tried teaching grammar school for a while, but was fired because he became frustrated and violent toward some of his students. He also tried to survive as a fisher in a Norwegian fishing town, but was not successful at that, either, because he didn’t know much about fishing, much less supporting yourself through fishing.

One day, he learned that a brilliant Swedish economics student had found a flaw in his Tractatus, and his inner turmoil about the puzzling problems of philosophy flared up again. He decided to return to the study of philosophy.

He applied to be an advanced undergraduate at Cambridge University, but when someone in the admissions office spotted his application, they recognized his name and showed his application to Bertrand Russell, who had been wondering what had become of the young man who once sent him such a brilliant manuscript. Russell, who was the chair of the department of philosophy, said to being Wittgenstein to his office immediately for an interview.

Russell explained that he would have to reject Wittgenstein’s application to be an undergraduate at Cambridge University. Deeply disappointed, Wittgenstein asked why. Russell told him it was because he was already recognized as the greatest philosopher of the 20th century.

Bertrand proposed that if Wittgenstein would agree to skip college and graduate school, they would immediately award him a PhD for the manuscript he’d sent to Russell years earlier. Russell also offered him a full professor ship in the department of philosophy.

Wittgenstein protested and said he needed to study philosophy again, because of the error in Tractatus, and that he didn’t know anything, and definitely could not teach in a classroom. Bertrand Russell insisted, and they finally struck a deal where Wittgenstein would agree to be a professor of philosophy but all he would have to do was to have a conversation session with anybody who wanted to talk to him at his dormitory room once a week.

Wittgenstein accepted and met for years with students and famous philosophers who came from around Europe to crowd into his dormitory room for his weekly seminars, and he began to shape a radically different philosophical approach from the one he’d described earlier in his Tractatus. He was determined to find a new way to solve all the problems of philosophy.

And, to my way of thinking, along with those few who really understand him, he was successful.

But he was often frustrated because, so few understood him. This was unfortunate, because what he was saying was incredibly simple and basic, and it was pretty similar to, if not identical to, the thinking of the Buddha 2500 years earlier.

The Buddha apparently had the same problem—almost nobody could understand what he was trying to say when he was still alive. They couldn’t “get it” when he was talking about the so-called “Great Death” of the “self,” or talking about the path to enlightenment. The Buddha’s frustration resulted from the exact same problem Wittgenstein encountered 2500 years later.

The Buddha was saying something that was extremely simple, obvious, and basic—and yet, it was rumored that of his more than 100,000 followers when he was alive, only three actually “got it” and experienced enlightenment. When I read Philosophical Investigations my senior year in college, it was rumored that only seven people in the world understood what Wittgenstein was trying to say.

Wittgenstein’s dream was that philosophy students would “get” his thinking and give up philosophy when they realized that most if not all philosophical problems are sheer nonsense. He wanted them to do something practical and real in the world instead of studying philosophy.

He was verry disappointed when his favorite student, Norman Malcolm (one of the seven who “got it,”) pursued an illustrious career teaching philosophy in America at Cornell University.

I always wished I could have known Wittgenstein when he was alive, so I could have told him this:

I loved you, too, and I got it after several months of confusion, trying to understand your Philosophical Investigations, but eventually understood it with the help of your student, Norman Malcolm. His book about you was very inspiring. And that’s why I left philosophy for something more practical in the world. I decided at the last minute to go to medical school to become a psychiatrist instead of philosophy graduate school. Hopefully, I am doing something that you might be proud of!

But oddly enough, your thinking has also influenced my approach to people who feel depressed and worthless. They are also under a kind of destructive “enchantment,” thinking that there is some such “thing” as a more or less worthwhile human being! And this is a major cause of depression and anxiety and feelings of worthlessness and hopelessness.

I wonder if you, Wittgenstein, ever felt that you weren’t “good enough” when you were feeling down. hopeless and suicidal? I sure wish I could have helped you with that!

If you want to understand Wittgenstein’s work, the best book in my opinion is Norman Malcolm’s moving and affectionate tribute to his beloved teacher, entitled “Ludwig Wittgenstein: A Memoir.” It’s a short moving tribute to his beloved teacher, and tears go down my cheeks every time I read it, or even think about it. If you ever visit my office here at home, you’ll find that memoir proudly sitting on my bookshelf, with a handsome photo of Wittgenstein on the cover.

Toward the end of his life, Wittgenstein appears to have become more or less homeless, and he died from prostate cancer. His doctor said he could live in his home, where he was befriended by the doctor’s wife in his final days. His dying words were, “Tell them that I had a wonderful life.”

He died on April 29, 1951, just a few hours before my wife was born in Palo Alto, California. Surprisingly, she is the only person I’ve ever met who understood Wittgenstein’s thinking entirely the first time I explained it to her. She “already knew” what Wittgenstein, the greatest philosophical genius of the 20th century, spent a lifetime figuring out!

Reincarnation is pretty “out there,” and fairly silly, to my way of thinking, but sometimes it can be fun to think about it!

Here is my understanding of how the thinking of the “later Wittgenstein” actually developed. His first book, which is nearly impossible to understand, was called the Tractatus Logico Philosophicus. It is a series of numbered propositions, which he compared to climbing up a ladder, rung by rung, as you read the book until you got to the roof at the top of the ladder.

Then you could throw your ladder away and give up philosophical thinking, since he thought his book contained the solution to all the problems of philosophy that had tormented him since childhood, as mentioned previously.

The philosophy of language in the Tractatus is based on the thinking of Aristotle and Plato, who thought that the function of language was to name things that exist in the real world. Plato’s idea was that our real world consists of imperfect examples of a “Platonic Reality” which consisted of “perfect” representations of everything.

So, for example, Plato believed there could be a perfect “table,” a perfect “lamp,” and so forth. In other words, he thought there was an ideal essence to the concept of a “table.” And, I suppose, there might also be a “perfect” version of you! The early Wittgenstein also thought that the logic inherent in our sentences reflected the logic inherent in an external reality.

If that doesn’t make much sense to you, join the club! But that’s kind of what Plato and Aristotle were promoting, at least in my (David’s) understanding.

When Wittgenstein’s Tractatus was debunked, he was devastated, and desperately wanted to find another way to solve the problems of philosophy, since they started tormenting him again. It was much like a relapse of OCD or some other emotional problem. In fact, he thought of philosophy as a kind of mental illness that needed treatment.

Here’s an example of the types of philosophical problems that tormented him. Do human beings have free will? Do we have a “self?” Is the universal “real?”

Of course, we THINK we have free will, and it SEEMS like we make “free decisions” all day long, but is this just an illusion? For example, some people would argue that we cannot have “free will” because we “have to” follow the laws of science that govern everything, including how the brain works. So, since we “have to” do what we are doing at every moment of every day, we must not have free will!

Here is an argument that we do NOT have “free will.” When a powerful storm or hurricane destroys a portion of a city, and people die, we see this as a tragedy, but we don’t get angry at the hurricane because it does have “free will.” It is just obeying the laws of physics that govern the forces of wind, air pressure, heat and cooling, and so forth. A storm cannot behave in any other way.

So, the argument goes, we are also following the laws that govern the functioning of our bodies and brains, and so we cannot do other than what we do, so we, too, have no “free will.” We THINK we are acting freely but it is an illusion, so our brains are obeying the laws of the universe at every moment!

For hundreds of years philosophers have struggled with this puzzle, and many people still wrestle with this problem today. It was one of the problems that drew me to philosophy. Impractical for sure, but still tantalizing.

Another way to express the free will puzzle is via religious thinking. I was taught when I was growing up that God is omnipotent (all powerful), omnipresent (present everywhere) and omniscient (all knowing.) So, God knows the past, present, and future.

And if God knows the future, then God knows what we will do at every moment of every day, and we are helpless to do otherwise. Therefore, we have no “free will,” even though we “think” we do!

This free will problem can definitely be unsettling, with troubling moral consequences. If we do not “free will,” then are serial killers really responsible for, or guilty, or accountable for their actions? If we do not have free will, then wouldn’t that give us license to do whatever we want whenever we want?

Clever arguments for sure! We may “feel” like we have the freedom to do whatever we want at almost any moment of any day, but are we fooling ourselves and living in some gigantic hoax, or illusion? Are we total slaves with the delusion that we are actually acting “freely?”

How do we resolve this problem?

Well, one day Wittgenstein was walking past a soccer game at the park, and the soccer ball hit him on the head.

He wasn’t hurt, but had the thought, “What if the function of language is NOT to name things (like trees, or lamps, etc.) that exist in some “external reality,” like Plato and Aristotle thought? What if language actually functions as a series of “language games,” with rules, just like the game of soccer?

Then the meaning of any words would simply be the many ways the word is used in different real world situations. In fact, that’s what you find in the dictionary when you look up the meaning of a word. The dictionary doesn’t ever give you some “correct” or ”pure” meaning, since most words have many meanings.

This would be the opposite of the philosophy of Aristotle and Plato who argued that there were “true” meanings for every word, noun, or concept. What if, instead, words had NO true or essential meanings, and their meanings were simply embedded in the context in which they are used in ordinary, everyday language?

If so, this might mean that philosophical problems emerge when we try to pull words out of their ordinary meanings, which are always obvious, and put them into some metaphysical realm where philosophers argue about “ultimate truth.”

Let’s say we wanted to find out if humans have “free will.” Well, not being sure if there is such a “thing” as “free will,” we could look up “free” and “will” in the dictionary. (I know this sounds incredibly obvious and almost ridiculous.) What does “free” mean?

Well, we could talk about the many ways we use “free.” Political freedom means that in some countries you cannot contradict the leader (the dictator) without the danger of being thrown in prison or even murdered. But in other countries, you are, In fact, free to express your own ideas and opinions, without fear of punishment.

Free also means getting something without having to pay for it, like a seventh bottle of soda is free at the local grocery store if you purchase a six pack.

Free can also mean “available.” I am starting up my Sunday hikes again, and I might say, “If you are free this Sunday morning, meet at my front door at 9 and we’ll go for a hike and have a dim sum feast afterwards at a Chinese restaurant on Castro Street in Mountain View, California,

Now notice that when you talk about “free will” you have taken this word, “free,” out of the familiar contexts in which we find it, and given it some type of metaphysical “meaning.” But in this metaphysical, philosophical arena, it has no meaning.

So, instead of trying to “solve” the so-called “free will” problem, we can dismiss it as nonsensical, and ignore it as having no practical meaning, and move on with our lives. We can say, “I just don’t understand that problem! I don’t know what you’re talking about when you ask the general question of whether we have something called ‘free will.’”

That either works for you, or it doesn’t work for you! Your choice. It does work for me, but it took me months of thinking until I suddenly “got it.”

My way of describing this philosophical error is “nounism.” You think that nouns always refer to things that could “exist” or “not-exist,” just like Plato and Aristotle thought. So, you ponder and try to figure out if this notion of “free will” exists or does not exist. But it’s arguably a meaningless question.

That’s why I say, and Wittgenstein might say, I have no idea what you’re talking about.

Today we’ll discuss the free will problem and how it might relate to our field of psychotherapy. Next week, we’ll deal with another thorny problem: Do we have a “self?” Or is that also just some kind of illusion?

I (David) wrote these show notes before the show, and we have had fairly extensive email exchanges, with a variety of points of view on whether or not we have something we can call “free will.” First, I’ll put a great email by Matt, followed by a comment by Fabrice.

Here’s Matt’s email first:

Subject: Re: question

Yes, that's getting very close to what I'm trying to communicate. I don't believe you are 'slow' or 'super lame', either. In fact, quite the opposite.

I suspect I'm failing to do an adequate job of disarming your claims that 'free will' and 'self' are words taken out-of-context and, therefore, can't be shown to exist or not-exist.

I apologize, as I am pretty excited about the potential to help people, suffering with self-blame and other-blame, by realizing that we and others don't have a 'self' or 'free will'. I believe we have a brain that makes decisions and creates experiences, including the experience of having a 'self' and 'free will'. I believe that the experience of 'making' a decision is an illusion, as is the idea of a static, unchanging 'self' that controls decision-making.

I asked you to pick a movie and you said, 'Green Mile'. You acknowledged that this movie title simply 'popped into my head'. That's correct. Your 'self' didn't control what you selected, using 'free will'. Your brain just came up with that movie title. There was no 'self' that made a decision to choose that word.

I agree that we have a brain which is incredibly powerful. I'm claiming that we don't have an auxiliary 'self', with extra super powers, controlling our brain. We can make decisions, but we don't have 'free will', meaning, the ability to control those decisions.

I do think you have some resistance to seeing through the illusions of 'self' and 'free will', all of which say awesome things about you, e.g. morality and justice. I'm not trying to convince you, one way or another, and I don't expect to. I'm more interested in the listening audience, as many people are significantly relieved when they realize that we are more the victims of our biology and circumstance rather than defective 'selves' lacking 'willpower'.

To put a slightly finer point on the subject, when people say they have 'free will', they don't mean that 'decisions are made'. Obviously, decisions are made. You decided to keep reading this email, for example. Or you didn't. I'm not sure. Either way, a decision was made. When people say they have 'free will', they are saying that they (really, their 'self') are/is free to decide whether to continue reading this email, and that this power goes above and beyond what their brain is doing, according to the laws of physics. I am claiming that this is a ridiculous and dangerous thought, for which there is no evidence.

You're saying these terms haven't been defined. I'm pointing out that they already have been, intuitively, by anyone who thinks, 'I shouldn't have done that', or 'they shouldn't have done that'. These thoughts require a belief that they 'could have' done something different, that they had free will.

Aside from rage and guilt, let's examine the narcissism and excessive sense of confidence a patient might have, if they believe that they can simply 'decide', through sheer 'willpower', not to beat up on themselves anymore. Or a patient who believes they can simply 'decide' to always use the 5-Secrets, rather than criticize and blame. Can they? I've never seen that happen. That's why I assign homework. I know that the goal is to rewire the brain so they can feel and perform better, later.

We can't simply decide to feel good all the time. We all drift in-and-out of enlightenment. If we want to increase the likelihood that we will be able to set aside self-criticism or communicate more effectively, we have to practice new thoughts and behaviors. If we do, we will develop greater skills at defeating negative thoughts and communicating effectively. Otherwise, our brains will do, in the future, what they are programmed to do, now. It's because we lack 'free will', that we must do homework.

Similarly, you couldn't simply 'decide' to be the world's best ping-pong player. You realized you would have to work hard to re-wire your brain, if you wanted to have a chance at that.

Let's use the murderer/cat example:

A cat tortures and kills mice for the same reasons that a murderer does: their brains are programmed to do so. Murderers don't have a defective 'self' that is failing to express 'free will' adequately, when they murder. They're doing precisely what the atomic structure of their brain caused them to do, according to the laws of physics, in that moment, when presented with those precise stimuli. We don't have to judge or punish the cat or the murderer's 'self' and insist they should have used their 'free will'. We can accept that neither creature had the ability to decide differently from what their brain decided, in that moment. That is where the therapeutic element of this realization comes into play. I think it's important on a lot of levels, to stop blaming cats for being cats and murderers for being murderers.

Similarly, if a patient doesn't want to do homework, will it do any good to blame them and think they're bad and should decide differently? No, it helps to accept them where they are, and to accept ourselves where we are, with open hands.

Realizing nobody has a 'self' operating their brain and making decisions that are better than their brains' decisions doesn't mean we have to let all the murderers go or trust our cat with a new mouse companion. We can still be aware that their brains are programmed to murder. We would still be motivated to do whatever is necessary to protect society and mice. The difference is the attitude towards the murderer. We aren't trying to 'punish' or 'get vengeance' but to protect and, instead of 'labeling' them as having a 'bad self' or even being a 'murderer', but someone who has murdered and, left to their own devices, likely to do so again.

Instead of judging and demanding vengeance, we would see a murderer as the victim of their biology and environment. Instead of condemning them as permanently evil and bad, we could recognize that their brain is currently wired to do bad things and they might still learn new ways to interact with others. Perhaps they're not hopeless cases, after all. From the other side, if I ever committed murder, and sentenced to death, I wouldn't want to be feeling defective, thinking what a bad self I have and guilty/ashamed for not flexing my 'free will' in the heat of the moment. Instead, I might feel a sense of relief, purpose and meaning, that I was protecting others by being put to death.

Alright, enough out of me!

Thanks,

Matt

And now, the response from Fabrice:

Matt’s thinking is exactly in line with mine. I don’t know if the topic came up in your discussion, but some people argue that actually someone could have done something differently than they did, because there is some randomness in Nature. But that argument doesn’t hold water because even if the decision “made” by their brain is different, it has nothing to do with their will but only with the Heisenberg principle.

Cheers!

Fabrice Nye
[email protected]

David’s wrap up comment. Matt and Fabrice have quite a different view of “free will” and the “self.” They are arguing, very thoughtfully and persuasive, that we do not “have” a “self” or “free will.” People have been involved in this debate, as I’ve mentioned, for hundreds of years, taking one side or another.

My own thinking is different, and reflects my understanding of Wittgenstein’s thinking. They have take these words out of the contexts in which they exist in everyday language, (which is a huge temptation) and involved in a debate about abstract concepts which have no meaning.

Very few people, it seems, were able to grasp this idea when Wittgenstein was alive, or even today.

So, if what I’m saying makes no sense to you, be comforted, since it seems likely that 99% of the people reading this, or listening to the show, will agree with you!

And that’s still a puzzle to me. It is not clear to me why so many people still cannot “see” or “get” this idea that words do not have any pure or essential “meaning” outside of the context of everyday use of language.

The best psychotherapy example I can use is the fact that nearly all depressed individuals are trying to figure out, on some abstract or philosophical level, whether they are “worthwhile” or “good enough,” or whatever. This seems to be a “real” problem, and so they believe that they are not sufficiently worthwhile.

This belief can be so convincing that many people commit suicide, out of a sense of hopelessness and self-hatred.

But there is not such thing as a human being who is more or less “worthwhile.” Of course, your actions can be more or less worthwhile at any moment, and we can evaluate or judge our specific behaviors. Yesterday, we had our first recording session in a video studio we have set up for our Feeling Great App.

We had a lot of fun and recorded some (hopefully) interesting stories we’ll publish on our two new YouTube channels. I really appreciated the colleagues who made this possible. It was a relief for me because I tend to have performance anxiety, which impairs my ability to speak naturally and with emotion. But this time, there was no anxiety at all, so it was fun.

Did this make me or my colleagues more worthwhile human beings?

No! But it did show that we’d become a bit more effective and communicating messages that will trigger healing and understanding in our fans, and hope that includes you!

When you “see” this, perhaps for the first time, it can be incredibly liberating, since you no longer have the need to have a “self” that’s “special” or worthwhile.

And, as some of you know, my beloved teacher and cat, Obie, taught me that when you no longer need to be “special,” life becomes special. When your “self” dies, you inherit the world! There’s no funeral, only a celebration!

Feel free to contact us with your thoughts, ideas and questions!

Thank you for listening today!

Rhonda, Matt, Fabrice, and David
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405: Ask David: Why does my father try to control me? Why do women ghost me? And more!
15 Jul· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
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Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
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Today's Ask David Podcast
We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes.

We love your questions. Remember to send them to [email protected].

Ask David Questions for Today
Bosley asks: My father can be very critical of my plans for the future. What’s the best way to respond to him? Willie asks: I have a dating questions. Why do women keep ghosting me? Should they be more willing to work out differences with the Five Secrets of Communication? 1. Bosley asks: My father can be very critical of my plans for the future. What’s the best way to respond to him?
"To explain somewhat concisely, I just want to move to the nearest major city (Seattle) since I feel really really happy there. I also love volunteering for a specific organization and have some community there that I care about, and I feel very isolated having been away from for months.

I'm willing to carry the load of all the work I would need to do to make it happen, and do a business training my dad wants me to complete.

He has other thoughts. He looks down on volunteering and his thoughts on friends are simply that I can make new ones anyway. He is very aggressive and intimidating in his arguments, full of insults and many factually incorrect statements that are difficult to disarm on the fly.

He shoots down the idea upon mention, so it's difficult to collaborate to find mutually beneficial solutions. He is a successful businessman, despite recent financial issues, and has a sort of strict plan for me that he has wanted me to follow, although I really don't feel this conflicts with his goals to have me run things in the future.

I'm just worried since he has a long past of being emotionally abusive and of going back on his word. Plus, I just want some autonomy.

In the end, it's his way or the highway. He says “You keep scheming and going down a twisted path instead of doing what I tell you.”
David’s reply
I suggested he might complete the first four steps of the Relationship Journal so we could see how he’s communicating with his dad. Here is Bosley’s partially partially completed Relationship Journal (showing steps 1 to 4, but not 5.)

Step 1 – S/he said: Write down exactly what the other person said. Be brief:

You keep scheming and going down a twisted path instead of doing what I tell you!

Step 2 – I said: Write down exactly what you said next. Be brief:

What?
Circle or bold the emotions S/HE might have been feeling Circle or bold the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated Angry, mad, resentful, annoyed, irritated, upset, furious Angry, mad, resentful, annoyed, irritated, upset, furious Other (specify) Other (specify)
Step 3 – Good Vs. Bad Communication: Was your response an example of good or bad communication? Use the EAR Checklist to analyze what you wrote down in Step 2

Step 4 – Consequences: Did your response in Step 2 make the problem better or worse? Why?

It probably made things worse. I came off dismissive, which probably confirmed for him that I automatically ignored any advice or direction that he gave me. I wasn’t assertive in fear of escalating anger or just being shut down anyway, but that also maintains the status quo. I didn’t, and typically don’t, show a caring respectful attitude. This, I think, allows his anger to continue snowballing into more intensity.
2. Willie asks why women he’s dating “ghost” him instead of working out the problems in the relationship using the techniques in your book, Feeling Good Together.
Good morning, Dr. Burns!

I hope you are doing well! I want to start off by saying that I love your books and they've played a massive role in changing my personality for the better.

However, there is a question I struggle with. In feeling good together, you say that one can keep status quo, solve their problem, or walk away from a relationship.

I lean very strongly on the side of always wanting to solve problems. However, at my age, most of girls I date err on the side of just walking away and this opens me up for unnecessary headache and pain.

I don't know where to draw the line? My heart says that any two reasonable adults can always make a relationship work given that at least one wants to make things better and, unfortunately, this does not seem to be the case in my experiences.

Your insight would be greatly appreciated! Thank you for taking the time!

Best Regards,

Willie
David’s reply
Thank you, Willie,

I’d love to use this as an Ask David question for one of the podcasts, if that’s okay, using your first name or a fake name if you prefer.

Here’s the super short answer. I wrote a book on that exact topic called Intimate Connections. Essentially you probably need to learn a little more about how to “play the game” when dating. You’ll see what this means when you read the book.

Warmly, david
Willie's Response: Good morning, Dr. Burns!
Frankly, I was not expecting a response at all, much less as quick as it was. For this, I truly want to thank you for taking the time to do so.

Secondly, it will be my honor if you do bring it up to your podcast. Please don't use my first name - I'd prefer staying anonymous. Please do let me know which podcast this will be so I can give it a listen as well.

Lastly, thank you so much for referring me to your book. That will be my next read so I am super excited. If you have any other books which you believe are worth reading which will be beneficial in the dating world, corporate world, etc., please point me to those. I absolutely love your books and their effects on me have been immeasurable.

Thank you!

Willie

I wrote back and suggested we could use the fake name Willie, as he wanted to remain anonymous, and he responded:

Now that you say, Willie is definitely sexier!

Question: when are you planning on doing the next episode with this question in it? I wouldn't want to miss it.
Here was my response to “Willie.”
We’ll just read your question, and then provide opinions. My career in private practice has a majority of single individuals who were trying unsuccessfully to connect in the dating world. That’s why I wrote that book, which is intensely personal as I was the biggest loser of all for a long time because I was a minister’s son and never learned how to “play the game” or be a “bad boy.” But I learned from a friend who was a “hustler” when I was in medical school.

I learned a tremendous amount, including that there is a game-playing phase in dating, and a time to be more serious, open and vulnerable. The biggest mistake men make is trying to get too serious when they should be playing the game.

What’s the game? Well, you’d know if you ever had or loved a cat. If you chase them enthusiastically, you force them to run away.

You have to learn how to make them chase you.

Many men are stubborn about this, and lamely insist, “But I shouldn’t have to play the game!”

My answer would be, “You don’t! Especially if you don’t want to get laid and have lots of ladies chasing you!”

Warmly, david
Willie’s response
This is extremely valuable to me. I never knew that you come from a religious background and I do too so I do want to ask you some more questions / share my experience.

One pattern I am noticing is that either Muslim ladies have a lot of religious trauma or they have very strict conservative values - usually a combination of both. In the modern world, I try using dating apps and might get matched with someone 2-3 states away so usually we would hop on a FaceTime and the topic of religion almost always comes up. And, due to differing opinions, they just walk away which deeply upsets me because they make the false assumption that humans are snapshots in time i.e., opinions / perspectives don't change.

In fact, a personal experience I would like to share with you. I was in a relationship for 1.5 yrs (long distance) and it just ended 1-2 months ago. Our intention was always to get married. However, a few weeks before breaking up with me, she basically said "oh you don't pray and I cannot even imagine my future husband not praying etc etc" and she ended things with me on that. I even tried using the 5 methods of effective communication to acknowledge and validate her opinions while simultaneously sharing mine but she was dead set and did not even want to think about working on problems.

How could I "play the game" in such instances or over long distances?
David’s response
Hi Willie,

The principles of dating are the same in all cultures for the most part, and one rule is “Never chase a distancer.”

So, when she switches to religion, you could use the listen skills subset of the Five Secrets, and buy in to what she’s saying, WITHOUT arguing or presenting your own thinking. You can admire her, urge her to tell you more about her religious feelings and spiritual life, using liberal Thought and Feeling Empathy, and lots of Disarming Techniques, and Stroking, with Gentle Inquiry. You would NOT chase, or try to persuade, or argue, or defend yourself. Be totally admiring and other-centered at those times.

If she says she wants to break up, you might say that you’ve been sensing some distance, and are relieved that she is doing that, because you, too, would like to date other women, but that the two of you can still be friends if she promises not to get romantically involved with you, and that you will be on the lookout for some really great guys she might want to date.

This is a paradoxical approach, and it is an art form. And I can also tell you to date other women immediately, and the moment you find one you like better than her, she will find out, even if no one tells her, and she will likely want you back again. That’s because of the Burns rule, which states: “People NEVER want what they CAN have; they ONLY want they CAN’T have!”

Now, if you tell me this approach is phony, I would tell you that you’re 200% right! And it’s not only incredibly phony, it’s amazingly effective! And a kinder word that “phony” might be to say that when someone starts pulling away, you have to switch into this style and strategic approach, and stop trying to be loving and sincere or logical, etc. Do NOT chase, simply open your hands and let go.

It’s the exact same strategy you might use to get close to a cat!

Best, david

Hi Willie,

If you’d like, you can send me an example of what one of the Muslim ladies said to you, and exactly what you said next. Please select an interaction that didn’t go well. Then I can analyze your response and suggest some alternative ways to respond in a dating situation. In fact, if you like, you can record it on the Relationship Journal that I’ve attached. Please fill in steps 1 through 4.

Please do this right away as we record tomorrow.

Best, david

Hi Dr. Burns,

I cannot even tell you how much these emails are already changing my outlook. I truly want to thank you for taking the time and responding to these.

One thing that caught my eye is the paradoxical approach. I never thought about it. In my mind, I feel you should work on relationships / never let go but if letting go is working on it, then that is something I really need to do.

I am attaching two copies of the Relationship journal. One dealing with the topic of drugs and one with prayer. One thing I will tell you is that I usually bring these topics up myself because, in my mind, I don't want to deceive anyone and get these big topics out of the way as early on as I can and I think I am making a mistake somewhere here.

Thank you, again, for taking the time and responding to these emails! Looking forward to what you think about the topics of conflict I have been having!

Best Willie 😉
Willie’s Relationship Journal #1
Step 1 – S/he said: Write down exactly what the other person said. Be brief:

Religion is super important to me. As a Muslim, I want my partner to pray 5x a day.

Step 2 – I said: Write down exactly what you said next. Be brief:

Religion is super important in today’s day and age. It is a part of our culture and I definitely want to introduce my kids to it.

However, I don’t think that prayer in and of itself makes you religious - if anything, the more external your religion means the higher likelihood of hypocrisy. In my mind, everyone’s religion is between them and god so the best you can carry is one that no one else even knows of - kind of like charity.
Circle the emotions S/HE might have been feeling Circle the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated Angry, mad, resentful, annoyed, irritated, upset, furious Angry, mad, resentful, annoyed, irritated, upset, furious Other (specify) Other (specify) Taken for granted, unappreciated Willie’s Relationship Journal #2
Step 1 – S/he said: Write down exactly what the other person said. Be brief:

All kinds of drugs are bad and I don’t want to date anyone who does them.

Step 2 – I said: Write down exactly what you said next. Be brief:

I strongly agree. Any kind of drug that can open you up to addiction can have a lot of negative effects and that’s one of the reasons why I don’t even drink coffee.

On the other hand, latest research does suggest that drugs like hallucinogens can have positive effects on people so even though I don’t do them, I have tried once and keep an open door for them primarily because they are not addictive.
Circle the emotions S/HE might have been feeling Circle the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated David's Reply to Willie's RJs
This is the analysis of his initial RJs

Thanks good start. You might have time to redo them a bit. You failed to circle the feelings she might be having (or use bold face) as well as your own feelings. This will help you with the E and A of the EAR Checklist. You got the general idea, but you’re missing some crucial details. Also, your responses are both argumentative, all about you, and not using any real disarming or empathy / inquiry to draw her out.

You are trying to “win” an argument, which is a a 100% guarantee that you will lose! And you are trying to persuade, which is a 100% guarantee to push her way and force her to reject you.

Best, david

In the show, We analyzed Willie’s responses to the two examples from the Relationship Journal. Rhonda, Matt, and David agreed that Willie was not acknowledging her feelings or empathizing with her at all. She likely had many feelings that we listed on the show, along with his. We focused on how he might respond with Other- rather than Self-Centered conversational skills.

It was clear how he was “forcing” the ladies to reject him, and how could respond in a radically different and far more appealing manner.

Both Matt and Rhonda did a superb job of role-playing and teaching in this podcast segment!!

After the podcast was recorded, Matt had some thoughts about how his response (when playing the role of Willie during the podcast) could be improved. Here's his commentary:

Hi Rhonda and David,

I had some follow-up thoughts on the role-play with Willie, which I hope are potentially helpful for him. If you agreed, maybe they could go into the show notes?

I had given myself a B, but wasn’t sure why. I think I have a better understanding now.

First, I agree with Rhonda that suggesting I simply fulfill her request to pray five times per day and that that would mean my dreams come true if it might lead to being with her was an error. I think it was probably problem-solving, as well as an agenda-setting error with Willie, who will likely want to stick to his decisions around what’s right for him in terms of practicing his faith.

Instead, I think my error might have been “chasing”, and the missing ingredient was probably “Open Hands”.

While Rhonda really appreciated my empathic response, it is also possible that such a response would backfire, at the “intensity matching” level, especially if what willies ex is saying is that she doesn’t want to be with him. It would then be an error to push her towards talking more about her feelings.

Something like (in addition to other 5-Secrets)…

“On the other hand, it would make sense if you didn’t want to talk about those feelings with me. Perhaps you’re just letting me know that this isn’t going to work for you. That would be sad, but also totally understandable and we could just end the conversation, here. I’d be sad if that were the case because I really like you. On the other hand, prayer is very important to you and it’s perfectly valid that you wouldn’t want to be with a guy who doesn’t pray”.

This would have better demonstrated the paradoxical element of being a “bad boy” or just interpersonally effective, than what I had said.

Thanks again for having me in the podcast!!

Fondly, Matt

And here is Rhonda's response to Matt:

Hi Matt: Now your response jumped from A+++ to A++++. I think acknowledging their differences is so respectful. The conversation may indeed have ended there, but it would have ended with respect and understanding and good feelings instead of the confusion, betrayal and other challenging feelings we mentioned on the podcast.

Thank you for following up, Rhonda

Thanks for listening today!

Next week we will start Practical Philosophy month. We will provide solutions to the five most popular puzzles in philosophy, and will also show how they related to emotional problems as well as The DSM and how we think about and diagnosis so-called "mental disorders."

Rhonda, Matt, and David
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404: Raw Emotion: Dad, I let you down! Part 2 of 2
8 Jul· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
A Riveting Story of Raw Emotion. . . “Dad, I let you down!" Part 2 of 2 Special Announcement The long awaited Feeling Great App is now available in app stores. IOS and android! Check it out. Take a free ride!
And now, on with the exciting conclusion of the personal work Dr. Jill Levitt and I did with Chris, along with a fabulous followup interview you will hear at the end of the session.

I hope you enjoyed the session with Chis, and hope you found it inspiring. His message of hope and joy could be helpful and inspiring to any of you who may be struggling, and feeling, as he was, that you're just "not good enough." His work is, of course, important from a psychological perspective, because it illustrates the powerful steps of TEAM in a sequence that brought Chris from the depths of despair to the peaks of enlightenment. However, as you will hear in the postscript dialogue, the work for sure takes on a spiritual and mystical quality for sure!

When you hear Chris live during the follow-up interview at the end of Part 2 of this two-part podcast, you will not be disappointed!
Postscript
As I mentioned earlier, I was overjoyed when I learned that Chris had unexpectedly changed his mind and offered us the chance to publish his personal work and provide a follow-up recording of how he’s doing now.

Here’s my email to him just prior to the follow-up recording.

Hi Chris,

I’m assuming that Rhonda will coordinate this and she has us scheduled for this Friday, I believe. When it is 4 PM in your time zone, what time is it in our time zone? Are you two hours later?

I just reviewed my chart notes from a year or so ago, and it will be terrific to reconnect with you. I deeply appreciate the chance to share your session with our many listeners, as it is full of raw emotion and is riveting. You are making a super strong statement to the world, to my way of thinking, and it takes incredible courage to say, “This is me! I am very real, and sometimes very raw!”

I think many people suffer due to thinking that everyone else is somehow “better” than they are, and that they are somehow “not good enough.” That is perhaps the main theme I hear when doing clinical work, and that includes my work with mental health professionals who are equally vulnerable to this kind of thinking.

What triggered your decision to go public, so to speak. And how might this impact your students, and their parents, and so forth?

Hopefully, we can chat this Friday about those and any other questions or topics that touch or interest you. It will be great to get caught up on your past year!

If Jill or Rhonda want to add your thoughts, please do! To me, this is a very significant occasion to have the chance to connect with you, Chris, again! The work you did is among the most powerful and impactful ever in my memory, although every time we do live work it is pretty incredible to my way of thinking, especially when people become “real,” whatever that means!

Humans have a dark side, to be sure to my way of thinking, but something incredibly beautiful and amazing can emerge.

I am babbling so will stop. But I am so excited to talk to you again, Chris!

Warmly, david

Thank you for listening, and please let us know what you think.

if you are a therapist, and want to learn how to do this, consider attending the summer intensive from August 8 to 11, on line, or in person at the South San Francisco Conference Center (ten minutes from the SF airport.) See the details and a link below, or go to www.cbtintensive.com.

Chris, Rhonda, Jill, and David
Click for registration / more information!
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403: Raw Emotion: Dad, I let you down! Part 1 of 2
1 Jul· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
A Riveting Story of Raw Emotion. . . “Dad, I let you down!" Special Announcement The long awaited Feeling Great App is now available in app stores. IOS and android! Check it out. Take a free ride!
And now, on with today's podcast!
Part 1 of 2
Our work with Chris started with this email:

Hi David and Jill,

I am 40 years old and have never been in a relationship. I've only had a handful of sexual experiences.

I used to carry a lot of shame around this, but have done some work on myself, have more or less come to terms with where I'm at, and actually really enjoy my life and am pretty happy most of the time. However, I recently developed some strong feelings towards a coworker, and this led me to re-evaluate my stance on being single.

The DML (LINK) details an incident from last week concerning this coworker. I haven't had extensive interactions with her and she works at a different site. Our clinical team meets twice monthly for online zoom meetings. She recommended a book to the team a few months ago, I read the book and enjoyed it, and was hoping to meet up with her and talk about it sometime. I was feeling a little terrified and didn't know if it was the right thing to do, but ultimately sent her an email asking if she'd like to speak with me about the book sometime.

She politely declined the invitation. The daily mood log documents the hour or two immediately after I sent the email, as well as some of the thoughts that happened after I received her reply.

There were a lot of negative thoughts, so I only included a few. There were also a number of hidden thoughts/beliefs that occurred to me over the last few days, which I have not included.

It seems worth noting that for 2-3 hours after I sent the email, I experienced a lot of emotional turmoil. However, at 4pm when I got off work, from the long drive home until I went to bed, I was in a euphoric state. I was happy about what I did, how I responded to the rejection, and was optimistic about my future. I was working out at the gym and had a hard time keeping a smile off my face.

I went to bed feeling great, but woke up in the middle of the night and felt terrible again, the painful sting of rejection kept me from sleeping. Since then, I've mostly felt just fine about it, only a few brief moments of really feeling that sting and they don't last long.

My goal isn't to necessarily get into a relationship or have more sex; it's to feel more confident in my interactions with women. After being rejected, I think 15 seconds of agony is enough, no need for more than that. In the past, when I've developed strong feelings towards a woman, I notice that I am prone to both negative and positive distortions, some version of:
"It's the end of the world if she isn't attracted to me," or "She's perfect for me; there is no one else like her," or "Sex with a beautiful woman will complete my life, or completely fulfill me".
I think I'd be better off without these distortions, but find the positive distortions to be somewhat addictive. They also make it hard for me to let go and move on. I still feel somewhat attached to this woman and haven't been able to let go and move on.

Also, I want to note that there are a few experiences from high school that really impacted my sexuality, relationship with women, and probably inform some core beliefs on these subjects that have recently come to surface. I'm not sure how much to share about this or whether it's even necessary to, but I suppose that could be addressed in the empathy phase on Tuesday.

One other thing that I didn't include in the DML, is when I'm in that negative state, sometimes I have intense thoughts directed at me that come in the form of the second person, like
You're a piece of shit. I fucking hate you. Cut your throat You don't deserve to be alive. I'll fucking kill you.
I don't really believe these thoughts, but they do make me sad.

Hope this all makes sense, let me know if you have questions or if I'm missing something. Looking forward to working with you.

Thanks,

Chris

This email led to personal work with Chris in our Tuesday TEAM-CBT training group, roughly one year ago. Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California, was my co-therapist. It was one of the rawest and most riveting sessions that I can recall.

Here is the Daily Mood Log he sent, along with his Daily Mood Log:

Daily Mood Log

Due to the intensely personal, explosive revelations Chris shared with us during his session, he decided he did not want us to publicize his work as a podcast, which was totally understandable. Our highest priority is always the peace, safety, confidentiality, and well-being of the people we work with.

However, roughly a year later, Chris contacted us and said he’d changed his mind, which was fantastic news. He said he’d changed his mind because he had a relapse, and decided to listen to the recording of the work you’re about to hear. He said it was extremely helpful, and so he decided to let go and share it with the world.

I think you will find his personal work, published as usual as two consecutive podcasts without editing, to be mind-blowing, jaw-dropping, intensely inspiring and moving.

One word of caution is that his voice is soft and at times difficult to hear. We decide to publish it in spite of this because of the overwhelming power of his work. We are now setting up a professional quality recording studio and hope to record more sessions for you in the highest possible video and audio quality so we can bring you more inspiring Feeling Good Podcasts as well as live therapy sessions.

In the meantime, here is part 1 of our work with Chris. Next week, you’ll hear part 2.

Thanks so much for listening today!

Chris, Rhonda, and David
End of Part 1
Thank you for listening. Tune in next week for the exciting conclusion of our work with Chris!

Chris, Rhonda, Jill, and David
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402: Ask David: Unfairness; Erasing Depression with Lasers; TEAM in the UK; Most Powerful Technique
24 Jun· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Ask David Unfairness Worthwhileness Erasing Depression with Lasers TEAM in the UK What's the Most Powerful Technique?
We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes.

We love your questions. Remember to send them to [email protected].
Special Announcement Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information!
Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.

But there's some good news, too! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out!

Today’s Questions
Kiernan asks about “unfairness” and the connection between worthwhileness and achievement. Brittany asks: Can you “erase” feelings of sadness and depression by shining lasers in the patient’s eyes? James asks about the use of TEAM methods in the NHS in the UK Brian asks: Is positive reframing the most successful technique you have used with your patients? 1. Kieran asks (slightly edited for clarity): How would you talk back to negative thoughts like this one: “It's not fair that I can't afford quality food when there are millionaires that will have access to better food and a healthier lifestyle which has an effect on overall health and longevity'”? Or what if you feel like it’s unfair that you should have to pay a lot of money for an expensive dental treatment that you can’t afford? Kieran also asks (slightly edited by david): What if worthwhileness is not based on achievement but there are still things you would like to have and enjoy? They would buy and own things that they happen to like and not to impress others.
Hi David and Ronda, and if Matt is on

I have been listening to your wonderful podcast for about the last 3 years as I drive to work. It has really opened my eyes about how your thoughts create your interpersonal reality. Loved the podcasts on jealousy addiction, perfectionism, achievement addiction and many more.

My questions would be: What about if someone wants to achieve more but it isn't based on worthwhileness? They would buy and own things that they happen to like and not to impress others.

Let's say they wanted to be able to afford a nice house, healthier higher quality food and water. As the quality does have an effect on health especially in the US as the regulations are not the greatest.

However, the fact that they couldn't afford to buy these upsets them? Thoughts: 'It's not fair that I can't afford quality food but there are millionaires that will have access to better food, lifestyle which has an effect on overall health and longevity'

Or if someone has to pay for unexpected expensive dental treatment.

Thoughts: 'It's not fair that I have to pay £14,000 for this treatment'. 'It should be more affordable to lower income households, as it is essential to have functional teeth'

I hope I have explained this well, I would love to hear your thoughts. Keep doing what you are doing and all the best.

Kieran
David’s response
Sure Kieran, if you like I will make this an Ask David question for a podcast. LMK if that’s okay, and if it is okay to use your first name.

Great question, and has to do with the theme of acceptance: should I or shouldn’t I?

Here are the quick versions, but we can discuss in more detail on the live podcast. First, I do not find it useful to base my worthwhileness on my achievements or on my failures. I do work hard and like creating things that are helpful to people, and I enjoy earning money to support my family. I can be motivated to work hard to get things we want or need, but I don’t base anyone’s worthwhileness on how much money they have, or anything, to be honest.

In fact, I could also easily accept wanting to buy something really cool, not just because I like it, but because it might impress others, or because they might find it fascinating, too! I don’t try to regulate my life with a lot of shoulds and shouldn’ts, and find that I am happier and more peaceful without lots of shoulds.

In the Feeling Great App I have created a class called “Your PhD in Shoulds.” You might enjoy it!

Second, you can say that it is unfair that some people have more money and resources than other people if you like. And you have every right to feel angry if that’s what you want, as well.

Acceptance is more of a decision than a technique. Take the fact that lions kill deer when they are hungry. You can say, “they should not do that. It’s unfair!” But that won’t stop a hungry lion.

You don’t have to LIKE seeing a lion kill an innocent deer, but you can accept it. Again, that’s a choice. The behavior of a lion is dominated by millions of years of evolution. Humans are no different.

One thing that sometimes helps is to make a list all the REALLY GOOD reasons NOT to accept the “unfairness” in the world. I’ll bet you could come up with at least ten to fifteen strong reasons.

Then you can ask yourself, “Given all those good reason NOT to accept the fact that some people have more and some people have fewer resources, maybe I should just stay good and angry! Why in the world would I want to change?”

Also, when you find an injustice, you can use your energy being good and angry, and complain about it, or you can use your energy to do something about it. Or, you can also work to change yourself, instead of complaining about the world.

I also have a new class on acceptance. It’s called, “Accept this shit? Hell NO!” You might like it as well.

I am babbling so will stop.

Warmly, david
2. Brittany asks: Can you “erase” feelings of sadness and depression by shining lasers in the patient’s eyes?
Hi David,

My husband’s boss was telling him she’s going to be doing some laser therapy to “cure” her depression. She had to undergo 9 hours of testing to see if she’d be a candidate.

Apparently, they plan to shine lasers in her eyes to “erase” her sadness.

Obviously, I assume this is a load of garbage. But have you ever heard of such a thing? Is this just hypnosis?

Best, Brittany
David’s Reply
Hi Brittany,

Probably. As they say, follow the money! There is a placebo effect if you believe something will help, so tons of garbage gets served up as costly gourmet food.

You can read up on this on the internet I suspect. Let me know what you learn!

Best, david
Brittany responds to David
Love your answer! I was looking into it and read they use a cold laser in the eyes which allegedly releases endorphins. I already know from you that just like with exercise and that study about the endorphin blockers, it made no difference. People just feel better because they think they are doing something good for their body by exercising.

They also allege that the lasers aid damaged neurological tissue. They claim it has helped many patients but there is no data backing it up that I see.

They really lost me when I read that lack of activity, stress, and maternal deprivation cause depression in the first place.

Thanks! Brittany
David adds
As it turns out, I know two laser experts who are regulars on my Sunday hikes. Dr. Alexander Makowski is a brilliant scientist who is involved in the research and development of lasers and their marketing. Here is his email, along with some terrific links to articles about the hype of “low light lasers.”

Hope you enjoy the email and links from Alex:

Hi David,

I'll chime in too! From a different angle.

Zak knows some great doctors who are doing real work, but the general field of low-level laser/ light therapy (LLLT) for medical issues has been fraught with charlatans for some years.

(David note: Zak is a laser expert at the Stanford Medical School and is currently preparing a blog on the topic of LLLT. I will include a link to her blog when it is published, likely in a couple weeks. She is awesome and also often joins our Sunday hikes!)
Dr, Alex Makowsy continues
Good work by Tiina Kaaru (https://www.spiedigitallibrary.org/profile/Tiina.Karu-8010) and Juanita Anders (https://www.usuhs.edu/profile/juanita-anders-ms-phd) on mechanisms behind using light to stimulate our mitochondria or deactivate infectious bacteria are well documents

However, the good work done by the few was overshadowed and worse, was perverted for many years into crackpot devices using bad stats and poorly designed studies. Or sometimes just straight preying on vulnerable people. It is the great shame of the laser industry. Worse yet, some of these devices were actual lasers that led to people getting hurt.

I can't recommend in good conscience that lasers be shone into eyes at any time other than diagnostic devices meant to diagnose the eye itself. It may be that some day soon a good scientific body of evidence changes my stance but not yet...

The story starts in the origin of my journey into light and lasers. I got involved in this field in 2005 while taking an elective class on optics and lasers when I got a call from my mom that she was seeking a laser therapy for her fibromyalgia.

My mother's desire to get her fibromyalgia treated with a "cold laser" pulled me into this field since I was taking a class with a professor who later became my doctoral mentor. A full semester of my free time disappeared as I tried to source out of print articles and do a deep dive on whether this was real or garbage.

A research term paper and a conference visit later I could finally see the same trends you saw with medication. I talked her out of the potentially dangerous unproven device usage.

[As you may have suspected, In fact my mom was having significant issues in her marriage and life and a very good doctor set her straight. My mom divorced and is now happily remarried, about 95 pounds lighter, no fibromyalgia or serious insomnia. If only we had known you back then she would have recovered in a session or two rather than 3 years]

However, in the process, I dug into some of the real research that small doses of light can affect our bodies in ways we don't understand fully due to lack of research.

Fast forward several decades and some of the best researchers survived the public scandal of LLLT and found a scientific mechanism (cytochrome c oxidase activation) to explain observed changes in mitochondrial activity. However, the scientists don't claim to cure everything or anything. Then they published this mitochondrial activation and suddenly:

This, of course, proves that blogablum does in fact exist and now the truth about the panacea is available for all!!

David note: “blogablum” is a fake nonsense word I made up that refers to nothing meaningful. Now continuing with the Alex email:

This is a good review of the history and current evidence about it : https://www.mcgill.ca/oss/article/medical-critical-thinking/hype-around-photobiomodulation

But if you want the real goods, the hard truth about cold lasers has been out there for over 15 years:

Introducing the New Low Level Laser Treatment!

youtu.be

The following search on YouTube will reveal the secrets of the universe:

"cold laser before:2009"

Warmly,

Alexander J Makowski, Ph.D.
Dr. Matt May’s reply
Hi David,

Thank you for forwarding this question to me. I am very concerned and wonder if this may fall under the category of 'malpractice'.

For one, I am unaware of any FDA approved treatment for depression that involves shining lasers into people’s eyes to erase their sad memories. For a list of FDA approved treatments for depression, you could refer to:

https://www.ncbi.nlm.nih.gov/books/NBK559078/

It's possible that there is new evidence I'm not aware of, but I searched online for studies of light in treatment of depression and was unable to find any placebo-controlled trials. This is a problem because placebo responses can be so high in the case of depression and anxiety. There were some studies on light therapy, but nothing fitting the description of 'shining lasers into eyes to erase sad memories'.

Other concerns I have relate to the high cost of such an extensive “evaluation”, as well as possible risk of shining lasers into someone’s eyes. In the absence of evidence supporting the treatment, it seems like a high cost, and potential risk, to the patient, hence my concern for malpractice.

It's pretty common for people with depression to feel a sense of desperation, especially after many failed efforts to address their symptoms. This group of individuals are likely to be extremely susceptible to scams and purveyors of 'snake oil' (sham treatments).

It's also concerning to me because the theory behind the idea of shining light into people's eyes to erase sadness doesn't make logical sense to me. It's a potentially-testable hypothesis, but it's such an absurd hypothesis that I don't see it as worth testing or entertaining.

If we are defining depression as some combination of worthless, hopeless, ashamed and guilty feelings, then the hypothesis that such feelings could be meaningfully addressed by such a crude instrument as a laser or a pill or an electrical impulse is absurd.

This is because our feelings arise from our thoughts/perceptions. I've never met a single person or patient who was suffering from depression but had healthy positive thoughts about themselves. I've also never met someone who had patterns of negative thinking, but felt fine, up-beat and positive.

The idea that a pill, a laser, a magnetic pulsation or electrical current could selectively alter the specific thoughts that cause depression doesn't make sense with what we know about the brain and thoughts and feelings. How could a pill, for example, which crosses the blood-brain barrier and impacts every neuron in the brain, selectively target only the neurons that give rise to depressed thinking? It's like imagining that we could carpet-bomb a city but only kill the murderers and rapists.

I'd encourage all potential clients who are receiving treatment for depression or other conditions to ask their providers for literature that documents the effectiveness of the treatment and to get a second opinion if they are unsure.

These are my 2-cents on the topic and I could be completely wrong about it all. Hoping to hear from others what they think.

Also, David, I saw several other people included in the invitation to respond to this question but I didn't see them cc'd. Perhaps they were bcc'd?

Wishing you the best,

fondly,

Matt
David’s reply to Matt
Thanks, yes, I have a fantastic response already in the show notes from Dr. Alex Makowski who does research and development of lasers with valid medical applications. His thrust is similar to yours.

Our field is littered with junk “scientism” intended to fool and exploit people, similar to the snake oil salespeople who use to go from town to town in America selling magical “elixirs” that “cured” just about everything!

But people are endlessly gullible, and con artists are still in endless abundance these days, it seems!

Best, david

Will add your kind and thoughtful comment to the show notes!
3. James asks about the use of TEAM methods in the NHS in the UK.
Hi Rhonda,

I hope you are well. I had a couple of questions for an 'ask David' on the podcast if that's okay. A bit of background....

I am Level 1 Team and have attended David's training in Atlanta. I live in the UK and have recently changed career to work in the NHS delivering CBT interventions for patients because David's work inspired me so much.

The NHS uses specific interventions for particular diagnoses and because I am in training I have to try and stick to this. I do use the TEAM materials and approach when I can and have already seen some great results.

The NHS uses 'Behavioural Activation' for certain patients with Depression and I just wondered what David thought about the effectiveness of this (perhaps compared to Cognitive Restructuring). I believe Beck introduced this into the CBT model as he thought it was useful.

Another question was regarding treatment of GAD and whether dividing worries between hypothetical and practical, and then using a certain time to actually worry rather than letting the worries dominate throughout the day was something he thought was useful or had heard about.

Thanks so much for all the great work you are all doing and inspiring people all over the world!

Kind Regards James Bibby.
David’s response
Hi James,

Thanks for the great questions. In today’s recording of an upcoming Ask David podcast, we can address:
The history of “Behavioral Activation,” including the pros and cons of this approach. The history and pros and cons of “Worry Breaks.” The idea of matching a “technique” to a “diagnosis,” as opposed to learning to treat the whole patient with TEAM. The results of our latest research with the Feeling Great App, and whether it might have some value for patients struggling with depression and anxiety disorders in the UK.
Best, David
Matt’s Thots:
Great question! I’m looking forward to discussing.

There are certainly some techniques that are more effective, than others, for addressing specific negative thoughts. Meanwhile there are a number of problems that come up when we are, as clinicians, throwing solutions at diagnoses, rather than treating the human being who is suffering.

Studies on the treatment of PTSD at the VA, for example, showed veterans often got worse after this approach, in which their diagnosis was matched with a method, ‘prolonged exposure’, without any agenda-setting. This just retraumatized lots of veteran!

Similarly, if someone is secretly blaming, and haven’t experienced the ‘death of the blaming self’, they might be assigned ‘communication skills training’, only to see this backfire, because their intent is still to try to change someone, rather than accept them.

You might tell a patient with depression that they should go exercise, only to cause them to resist you, ‘you don’t understand, I can’t even get out of bed!’. In short, most therapy fails or even makes patients worse because it doesn’t consider the good reasons to continue to blame, give up, criticize ourselves, etc.
4. Brian asks: Is positive reframing the most successful technique you have used with your patients?
I can see how it would cure someone in 2 hours!

Feel free to use my question and do and use my name if you wish. I'd be honored.

Best,

Brian
David’s reply
Hi Brian,

Thanks. Great question! It’s one of the latest powerful techniques, but Ext of Voices might still be the “champion.” Using them in the T, E, A, M sequence is especially powerful. Positive Reframing often gets them closer, but not quite all the way to enlightenment.

Externalization of voices (EOV) often gets them over the finish line, especially if you know how to use it skillfully, incorporating Self-Defense with the Acceptance Paradox and Counter-Attack Technique! In fact, you can incorporate many of my > 100 techniques when using EOV, such as Be Specific, Semantic Technique, Examine the Evidence, and a host of other.

Best, david
Matt’s comments
I agree, Positive Reframing and Externalization of Voices are incredibly powerful and it’s often what we’re doing when we see recoveries. What works for a given individual, however, is quite hard to predict, in advance and there’s a ‘process’ to therapy, such that we can’t really skip steps, except in some unusual circumstances.

Some other super-powerful methods include Externalization of Resistance, Double Standard, Flooding, Feared Fantasy, and the Hidden Emotion Technique. I’m probably forgetting some.

Thanks for listening today!

Matt, Rhonda and David
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401: Ask David: Bipolar, the Dark Side, Changing Behavior
17 Jun· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Ask David Bipolar, the Dark Side, Changing Behavior
We have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes.

We love your questions. Remember to send them to [email protected].

Announcement: Our awesome summer intensive is returning after a long, five years due to the pandemic. It is typically the most outstanding and rewarding TEAM-CBT training of the year, and it will take place again and the wonderful South San Francisco Conference Center from August 8 – 11, 2025.

You can attend in person if you register soon, since in-person seating will be strictly limited and only a small number are still available. You can also attend the online, live-streamed version of this program at a substantial discount. The online experience and small group exercises will be similar for the in-person and online participants.

Check out the details, including early-bird discounts, at www.cbtintensive.com

www.cbtintensive.com

Hope to see you there!

Warmly, david

Today’s Questions
Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I’m suffering. What can I do NAME WITHHELD asks: Can or should a person really and truly accept their dark side? Trainor asks: In TEAM there is a strong emphasis on changing the way you think. But is it sometimes also important to change your behavior, or to make real changes in your life, or to help others who need help changing their circumstances==for example, people who are struggling in poverty. 1. Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I’m suffering. What can I do?
Hi David,

Many years ago I used your book to beat depressive thinking… in the last three years I’ve been diagnosed with Bipolar Disorder and have found my depressive thinking too difficult to budge with your book.

I’m really suffering; any ideas about what I could do?

Thank you for your service to humanity. I always recommend your book.

David’s response

Hi Alison,

A therapist could help. The new Feeling Great App could help. And tons of free resources at www.feelinggood.com.

In addition, can you please give me an example of the negative thoughts you can’t budge. Then we can point things out in the podcast and try to figure out why you’re getting stuck!

I have found that doing cognitive therapy / TEAM-CBT with individuals with Bipolar Disorder is exceptionally helpful during the depressed (not manic) phase, and works pretty much the same way as with anyone who’s feeling down.

Best, david
2. NAME WITHHELD asks: Can or should a person really and truly accept their dark side?
Hello David,

My name is NAME WITHHELD and I am doing my PhD degree in Neuroimmunology in LOCATION WITHHELD. I had come across your book feeling good and your podcasts by one of my therapists - they have had an immense impact on my way of thinking.

I really love disarming and using “I feel” statements to connect! I had also realized that by finding some genuine truth in a person’s belief even if it sounds ridiculous, I would automatically develop certain level of respect for that person! I really love that! I feel really happy that I can respect a person even without accepting his/her beliefs!!

I am now working on my distortions. I really love working on my mind that way.

Anyway, I have wanted to ask you if a person CAN accept his/her dark side? I seemed to have loathed myself for quite a long time and couldn’t stand living alone without a partner or a person around. I hated myself for disrespecting my mother whilst growing up.

But, sometime during Dec last year, I had had an epiphany of why things happened the way they did and somehow, I learnt that the reason why I had disrespected my mother was because my father, after their separation, kept filling my mind about how wrong my mother was for breaking up the family and I believed him because I had a good rapport with him, than I had with my mother.

Also, my mother was very awkward in building a relationship with me and I had misconstrued that with her indifference towards me. After that, I stopped hurting myself over it because I had learnt to empathize with myself then. I sobbed profusely that day.

Is it really possible to truly accept yourself? I feel at ease a lot more these days than I used to before. But I also have to battle my distortions too on a regular basis!

Please help me out here! Thank you so much for everything that you have done!! I really love your work!!

Regards,

NAME WITHHELD

David’s reply

Thanks so much. I hid your name and location, and hope that’s okay, and we WILL include your excellent question on our upcoming podcast. My brief reply is that all human beings have a “dark side,” and that we are far better off accepting it, as opposed to denying it and seeing ourselves as “totally good,” because then we might see others as “totally bad,” and feel morally superior. This dynamic is the cause of wars and a great deal pf hatred and suffering.
3. Trainor asks: In TEAM there is a strong emphasis on changing the way you think. But is it sometimes also important to change your behavior, or to make real changes in your life, or to help others who need help changing their circumstances--for example, people who are struggling in poverty.
Hey David!

I have asked several questions over the years (I asked about A.I. which I much enjoyed the episode on that!), so feel free to ignore this email if you feel I've overburdened you guys.

Anyway, I had a question about changing thoughts versus circumstances.

You often say that our thoughts create all of our emotional and interpersonal realities. I thought maybe a better or more nuanced definition would be to also mention that events CAN change our feelings but they do so through changing our thoughts.

I have heard Matt May mention this idea in some circumstances as the "low road to recovery." Where you actually get the thing you think you need and as a result feel better.

However, I thought about certain situations where changing the circumstance could also be a valid solution to an individual's problems. Take someone living in poverty, I am certain that CBT could help this person change their emotions around the experience of living in poverty. But would bringing the individual out of poverty be considered a "low road to recovery"?

Or could we say that bringing someone out of poverty is also a valid way of changing their emotional distress? Like sort of how therapists use both exposure and cognitive techniques to quell phobias or certain anxieties.

I personally like this definition because it includes the ability to change your circumstances as a method to change your thinking, without it being the only method. It also makes sense in a world where people want to make changes in society (giving women the right to vote, ending child labor) and create environments that foster positive thinking.

I think so much focus on the cognition (while fundamentally true) makes it feel like people should focus exclusively on changing the way they think about a situation. When, in reality, it seems like we can both change our circumstances and thinking simultaneously to make our lives better. Anyway, just wanted to know what you thought about this idea.

Thanks for everything you do,

Trainor Peters

P.S. I have nearly completed my first year of my psychology undergrad to become a counselor. In great part to you and all the wonderful people on your podcast. So, thank you!

David’s reply.

Thanks, Trainor,

I will add this excellent question to our Ask David list, if that’s okay, and discuss with Matt and Rhonda on a podcast.

My hospital in Philadelphia was located in an inner-city neighborhood, and many (perhaps most) of our patients have very limited resources. Some were homeless, and many had not completed the 5th grade. This gave me abundant opportunities to work with people with “real” problems in addition to their distorted perceptions.

In addition, I have always emphasized that sometimes you need to change the way you behave in the “real” world in addition to changing the way you think about it.

We’ll give these topics a deeper dive on the live podcast discussion.

And, best of luck in your ongoing training! Once you are in a graduate program, you will be eligible, if interested, to join one of our two free weekly TEAM-CBT training groups, which are both virtual.

Warmly, david

Thanks for listening today!

Rhonda and David
Special Announcement Attend the legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 long years. It will knock your socks off! Limited Seating--Act Fast! Click for registration / more information!
Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.

But there's some good news, too! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out!
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Celebrating Podcast #400
10 Jun· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
#400! Yippee!
Today, Rhonda has prepared a special celebration for our 400th podcast, and still going strong! She has invited a number of our favorite people and podcast guests to celebrate with us, starting with our beloved friend and frequent Ask David contributor, Matt May, MD, who officially joined us in early 2000.

Matt’s presence on the show had meant a great deal, personally and professionally, because I supervised Matt when he was a Stanford psychiatric resident, and had been missing our weekly chats! Our reunion via the Feeling Good Podcast has been special for that reason, but also because of Matt’s kindly but scholarly answers to the many questions all of you submit. Keep them coming, and send them directly to Rhonda or David. We love reading and answering them!

Next, we were joined by two more extraordinary psychiatrists and human beings, Drs. Heather Clague and Brandon Vance, who song their rendition (with guitar accompaniment) of “Help Dr. Burns!” (Based on Beetles’ Help, I need somebody!”

With their kind permission, here are the brilliant lyrics!

Help! I need a podcast!

Help! Not just any podcast!

Help! Pushing the Magic Button for ....

Help!

When I was younger, 8 years younger than today

I thought I could help everybody; help them in every way.

I got so grandiose; I was so self-assured.

I’d push my brilliant techniques, but my patients were never cured.

So, Help me not to Help oh Dr. Burns

Will they like me if they have to do the work?

If I set an ultimatum, am I a jerk?!

Won’t you please, please stop me?!

So many times, I tried to help, but then got stuck

I didn’t know but my patients were also thinking what the #?@!

Your podcast said to test at the start and after every session.

And then my eyes they opened wide

Boy, was that a lesson!

Oh Help me not to help, oh Dr. Burns!

Help me unlearn the bad habits I have learned

I’ll do homework when my urge to help returns

Won’t you please, please help me?!

Now I explore my patients’ reasons not to change.

I learned to sit with open hands if they choose to stay the same.

Only when they fight for change and want to do the work,

That’s when I offer tools, and know the changes will endure.

You’ve helped me not to help, oh Dr. Burns

‘Til my patients show me that they really yearn

To do the work and ask me really firmly

Won’t you please, please help me?

Your podcasts helped ME!

Oooooooh!

Much warmth to each of you!

Heather and Brendan

Our next guest was the brilliant and beloved Dr. Jill Levitt who joined my weekly Stanford training group when she and her husband, Brian, and two boys moved to the Bay Area from New York in 2007. Jill has moved up in the ranks and now co-leads the Tuesday group with me, and also joins me as co-therapists in a great many live sessions we have published as two consecutive podcasts.

The idea is to document exactly how TEAM-CBT works, and how we can nearly always get such blow-away results in a single, extended session. That was my dream as a young man, since the methods I was taught as a psychiatric resident almost never got rapid results, or even any noticeable changes in my patients. Now that dream has become a reality, and a great many people in our TEAM-CBT community have contributed to that evolution.

Next we were joined by our beloved Dr. Amy Huberman. Her riveting personal work on perfectionism was published recently on two consecutive Feeling Good Podcasts. Amy was glowing and filled with joy, which gave us great feelings of joy as well!

And then we were graced by a visit from Mina, who has starred in many Feeling Good Podcasts on a number of personal issues. I will be seeing Mina and her beloved husband in a few minutes for our Sunday morning hike and dim sum feast afterwards. It is always a highlight of my week!

Next was another Amy Berner who reported on her recent and wildly successful Intimate Connections Book Club with yet another psychiatrist, Dr. Leigh Harrington. Amy did some personal work with me on dating and sex appeal three years ago, when we discussed the Queen Bee phenomenon.

Apparently, it was successful, because she brought her fantastic husband, Randy Kolin, as proof of the effectiveness of the many dating strategies and tips in that book. Randy is also a mental health professional who works with stressed-out scientists working on nuclear fusion at the Lawrence Livermore Laboratories.

We wish him all the best since the work of those scientists is well on the road to creating commercially viable nuclear fusion, which will transform life as we know it on the surface of the earth by supplying unlimited, clean, low-cost energy.

Their visit was followed by Zane Pierce, whom I hadn’t had the chance to chat with much for a number of years. He led a recent “delight” and “gratitude” hike that we published on podcast # 361entitled “Finding Joy in Everyday Life,” with Dr. Angela Krumm from the Feeling Good Institute in Mountain View, California.

We have done previous podcasts with Zane, and his lovely wife, Daisy, including one of our most popular podcasts ever on “What’s the Secret of a Meaningful Life,” Episode 079.

And then came the magnificent colleague and friend, Indrani Mookerjee. Indrani joined our community after attending the 2019 intensive, and recently did one of the most explosive and jaw-dropping podcasts, Episodes 359 & 360, “You Wowed Me, A Mother-Daughter Conflict,” featuring her personal work on her relationship with her daughter.

Indrani had struggled, unsuccessfully, to get close to her daughter, whom she loved greatly. She made a mind-blowing discovery of why during her personal work, and instantly achieved what I call “interpersonal enlightenment.) She now provides the joyous follow up on how her relationship with her daughter has blossomed and evolved since that momentous moment.

Next, we were joined by Mike Christensen, who is our top TEAM therapist in Canada. Mike became familiar with my work when he read Feeling Good in 2006 and then heard a keynote speech I gave at a conference in 2009. Since that time, he attended many of my two-day workshops in Canada, and now is a leading TEAM-CBT therapist and teacher. He’s been a featured guest on seven Feeling Good Podcasts or episodes of Facebook Live, when I was doing televised work on Facebook every Sunday afternoon.

Mike describes himself as “joyously average,” a idea that really resonates with me. It is a form of “invisible enlightenment” which nearly everyone fears, but you cannot understand the incredible liberation of this “Great Death” of the “self” until you’ve experienced. We recollected a Feared Fantasy exercise we once did together while hiking one evening following a workshop in Canada.

We also got updated on his beautiful and brilliant daughter, Katlin, who is now studying psychology in college and hopefully heading for her own career doing TEAM-CBT.

And finally, one my most favorite people in the, our brilliant, wonderful, and funny Sara Shane, whose life-changing enlightenment has been a fantastic source of joy and inspiration to me and to many. Sara came from humble roots, as a Mexican immigrant picking fruit with her parents for survival in the US, and is now living in the Central Valley and attending not one, but two weekly TEAM-CBT training groups.

She specializes in brief intensive treatments for the patients she treats. You may recall her from podcast #162, High Speed Cure for OCD, where she described her single-session treatment for 20 years of OCD / contamination phobia. She also did a lot of personal work to achieve liberation from her fairly severe social phobia and feelings of inferiority that were embedded from early childhood.

We love you and so much appreciate you, Sara!

That’s about it for today, but than you all for listening. Next week, we will likely have two consecutive Ask David podcasts with Dr. Matt May, followed by two consecutive podcasts called “Raw Emotion: Personal work with Chris,” featuring the work that Jill and I did with a young man with social fears and an almost unbelievably traumatic childhood, growing up in Palo Alto. The sound quality is not always top-notch, sadly, but the unbelievable quality and impact of this session easily makes up for that, so we have decided to publish it anyway, and hope you find it as amazing as we did.

David, Rhonda, and the whole gang!
Special Announcement Attend the legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 long years. It will knock your socks off! Limited Seating--Act Fast! Click for registration / more information!
Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Hey, another special announcement! The long-awaited Feeling Great App is finally available in the Apple and Google stores. Check it out! You can try it for free!
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399: The Deep Freeze, Part 2 (of 2)
3 Jun· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
FROZEN: Part 2 of 2 Featuring Personal Work with Cody
Today, you will hear the exciting conclusion of the work that Jill and David did with Cody, a young man who sometimes freezes in social situations due to feelings of anxiety. He actually froze up when Jill and David were working with him in part 1 last week. What will they do?

Tune in today and you'll find out!

Before I describe Cody’s session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements.

For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at
Intensive Information / Registration
The online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year!

But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree!

In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Beginning of Part 2 with Cody
You will hear some of the tools that seemed especially helpful, including
Self-Disclosure Positive Reframing, not only for his negative feelings but also for his freezing Identify and Explain the Distortions Externalization of Voices with Acceptance Paradox the Feared Fantasy the Experimental Technique And more.
Whether you are a shrink or general citizen, I think there might be a lot for you to learn from Cody, not only about techniques to treat social anxiety and feelings of inadequacy, but also about enlightenment as well. ‘

That’s because the goals of a TEAM-CBT session are not just the reduction of negative feelings, but the complete obliteration of negative feelings, along with jumping on a psychic trampoline that catapults you into a state of profound self-acceptance and enlightenment.

At least, that’s my take on it!

Did it really happen?

Here's how Cody was feeling at the start of the session, along with his goals for each feeling at the end of Positive Reframing, and his feelings at the end of the session. As you can see, all of his negative feelings went to zero.
Emotions
% Before
% Goal % After Sad, blue, depressed, down, unhappy
40
10 0 Anxious, worried, panicky, nervous, frightened 95 15 0 Guilty, remorseful, bad, ashamed 20 5 0 Inferior, worthless, inadequate, defective, incompetent 40 10 0 Lonely, unloved, unwanted, rejected, alone, abandoned 50 10 0 Embarrassed, foolish, humiliated, self-conscious 100 30 0 Hopeless, discouraged, pessimistic, despairing 50 15 0 Frustrated, stuck, thwarted, defeated 50 15 0
Angry, mad, resentful, annoyed, irritated, upset, furious

30
5 0
Confused
60 10
0

What explains these seemingly impossible changes in a single therapy session? And are they real, or is this all just a bunch of hype?

Stay tuned and let us know what you think at the end!

Early, I had a challenging exercise to do on Cody’s SDBa. Here’s the solution.

To my way of thinking, Cody’s Downward Arrow chain of thoughts suggest a number of related Self-Defeating Beliefs, including:
Perfectionism: I should always try to be perfect. Perceived Perfectionism: Others will not love and accept me if they see that I’m flawed or if I screw up. I must earn the respect of others. Approval Addiction: I need everyone’s approval to be worthwhile. Achievement Addiction: My worthwhileness and capacity for happiness are based on my intelligence, achievements, and productivity. Fear of Rejection. Being rejected and alone would be devastating. Worthlessness Schema (possibly): I’m not inherently lovable, likeable, or worthwhile. Mistrust Schema (possibly): Other people are unsafe or predatory, and powerful, and eager to judge or hurt me. (David: this is a new one similar to Perceived Perfectionism, but this belief puts more of a negative twist on the perception of inherent malevolence in others.)
You always have to be the patient’s point of view about the SDBs, so these are just my guesses.

End of Session

Thanks so much for listening, and a big hug for Cody for sharing his inner self with all of us! To me, this is the best teaching because it is real, and you can see what the shrinks REALLY do behind closed doors.

You also get to see shrinks as struggling, vulnerable, and imperfect human beings, just like yourself!

Cody, Rhonda, Jill, and David
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398: The Deep Freeze, Part 1 (of 2)
27 May· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
FROZEN: Part 1 of 2 Featuring Personal Work with Cody
In today’s, and next week’s, podcasts. we present the next episode of live work with Cody. The first, which featured Rejection Practice for social anxiety, was published as Podcast #326 on January 9, 2023 at this LINK.

My co-therapist for this session was the wonderful Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mt. View, California (LINK.).

Before I describe Cody’s session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements.

For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at
Intensive Information / Registration
The online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year!

But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree!

In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.

Now, back to the podcast, in which you’ll hear some additional TEAM-CBT magic. Cody asked for help with a problem that’s been bugging him for some time. He sometimes freezes up when asked to do a role play or answer a question during psychotherapy training sessions. This typically leads to an awkward silence, and feelings of intense anxiety, inadequacy, frustration, embarrassment and more.

Here's how he described it:

Upsetting event: I was doing a suicide screening role-play with our clinical supervisor and other therapists. After working through the first step of the role-play, I froze and did not say a word!

Here's how Cody was feeling.

Emotions
% Before % Goal % After Sad, blue, depressed, down, unhappy 40 Anxious, worried, panicky, nervous, frightened 95 Guilty, remorseful, bad, ashamed 20 Inferior, worthless, inadequate, defective, incompetent 40 Lonely, unloved, unwanted, rejected, alone, abandoned 50 Embarrassed, foolish, humiliated, self-conscious 100 Hopeless, discouraged, pessimistic, despairing 50 Frustrated, stuck, thwarted, defeated 50 Angry, mad, resentful, annoyed, irritated, upset, furious 30 Confused
60

As you can see and might imagine, the most intense feelings were anxiety and embarrassment, but several other feelings were fairly intense as well: such as feeling alone, discouraged, frustrated, and confused.

These were some of his negative thoughts on the Dailly Mood Log that he brought to the session, and the percent he believed each one. Thought 5a, b, and c are an Individual Downward Arrow series, designed to get at the Self-Defeating Beliefs underneath the Negative Thoughts.

What do you think Cody’s SDBs are? Take a guess, and then you can look up the answers, or at least my own thinking, at the end of the show notes.

Negative Thoughts

% Belief
1. I shouldn’t have screwed up. 80 2. I’m not good enough. 80 3. I don’t belong here/I shouldn’t be here. 50 4. Something is wrong with me (my brain) 100 5a. Everyone thinks I’m an idiot ↓ 100 5b. I should not be in this ↓profession ↓ 70 5c. I failed to find something I’m good at. ↓ 70 6. I’m worthless 60
Although freezing in social situations is fairly common, it can be incredibly challenging and painful for those who experience it. Cody said:

Sometimes they try to help, or may switch to someone else. It sucks, and everyone feels awkward.

The hangover can last a few hours or a day, and keeps me up at night. Over time, some emotions get worse, especially the feelings of depression and inferiority.

I asked if there was also some hidden anger behind his anxiety when called on to perform in a group setting. He said,

Definitely. I feel irritated if I didn’t sleep that well the night before. My heart may not be into it 100%. I sometimes feel forced into it (performing), and just don’t want to be put on the spot. . . What makes it bad is the belief that everyone is looking at me and the belief that I’m being evaluated.

One of the most challenging and exciting events in the work with our courageous Cody was when he actually froze during the session! This gave us the chance to demonstrate and apply in real time. As you know, TEAM is extremely rich in specific methods to help patients within and between therapy sessions. What would be YOUR approach to helping Cody? Or, if you also struggle at times with social anxiety SDB, what is your prescription for yourself?

As usual, Jill and I went through the T, E, A, M. sequence in our session with Cody, which, of course, is highly and totally individualized for every person we work with. In today’s podcast, you will hear the T = Testing and E - Empathy portions of the session. Next week, you will hear the A = Assessment of Resistance and M = Methods portions of the session.

You might be curious to find out which techniques we used, and what approach was the most effective. So tune inn next week to find out!
End of Part 1
Some of the tools that seemed especially helpful included
Self-Disclosure Positive Reframing, not only for his negative feelings but also for his freezing Identify and Explain the Distortions Externalization of Voices with Acceptance Paradox the Feared Fantasy the Experimental Technique And more.
Whether you are a shrink or general citizen, I think there might be a lot for you to learn from Cody, not only about techniques to treat social anxiety and feelings of inadequacy, but also about enlightenment as well. ‘

That’s because the goals of a TEAM-CBT session are not just the reduction of negative feelings, but the complete obliteration of negative feelings, along with jumping on a psychic trampoline that catapults you into a state of profound self-acceptance and enlightenment.

At least, that’s my take on it!

Did it really happen?

Here's how Cody was feeling at the start of the session, along with his goals for each feeling at the end of Positive Reframing, and his feelings at the end of the session. As you can see, all of his negative feelings went to zero.
Emotions
% Before
% Goal % After Sad, blue, depressed, down, unhappy
40
10 0 Anxious, worried, panicky, nervous, frightened 95 15 0 Guilty, remorseful, bad, ashamed 20 5 0 Inferior, worthless, inadequate, defective, incompetent 40 10 0 Lonely, unloved, unwanted, rejected, alone, abandoned 50 10 0 Embarrassed, foolish, humiliated, self-conscious 100 30 0 Hopeless, discouraged, pessimistic, despairing 50 15 0 Frustrated, stuck, thwarted, defeated 50 15 0
Angry, mad, resentful, annoyed, irritated, upset, furious

30
5 0
Confused
60 10
0

What explains these seemingly impossible changes in a single therapy session? And are they real, or is this all just a bunch of hype?

Stay tuned and let us know what you think at the end!

Early, I had a challenging exercise to do on Cody’s SDBa. Here’s the solution.

To my way of thinking, Cody’s Downward Arrow chain of thoughts suggest a number of related Self-Defeating Beliefs, including:
Perfectionism: I should always try to be perfect. Perceived Perfectionism: Others will not love and accept me if they see that I’m flawed or if I screw up. I must earn the respect of others. Approval Addiction: I need everyone’s approval to be worthwhile. Achievement Addiction: My worthwhileness and capacity for happiness are based on my intelligence, achievements, and productivity. Fear of Rejection. Being rejected and alone would be devastating. Worthlessness Schema (possibly): I’m not inherently lovable, likeable, or worthwhile. Mistrust Schema (possibly): Other people are unsafe or predatory, and powerful, and eager to judge or hurt me. (David: this is a new one similar to Perceived Perfectionism, but this belief puts more of a negative twist on the perception of inherent malevolence in others.)
You always have to be the patient’s point of view about the SDBs, so these are just my guesses.

End of Session

Thanks so much for listening, and a big hug for Cody for sharing his inner self with all of us! To me, this is the best teaching because it is real, and you can see what the shrinks REALLY do behind closed doors.

You also get to see shrinks as struggling, vulnerable, and imperfect human beings, just like yourself!

Cody, Rhonda, Jill, and David
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397: Ask David: Assertiveness; Suppressing your Feelings; the "Miracle Cure" question
20 May· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Ask David, Rhonda and Matt Assertiveness, Suppressing your Feelings, and the "Miracle Cure" question Questions for today’s Ask David podcast. Chris asks if I have a book about assertiveness. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Matt asks about the “Miracle Cure” question in the Assessment of Resistance portion of a TEAM therapy session.
Rhonda began with a lovely endorsement and a cool reminder of the classic book, Robinson Crusoe, who created cognitive therapy (the double column technique) when he was stranded on a deserted island! I believe I wrote about it in one of my books, possibly Feeling Good. It’s pretty cool! You will hear Matt playing the role of the “evil” thoughts, like, “I am stranded alone on a deserted island,” and Rhonda will play the role of the “good” thoughts, like, “Yes, but my life was spared, and all of my shipmates died.”

Here's what it looks like in the novel:
Evil. Good. I am cast upon a horrible, desolate island, void of all hope of recovery. But I am alive; and not drowned, as all my ship’s company were. I am singled out and separated, as it were, from all the world, to be miserable. But I am singled out, too, from all the ship’s crew, to be spared from death; and He that miraculously saved me from death can deliver me from this condition. I am divided from mankind—a solitaire; one banished from human society. But I am not starved, and perishing on a barren place, affording no sustenance. I have no clothes to cover me. But I am in a hot climate, where, if I had clothes, I could hardly wear them. I am without any defence, or means to resist any violence of man or beast. But I am cast on an island where I see no wild beasts to hurt me, as I saw on the coast of Africa; and what if I had been shipwrecked there? I have no soul to speak to or relieve me. But God wonderfully sent the ship in near enough to the shore, that I have got out as many necessary things as will either supply my wants or enable me to supply myself, even as long as I live.
I know this novel is a couple hundred years old, so it certainly deserves nomination of the earliest cognitive therapy!

Now, for the answers to today’s Ask David questions. Keep in mind that these answers were written BEFORE today’s recording, so the actual live answers will differ in some regards from the written answers below.
1. Chris asks if I have a book about assertiveness.
Hi Dr. Burns,

I hope you're doing well. Do you have a book on assertiveness training?

I've used your books to help me with my hidden "should" statements, which has enabled me to be less angry or anxious whenever someone treats me less than satisfactorily.

While this has helped immensely, I realize it's still in my interest to reduce the behavior I disagree with. For example, my sibling scheduled an early morning shift after I had a long day of work. Because they can't drive, they expect me to take them to work, which means I'll only get about 5 hours of sleep; this in itself isn't a bad thing... except this is the 3rd time in a row they've done this.

After using your techniques, I'm less angry and anxious, but I still want to address the behavior to reduce the likelihood that they do something like this again, which is why I'm reaching out.

Thanks for your help.

Kind regards,

Chris

David’s Reply

Sure. I like my own book, Feeling Good Together, and have often recommended Manuel Smith’s When I Say NO I Feel Guilty.

There is a LOT to be said about assertiveness training, including the fact that it doesn’t always work! I can give a great personal account of that!

Sometimes, or always, skillful listening is also effective. Assertiveness without listening makes it sound like only your own feelings are important, which is obviously pretty self-centered.

One of the most helpful things to me is the difference between healthy and unhealthy anger, and how to express tough messages in a loving, respectful way.

Can discuss more on the show. For example, what are the problems with the assertiveness movement? And where can it be helpful?

And what mistakes do unassertive individuals make when trying to be more assertive? Do they sometimes overdo it?

Warmly, david
2. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Thanks!!
David’s reply.

Thanks, Brian. Great question!

You can listen to the podcasts on the Hidden Emotion Technique, or read about it in my book, When Panic Attacks.

Will make this an Ask David question if that’s okay!
3. Matt asks about the “Miracle Cure” question in the Assessment of Resistance portion of a TEAM therapy session.
Hi David,

I've noticed that when I ask the 'miracle cure' question or 'magic wand' question, I'll sometimes get a response that isn't all that useful and I might waste time trying to figure out what the person is really asking for.

An example might be, 'I want to be able to support and understand my husband, who is addicted to video games and spends a lot of our money on games'.

I've found it helpful, in such situations, to ask, 'let's imagine you could achieve that goal, you were perfectly understanding and supportive, at all times, of your husband, who is addicted to video games and spends a lot of your money on games...what would change, in your life, if all your dreams came true?'

I think this might help in a lot of cases where the agenda is a bit fuzzy and unclear.

Wishing you the best!

Matt

David’s response

Matt and I exchanged several emails we’ll discuss on the podcast. Essentially, I don’t think this woman is asking for understanding why her husband is addicted to video games and spends money on them. Instead, she is secretly blaming him and is probably angry with him for not spending time with her! She wants to change him.

Matt agreed with this and has proposed a new tool therapists can use when setting the agenda.

I, David, also raised the problem of “hearing the music” behind the patient’s words. This is incredibly important—but hard for therapists to learn—when using the Disarming Technique. They have a tendency to agree with the patient’s words in a literal way without “hearing” what the patient is really trying to say.

If you use any form of therapy literally, with really grasping the patient’s feelings, your treatment will not be effective or helpful. There is a human art to therapy, and following rigid formulas simply won’t come across as compassionate or genuine most of the time.

That’s why I am dubious about testing different therapies with outcome studies with human therapists. You are actually testing the impact of a miscellaneous group of therapists with potentially widely divergent skill sets. This is one of the many reasons why psychotherapy outcome studies for depression all come out about the same—somewhat better than placebos, but not much better.

And there’s been no one winner when using human therapists.

Dr. Paul Crits-Christoph from the University of Pennsylvania Department of Psychology once published a study showing that the differences between therapists within each arm of an outcome study were grater than the differences between the two schools of therapy!

That’s why I’ve been so excited about analyzing data from our beta tests with the Feeling Great App. Each “patient” gets the exact same shrink! This makes the “dose” of the TEAM done by the computer the same for each patient, much like an outcome study of a medication.

TEAM is a actually series of metaphors! If you don’t “get” the metaphors, and try to apply TEAM in an overly literal way, you’ll have a lot of trouble learning TEAM!

David

Matt’s Musings:

David is incredibly gifted when it comes to ‘hearing the music’ behind what folks are saying, verbally. I suspect this is partially an innate gift, like someone who’s a prodigy at math, only for emotional states and understanding people.

After years of practice, I’m not quite as good as David. However, I think there were specific forms of experience that helped me improve my skill ‘hearing the music’.

In addition to using measurement and processing feedback with my patients, one thing that helped me a lot was using a lot of ‘uncovering techniques’. These include the ‘What If’ technique, to expose hidden fears, the ‘Individual Downward Arrow’, to expose hidden insecurities, the ‘Interpersonal Downward Arrow’, to expose hidden assumptions about how we ‘should’ act in our relationships.

Seeing several thousand of these has helped me with ‘pattern recognition’, which I think is related to ‘hearing the music’. I’m proposing that beginning therapists might also benefit from an ‘Uncovering Technique’ for agenda-setting, following the ‘Miracle Cure Question’, which keeps asking, ok, let’s say you got that, what would you hope for, if you got absolutely everything you wanted? Ok, and let’s say you also got that, what would you hope for, in your wildest dreams?

This might expose hidden agendas which can be super important if we want to be able to anticipate resistance and identify the ‘cost of recovery’.

Thanks for listening today!

Rhonda, Matt, and David
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396: The Magnificent Summer Intensive Returns!
13 May· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Incredible Voices from the Past! Plus: David's Amazing Summer Intensive Returns August 8 - 11, 2024
Today, David and Rhonda are joined by Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mountain View, California, and two incredible voices from the past: Dr. Karen Radella, a clinical psychologist who volunteered to do personal work at the 2013 summer intensive at the South San Francisco Conference Center, and Jacqueline Ong, LCSW, who volunteered to do personal work at the 2019 summer intensive. That was the last summer intensive, due primarily to the Covid pandemic.

Karen Radella, PhD

But here’s some fantastic news. The intensive returns again this summer, from August 8 to 11, 2024, at the same location. And Karen and Jacqueline give testimonial today, along with Rhonda, to the magic of the intensive, by describing the phenomenal impact of the personal work they did years ago, and the tremendous impact that work has had on their personal and professional lives.

Both Karen and Jacqueline had been suffering from the devastating emotional impact of severe personal trauma for many years. Nine years earlier, when Karen’s daughter was 12, she asked Karen if she could go out to play after dinner. She’d done this for years, but Karen had the thought that it was late and cold outside, but gave in and let her daughter go out to play.

Minutes later, some neighborhood boys snuck up on her and shot her in the mouth with a high-powered pellet rifle that blew out one of her teeth and did considerable damage to her mouth which triggered PTSD and required many dental surgeries to correct. Both Karen and her daughter had been suffering emotionally for the nine years since that incident.

Karen was telling herself that she was a bad mom, that she “shouldn’t have” let her go out to play on that particular night, and that her daughter’s horrific trauma was her fault. She was also convinced that other people, including the 100+ in the audience that evening, would be judging her as harshly as she was judging herself, and her feelings of fear and despair were palpable at the start of her live work.

Karen described the techniques that were so helpful to her in her fantastic recovery that evening during her two hour session with Jill and David, including the Survey Technique, which she said was the “coolest experience of my entire life.” She was also helped by other techniques, including Explain the Distortions, the Double Standard Technique, and the Externalization of Voices.

Jacqueline had suffered a different but equally severe traumatic event of a personal nature, but also disclosed it and worked it through with great courage in front of an audience of the same size in 2019. Like Karen, she experienced a complete elimination of her symptoms in the 2 hour session with Jill and David. She describe the keys to her suffering and recovery involved perfectionism (the need to be flawless) and perceived perfectionism (a term David coined that refers to the belief that others expect us to be perfect in order to be loved and respected.)

Jacqueline emphasized that “failing as fast as you can” is one of the keys to the rapid recovery we so often see in TEAM. Instead of meeting once a week for an hour, which sets you up for very slow progress with relapses between sessions, you use technique after technique in one session until you find the one that works.

Of course, following “recovery,” your negative thoughts will return over and over throughout your life, because no one is entitled to be—or would even want to be—happy all the time. But once you’ve experienced your own enlightenment, you know the tools that work for you, so you get better and better at heading off the relapses at the pass.

Jacqueline and Karen both said they’d heard that the personal work at an intensive can be life-changing, but they “wouldn’t have believed it” until they experienced it. Rhonda said,

“I saw both live demonstrations. My first intensive was also the 2013 intensive when Karen did her personal work and saw Jackie's work at the 2019 intensive. I cried my eyes out with both of you at those intensives. After watching David and Jill's personal work with Karen at the 2013 intensive, I decided that TEAM was the therapeutic method I wanted to learn, and that’s why I’ve dedicated my life to learning, practicing and teaching TEAM.”

David, Jill and Rhonda hope YOU can attend the magical intensive this year. To learn more, you can just go to www.CBTintensive.com. This year you can attend in person OR online, since the program will be live-streamed.

In the past, David has done all the teaching, but this year, David and Jill will do their dynamic “tag team” teaching made famous by their weekly free training group at Stanford. It is now online and is free for therapists around the world. It is Tuesdays from 5 to 7 PM west coast time. If you are interested in joining, contact Ed Walton, [email protected].

You could also join Rhonda’s Wednesday TEAM training group that meets over zoom from 9-11:00 am. The timing of this group is more convenient for therapists from many parts of the globe. If you are interested in the Wednesday group, please contact Ana Teresa Silva, [email protected].

We hope to see you on August 8 at the South San Francisco Conference Center. But move fast if you want to attend in person, since seating will be strictly limited for those who wish to attend in person.
Click here for further Summer Intensive information
Best, rhonda, jill and david

Thanks for listening today!
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395: Ask David: More on Insomnia; Porn Addiction Guilt; Help with Rage
11 May· Feeling Good Podcast | TEAM-CBT - The New Mood Therapy
Ask David, Rhonda and Matt More on Insomnia; Porn Addiction Guilt; Rage Questions for today James asks for help with insomnia. Arjun Asks: How can I stop blaming myself for my porn addiction as a teen? Stephan asks: How do you treat feelings of rage? And what if you are simply very angry, but you don’t have any thoughts? James asks for help with insomnia,
Hi Dr. Burns,

I enjoy your newsletter and have experienced moments of clarity with your book. However, my current struggle is that I have developed terrible sleep anxiety. I feel nervous tension in my stomach and trembling limbs as nighttime approaches. Some nights I can put these feelings aside and dose off and others I just cannot stop dwelling on the negative body sensations and it does not allow me to sleep. I wonder if you can offer some advice on how to get over this fear and accompanying sensations.

Best,

James

David’s reply

Thanks, James. Sorry you’re struggling with trouble sleeping.

Yes, a Daily Mood Log can help, to find out what you are telling yourself that makes you so anxious about not sleeping.

Also, the Hidden Emotion Technique may be important to find out if there’s a problem in your life that’s bugging you.

There are also the typical sleep hygiene tips that can be useful for some folks, too! You can find these with an internet search.

Can I use this as an Ask David question for a podcast, with your first name or a fake name?

Best, david
Arjun Asks: How can I stop blaming myself for my porn addiction as a teen?
Hi Rhonda,

I Really appreciate the work that you guys do and I listen to most of the feeling good podcasts. I'm 27 and have struggled with depression and anxiety since my teens. I'm currently in therapy with a TEAM certified professional from India, but I'm still grappling with feelings of being stuck in my past.

During my pre-teen years, I battled a porn addiction for about a year, which has left me with ongoing feelings of anxiety, guilt, and depression. Despite trying various therapies, I haven't found relief.

I keep fixating on the thought: "I shouldn't have indulged in porn addiction in the past. It's led me to develop anxiety and depression."

How do I debunk this thought, reduce its hold on me, and cope with the regret it brings? It feels like I'm trapped in my past. and constantly blaming myself for that one mistake. because that indulgence in porn really did change my life. I wasn't the same as before. and never could go back to being who I was.

How do I put the lie to this thought? Any methods you'd recommend putting in the recovery circle?

Your insights would be invaluable in helping me move forward.

Thank you,

Arjun

David’s reply: The key concept is that the problem is perfectionism, plus the beating up on yourself in the here and now, and not the behavior or misbehavior in your past. In the live podcast, we can discuss the importance of T = Testing (with DML), E = Empathy and A = Assessment of Resistance, and M = Methods, like explain the distortions, Perfectionism / Self-Blame CBA, D. Standard, EOR, EOV, etc. etc.

The issue, as I see it, is that you are looking for a technique to help you accept yourself, but in reality, it is a decision for you to make. The choice is to accept yourself with compassion or continue to beat up on yourself.

There are many really GOOD reasons to beat up on yourself, and we can perhaps outline some on the podcast. You would then have to explain why you’d really want to accept yourself, given all the good reasons to keep beating up on yourself, and given all the positive things your self-criticisms show about you.

Also, I will try to remember to tell one of my favorite Buddhist stories that relates to this problem.
Stephan asks: How do treat feelings of rage? And what if you are simply very angry, but you don’t have any thoughts?
Hello Mr. Burns, I hope this email finds you in good spirits.

I’ve just begun your book “Feeling Good” and I have just reached the point where you begin to speak about cognitive distortions and how to get over your thinking. I’ve been doing your exercise on the days that my thoughts are heavily saturated in my mind and I’ve realized something within doing this exercise.

A lot of my thoughts do focus on the cognitive distortions that you’ve outlined in your book, but the other 75% of my thoughts focus on pure trauma of past situations and experiences that channels pure hate, anger and rage that pours out of my thoughts about the past situations. For example, one situation was someone purely scamming and taking advantage of me for years. And while doing your exercise, my hate and rage for that situation really comes out to where I wrote down “F*** that stupid a** b***** I hope she continues through her life being scammed as the fraud she is”.

A lot of my thoughts surround things like this with situation that I’ve been in. Or another example “This stupid a** girl gonna be married and divorced five times before I get married once And I went the wrong path. Ha.” Most of my thoughts are like this surrounded past relationships, friendships, and coworkers. And honestly, I don’t think it has anything to do with the list of cognitive distortions that you’ve provided. Not saying that I don’t have those thoughts, but the majority of my thoughts surround different topics.

I would love your input in your thoughts on what is going on in my head, and possibly even the name to the type of cognitive distortion, that these thoughts could fall under, if any. In the meantime, I will continue reading your book. Hopefully the answer is in there, but if not, I graciously await your response and I also thank you for your time.

Best regards, Stephan

David’s reply

Hi Stephan,

Anger always results from thoughts, and those thoughts are often extremely distorted. This thought, for example, contains Labeling, and many other distortions: “F*** that stupid a** b*****

Sorry you’ve been taken advantage of by someone acting fraudulently and scamming you, as I understand from your note. Anger is totally understandable. The first treatment tool would be a paradoxical Cost-Benefit Analysis, which we could illustrate on a podcast, if you are interested. Your questions touch on many important topics!

Best, david

Matt’s Reply

Thanks for the question, Stephan, like David is saying, getting out of rage and into peace and harmony, which is part of ‘enlightenment’, requires identifying the motivational elements that are pushing you away from, as well as pulling you into, that emotion.

For example, David has identified, over 30 Good Reasons to Blame Others and has a handout on this.

Here's an example of a reason to keep rage: You’ll be protected, from being taken advantage of, again, if that person is labeled as ‘bad’. This keeps them, and others like them, at a distance.

Another motivator for rage is that revenge fantasies can be pleasant, feel powerful, just, and gives us a sense of moral superiority.

Also, sometimes we’re not quite ready to just ‘let go’ and ‘move on.’ There might be things we really liked about the relationship that we don’t want to lose and we might not want to grieve the loss of that person, or the loss of our own time. We want our time back and for them to change!

Lots of other good reasons, again there’s a list of 30 Good Reasons to Blame, created by David.

Please bear in mind that rage can get you into lots of trouble, so if you’re at risk of acting out your anger, it’s a good idea to get professional help, not something we can provide, here.

Thanks for listening today!

Rhonda, Matt, and David
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Show more

Episodes

414: All About Coaching: What Is it? Is it Different from Therapy?

413: Intrusive Thoughts; Alone and Liking It; Shoulds, and More

412: Ask David: Give-Get Imbalance; Best Anxiety Treatment; Externalization of Voices; and more

411: Ask David: What’s Self-Esteem? What’s Self-Acceptance? Do We "Need" Them?

410: What's the Meaning of Life?

409: Is the Universe One? Is the Universe Real?

408: Do You Believe in God? Does God Exist? The Spiritual Dimension in TEAM-CBT

407: Do You Have a "Self?"

406: Do Humans Have "Free Will?"

405: Ask David: Why does my father try to control me? Why do women ghost me? And more!

404: Raw Emotion: Dad, I let you down! Part 2 of 2

403: Raw Emotion: Dad, I let you down! Part 1 of 2

402: Ask David: Unfairness; Erasing Depression with Lasers; TEAM in the UK; Most Powerful Technique

401: Ask David: Bipolar, the Dark Side, Changing Behavior

Celebrating Podcast #400

399: The Deep Freeze, Part 2 (of 2)

398: The Deep Freeze, Part 1 (of 2)

397: Ask David: Assertiveness; Suppressing your Feelings; the "Miracle Cure" question

396: The Magnificent Summer Intensive Returns!

395: Ask David: More on Insomnia; Porn Addiction Guilt; Help with Rage