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Feeling Good Podcast by David D. Burns

Feeling Good Podcast

by David D. Burns

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The Feeling Good Podcast is a new podcast from Dr. David D. Burns, author of the bestselling book Feeling Good: The New Mood Therapy which has sold over 5 million copies in the U.S. since it was published in 1980. The book popularized cognitive behavioral therapy (CBT) which has become one the most effective therapy treatments for depression, anxiety, and numerous other mental disorders. Burns’s mentor, Dr. Aaron T. Beck is the father of cognitive therapy which is one of the most practiced psychological therapies used today.


In this podcast Dr. Burns sits down with host Dr. Fabrice Nye and discusses the techniques of CBT along with other techniques that Dr. Burns has developed in his practice over the years. Burns confronts the issue of therapeutic resistance many patients have and how to overcome it with his T.E.A.M. model that he lays out over many podcast episodes. The "Methods" podcast episodes get into cognitive distortions and negative thinking patterns that are often present when people are depressed or anxious. Burns provides examples of this distorted thinking that accompanies low mood, and the CBT method for overcoming this thinking. No matter what mood you are in, you can benefit from the practices of CBT and other techniques that Dr. Burns lays out in this podcast in order to overcome negative thinking patterns.


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  • 076: Five Simple Ways to Boost Your Happiness (Part 3) — Confront a Fear
    Mon, Feb 19, 2018

  • 075: Five Simple Ways to Boost Your Happiness (Part 2) — The Anti-Procrastination Sheet
    Mon, Feb 12, 2018

    Procrastination is one of the most common causes of unhappiness, and this bad habit is almost universal. We all put off the tasks we dread because they make us anxious, and because we're tempted to do other things that are way more rewarding. But the longer you procrastinate, the worse you feel, and this robs you of motivation. As a result, you fall into a vicious cycle where procrastination triggers negative feelings like depression, anxiety, and guilt, and your negative feelings, in turn, reduce your motivation and trigger more procrastination. A vicious cycle.

    Fabrice and I are going to show you how to break the cycle and boost your happiness. To get started, please think of ONE thing you've been procrastinating on. It could be anything, such as working on your taxes, cleaning your garage, filing papers, working on a paper or presentation you've been avoiding, reading something you have to read for school or work--anything at all.

    Now I want to ask you a question. Would you like to overcome the procrastination so you can get started on that task? If your answer is no, you can come back and listen later when you do want to solve this problem.

    If the answer is yes, then I have a second question for you. WHEN would you like to overcome your procrastination and get started? Today? Or later on?

    If your answer is today, then we're ready to rumble. If you say, "tomorrow," or some later time, then I'd encourage you to come back to this podcast when you are ready to solve the problem. I can ONLY help you overcome your procrastination today! NOT tomorrow.

    Finally, I want to know if you'd be willing to devote a very small amount of time to getting started TODAY. I'm asking you to invest something like five minutes, and I'm also asking you to agree to limit your work this small amount of time. This is crucial, because if you tell yourself you have to do the entire job, that may take hours, and you'll probably feel so overwhelmed that you won't do a thing!

    Finally, I want to know if you'd be willing to get started for five minutes even if you're not "in the mood," and even if you're completely unmotivated, and EVEN if the very thought of the task makes you anxious and guilty. If the answer is YES, then we've got a deal. But if you want to wait for the motivation, I urge you to turn off the podcast and come back to it at some later time.

    One philosophical principle is the approach we're going to teach you is NOT to wait for motivation. Most procrastinators think that motivation comes first, followed by productive action, but this is an illusion, because you'll probably NEVER feel motivated to do some awful task you've been putting off. If you're waiting for motivation, you'll be waiting forever!

    As I wrote in my first book, Feeling Good: The New Mood Therapy,  highly productive people know that ACTION comes first, followed by motivation. In other words, you have to get started on some task before you'll feel motivated. You're not entitled to feel motivated until you've start accomplishing something! Waiting for motivation is the trap that keeps your procrastination alive and prospering.

    I'm going to make things simple for you using a tool I created years ago called the Anti-Procrastination Sheet! To make this podcast experiential, think about the specific task you've been putting off, like filing papers, preparing your taxes, cleaning the garage, a paper or report you have to prepare--anything at all.

    Now take a look at the Anti-Procrastination Sheet. As you can see, it has five vertical columns, but they're different from the columns on the Pleasure Predicting Sheet that we discussed in last week's podcast. In the first column you break the task into small, or even tiny, steps, and number them. Make sure that each step can be completed quickly and easily--for example 30 seconds, or a minute or two.

    You don't have to outline the entire task, just the first four or five steps. And make sure the steps are small enough so you can complete all or most of them in five minutes or so. The philosophy behind this is called "little steps for big feats!" If you aim to do just a little, you may end up doing a great deal. But if you aim to do it all at once, the odds are high that you'll just end up procrastinating, because the task will seem overwhelming.

    After you've outlined the first few steps, predict how satisfying or rewarding each step will be in the second and third columns, on a scale from 0% (not at all satisfying) to 100% (tremendously satisfying.) Make sure you complete this column before you do the activity. And make sure you do it on paper, and not just in your head!

    Now complete the first step, and indicate how satisfying and rewarding it turned out to be on the same scale, from 0% to 100% in the fourth and fifth columns. That's all there is to it! Now do the same thing for the second step of the task.

  • 074: Five Simple Ways to Boost Your Happiness (Part 1) — The Pleasure Predicting Sheet
    Mon, Feb 05, 2018

    David begins with a brief discussion of the philosophy of happiness, including the ancient Buddhist idea that everything in the universe is transitory and constantly changing, including our positive and negative moods, so the idea that you will be hopelessly depressed forever, or endless happy, are both illusions. Happiness, or pleasure, are transitory, and can only be achieved at specific moments. However, you can significantly increase the number and duration of the happy periods in your life.

    David briefly discusses research evidence that simply doing potentially satisfying and rewarding activities, whether or not you're "in the mood," can reduce depression and enhance feelings of happiness and joy in daily living. This simple treatment method, called "Behavior Therapy," was pioneered by Dr. Peter Lewinsohn, from the Oregon Research Institute, and has been shown to have significant anti-depressant effects.

    One way of doing this is with David's famous "Pleasure-Predicting Sheet." It's pretty simple to use. As you can see from the link, it is a sheet with four vertical columns. In the first column, you schedule activities with the potential for pleasure, learning, personal growth, or helping others. You can include activities that are not overly time consuming or burdensome. In the second column, record who you plan to do each activity with. If you do the activity alone, put "self" in the second column, since you're never truly alone. You're always with your "self."

    In the third column, predict how satisfying or rewarding the activity will be, on a scale from 0% (not at all satisfying) to 100% (tremendously satisfying.) Make sure you complete this column before you do the activity! And make sure you do it on paper, and not just in your head!

    Once you've completed each activity, indicate how satisfying and rewarding it turned out to be on the same scale, from 0% to 100%. That's all there is to it!

    Then you can compare the last two columns (the predicted and actual satisfaction). Sometimes, depressed individuals think that things they used to enjoy will be boring or unrewarding, so they give up on things, fail to answer the phone, and mope around at home in a state of hopelessness and self-pity. Of course, that's a self-fulfilling prophecy and a vicious cycle, because when you stop doing things, you will probably become more depressed, and then you'll be even more likely to give up doing things for pleasure. In contrast, when you do things, you may discover that many activities are more rewarding than you anticipated.

    You can also compare the satisfaction you experience when doing things by yourself versus the activities you do with others. Many depressed people with the Love Addiction believe they cannot be happy when they're alone, thinking they must be loved to feel truly happy and fulfilled. David describes a woman who tested this belief, and made an unexpected discovery, after her husband rejected her for another woman. You can see her Pleasure Predicting Sheet if you click here.

    Finally, David gives an example of how a depressed, perfectionistic medical professor made another unexpected discovery with a modified version of the Pleasure-Predicting Sheet.

    The Pleasure-Predicting Sheet is one of only 50 to 100 methods that David has learned or created for defeating depression and anxiety. He doesn't see it as a complete treatment for depression, but it usually has some nice mood-elevating effects. Fabrice and I encourage you to try it this week, so you can let us know how it works for you!

    Next week, we'll have another cool tool you can use to boost your happiness by overcoming procrastination!

  • 073: Ask David — Implementing the Five Secrets
    Mon, Jan 29, 2018

    We address five questions submitted by listeners who listened to the recent series of podcasts on the Five Secrets of Effective Communication.

  • 072: Secrets of Weight Loss — Make Good on Your New Year's Resolutions!
    Mon, Jan 22, 2018

    You definitely do NOT want to lose weight. You probably DO want to be thin and attractive, and in great physical condition, but you DON'T want to lose weight. Do you know why? There are only two things that you can do to lose weight--diet and exercise. And they both suck!

    David describes two new, powerful techniques he has created for resolving this dilemma--the Double Paradox and Devil's Advocate Technique. David and Fabrice bring these techniques to life for you. If you are interested in losing weight, make sure you do the two exercises on paper while listening to this podcast.

  • 071: Ask David — Expressing Anger, Narcissistic Bosses, Social Media Bullying
    Mon, Jan 15, 2018

    • What do I do if I am using the Five Secrets and I feel angry? If I use the Disarming Technique, isn't there a danger that I might not express my own feelings? And isn't this the same as your "Hidden Emotion" Model, where we don't express our feelings due to excessive niceness?
    • How would you use the Five Secrets if you're attacked in public by a narcissistic boss? Should you use the Disarming Technique? Won't that make you look weak? Should you only use the Five Secrets in one-on-one situations?
    • Why is the Self-Monitoring technique rarely effective?
    • How would you help young people who are being bullied in social media?

  • 070: The Five Secrets (Part 6) — Stroking
    Mon, Jan 08, 2018

  • 069: The Five Secrets (Part 5) — "I Feel..." Technique
    Mon, Jan 01, 2018

  • 068: The Five Secrets (Part 4) — Inquiry
    Mon, Dec 25, 2017

    David and Fabrice discuss Inquiry, the third of the Five Secrets of Effective Communication. Inquiry means asking gentle, probing questions to learn more about what the other person is thinking and feeling.

    David encourages listeners (that includes you!) to try using Inquiry five times each day, even in superficial interactions with people in any setting, such as the grocery store, and gives examples of how to do this. Although this will not be the deepest application of Inquiry, the practice will give you a clear understanding of how this technique works.

     

  • 067: The Five Secrets (Part 3) — Thought and Feeling Empathy
    Mon, Dec 18, 2017

    David addresses a question submitted by a listener after he heard the introductory podcasts on the Five Secrets of Effective Communication. He questioned the value of the Disarming Technique, and protested that every time he "turned the other cheek" he simply ended up with two sore cheeks!

    A great question, and David and Fabrice share their thinking. Many people, including therapists, are afraid of the Disarming Technique, thinking that something terrible will happen if they agree with someone who is criticizing them.

    They emphasize the value of questions submitted by you, the listeners, and also suggest giving specific examples when they are having trouble using the Five Secrets. Specifically, if you write down exactly what the other person said to you, and exactly what you said next, David and Fabrice will gladly analyze the interaction and show you what errors you made that caused a bad outcome, as well as how to correct those errors!

    David and Fabrice then discuss Thought and Feeling Empathy, the second of the Five Secrets of Effective Communication. The definition of Thought Empathy is repeating or paraphrasing what the other person is saying, so he or she will see that you listened and got the message. Feeling Empathy, in contrast, involves acknowledging how the other person is likely to be feeling, given what he or she just said. You can often follow this with Inquiry, asking if you got it right, and inviting the other person to tell you more about what he or she is thinking.

    Although David does not like formulas, they can sometimes help you get started. So here's the formula:

    1. Thought Empathy: Let me see if I got what you just said. You told me that A, B, and C. (A, B, and C would be what the person said to you, using his or her words.)
    2. Feeling Empathy: Given what you just said, I can imagine you might be feeling X, Y, and Z. (X, Y, and Z would be words from the Feeling Words list.)
    3. Inquiry: Did I get that right? Can you tell me more about what you've been thinking and feeling?

    These techniques are invaluable in therapy, and go back to the pioneering work of Karl Rodgers, who argued that therapist empathy is the necessary and sufficient condition for personality change. Although subsequent research did not confirm this idea, there is still little argument that empathy is absolutely necessary for good therapeutic work.

    In addition, skillful empathy is for everyone, and can greatly enhance your relationships with family members, friends, and colleagues, and strangers as well. For example, if you have a family member or friend who is feeling anxious, down, angry, or depressed, the skillful use of Thought and Empathy will almost always be far more effective than trying to help, rescue, or "fix" that person.

     

    David brings Thought and Feeling Empathy to life with an example of a patient who criticizes his therapist, and then asks listeners, including you, to pause the podcast briefly so you can write down, from memory, what the patient just said. Most therapists who try this end up "forgetting" or editing out important portions of what the patient said. This irritates the other person, because you clearly did not "get it," and his or her attack or complaining will usually escalate.

    David and Fabrice discuss common errors therapists and general public make when trying to use Thought and Feeling Empathy. The most common error involves using the techniques in a robot-like manner, parroting back the other person's statements repeatedly, without using "I Feel" Statements. They illustrate this error with a humorous example.

    Other common errors when using Thought and Feeling Empathy include:

    • Helping
    • Rescuing
    • Giving advice
    • Correcting distortions
    • Making interpretations
    • Failing to acknowledge the other person's anger

     

    David encourages listeners (that includes you!) to try using Thought and Feeling Empathy three times each day, even in superficial interactions with people in any setting, such as the grocery store, and give examples of how to do this. Although this will not be the deepest application of these techniques, the practice will give you a clear understanding of how these techniques actually work.

    David and Fabrice end this podcast with a powerful example of Thought and Feeling Empathy during an actual therapy session in David's weekly psychotherapy training group. The "patient" in the therapy is a TEAM-CBT therapist named Rhonda who became depressed and anxious after receiving some critical therapy from a participant in a therapy group she was teaching.

    Even if you are not a therapist, you can perhaps identify with the "ouch" we all feel when we are criticized by someone, and it hits a vulnerable spot. This is an almost universal human concern. It is so easy to feel hurt, depressed, ashamed, anxious, inadequate, and perhaps even a bit angry!

    David invited one of the therapists in the group to empathize with Rhonda, as a part of his training, but he ended up with a less than stellar grade. David, Fabrice and Rhonda explain the errors he made--which actually made her feel worse.

    Making errors is totally okay in a training and learning situation, as well as in real therapy sessions--as long as you get feedback and try to correct your errors with humility. This can actually deepen the therapeutic relationship.

    David then asked Dr. Jill Levitt to try to model empathy again, and to address Rhonda's concerns. Jill hits the ball out of the park and gets an A+ on empathy. David and Fabrice explain why her intervention was so effective, and why the Five Secrets have to come from the heart if they are to be maximally effective.

    Jill is a master therapist and co-teaches the weekly TEAM-CBT training group, along with David and Dr. Helen Yeni-Komshian. If you would like to hear more of Jill's fabulous empathy work, make sure you listen to the live therapy podcasts with Mark, the physician who felt like a failure as a father!

    Next week, Helen returns for the remaining Podcasts on the Five Secrets!

     

  • 066: The Five Secrets (Part 2) — Disarming Technique
    Mon, Dec 11, 2017

    David, Helen and Fabrice focus on the Disarming Technique, which is the first of the Five Secrets of Effective Communication. The definition of the Disarming Technique is finding truth in what the other person is saying, even if it seems blatantly wrong, or illogical, or exaggerated. And it's based on the Law of Opposites.

     

  • 065: The Five Secrets (Part 1) — Overview
    Mon, Dec 04, 2017

    Is there someone in your life who just 

    • won't listen?
    • won't open up?
    • always has to be right?
    • always has to get his or her way?
    • doesn't seem to understand how you feel?
    • doesn't seem to care?
    • is relentlessly critical?
    • whines and complains endlessly, but always ignores your attempts to help?

    Would you like greater intimacy and respect, and more rewarding relationships with the people you care about?

    If so, this podcast series on the Five Secrets of Effective Communication will be right up your alley. Although the Five Secrets have been introduced in previous podcasts, David and Fabrice will bring them to life with clear explanations and vignettes, and will give you homework assignments so you can practice them, one at a time, between podcasts. In the first two Five Secrets podcasts, David and Fabrice will be joined by Helen Yeni-Komshian, MD. Helen was David's student during her psychiatric residency training at Stanford roughly 15 years ago, and she now teaches David's at weekly psychotherapy training group at Stanford, and is on the adjunct faculty there.

    David, Helen, and Fabrice begin with a brief definition of each of the Five Secrets of Effective Communication. They emphasize the importance of intense desire if you really want to learn and master these techniques. They compare the Five Secrets to the notes on a musical instrument. Lots of dedication and practice will be necessary if you hope to use them skillfully and effectively in your relationships with the people you care about. The goal is to help you develop greater  satisfaction in your interactions with others and to resolve conflicts and arguments with others.

    Helen emphasizes that these techniques must be applied in a genuine fashion if they are to be effective. If they are used simply as techniques to manipulate another person, they will not be effective.

    David mentions that the Five Secrets exist on two levels. One the one hand, they are sophisticated and powerful psychological techniques that can change your life and your relationships with others. But on the other hand, they are profound spiritual techniques that require the death of the ego. And they also require us to relearn our usual knee-jerk habits of arguing, blaming, and defending ourselves when we're at odds with another person.

    These podcasts will be for mental health professionals and for the general public. We will give vignettes illustrating challenging therapeutic logjams that were resolved with the skillful use of the Five Secrets, as well as examples  how you can use the Five Secretes with loved ones, friends, colleagues, customers, and even aggressive or irritating strangers.

    The Five Secrets require lots of hard work and practice, in much the same way that learning to play a musical instrument will require lots of practice. In addition, when you practice you may initially find them difficult to use, and you may experience some failures. David, Helen, and Fabrice emphasize the spirit of "joyful failure" or "learning through failure," and urge you to check your ego at the door, since the rewards of the learning can be immense.

     

  • 064: Ask David — Quick Cure for Excessive Worrying!
    Mon, Nov 27, 2017

    How would you treat excessive worrying? a listener asks.

    David describes a new patient who had struggled with 53 years of failed therapy for excessive, relentless worrying, and describes how she was "totally and irreversibly cured" in just two therapy sessions, which was the "good news." The Hidden Emotion Technique was the key to her remarkably rapid recovery. David explains that the "even better news" was that her relentless worrying would come back over and over in the future, and that this was actually a really good thing!

    David also emphasizes the importance of using all the four models, along with a Daily Mood Log, when treating any form of anxiety: the Motivational Model, the Cognitive Model, the Exposure Model, and the Hidden Emotion Model. To learn more about how these four powerful treatment models work, you can listen to Podcasts 022 through #028.

    The DSM5 is the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. It is used to assign diagnoses to patients. David critiques the DSM5  diagnostic criteria for "Generalized Anxiety Disorder" (GAD) and emphasizes that while worrying exists, and can easily be treated in most cases, the "mental disorder" called Generalized Anxiety Disorder does not exist, and is simply a fantasy made up by the psychiatrists who have created the DSM.

    Soon, David and Fabrice will launch a series of five podcasts on the Five Secrets of Effective Communication, focusing on one technique each week. Say tuned, because these podcasts could change your life and show you the road to more loving and satisfying relationships with friends, patients, colleagues, and family members--and "enemies" as well!

     

  • 063: Ask David — What’s Good About Hopelessness or Addiction? What Is it to Be a Worthwhile Human Being?
    Mon, Nov 20, 2017

    Is there anything positive about hopelessness or an addiction ? What does it take to be a "worthwhile" human being, or to have a valuable life?

    In today’s podcast, David and Fabrice address three questions submitted by listeners:

    1. Avi asks another great question about the importance of Positive Reframing in TEAM-CBT. But how can we possibly find something positive in the feeling of hopelessness. After all, Dr. Aaron Beck has taught us that it's the worst emotion of all!
    2. Avi asks a similar question about an addiction. How can an addiction possibly be a good thing?
    3. Eugene asks a tremendous question about a passage in Dr. Burns' book, Feeling Good: The New Mood Therapy, on the topic of what it means to be a worthwhile human being, and what it takes to make a life valuable. Eugene hints that Dr. Burns may have the wrong idea, and asks what he would say to a patient who doesn't "cry uncle!"

    David and Fabrice love your questions so keep them coming!

     

  • 062: Ask David — The Five Secrets of Effective Communication & Psychotherapy Homework
    Mon, Nov 13, 2017

    Will people manipulate you if they catch on to the fact that you're using the Five Secrets of Effective Communication? Is it fair to ask depressed patients to do psychotherapy homework between sessions when they're already struggling with a loss of motivation?

    In today’s podcast, David and Fabrice address two questions submitted by listeners:

    1. Robert asks whether it would be a problem if you are using the Five Secrets of Effective Communication (the Disarming Technique, Thought and Feeling Empathy, Inquiry, "I Feel" Statements, and Stroking) with someone who is already familiar with these techniques. Isn't there a danger that they might see through you and  therefore thwart your efforts and manipulate you?
    2. Avi asks about the importance of psychotherapy homework in TEAM-CBT. He points out that the loss of motivation is one of the central symptoms of depression, so aren't we in a catch 22 type of situation since patients might not have the strength and perseverance to do their homework?

    David and Fabrice love your questions so keep them coming!

  • 061: Ask David — Test Validity, Uncovering the Negative Thoughts, Benefits of Laziness, and More...
    Mon, Nov 06, 2017

    We address a number of excellent questions submitted by listeners:

    1. Are the scales on your Brief Mood Survey reliable and valid?
    2. How can I identify my Negative Thoughts when I'm upset but I can’t figure out what I'm thinking and telling myself?
    3. I have social anxiety and don’t want to get out of bed. I'd rather just lie in bed and watch Game of Thrones. Help me! What should I do?
    4. I saw an article in the paper that claimed that bacteria in the gut cause anxiety. Is this true? If not, what does cause depression and anxiety?
    5. Could your tools, like the Cost-Benefit Analysis, help with problems that aren’t necessarily emotional problems? Like what career to pursue, or what college to go to?
    6. What should you do if you feel great at the end of a therapy session, and then become severely upset again during the week?
    7. How does Dr. Burns deal with resistance from colleagues when he is trying to teach these new TEAM-CBT techniques? Does he run into much resistance? How does he feel about the resistance?

  • 060: Self-Monitoring
    Mon, Oct 30, 2017

    David describes one of the more obscure methods called “Self-Monitoring”. He thinks of it as “Meditation in Daily Life.” The whole idea is to note a negative thought that suddenly pops into your mind, and then to track it, or count it, with some type of counting device, list the wrist counters golfers wear to keep track of their scores, and then to simply let go of the thought and continue with what you were doing, instead of dwelling on the thought and getting distracted and upset.

    David explains that Self-Monitoring often is not effective, but occasionally it can be life changing for individuals who are struggling with anxiety, depression, or anger. He brings the method to life with the story of an eye doctor with severe OCD who recovered completely because of Self-Monitoring in combination with Response Prevention.

    He also explains how this technique, along with the Daily Mood Log, was curative for a retired carpenter with severe depression following a stroke. The type of stroke is called “Pseudo Bulbar Palsy,” and the symptoms include uncontrollable sobbing or laughing after the slightest sad or funny event or comment.

    This case was particularly interesting because the therapist for the carpenter was one of David’s students, a clinical psychologist who had raised the question, “How could cognitive therapy possibly help someone if his or her depression is caused by a chemical imbalance in the brain?” And in this instance, since we know the carpenter’s depression was caused by thousands of microscopic hemorrhages in the deep structures of his brain, how could any kind of psychotherapy possibly help?”

  • 059: Live Session (Marilyn) — 8-Week Tune-up
    Thu, Oct 26, 2017

    This podcast was recorded eight weeks after the initial session with Marilyn. As you may recall, Marilyn became severely depressed when she discovered that she had Stage 4 Lung cancer. In spite of that horrific and real trauma, she completely overcame her negative feelings in the first session, which was broken down into a series of three consecutive podcasts, with commentaries as the session unfolded.

    Sadly, Marilyn experienced severe pain in her left rib cage from a metastasis from her lung cancer roughly two months later. This physical relapse triggered an understandable emotional relapse as well, with an understandable return of severe depression, anxiety and anger, so Marilyn agreed to record another podcast to illustrate how a tune-up works following the initial treatment.

    I would like to point out that the Relapse Prevention Training was critically important, so that Marilyn would know that relapses are a certainty, and that they can be dealt with effectively using the same techniques that worked the first time. This message is important so that the patient does not feel broadsided when the negative feelings return. Some patients have the false expectation that they'll be happy forever after they've recovered.

    But no one is entitled to be happy all the time! If the therapist and patient know how to deal with a relapse, and have practiced ahead of time, it will still be painful, but the patient and therapist will know what to do to make sure the patient can recover from the relapse quickly, instead of getting caught in another length episode of depression or anxiety.

    The entire session has been included in this single podcast. That’s why we’ve offered this as a bonus session between our weekly podcasts. You will need nearly two hours to listen to it, but I think you will find it’s a great investment of your time.

  • 058: Ask David — Third-Wave Therapies & Exposure for OCD
    Mon, Oct 23, 2017

    David and Fabrice begin by reading several incredibly touching reader comments on the live therapy with Marilyn. Marilyn experienced a severe depression relapse eight weeks after her initial session with Matt and David, because of a painful metastasis to her rib cage which frightened and demoralized her. She graciously agreed to come in for a tune-up with David and Matt which will be published as a special podcast within the next week or so. You will not want to miss this session!

    David addresses two questions posed by listeners. The first question has to do with so-called “third wave” CBT as well as Mindfulness-Based CBT and other innovations in CBT. David stresses the difference between specific and non-specific therapeutic techniques. He also discusses the distressing but exciting fact that few or no therapies have proven to be much more effective than placebos in the treatment of depression, and why this is the case.

    Another listener asked why David did not use Exposure initially in his treatment of the woman who was afraid that her baby would be switched at the hospital, and that she’d end up with the wrong baby. David concedes that if he’d thought of using Cognitive Flooding initially, it likely would have been effective. He also argues that Exposure and Response Prevention are not treatments for OCD, or for any anxiety disorder, but are simply tools one can use in treatment. David argues that for an optimal outcome, he combines four treatment models with every anxious patient: the Motivational Model, the Cognitive Model, the Exposure Model, and the Hidden Emotion Model. These models are discussed in detail on previous podcasts.

  • 057: Interpersonal Model (Part 4) — "And It's All Your Fault!" The Relationship Journal
    Mon, Oct 16, 2017

    David emphasizes that the goal of the RJ is not simply to learn how to transform troubled, adversarial relationships into loving ones, but also how to achieve Interpersonal Enlightenment, which is the empowering but shocking realization that we are creating our own interpersonal reality—for better or worse—at every moment of every day! And although the reward of the RJ is greater love and joy in your daily living, the price is steep—it requires the death of the ego, which the Buddhists have called “the Great Death!”

    Together, David and Fabrice walk you through the five steps in the RJ, using real examples of individuals David has worked with in his workshops for the general public or for mental health professionals. One vignette involves a woman who complained bitterly that her husband had been relentlessly critical of her for 25 years. She said she came to the workshop because she wanted to know why men are like that. She found out why her husband was so critical, but the answer was not the one she expected!

    The other vignette involved a minister’s wife who complained that her husband was overly “nice” and unable to deal with negative feelings. As a result, she said their marriage was superficial and lacking in intimacy. She discovered precisely why their relationship was superficial—but it wasn’t exactly the answer she was looking for!

  • 056: Interpersonal Model (Part 3) — "And It's All Your Fault!" Interpersonal Decision-Making and Blame Cost-Benefit Analysis
    Mon, Oct 09, 2017

    Bob, a psychiatric resident named was treating a divorced woman who complained bitterly about her ex, and constantly argued with him whenever he came to visit with the children.

    Their relationship was clearly acrimonious, so Bob asked the woman if she wanted some help with the way she was communicating with her ex. She bristled and said that she was an attorney and that she could communicate just fine, thank you! Bob’s error was the same that many therapists make—of thinking that people with troubled relationships want help. Clearly, Bob’s patient was not asking for help. She just wanted Bob to agree that her ex was a bum!

    In many cases, and perhaps most, individuals who aren’t getting along with someone—such as their spouse, sibling, parent, colleague, or friend—aren’t really asking for help. They just want to vent and persuade you to buy into their negative view of the person they aren’t getting along with. They just want you to know what a loser the other person is!

    So how do we help people with troubled relationships? David emphasizes that empathy is always the first step. You try to see the world through the eyes of the patient without jumping in to try to “help.” Empathy, of course, is the "E" of TEAM therapy.

    Once the person feels understood and supported, the next step is called Agenda Setting. That’s the A of TEAM. One of the most important tools in Agenda Setting for individuals with troubled relationships is to first ask, “Is this relationship conflict something you want help with?” In many cases, the patient will say no, so you can ask if there’s something else he or she wants to work on.

    In the language of TEAM, this is called “Sitting with Open Hands.” The therapist has to let go of his or her attachment to “helping.” This is difficult for many therapists, due to the therapist’s compulsive urges to help.

    If the patient does want help, the next step is called Interpersonal Decision-Making. You ask what kind of help the patient wants, and make it clear that the patient has three choices.

    1. To leave the relationship.
    2. To improve the relationship.
    3. To stay in the relationship and behave in a way that will guarantee that the relationship will remain miserable.

    David emphasizes that the last choice is by far the most popular. The second most popular choice is the decision to leave the relationship. And occasionally, you’ll find a person who wants help improving the relationship. As you can see, Interpersonal Decision-Making is simply a more sophisticated way of asking the patient if she or he wants help!

    If the answer is still yes, the next Agenda Setting step is the Blame Cost-Benefit Analysis (CBA). You can ask the patient something along these lines:

    “Who, in your opinion, is more to blame for the problems in the relationship? You? Or the other person? And who, in your opinion, is the bigger jerk? You? Or the other person?”

    At least 80% of the time, the patient will say, “the other person!” You may feel the same way if you’re in a conflict with someone right now. However, blame is the most formidable barrier to intimacy, so before we can continue with the treatment, this issue must be skillfully addressed, or the treatment will probably fail.

    David and Fabrice guide the listener in doing a written Blame CBA, listing the advantages and disadvantages of blaming others for the problems in our relationships with them. They encourage you to pause the recording and to the written exercise during the podcast, but warn you not to do it if you are driving!

    Then they discuss how to process the results of the Blame CBA. If you would like to see a completed Cost-Benefit Analysis, click here. As you can see, the weightings at the bottom have not been filled out, so you can do that for yourself if you like. Make sure you put two numbers that add up to 100 in the two circles. Put the larger number in the circle under the column that feels more desirable. For example, if the advantages of blame greatly outweigh the disadvantages, you might put a 70 in the circle on the left and a 30 in the circle on the right.

    If the patient concludes that the disadvantages outweigh the advantages, you can proceed to the M = Methods phase of the TEAM therapy session, which involves the Relationship Journal (RF). This is a powerful tool that David has designed to create interpersonal enlightenment and the death of the ego. David and Fabrice will discuss and illustrate the RJ in the next podcast.

  • 055: Interpersonal Model (Part 2) — "And It's All Your Fault!" Three Basic Assumptions
    Mon, Oct 02, 2017

    David describes the three assumptions of the Interpersonal TEAM Therapy:

    1. We cause the very relationship problems we are complaining about, but don’t realize this, so we blame the other person and feel like victims of his or her“badness.” David describes a man who endlessly complained about his wife during therapy sessions--she didn't like having sex with him, she spend money behind his back, and never bragged about him when they were out to dinner with friends. He had even taken notes for years on all the “bad” things his wife had been doing every day throughout their marriage, but overlooked the many hurtful and self-centered things he was doing to break her heart every single day.
    2. We do not want to have to look at our own role in any relationship conflict because it is too painful to have to confront our “shadow,” to use a Jungian concept, and because we want to do our dirty work in the dark. So we will deny our role and angrily punish anyone who tries to shed light on our role in the problem. David describes a severely depressed woman who complained that she was the victim of "loneliness in marriage," a concept she'd just read about in a popular women's magazine. She explained that her husband would not and could not express his feelings, and felt that he was to blame for their marital problems as well as the severe depression and loneliness she’d been struggling with for 25 years. And yet, in a therapy session when he tried to express his feelings, she exploded angrily and told him to shut the F__ up! When Doctor Burns asked her to reflect on what had happened in the session with her husband, she angrily threatened to fire him if he ever brought up the topic again!
    3. The first two principles paint a dark picture of human nature. The third principle is more optimistic—namely, that we have far more power to heal a troubled relationship than we realize, and this can often happen quickly, but there’s a stiff price to be paid.  First, we have to be willing to stop blaming the other person so we can examine and pinpoint our own role in the conflict. Second, we have to focus all of our energy on changing ourselves, rather than trying to change the other person. This can be extremely liberating and joyful, but it involves the exceedingly painful death of the ego. The Buddhists have called this type of enlightenment “the Great Death.’

    In the next podcast, David and Fabrice will show you how to transform your own troubled relationships into loving ones--if that's what you want to do!

  • 054: Interpersonal Model (Part 1) — "And It's All Your Fault!" Healing Troubled Relationships
    Mon, Sep 25, 2017

    First in a series of podcasts on how to transform troubled relationships into loving ones—if that's what you want to do!

    David begins with the story of how he got into working with troubled couples as well as individuals with troubled relationships shortly after his first book, Feeling Good, was published. Because cognitive therapy was beginning to generate excitement worldwide as the first drug-free treatment for depression, everyone thought it might also be effective for other kinds of problems, including troubled relationships.

    And there were fairly good reasons to suspect that cognitive therapy might be helpful. When you’re in conflict with a loved one, friend, colleague or stranger who you can't get along with, you’ve probably noticed that you will usually have negative thoughts like these running through your brain:

    1. It’s all his fault. (Blame, All-or-Nothing Thinking)
    2. She’s a jerk. (Labeling, Should Statement, Mental Filter, Hidden Should Statement)
    3. He’ll never change! (Fortune Telling, All-or-Nothing thinking, Discounting the Positive, Emotional Reasoning)
    4. All she cares about his herself. (Mind-Reading, Discounting the Positive, Mental Filter, Over generalization)
    5. I’m right and he’s wrong about this! (Blame, All-or-Nothing Thinking)
    6. She shouldn’t be like that. (Should Statement, Blame)

    Sound familiar?

    And as you can see, these thoughts contain all the same kinds of cognitive distortions that depressed individuals have, as I've indicated in parentheses. If you're familiar with the cognitive distortions, you may be able to pinpoint even more than the ones I've listed. The only difference is that when you're in conflict with someone, the distortions will usually be directed at the person you’re not getting along with, rather than yourself.

    Although these thoughts will usually be distorted, you may not realize this (or even care) when you're upset. You'll probably be convinced that the person you're mad at really is a jerk, or really is to blame, or really is wrong. In addition, these thoughts will tend to function as self-fulfilling prophecies. For example, if you think someone is a self-centered jerk, you will usually treat him or her in a hostile or unfriendly way, and then he or she will get defensive and hostile, and will look like a jerk. Then you'll tell yourself, "See, I was right about him (or her)!"

    David got excited about these insights and wrote a draft of a book called Couple in Conflicts, Couples in Love, and sent it to his editor in New York to see what she thought. The new book was about how to modify the distorted thoughts and self-defeating beliefs that trigger and magnify relationship problems. David's editor called the next day with an offer of a large advance, exclaiming excitedly that the book was sure to be a #1 best seller.

    David was ecstatic, and set out to edit the book for publication. In the meantime, he was using the new approach with troubled couples as well as individuals with relationship conflicts. But after six months of repeated treatment failures, he concluded that cognitive therapy was not at all effective in the treatment of relationship problems. The approach sounded great on paper, but it didn't work in the real world.

    David sadly returned the advance to his publisher and cancelled the contract. He promised that if he could figure out why cognitive therapy didn't work for troubled relationships, and if he could find a better treatment method, he’d write another book. Figuring it out took 25 years or research and clinical experience, and the name of the book he eventually did publish is called Feeling Good Together, now available on Amazon.com.

    David and Fabrice then discuss some of the most popular theories about the causes of relationship problems:

    1. The skill deficit theory: We want loving relationships, but don’t have the communication and negotiation skills to get close to the people we’re not getting along with.
    2. The barrier theory: We want loving relationships, but something gets in the way, such as unrealistic expectations or distorted thoughts about the person we’re not getting along with. Other barrier theories include the idea that women are from Venus and men are from Mars popularized by John Gray, Deborah Tannen, and others. According to this theory, women use language to express feelings, and men use language to solve problems, so they both end up frustrated and not understanding one another. Another popular theory is the idea that we project childhood conflicts with our parents onto others, and thus recreate the same dysfunctional patterns repeatedly in every new relationship.
    3. The self-esteem theory: You can’t develop loving relationships with others if you don’t know how to love yourself.
    4. The motivational theory: We have troubled relationships because we WANT them!

    David emphasizes that the first three theories are all very optimistic--they all are based on the idea that human beings are basically good and want loving, peaceful, joyous relationships. But something gets in the way, such as a barrier of some type, or the lack of communication skills, or the lack of self-esteem. And they are all very hopeful, since we can teach people better skills, or remove the barriers to intimacy, or help people develop better self-esteem.

    David also emphasizes that these theories have only two problems. First, the theories that they're based on are false. Second, the treatments that have evolved from these theories are not effective. David and Fabrice describe research on the validity (or total lack of validity) for these theories as well as the effectiveness (or lack of effectiveness) of the treatment techniques and schools of therapy that have evolved from these theories.

    David then discusses the motivational theory which is much less optimistic about human nature, and emphasizes that humans have competing positive and negative motives.

    In the next podcast, they will discuss the basics assumptions of the new treatment approach David has created for relationship problems, based on the motivational theory.

  • 053: Ask David — “I don’t feel like doing it!” Quick Cure for Procrastinators
    Mon, Sep 11, 2017

    A listener named Benjamin asks about procrastination. He wrote:

    “The live therapy with Marilyn was very interesting - like other listeners, I was impressed by her character and strength.

    “Towards the end of this most recent podcast, you were musing on what topics to cover in future podcasts. I would love to hear about how you treat people suffering from chronic laziness ("Do Nothingism"). In particular, there seems to be a strong potential of a Catch-22 with Process Resistance: The patient cannot find the motivation to do anything, yet they have to carry out the process (do the homework) to improve.

    “Even worse, in "Feeling Good", you categorize "Do Nothingism" into around 10 different categories, and suggest a different approach for each one. What should a lazy person do, who identifies with multiple categories, but is already starting to feel overwhelmed at the prospect of doing one of those activities, let alone five of them?

    “I would love to hear David's thoughts on this!”

    David and Fabrice begin by thanking Benjamin, and David emphasizes how helpful and inspiring it is to receive specific questions like this, which makes it easy to create a (hopefully) informative and interesting podcast.

    David says that his thinking about the treatment of procrastination has changed greatly since he wrote Feeling Good. One big change is that he no longer tries to “help” individuals who procrastinate, since this will cause them to continue to procrastinate, and the failure will now be the failure of the therapist, who’s “helping” wasn’t good enough.

    Instead, David outlines a multi-step approach, based on someone who has ten years of unfiled papers that have piled up in his office, so that by now 15 feet of desk space is completely covered by piles of papers roughly one foot high. Fabrice plays the role of the resistant patient, and David plays the role of the therapist.

    The steps include:

    Paradoxical Agenda Setting: David asks, “The procrastination seems to be working for you. Why would you want to change? Let’s make a list of all the benefits of procrastination, and all the reasons NOT to change.” David emphasizes that the patient has to convince the therapist that this is something he really does want to change. It’s NOT the therapist’s role to help or to convince the patient to change!

    Miracle Cure Question: What kind of help would you like in today’s session? Most patients say they need help with motivation. David declines to offer this, explaining that it isn’t on the therapeutic menu today—only the “Blue Plate Special!” The patient must agree to begin working on the filing in spite of having no motivation.

    David also explains the underlying concept behind this strategy: most procrastinators are waiting for motivation, but that never works. You’ll be waiting forever, because you’re NEVER going to feel like doing all that filing! You aren’t entitled to motivation!

    Productive individuals know that action comes first, and motivation comes second.

    Specificity: What time would you like my help in overcoming your procrastination? The patient’s requests for help yesterday or tomorrow are declined by the therapist, so they settle on 6 PM today.

    Little Steps for Big Feats: Let’s list the first five things you would need to do tonight at 6 PM, making sure that every step can be completed in 15 to 30 seconds. They list these steps:

    1. Walk into my office
    2. Choose one pile to start working on
    3. Pick up the top piece of paper on the pile
    4. Put it into a blank manila file folder
    5. Label the file folder

    Let’s Be Specific: David asks if Fabrice needs help with Step 1? Step 2? Etc. Fabrice finally admits he can do these five steps.

    Five Minute Rule: David asks if Fabrice will agree to do these five steps between 6 PM and 6:05 PM, and if he will agree to work on his filing for ONLY those five minutes. At the end of the five minutes he has completed 100% of the assignment. The rationale is that if Fabrice tries to do it all, he’ll get so overwhelmed that he won’t do anything. But if he agrees to ONLY five minutes, that will be do-able. And if he surprises himself, and gets motivated to do more, he can, be he only gets credit for the first five minutes.

    Problem – Solution List: David asks Fabrice to put a line down the middle of a piece of paper, from top to bottom, and list all the problems that will get in the way at 6 PM, and then to list convincing solutions to each problem in the right-hand column. Fabrice lists two problems: 1. I won’t feel like it. And 2. Traffic might be heavy, so I might not get home by 6 PM.

    “I Stubbornly Refused” Technique: David asks Fabrice to agree to an unusual phone call at 6:05 PM!

    TIC – TOC Technique: David plays the role of Fabrice’s “Task-Interfering Cognitions” (TICS) that will tempt him to procrastinate, and asks Fabrice to play the role of the “Task-Oriented Cognitions” (TOCS) he can use to combat the TOCs. The TICS include the familiar ones such as:

    1. Five minutes won’t help, the job is overwhelming.
    2. Even if I get started, I’ll just relapse, so there will never be a permanent solution.
    3. It’s not such a big problem, I don’t need to do my filing now.
    4. I can watch Game of Thrones on TV instead. That will be more fun.
    5. It will be too anxiety provoking to get started.
    6. It’s too late to get started anyway.
    7. Tomorrow will be a better day.

    David confesses the problem is one that he actually had, and describes how he solved it, using this exact approach!

  • 052: Your Responses to the Live Work with Marilyn — Are People Honest in Their Ratings, and Do the Improvements Stick?
    Mon, Sep 04, 2017

    The responses to the Marilyn session were extremely positive. At the start of the podcast, Fabrice reads a response from a listener who was moved and inspired by the work Marilyn did.

    David and Fabrice discuss two questions commonly raised by people who have seen David's live demonstrations with individuals experiencing severe depression and anxiety. Since the change in Marilyn’s scores were so fantastic, some skeptical listeners have asked, “Was this real, or was it staged?” Others have asked if patients are simply giving favorable answers on the Brief Mood Survey and Evaluation of Therapy Session forms as a way of being “nice” to the therapist.

    David points out that the opposite is true. If patients are in treatment voluntarily, without some kind of hidden agenda such as applying for disability, they tend to be exceptionally honest in the way they fill out the forms. In fact, most therapists find that they get failing grades from nearly every patient on every scale at every session at first. This can be very upsetting, especially to therapists who are narcissistic and defensive about criticism. But if the therapist is humble and open to the feedback, the patient’s feedback on the Brief Mood Survey as well as the Evaluation of Therapy Session forms can provide a fabulous opportunity for growth and learning.

    So in short, it is not true that patients fill out the forms just to be “nice” and to please the therapists. The scores are brutally real! If you are a therapist and a doubters, you can give the assessment instruments a try, and I think you’ll be surprised, and perhaps even shocked when you review the data!

    Still, David acknowledges that the rapid and phenomenal changes he now sees most of the time when using TEAM-CBT are hard to believe, especially when you've been trained to think that recovery is a long, slow process. David discusses a model of brain function proposed by a molecular biologist / geneticist, Dr. Mark Noble, that allows for extremely rapid change.

    David and Fabrice also address the question—can these kinds of miraculous results last, or are they only a flash in the pan? David emphasizes the importance of ongoing practice whenever the negative thoughts return. The “one and done” philosophy is not realistic. Part of being human is getting upset during moments of vulnerability, and that’s when you have to pick up the tools and use them again!

    David describes experiencing three hours of panic just a few days ago, and Fabrice asks what techniques he used to deal with his own negative feelings, including Identify the Distortions, Examine the Evidence, Reattribution, and the Acceptance Paradox.

    David agrees with the Dalai Lama that happiness is one of the goals of life, but emphasizes that it is not realistic to think one can be happy all the time. Fortunately, you can be happy most of the time--but you have to be willing to pick up the tools and use them from time to time when you fall into a black hole!

  • 051: Live Session (Marilyn) — Methods, Relapse Prevention (Part 3)
    Mon, Aug 28, 2017

    Crushing Negative Thoughts

    In this third and final podcast featuring live therapy with Marilyn, David and Matt move on to the M = Methods phase of the session along, and encourage Marilyn to challenge the Automatic Negative thoughts on her Daily Mood Log using techniques such as Identify the Distortions, the Paradoxical Double Standard Technique, the Externalization of Voices, and Acceptance Paradox. Marilyn emerges as a powerful partner and begins to crush the negative thoughts that had seemed so real and overwhelming at the start of the session.

    David emphasizes that the perceptions of therapists can often be way off base, so even though Marilyn appeared to change—fairly dramatically—during the session, David, Fabrice, and Matt will not know for sure until they review Marilyn’s end of session ratings on the Daily Mood Log, Brief Mood Survey, and Evaluation of Therapy Session.

    David defines a relapse as one minute or more of feeling lousy. Given this definition, all human beings will “relapse” frequently, including Marilyn. But relapses following recovery do not have to be a problem if the patient is prepared for them ahead of time. You will hear David and Matt doing relapse prevention using a number of techniques, including the Externalization of Voices.

    Fabrice, Marilyn, Matt and David discuss the session, and what it meant to Marilyn from a personal and spiritual perspective. You can view this session as a powerful psychological experience—a “mind-blowing” single session “cure,” if you will—or as a profoundly healing spiritual experience: the emergence, resurrection, or rebirth from the “Dark Night of the Soul.” And you can ask yourself—did a genuine miracle happen here today?

    Marilyn DML, end of session, mood only
    Marilyn BMS before and after, v 1

    I, David, am very indebted to Marilyn for making this phenomenal and intensely personal experience available to all of us. What a gift! Thank you, Marilyn. We love you!

    I also want to thank my co-host, Fabrice, for making these podcasts happen! What a joy it is to work with you every week, Fabrice.

    And I want to thank my fantastic co-therapist, former student, and colleague, Matthew May, MD, for support and friendship over these many years! Matt, as you know, I often sing your praises in my workshops around the country, telling people how amazing you are. Now they will see what I mean first-hand!

    I hope that through these three podcasts, Marilyn will touch large numbers of people for years, even decades, to come. If you were touched by these recordings, please let your friends and colleagues know, so that they might have the chance to “tune in” as well.

    In the first session with Marilyn, I mentioned the highly controversial theory that our pain usually results from our thoughts, and not from the circumstances of our lives. What do you think now?

  • 050: Live Session (Marilyn) — Agenda Setting (Part 2)
    Mon, Aug 21, 2017

    The Hidden Side of Depression, Anxiety, Defectiveness, Hopelessness and Rage

    We nearly always think about negative feelings, such as moderate or severe depression, as problems that an expert must try to fix, using drugs and / or psychotherapy. There are a multitude of theories about why humans become depressed, including, but not limited to:

    • We get depressed because reality sucks. We believe our mood slumps result from the circumstances in our lives, such as being alone following a rejection, experiencing the loss of a loved one, not having enough money, education or resources, social prejudice, or (as in Marilyn’s case) facing some catastrophic circumstance, such as severe illness.
    • We get depressed because of insufficient love and nurturing in childhood, or because of traumatic childhood experiences.
    • Biological factors. We get depressed because of our genes, or diet, or because of a chemical imbalance in our brains.

    Certainly, there can be some truth in all of these theories. Reality does kick us all in the stomach from time to time, and the pain we feel is understandable. My wife and I lost her father to Parkinson’s Disease a few years ago. We loved him tremendously, and his loss was extremely painful for everyone in our family.

    And most of us have experienced less than ideal circumstances when growing up, and many have even been victimized by horrific and tragic circumstances, such as child abuse. And clearly, some severe psychiatric illnesses, such as schizophrenia, do result from some kind of brain abnormality.

    But the problem with all of these theories is that they put us at the mercy of forces that are largely beyond our control—since we often cannot do much to change reality, rewrite our childhoods, or modify our brains short of taking this or that medication.

    In this podcast, Matt and David take a radically different approach, and argue that Marilyn’s intense feelings of depression and anxiety are not “mental disorders” that reflect some defect in Marilyn, but rather the expression of what is most beautiful and awesome about her. They also argue that there are large numbers of advantages, or benefits, of feeling the way she does, using several Paradoxical Agenda Setting techniques such as the Miracle Cure Question, Magic Button, Positive Reframing, and Magic Dial. The results are stunning and unexpected. Or, as Marilyn put it, this portion of the session was “mind-blowing.”

    The third and final podcast next week will include the M = Methods phase of the session along with the end-of-session T = Testing and wrap-up, including Relapse Prevention Training.

    Marilyn DML with goal column

  • 049: Live Session (Marilyn) — Testing, Empathy (Part 1)
    Mon, Aug 14, 2017

    The Dark Night of the Soul (Part 1)

    The first live therapy podcasts with Mark (the man who felt like a failure as a father: podcasts 29 – 35) were enormously popular, and many people have asked for more. David and Fabrice were delighted with your responses, so the next three podcasts will feature a therapy session with Marilyn by David and his highly-esteemed colleague and co-therapist, Dr. Matthew May. These three podcasts will include the entire session plus commentary the session unfolds.

    We are extremely grateful to Marilyn for her courage and generosity in making this extremely private and intensely personal experience available to all of us. I believe the session will touch your heart, inspire you, and give you courage in facing any problems and traumas that you may be struggling with.

    According to the theory behind cognitive therapy, people are disturbed not be events, but rather by the ways we think about them. This notion goes back nearly 2,000 years to the teachings of the Greek Stoic philosopher, Epictetus, who emphasized the incredible importance of our thoughts—or “cognitions”—in the way we feel. Fifty years ago, this notion gave rise to a new, exciting, drug-free treatment for depression called “cognitive therapy,” which was based on this basic notion: When you CHANGE the way you THINK, you can CHANGE the way You FEEL—quickly, and without drugs. That’s why I wrote my first book, Feeling Good: The New Mood Therapy, because I was so excited about this notion and the powerful new “cognitive therapy” that was rapidly emerging.

    The idea behind cognitive therapy is simple. When you’re upset, you’ve probably noticed that your mind will be flooded with negative thoughts. For example, when you’re depressed, you may be beating up on yourself and telling yourself that you’re a loser, and when you’re anxious you’re probably thinking that something terrible is about to happen. However, it may not have dawned on you that your thoughts are the actual cause of your negative feelings.

    In addition, you’re probably not aware that your negative thoughts will nearly always be distorted, illogical, or just plain unrealistic. In Feeling Good, I said that depression and anxiety are the world’s oldest cons, because you’re telling yourself things that simply are not true. In that book, I listed the ten cognitive distortions, such as All-or-Nothing Thinking, Overgeneralization, and hidden Should Statements, that trigger negative feelings.

    In the years since I first published Feeling Good, my list of cognitive distortions has gone worldwide, and is used by enormous numbers of mental health professionals in the treatment of individuals struggling with depression and anxiety. The notion that depression, anxiety, and event anger result entirely from your thoughts, and not upsetting events or circumstances external events is enormously liberating, because we usually cannot change what’s actually happening, but we can learn to change the way we think—and feel.

    But a lot of people don’t buy, or understand, this notion which seems to fly in the face of common sense. For example, you might argue that when something genuinely horrible happens, such as failure, losing a loved one, or being diagnosed with terminal cancer, it is the actual event and not your thoughts, that triggers your negative feelings. And you might also argue, perhaps even with some irritation, that your thoughts are definitely not distorted, since the actual event—such as the cancer—is real.

    Would you agree? I know that’s what I used to think! The next three podcasts will give you the chance to examine your thinking on this topic, because Marilyn is struggling with a negative event that is absolutely real and devastating.

    As the session with begins, Marilyn explains that she was recently diagnosed with Stage 4 (terminal) lung cancer, which came as a total shock, especially since she’d never smoked. As Drs. Burns and May go through the T = Testing and E = Empathy phases of the TEAM-CBT session, they learn that Marilyn has been struggling with extreme levels of depression, anxiety, shame, loneliness, hopelessness, demoralization, and anger, to mention just a few of her negative feelings.

    If you’d like, you can review a pdf of the Brief Mood Survey and Daily Mood Log that Marilyn completed just before the session began. You will see that her negative thoughts focus on several themes, including

    • Her fears of cancer, pain, and death.
    • Her thoughts of spiritual inadequacy, doubting her belief in God, wondering if there really is an afterlife, feeling that she’s not spiritual enough, and thinking that she’s perhaps been duped by religions.
    • Her feelings of incompleteness at never having had a truly loving life partner.
    • Her feelings of self-criticism, beating up on herself for excessive drinking during her life.

    Click here for Marilyn's Brief Mood Survey, pre-session.
    Click here for Marilyn's Daily Mood Log.

    The next Feeling Good Podcast with Marilyn will include the A = (Paradoxical) Agenda Setting phase of the TEAM therapy session, and will include the Miracle Cure Question, the Magic Button, the stunning Positive Reframing Technique, and the Magic Dial. The third and final podcast will include the M = Methods phase, including Identify the Distortions, the Paradoxical Double Standard Technique, Externalization of Voices, and Acceptance Paradox, end of session testing, and wrap-up.

    Although the subject matter of these podcasts is exceptionally grim and disturbing, we believe that Marilyn’s story may transform your thinking and touch your heart in a deeply personal way. Because Marilyn is a deeply spiritual person who suddenly finds herself without hope and totally lost, we have called part one, The Dark Night of the Soul.

  • 048: Relapse Prevention Training
    Mon, Aug 07, 2017

    A reader ask how to handle relapses following recovery from depression. David emphasizes the importance of this question, since there is a 100% probably that every patient will relapse following recovery. And if the patient has not been properly prepared, the relapses can be disastrous. But on the other hand, if the patient has been prepared, the relapses do not have to be problematic.

    What is a relapse? David defines a relapse as one minute or more of feeling crappy. Given that definition, we all relapse pretty much every day. However, some people can pop out of a bad mood really quickly, while others can get stuck in these “relapses” for weeks, months, or even years.

    David describes the Relapse Prevention Training (RPT) techniques he has developed, but cautions that RPT does not make sense until the patient has experienced a complete elimination of symptoms. If the patient is being treated for depression, that means that the score the depression test has fallen all the way to zero (no symptoms whatsoever) and that the patients feel joy and self-esteem.

    There are four keys to David’s RPT, including:

    1. The patient must be informed that relapse is an absolute certainty. The question is not “will this patient relapse” but rather, “when will this patient relapse?”
    2. Patients have to know that the therapy technique that worked for them the first time they recovered will always work for them. It might be the Cost-Benefit analysis, Pleasure-Predicting Sheet, Acceptance Paradox, Double Standard Technique, Five Secrets of Effective Communication, Hidden Emotion Technique, or Experimental Technique, or simply recording their negative thoughts on the Daily Mood Log and identifying the distortions in them.
    3. Patients need to identify and modify the Self-Defeating Beliefs (SDBs) that triggered their depression and anxiety in the first place, such as Perfectionism, Perceived Perfectionism, or the Achievement, Love or Approval Addictions. In several previous podcasts, David and Fabrice have described the Uncovering Techniques that can be used to quickly pinpoint any patient’s SDBs.
    4. Patients need to write down and challenge the Negative Thoughts that will inevitably emerge at the time they relapse, such as “This relapse proves I’m hopeless after all,” or “This relapse proves the therapy didn’t work,” etc.

    David and Fabrice illustrate step #4 using a powerful technique called Externalization of Voices. David has patients record this role play procedure on a cell phone or other recording device so they can play it and listen if needed during an actual relapse.

    David explains that he used this approach with every patient he discharged, and encouraged them all to come back anytime they had a relapse that they couldn’t handle. In spite of having more than 35,000 therapy sessions with individuals with severe depression and anxiety, David says that he can count on two hands the number who every returned for “tune-ups” following termination of therapy, and in most of those cases, the patients were able to recover once again in just or two sessions.

    In the next Feeling Good Podcast, David and his highly esteemed colleague, Dr. Matthew May, will begin their live work with Marilyn, a severely depressed colleague who is facing “The Dark Night of the Soul.” Fabrice, as usual, will narrate and elicit enlightening commentaries on the therapeutic strategies that David and Matt are using as the session with Marilyn unfolds.

  • 047: Tools... not Schools of Therapy
    Mon, Jul 31, 2017

    The title of David's TEAM-CBT eBook for therapists is Tools, Not Schools, of Therapy. David explains that the field of psychotherapy is dominated by numerous schools of therapy that compete like religions, or even cults, each claiming to have the answer to emotional suffering. So you’ve got the psychodynamic school, and the psychoanalytic school, the Adlerian school, the Beckian cognitive therapy school, the Jungian school, and tons more, including EMDR, behavior therapy, humanistic therapy, ACT, TMT, EMT, and so forth. Wikipedia lists more than 50 major schools of psychotherapy, but there are way more than that, as new schools emerge almost on a weekly basis.

    David describes several conversations with the late Dr. Albert Ellis, who argued that most schools of therapy were started by narcissistic and emotionally disturbed individuals. Ellis claimed that most were self-promoting, dishonest individuals who claimed to know the true “causes” of emotional distress and insisted they had the “best” treatment methods. And yet, research almost never supports these claims.

    David, who is a medical doctor, points out that we don’t have competing schools of medicine. Can you imagine what it would be like if we did? Let’s say you broke your leg, and went to a doctor who prescribes penicillin. You ask why he’s prescribing penicillin for a broken leg, and he explains that he’s a member of the penicillin school. He says he always prescribes penicillin—it’s good for whatever ails you!

    That would be like an Alice in Wonderland world. And yet, that’s precisely how psychiatry and psychotherapy are currently set up. If you’re depressed and you go to a psychiatrist, you’ll be treated with pills. If you go to a psychoanalytic therapist, you’ll get psychoanalysis. Or if you go to a practitioner of EMDR, TFT, or Rational Emotive Therapy (RET), you’ll get EMDR, TFT, or RET. David argues that this just doesn’t make sense.

    David argues that the fields needs to move from competing schools of therapy to a new, science-based, data-driven psychotherapy. He emphasizes that we’ve learned a lot from most of the schools of therapy, and that many have provided us with valuable insights about human nature as well as some useful treatment techniques. But now it’s time to move on, leaving all the schools of therapy behind. David acknowledges that this message may seem harsh or upsetting to some listeners, and apologizes for that ahead of time.

    David and Fabrice also discuss the spiritual basis of effective psychotherapy, and David describes the reaction of his father, a Lutheran minister, on the day that David was born, as well as a tip his mother gave him when he was in third grade.

    In the next Feeling Good Podcast, David and Fabrice will describe Relapse Prevention Training, since the likelihood of relapse after successful treatment is 100%. But if the patient knows what to do, the relapse doesn’t have to be a problem.

  • 046: All You Need Is Love... or Do You?
    Mon, Jul 24, 2017

    The Beatles tell us that all we need really need is love, and in her famous song, “People,” Barbara Streisand proclaims that “People who need people are the luckiest people in the world.” But is this really true?

    Fabrice asks David whether love is a human need? David describes hearing Dr. Aaron Beck proclaim that love is not an adult human need, and feeling shocked, during one of Dr. Beck’s cognitive therapy seminars in the 1970s. Although initially skeptical, David did a number of experiments to test this belief, and came to a startling conclusion. David describes the impact of needing love on his depressed and anxious patients, including lonely individuals who were constantly being rejected in the dating scene.

    You’ll find this podcast provocative, controversial, and hopefully interesting. We’ll also include a survey you can complete below, indicating your thoughts about this topic!

    In the next Feeling Good Podcast, David and Fabrice will discuss Tools, Not Schools, the title of David’s TEAM-CBT eBook for therapists, and the following podcast will discuss Relapse Prevention Training, since the likelihood of relapse after successful treatment is 100%. But if the patient is prepared and knows what to do ahead of time, the relapse, while often painful and disturbing, doesn’t have to be a significant problem.

  • 045: More on OCD — Cognitive Flooding
    Mon, Jul 17, 2017

    Fabrice begins with another question on OCD—if you successfully extinguish the symptoms with Exposure and Response prevention, would they just resurface in some other form, such as worrying, or some other anxiety disorder. David agrees, and describes the solution to this problem.

    Then David describes his treatment of a pregnant woman with OCD who was afraid her baby would be switched at the hospital so that she’d end up with the wrong baby. Although she rationally recognized that this fear was irrational, she could not shake it from her mind, and obsessed about it constantly.

    After trying more than 30 CBT techniques that did not work, David used the What-If Technique to pinpoint her deepest fear, which turned out to be quite shocking, to say the least. He then encouraged her, with some reluctance, to confront this fear using Cognitive Flooding.

    After describing the surprising outcome, David and Fabrice discuss the fact that 75% of American therapists are afraid to use Exposure Techniques because of the fear that the patient is too fragile, or they will re-traumatize the patient. David reminds us that this is “reverse hypnosis,” where the patient hypnotizes the therapist into believing something that is not true. If the patient is successful, and the therapist agrees not to use Exposure, the prognosis for effective treatment is quite poor. David gives an example of a therapist who was afraid to ask an OCD patient to drink one ounce of coca cola—something the patient feared would drive him into insanity!

  • 044: Can OCD Be Cured?
    Mon, Jul 10, 2017

    David describes his treatment of a physician with OCD who was tortured by the fear that he would impulsively throw his newborn baby over the railing of his second-floor apartment. He also describes a psychologist with OCD who washed her hands more than 50 times a day for fear of contamination. In addition, she spent hours every day making sure that nothing in her house was arranged in groups of three—including furniture, table settings, decorative objects, magazines on tables, and so forth. Arrangements in groups of 2 were okay, as were groups of 4, 5 or more objects. Why was she so obsessed?

    What were the hidden emotions that fueled these obsessions and compulsions? David and Fabrice will give you the chance to pause the recording on three occasions to jot down your hypotheses before they give you the answers. It won't be important to get it "right," but it is highly desirable to take a stab at it.

    This podcast will be of interest to you if you or a loved one is struggling with OCD, or any form of anxiety, including phobias, panic attacks, chronic worrying, and so forth. That's because the hidden emotion phenomenon, or excessive “niceness,” may be a the root of your fears as well. Bringing those feelings to conscious awareness will often lead to sudden relief, or even a complete elimination of your symptoms.

    In the next Feeling Good Podcast, David and Fabrice will describe dramatic examples of exposure and response prevention in the treatment of OCD, including a woman who was tortured by the fear that she’d received the wrong baby at the hospital after her first child was born. What causes these bizarre symptoms, and what’s the most effective treatment? Stayed tuned and you’ll find out!

  • 043: Ask David — The Hidden Emotion Technique for OCD
    Mon, Jul 03, 2017

    Listeners submitted questions on OCD (Obsessive-Compulsive Disorder): Is it an organic illness? Are drugs necessary in the treatment? What’s the best book to read if you want to heal yourself? What’s the prognosis?

    Drs. Nye and Burns begin by explaining OCD and answering the questions. David emphasizes the importance of using four treatment models when working with OCD—the cognitive model, the motivational model, the exposure model, and the hidden emotion model if you are hoping for a rapid and complete elimination of symptoms. Treatment that focus on only one treatment method, such as exposure and response prevention, may have only limited success.

    He describes his treatment of a medical student named Ralph with classic OCD. Ralph was frequently plagued by the fear he was dying of AIDS; then he’d get so anxious that he’d go to the emergency room and insist on having a blood test for HIV. These always came out negative, and this brought temporary relief, but within a few days Ralph would be worrying about AIDS again and feeling the overwhelming compulsion to get yet another blood test.

    The case was especially curious because Ralph was engaged and faithful to his fiancé, so there was no rational reason for him to think he had become infected with the HIV virus. However, he’d tell himself, “Maybe I drew blood on a patient with AIDS and then pricked myself with the needle, and then forgot. And how can I know that this didn’t happen?” This are extremely typical of the kind of obsessions that plague OCD patients. Ralph would torture himself with these thoughts until he succumbed to the urge to get another blood test for AIDS.

    Although years of conventional psychotherapy had failed this patient, the Hidden Emotion Technique led to an incredible recovery in just a few minutes during a therapy session. You will find this true story inspiring and amazing! And David provides an even more amazing 40-year follow up report!

    In the next Feeling Good Podcast, David and Fabrice will describe more examples of patients with severe OCD who experienced dramatic relief because of David’s Hidden Emotion Technique. This technique can be helpful for all anxiety disorders, and not just OCD. However, David emphasizes that this is just one of many techniques he uses in the treatment of anxious patients. He cautions therapists against thinking three is just ONE best technique for any anxiety disorder, including OCD.

    See link to podcast #027: Scared Stiff — The Hidden Emotion Model.

  • 042: Shame-Attacking Exercises
    Mon, Jun 26, 2017

    The late Dr. Albert Ellis developed a technique to help individuals struggling with shyness. It’s called Shame-Attacking Exercises. Essentially, you do something bizarre in public to overcome your fear of making a fool of yourself; and you will probably discover that the world doesn’t come to end. When used skillfully, this method can be incredibly liberating.

    However, there are several ethical considerations. First, before therapists can ask their patients to do Shame Attacking Exercises, therapists have to do Shame-Attacking Exercises themselves! David explains his first, terrifying Shame-Attacking Exercise in a Chinese restaurant in New York after giving a talk at a workshop sponsored by Dr. Ellis.

    In addition, therapists have to be careful in the way they use Shame Attacking Exercises, and who they use them with. You have to have an excellent therapeutic alliance with your patient, and the patient has to trust you. In addition, the exercises have to be in an appropriate location—for example, it would be disrespectful to do them in a hospital. And you have to be careful that the Shame Attacking Exercises is not aggressive or frightening to other people.

    He also describes how Shame-Attacking Exercises helped a man and a woman he treated who were both afraid to flirt with people they were attracted to, and in both cases, he had to push fairly hard since the patients put up stiff resistance to the idea.

    TEAM-CBT includes many powerful techniques, and while they have the potential to bring about rapid and often fantastic change, they also have the potential to hurt if not used skillfully and appropriately. Any listeners who are interested in using these techniques should first consult with a mental health professional to make sure the techniques are appropriate and likely to be helpful to you.

    All that being said, you will (we hope) LOVE this podcast!

    In upcoming podcasts, David and Fabrice will address questions on OCD (Obsessive-Compulsive Disorder) submitted by several listeners. Is OCD an organic illness? Are drugs necessary in the treatment? What’s the prognosis? David will describe powerful, drug-free treatment methods based on the four models he uses to treat all anxiety disorders: the Motivational, Cognitive, Exposure, and Hidden Emotion Models.

  • 041: Uncovering Techniques (Part 3) — The What-If Technique
    Mon, Jun 19, 2017

    The third uncovering technique is called the “What-If” Technique, developed by the late Dr. Albert Ellis. The What-If Technique can will help you identify a terrifying fantasy under the surface that fuels your fears. David brings this technique to life with an inspiring story of a woman from San Francisco suffering from more than 10 years of mild depression and paralyzing Agoraphobia—the intense fear of leaving home alone. You may be surprised when you discover the Negative Thoughts that triggered her fear of leaving her apartment alone, as well as the core fantasy at the root of her Agoraphobia. David and Fabrice also discuss the dramatic techniques that helped her completely defeat her fears and overcome her depression.

    Below, we have included a PowerPoint presentation for you so that you can follow along when David and Fabrice do the What-If Technique together on the podcast.

    In the next podcast, David and Fabrice will discuss Shame-Attacking Exercises. This is a powerful and bizarre exposure technique that can helpful in the treatment of shyness--but there’s a hook. Therapists must be willing to do Shame Attacking Exercises themselves before they can ask patients to do them! And that can be intimidating!

     

  • 040: Uncovering Techniques (Part 2) — The Interpersonal Downward Arrow
    Mon, Jun 12, 2017

    The Roles and the Rules—Psychoanalysis at Warp Speed!

    Most of us run into conflicts with other people from time to time, or even frequently. In this podcast, you will discover precisely why this happens, and how you to change the beliefs that get you into trouble, if that’s what you want to do.

    Psychoanalysts sometimes help people discover what they call “core conflicts.” According to the highly regarded psychoanalytic researcher Lester Luborsky, PhD, an example of a core conflict might be, “My needs will never be met in my relationships with others.” If you believe this, it will tend to function as a self-fulfilling prophecy, so you’ll constantly feel hurt, lonely, and rejected, and perhaps resentful when you try to get close to others. And you probably won’t realize you’re creating your own painful interpersonal reality. You’ll think that this is just the way it is. Once you bring the painful system to conscious awareness, you can use a variety of powerful techniques to change your expectations and beliefs so you can enjoy far greater satisfaction and intimacy in your relationships with others.

    David and Fabrice will illustrate a powerful, high-speed method that to bring your own Interpersonal Self-Defeating Beliefs to conscious awareness. David has called it the Interpersonal Downward Arrow Technique. David and Fabrice will revisit the same clinical example from the last Podcast—the psychologist named Harold who felt devastated when his favorite patient unexpectedly committed suicide, but in this podcast they will examine how Harold sets up his relationships with his colleagues in a way that causes him to feel lonely, anxious, and resentful.

    You can use the Interpersonal Downward Arrow Technique to identify anybody's Self-Defeating Beliefs in five to seven minutes, as opposed to spending five years or more free-associating on an analyst’s couch to get the same information. Not a bad deal!

    During the podcast, you may want to download and print “The Rules and the Roles” form that David and Fabrice will be using during the podcast. There will be an exercise for you to do while you are listening. But don’t do the written exercise if you’re listening while driving in your car!

    In the next podcast, David and Fabrice will discuss a third powerful uncovering technique developed by the late Dr. Albert Ellis, a former psychoanalyst from New York who is considered the "Grandfather of Cognitive Therapy." It’s called the “What-If Technique," and Dr. Burns will bring it to life with an inspiring and dramatic story of a woman from San Francisco who had been suffering from years of mild depression and severe Agoraphobia—the intense fear of leaving home alone.

    So stay tuned! And feel free to comment below or ask questions. Fabrice and I greatly appreciate your feedback and guidance!

    If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and resources for mental health professionals as well as patients!

    Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

     

  • 039: Uncovering Techniques (Part 1) — The Individual Downward Arrow
    Mon, Jun 05, 2017

    What are the root causes of depression? Anxiety? Relationship problems? In this, and the next two podcasts, you will discover the answer!

    Cognitive Therapists believe that negative thoughts, or cognitions, can exist on two different levels. When you’re upset, you’ll have Automatic Negative Thoughts (ANTs) in the here and now, and they’ll usually be something like this:

    1. Depression: You may be telling yourself that you’re a loser, or a failure, or that you’ll be miserable forever.
    2. Anxiety: You’re probably telling yourself that you’re in danger, and that something terrible is about to happen. “When I get up to give my talk at my church group, my mind will probably go blank and I’ll make a total fool of myself!”
    3. Relationship conflicts: You may be telling yourself that someone you’re ticked off at is a self-centered jerk who only cares about himself or herself and shouldn’t be that way!

    Individual Downward Arrow

    But why do we get these ANTs in the first place? Cognitive therapists believe that Self-Defeating Beliefs, and other deeper structures in the brain, make us vulnerable to painful mood swings and conflicted relationships with the people we care about. To help you pinpoint your own Self-Defeating Beliefs, David has created two uncovering techniques called the Individual Downward Arrow and the Interpersonal Downward Arrow, and Albert Ellis, the noted New York psychologist, created a third called the “What-If” Technique. In today’s podcast, Drs. Burns and Nye illustrate the Individual Downward Arrow technique, using as an example a psychologist named Harold who was understandably devastated when his patient unexpectedly committed suicide.

    You can follow along on this PowerPoint presentation starting with Harold’s Daily Mood Log with David and Fabrice while they illustrate the Individual Downward Arrow technique.

    [office src="https://onedrive.live.com/embed?cid=4C33CD5BBD389DD2&resid=4C33CD5BBD389DD2%21158&authkey=AMjeMe-n6Qmswxc&em=2&wdAr=1.3333333333333333"]

    Once they come to the “bottom of the barrel,” they will ask you to pause the recording, and see if you can pinpoint five or six or more of Harold’s Self-Defeating Beliefs, using the list of 23 Common Self-Defeating Beliefs.

    David emphasizes that we create our own emotional and interpersonal reality at every moment of every day, but we aren’t aware of this, so we often feel like victims of forces beyond our control. We are really talking about emotional and interpersonal enlightenment, and the uncovering techniques will make this ancient Buddhist concept more understandable for you.

    If you’d like more tips on precisely how to do the Individual Downward Arrow Technique, you can read David’s recent Feeling Good Blog on this topic!

    In our next Feeling Good Podcast, David and Fabrice will illustrate the Interpersonal Downward Arrow Technique, which will allow you to complete a course of psychoanalysis in just 5 to 7 minutes, rather than the 5 to 7 years free associating on the couch. It is truly psychoanalysis at warp speed, and is pretty amazing! And when you change the beliefs that trigger interpersonal conflicts, you can change them and enjoy greater satisfaction in your relationships with the people you care about. But sometimes, that requires a little bit of courage!

    And in the third Feeling Good Podcast on the uncovering techniques, David and Fabrice will illustrate Dr. Albert Ellis' famous "What-If Technique." If you struggle with any type of anxiety, including fears and phobias, this technique can help you uncover the feared fantasy at the root of your fears, so you can challenge the monster and attain freedom from the fears that hold you back!

     

  • 038: Ask David — Negative Messages from Society
    Mon, May 29, 2017

    A listener named Daisy describes her despair at being unable to have a baby, despite intensive efforts at a fertility clinic. She gets well-meaning messages from friends, family and support groups that she really needs a baby in order to feel truly happy and fulfilled, and these messages make her feel anxious and depressed. But she wonders whether this is really true. Does she really need a baby to feel happy?

    In fact, we we get all kinds of messages from society that we need certain things in order to feel worthwhile, including:

    • Achievement / Success / Wealth
    • Intelligence
    • Perfection
    • Love
    • Approval
    • Popularity
    • Good looks

    Are these things really needs? Listen to today’s podcast and you may be surprised by the answer!

    In the next three podcasts, David and Fabrice will discuss three powerful uncovering techniques that can help you pinpoint the Self-Defeating Beliefs that may be at the root of your own unhappiness and anxiety. These include the Individual Downward Arrow Technique, the Interpersonal Downward Arrow Technique, and the What-If Technique. After that, David and Fabrice will also describe some powerful techniques to help you change the way you think and feel!

  • 037: Ask David — "My negative thoughts aren't distorted!"
    Mon, May 22, 2017

    “My problems are real! The world really IS screwed up! And that’s not a distortion. So what can I do about my severe depression and anxiety?”

    David and Fabrice discuss two questions submitted by Feeling Good Podcast listeners.

    #1. Shari writes:

    “I read your book Feeling Good and now I am reading your book When Panic Attacks--thanks to April's podcast with you. I still struggle but recently our current political situation and environmental research about our negative impact on earth—has triggered severe anxiety and depression again. The problem is that I don't think my thoughts are distorted—it certainly seems logical to assume that life on earth is threatened. So I am not sure how to do this. How can I make progress with my mental and emotional health while being aware of situations around the world? Any advice or thoughts would be deeply appreciated.”

    This is a wonderful note, and I’m sure that huge numbers of people feel the same way, in varying degrees. So how can we attend to our own emotional well-being in the face of genuine adversity?

    Dr. Burns discusses this from the perspective of Paradoxical Agenda Setting, which is the key component of TEAM-CBT, and emphasizes the most common therapeutic error of all—jumping in to try to help, without seeing all the really GOOD reasons for the patient NOT to change. From this perspective, Shari’s question becomes the most important question in all of psychiatry and psychotherapy—how do we help patients who may not want to change?

    #2. After listening to the A = Agenda Setting portion of the live therapy with Mark, Paul submitted this question:

    “Hi David,

    Thanks to you, Fabrice and Jill for this episode - as with the previous episodes with Mark, this has really helped in bringing the TEAM approach to life. As I have been using your books in the past few years to self-treat feelings of anxiety and depression, I was very keen to hear how the new agenda setting step works.

    I am wondering what your thoughts are on how effectively the "A" step can be carried out by a patient on his/her own (i.e. without someone else verbalizing the reasons not to change / playing the part of the patient's sub-conscious)? Do you have any tips? I think I heard Mark say something to the effect that, on his own, he wouldn't have thought of all the positives that you came up with in the session.

    Thanks again for sharing these great tools and techniques - looking forward to the "M" step soon.

    Paul”

    This was another terrific question on a topic of great importance. David explains that it is actually easier for patients to learn to use Positive Reframing and the other Paradoxical Agenda Setting techniques than for therapists to learn them. Because of his excitement over this prospect, David has just begun a new book which will show depressed and anxious individuals exactly how to do this on their own in a step-by-step manner. He is optimistic that the new TEAM-CBT techniques, in book form, may be even more helpful to patients than his first book, Feeling Good: The New Mood Therapy. Research studies indicate that 65% of patients with moderate to severe depression improve substantially within four weeks of receiving a copy of Feeling Good, even without any other treatment. Dr. Burns is hopeful that his new book will provide the answers for the 35% who were not helped by Feeling Good.

    So the answer is yes, I think many individuals WILL be able to do the “A” step on their own, and I am hopeful the positive impact will be great!

    If you would be interested in David's new book, please indicate this in the Survey attached to this podcast.

    David and Fabrice have exciting plans for upcoming podcasts. They will be addressing these two questions in one or two podcasts:

    1. Is it possible to measure our “worthwhileness” or “worthlessness” as human beings?
    2. Do we even have a “self”?

    These two questions have been discussed by experts for thousands of years, going all the way back to the Buddha, and most recently by the incredible Austrian philosopher, Ludwig Wittgenstein. And although the answers are tremendously simple, people can’t seem to “get it.” The issues are not simply philosophical, but eminently practical, since most depression and anxiety result from the perception that one is “worthless,” or “inferior,” or simply “not good enough.”

    In addition, David and Fabrice are hoping to create a second live therapy session broken into smaller podcast chunks, but featuring David and a totally awesome former student and now highly esteemed colleague, Matthew May, MD. For the past ten years, David has been telling workshop audiences that Matt is one of the finest therapists in the world. So this is an event you won’t want to miss!

    Click here to listen to Fabrice being interviewed on Dr. Carmen Roman's podcast.

  • 036: Ask David — Empowering the Victim With the Five Secrets
    Mon, May 15, 2017

    A blog reader made a fairly strong and impassioned comment that sometimes asking the patient to examine ways she or he may be contributing to the problem may be a mistake when the patient really IS a victim, and cautioned against blaming the victim. David’s goal is never to blame patients, but rather to empower you.

    David and Fabrice begin by discussing the fact that sometimes people vacillate between other-blame (it’s all his/her fault) and self-blame (it’s all my fault), and emphasize that neither approach is helpful. If you blame the other person, the problem escalates and may turn to violence, but if, instead, you blame yourself, you’ll probably end up feeling worthless, guilty, unlovable, and depressed.

    So what’s the solution to this dilemma? Dr. Burns encourages patients to use the Five Secrets of Effective Communication and make a radical change in the way they communicate with others, along the lines of EAR. E stands for Empathy, A stands for Assertiveness, and R stands for Respect. You can examine each of the Five Secrets if you CLICK HERE.

    David gives five compelling examples of how to deal with people who REALLY ARE violent and abuse, including a raging psychiatric patient who was threatening the staff and on the verge of exploding, a serial killer who kidnapped a social worker who had attended one of David’s communication workshops, some drunken, abusive teenagers in a huge jeep who threatened David, an insulting, demoralizing, critical boss who put down everyone who worked with him. He includes with the story of a Lutheran minister,  Dietrich Bonhoeffer, who was imprisoned and mistreated by the Nazis during world war two.

    This is a controversial topic that David included in the podcasts somewhat reluctantly, so give a listen and tell us what you think! Right now the world seems to be spiraling into greater and greater hostilities. Does David have a point? Or is he way off base?

  • 035: Live Session (Mark) — Final Testing, Wrap Up (Part 7)
    Mon, May 08, 2017

    This is the last live therapy podcast with Mark, the physician who was convinced he was a failure as a father because of his difficulties forming a close, loving relationship with his oldest son. Although the session appeared to go well, we can’t be sure until we see Mark’s end of session mood ratings on the Daily Mood Log and on the Brief Mood Survey and and Evaluation of Therapy Session. David emphasizes that therapists’ perceptions of patients are notoriously inaccurate, but most therapists are unaware of this because they don’t use the rigorous testing procedures at the start and end of sessions.

    To review Mark's partially completed Daily Mood Log, CLICK HERE. Jill and David will ask him to complete the additional negative thoughts on his own after the session.

    To review mark's end of session Brief Mood Survey and Evaluation of Therapy Session, CLICK HERE.

    After David review’s the phenomenal changes Mark reported from the start to the end of the session, David asks if the ratings were genuine, or, as some listeners might suspect, faked in order to try to please the therapists. Mark bursts into tears and says, in a choked voice, that it was a life-changing experience.

    After the end of the session, David and Fabrice discuss a number of highlights from the work with Mark:

    • The testing indicated a complete or near-complete elimination of symptoms. In 2 ½ hours, Jill and David have essentially completed an entire course of psychotherapy. Although there may still be some work to be done with Mark, the hard part has already been completed.
    • David emphasizes that he now views psychotherapy as a procedure to be done at one sitting, much like surgery, with brief follow-up visits, rather than a long, drawn out procedure meeting once pre week for months or even many years. And although a single 2 or 2 1/2 hour session may be more costly than a traditional 50-minute hour, it can be vastly more cost-effective Than dozens of sessions with little or no progress. In addition, it is vastly better for the patient who walks out feeling good today, rather than having to endure weeks, months, or even many years of traditional talk therapy or antidepressant drug therapy.
    • David and Fabrice talk about the fact that no one is permitted to feel happy all the time, and that Mark’s negative thoughts and feelings WILL return, David defines a “relapse” as one minute or more of feeling lousy. Given that definition, we will ALL relapse forever! But it doesn’t have to be a problem for Mark if he is prepared for this, and knows how to pop out of the relapses quickly, rather than getting stuck in them. This is where Relapse Prevention Training (RPT) becomes so important following the initial dramatic recovery. RPT only takes about 30 minutes and is easy to learn, and will perhaps be the topic for a future Feeling Good Podcast if our listeners express an interest in it.
    • David discusses the difference between an Internal Solution and an External Solution. In this session, David and Jill have guided Mark in the Internal Solution—this means crushing the negative thoughts that triggered Mark’s feelings of unhappiness, anxiety, shame, failure, and anger for years, if not decades. Now that he is feeling so much better about himself, he may want some help with the External Solution. This will involve learning how to develop a more loving relationship with his son using tools like the Relationship Journal and the Five Secrets of Effective Communication. This will be far easier now that Mark is no longer using up all his energy beating up on himself and feeling depressed and inadequate.
    • David wraps up by talking about the true wealth we have as therapists. Although we won’t develop the riches of a Bill Gates doing psychotherapy, we do have the fabulous and precious opportunity to see people as they really are inside, and to witness miracles like the one we saw in the session with Mark.
    • David expresses the hope that listeners have benefitted by listening. Although we are all different, most of us have had the painful experience, like Mark, of believing we were somehow failures, or inferior, or defective, or simply not good enough. We are deeply indebted to Mark’ courage and generosity in giving us the opportunity to see the solution to this ancient and almost universal human problem!

    There are many resources for listeners who want to learn more about TEAM-CBT, including:

    • David’s exciting two-day and four-day training workshops, listed on his website, feelinggood.com.
    • Tons of free resources for patients and therapists at feelinggood.com. Please sign up using the widget in the upper right hand corner of any page on his website and you will receive email notifications and links to every post.
    • David’s psychotherapy eBook entitled Tools, Not Schools of Therapy.
    • David’s Tuesday psychotherapy training groups at Stanford, which are co-led Jill Levitt, PhD and Helen Yeni-Komshian, MD. The training is free of charge to Bay Area and northern California therapists. You will have the chance to do free personal work, too!
    • David’s famous Sunday hikes, also free to members of the training groups.
    • Paid online and in-person weekly TEAM-CBT training groups, plus intensive TEAM-CBT treatment programs, at the Feeling Good Institute in Mt. View California.
    • In addition, many TEAM-CBT training and treatment programs are now offered in many cities throughout the US and Canada. For more information, visit feelinggood.com or www.feelinggoodinstitute.com.

  • 034: Live Session (Mark) — Methods Phase, cont'd. (Part 6)
    Mon, May 01, 2017

    Using the Externalization of Voices, which is arguably the most powerful Cognitive Therapy technique ever created, David & Jill continue encouraging mark to challenge his negative thoughts. The goal of the Externalization of Voices is to create genuine and lasting change at the gut level.

    Although it is one of the first cognitive Therapy techniques Dr. Burns created, it is rarely used by cognitive therapists in the United States, perhaps because it is so edgy, or perhaps because it is sophisticated and requires a high degree of therapist skill. The Externalization of Voices is often paired with another technique Dr. Burns created called the Acceptance Paradox. The goal of the Acceptance Paradox is a profound and lasting change in the patient’s core beliefs and values, and it sometimes triggers spiritual enlightenment, although it is an entirely secular method.

    Jill and David also use the Semantic Method and Re-attribution in this segment, and end with a brief illustration of how Mark might interact differently with his son using the Five Secrets of Effective Communication. David and Jill emphasize that this is the "External Solution," and that up to this point in the session they've been working on the "Internal Solution."

    In the next podcast, Jill and David will return to T = Testing to find out how Mark feels at the end of the session, and how he rates Jill and David for Empathy, Helpfulness, and other measures of the therapeutic relationship. At the end of the session, Dr. Burns asks Mark if the change was real, or simply something fake for the purpose of the podcast. At that point, something stunning happens, which turned out to be the highlight of the entire session. So stay tuned!

    And thank you, so much, for your ongoing support of our efforts! We all greatly appreciate your many kind and encouraging comments and emails on our podcasts. That motivates us to work really hard (and joyously) to bring more of this kind of teaching to you!

    One quick note. I do not answer messages from Facebook, as I am getting far more than I could ever attend to. Which is great, but sad for me since I don't want people to feel ignored. The best way to contact me is to make comments at the end end of my blogs, as I often respond to those, or simply to contact me through my website, feelinggood.com.

  • 033: Live Session (Mark) — Methods Phase (Part 5)
    Mon, Apr 24, 2017

    David and Jill begin using M = Methods to challenge the Negative Thought Mark wants to work on first: “There must be something defective in my brain that prevents me from forming a loving relationship with my oldest son.” You may recall that Mark believed this thought 90%.

    Do you know what the necessary and sufficient conditions are for feeling emotionally upset? The necessary condition is that you have a negative thought in your mind, such as “I’m a failure as a father,” or “There’s something defective in my brain,” but the mere presence of a negative thought will not generally trigger shame, depression, or anxiety. The sufficient condition for emotional upset is that you believe the negative thought. And if you review his Daily Mood Log from the last session, you’ll see that Mark does have a high degree of belief in all his negative thoughts. When you’re feeling depressed, anxious, inadequate, or hopeless, I suspect that your mind is also flooded with negative thoughts that seem entirely true to you.

    Do you know the necessary and sufficient conditions for emotional change?

    The necessary condition is that you can challenge the negative thought with a positive thought that is 100% true. Rationalizations and half-truths will never help anyone, at least not in my experience. But having a valid positive thought is not sufficient for emotional change. For example, Mark could tell himself that he’s a very high powered physician in a world-famous medical center, and that thought would be 100% true. But that thought won't help Mark because he’ll still believe there’s something defective in his brain that prevents him from having a loving relationship with his son.

    The sufficient condition for emotional change is that you can generate a positive thought that is 100% true, and in addition it has to crush the negative thought. In other words, the very moment you stop believing the negative thought that triggers your angst, in that very instant you will experience emotional relief, and the change will usually be dramatic.

    But how can we challenge Mark’s belief in the NT. Remember, he is incredibly intelligent, and he’s been hooked on this NT for decades. So we can’t just tell him to cheer up, or encourage him to think more positively, or reassure him that his brain is A-Okay. Not only will those simplistic approaches fail, they would likely annoy him because they sound patronizing and might convey the message that’s he’s an idiot for believing something so ridiculous.

    Instead, as a TEAM-CBT therapist, I think of 15, 20 or even more powerful and innovative techniques that I can use to gently guide the patient to his or her own discovery that the negative thought is simply not true. That's what we do during the M = Methods portion of a TEAM-CBT session.

    You will listen as David and Jill generate Next, Jill and David generate a Recovery Circle, selecting 16 techniques they could use to help Mark challenge the Negative Thought in the middle of the Recovery Circle. To see the Recovery Circle, CLICK HERE. David and Fabrice discuss the rationale for the Recovery Circle--you never know what technique is going to work, since people are quite different. One of the many unique and arguably powerful aspects of TEAM-CBT is the use of more than 75 techniques drawn from more than a dozen schools of therapy.

    One of the first methods we use is so basic that it is programmed right into the Recovery Circle, and it’s called Identify the Distortions. Fairly early in today's recording, Jill and David will ask Mark to identify the distortions in his Negative Thought (NT), “There must be something defective in my brain that prevents me from forming a loving relationship with my oldest son.” At that point, Fabrice will ask you to pause the recording and see how many distortions you can identify in the thought. You can write them down on a piece of paper, or simply print the linked PDF and identify them with check marks on the list of 10 cognitive distortions from my book, Feeling Good: The New Mood Therapy. CLICK HERE FOR TEN COGNITIVE DISTORTIONS

    After Mark identifies the distortions in his Negative Thought, Jill and David encourage him to challenge it, using a variety of techniques on the Recovery Circle, starting with the Paradoxical Double Standard Technique. This is a gentle technique that is often effective for people who are compassionate. Because this technique seems to be helping,  they ask Mark to record his positive thought in the Daily Mood Log, and to indicate how strongly he believes it. Then you will see that Mark's belief in the Negative Thought is reduced to zero if you CLICK HERE.

    In the next podcast, David and Jill will continue with the Methods portion of the session using additional techniques on the Recovery Circle. This will be a unique opportunity to hear many of these techniques in real time with a real person, as opposed to simply reading about them in a book. So--stay tuned to our Feeling Good Podcasts--and thank you so much for your enthusiastic support!

  • 032: Live Session (Mark) — Agenda Setting Phase (Part 4)
    Mon, Apr 17, 2017

    Jill and David encourage Mark to develop his list of positives. Mark draws a blank at first. This is very common among patients and therapists alike. Most of us have not been trained to think about depression, anxiety, shame, defectiveness, hopelessness and anger as being good or positive. In fact, we think of them as symptoms of “mental disorders,” according to the DSM (Diagnostic and Statistical Manual of the American Psychiatric Association.) So we think of them as bad, something to get rid of, something needing treatment.

    But after David and Jill prime the pump, Mark is surprised that they quickly come up with a list of 16 positives that are real and powerful. At this point, they ask Mark why in the world he’d want to press the Magic Button and have all of his symptoms suddenly disappear--given all these positives. This is called the Acid Test and it's also paradoxical. David and Jill have now become the resistant part of Mark's subconscious mind--the part that clings to these symptoms. And when the therapists become the voice of the resistance, the patient will nearly always become the voice that argues for change.

    The paradox is resolved with the Magic Dial. Toward the end of this podcast, you will want to review Mark’s Daily Mood Log, with the Goal column filled out on the table of negative emotions.

    David points out that there is no single tool or technique that triggers recovery in patients. Instead, each component of T E A M contributes in radically different ways to the substantial or even dramatic improvement the therapists are hoping to bring about it today's session.

    In the next Podcast, David and Jill will begin the M = Methods portion of the session.

  • 031: Live Session (Mark) — Agenda Setting Phase (Part 3)
    Mon, Apr 10, 2017

    In the early days of my career, I (Dr. Burns) would have assumed that Mark definitely wanted to change--after all, he'd been in a lot of pain for a long time, and he came to the session because he wanted help. So, following the empathy phase of the session, I would have jumped in with a variety of cognitive therapy techniques to help Mark challenge his Negative Thoughts, such as “I’ve been a failure as a father,” or "my brain is defective." Although this might have been effective, there’s a good chance that it might not have worked. That's because Mark might have “yes-butted” me or insisted that he really was a failure and that I just wasn’t “getting it.”

    In fact, the attempt to help the patient without first dealing with the patient’s resistance is the cause of nearly all therapeutic failure. But most therapists make this mistake over and over--and don't realize that their well-intentioned efforts to help actually trigger and reinforce the patient's resistance.

    Instead, TEAM Therapists use a number of Paradoxical Agenda Setting (PAS) techniques designed to bring the patient’s subconscious resistance to conscious awareness. Then we melt the resistance away before attempting to change the way the patient is thinking and feeling. I (DB) have developed 15 or 20 PAS techniques, and Jill and I  used several of them in our session with Mark:

    • The Invitation Step
    • The Miracle Cure Question
    • The Magic Button
    • Positive Reframing
    • The Acid Test
    • The Magic Dial

    When Jill and I use Positive Reframing, we are hoping that Mark will make an unexpected discovery--that his negative thoughts and feelings, such as his sadness, shame, discouragement, and inadequacy actually reflect his core values and show what a positive, awesome human being he is. In other words, he will discover that his core values are actually the source of his symptoms as well as his resistance to change.

    This approach represents a radical departure from the way many psychiatrists and psychologists think about psychiatric symptoms as well as resistance.  When I was a psychiatric resident, I (DB) was trained to think about resistance as something negative. For example, we may tell ourselves that resistant patients cling to their feelings of depression and worthlessness because they want attention, because they want to feel sorry for themselves, because they fear change, or because they are afraid will lose their identity if they recover. While there’s some truth in these formulations, they may not be helpful because they tend to cast the patient in a negative light, as if their symptoms and their resistance to change were somehow bad, or childish, or based on some kind of chemical imbalance in their brains. As you will see, the TEAM-CBT approach approaches resistance is radically different manner.

    We will give you the chance to pause the podcast briefly and try your own hand at Positive Reframing before you hear it live during the session. Specifically, we will ask you to review Mark's Daily Mood Log, and ask yourself these two questions about each of his negative thoughts and feelings:

    • What does this negative thought or feeling show about Mark that is beautiful, positive, and awesome?
    • What are some benefits, or advantages, of this negative thought or feeling? Are there some ways that this thought or feeling is helping Mark?

    As you so this, make a list of as many Positives as you can on a piece of paper. See what you can come up with.

    I want to warn you that it may be difficult to come up with your list of Positives at first. If so, this is good, because when you hear the next podcast, you'll have many "ah ha!" moments and it will all become quite obvious to you. Then you will have a new and deeper understanding of resistance--an understanding that can help you greatly if you are a therapist or if you are struggling with your own feelings of depression and anxiety.

    Jill gives a great overview of why the paradoxical approach is necessary during the Paradoxical Agenda Setting phase of the session.

    To learn more about Paradoxical Agenda Setting, you can read David’s featured article in the March / April 2017 issue of Psychotherapy Networker entitled "When Helping Doesn’t Help." You will see how he helped a woman struggling with intense depression, anxiety and rage due to decades of horrific domestic rape and violence.

  • 030: Live Session (Mark) — Empathy Phase (Part 2)
    Mon, Apr 03, 2017

    After reviewing Mark’s scores on the Brief Mood Survey, the Empathy phase of the session unfolds. During this phase of the session, David and Jill will not try to help, rescue, or save Mark. They will simply try to see the world through his eyes and provide some warmth and compassion.

    Mark explains that he had two goals in life when he was a young man. He hoped to have a large, loving family; and wanted to become a skillful and compassionate physician. Although he has achieved the second goal, he has felt sad and guilty for decades because of his failure to develop a loving relationship with his oldest son from a previous marriage.

    While Mark tells his story, David and Jill encourage him to record his negative thoughts and feelings on a form called the Daily Mood Log, and to rate how strong each feeling is, on a scale from 0% (not at all) to 100% (the most extreme).

    Click here and you will see Mark's Daily Mood Log.

    As you can see, Mark has many different kinds of negative feelings ranging in severity from 30% (moderate) to 80% (severe).

    If you've been listening to the Feeling Good Podcasts, you know that negative feelings do not result from what’s actually happening in our lives, but rather from our negative thoughts about what's happening. David and Jill encourage Mark to record his negative thoughts on the Daily Mood Log as well, and to indicate how strongly he believes each one on a scale from 0% (not at all) to 100% (completely).

    You can also see that Mark is telling himself that he's been a failure as a father, that his brain is defective, and that he is not doing a good job for David and Jill. These thoughts all involve self-blame. You'll notice that he also has two other-blaming thoughts. This is not unusual. When you’re not getting along with someone, you may spend part of your time telling yourself that the problem is all your fault, and part of your time telling yourself that it’s someone else’s fault. As a result, your negative feelings may shift back and forth from guilt and shame to anger and resentment.

    Most therapists would not interrupt and ask their patients to record their negative thoughts and feelings while they are venting. However, this information will prove to be incredibly valuable later in the session.

    Jill and David ask Mark how they’re doing on empathy. If Mark gives them a high rating, they will go on to the next phase of the session, called Paradoxical Agenda Setting. That’s where they will find out what, if anything, Mark wants help with, and see if he has any conscious, or subconscious, resistance to change.

  • 029: Live Session (Mark) — Introduction & Testing Phase (Part 1)
    Mon, Mar 27, 2017

    This is the first in a series of podcasts that will feature live therapy. As you listen, you’ll have the opportunity to peak behind closed doors to see how TEAM-CBT actually works in a real-world setting, and not role playing.

    The patient is a physician named Mark who has been haunted for decades by a problem with his oldest son, and he feels like a failure as a father. Although the facts of your life are likely to be very different, you might understand what it’s like to feel like a failure, or to tell yourself that you’re defective, or simply not good enough.

    The two co-therapists include David and his highly-esteemed colleague, Dr. Jill Levitt. We have broken the session down into a number of podcasts that will include excerpts from the session along with commentaries on the thought patterns of these two master therapists as the session unfolds.

    Part 1—T = Testing

    As the session begins, David and Jill review of Mark’s scores on the Brief Mood Survey (BMS), which he completed just before the session began. The scores indicate that Mark is only feeling mildly depressed, anxious, and angry, but is extremely dissatisfied with his relationship with his son.

    Click here to view Mark's initial Brief Mood Survey.

    At the end of the session, David and Jill will ask Mark to complete the BMS again. By comparing his patient’s scores at the start and end of the session, they will be able to see exactly how effective, or ineffective, the session was. Mark will also rate David and Jill on Empathy, Helpfulness, and several other important dimensions.

    Testing at the start and end of every therapy session is one of the new and unique components of TEAM therapy. The testing can revolutionize psychotherapy, because therapists can fine-tune their therapeutic strategies based on the scores, and make critical important changes if the session was not particularly helpful. However, the assessment instruments are extremely sensitive and pick up the smallest therapeutic errors. This can be quite threatening to therapists who don’t want to be held accountable.

  • 028: Scared Stiff — The Motivational Model (Part 6)
    Mon, Mar 20, 2017

    The key is bringing the patient’s subconscious resistance to conscious awareness, and melting it away with paradoxical techniques. This is absolutely critical if you are hoping to see a complete elimination of symptoms in any type of anxiety.

    You may recall that the Outcome Resistance for anxiety disorders usually results Magical Thinking—the anxious patient may be suffering intensely and asking for help, but secretly believes that something terrible will happen if the treatment is successful and the anxiety disappears. In other words, most anxious individuals are convinced that the anxiety is protecting him or her from some catastrophic event.

    David brings this concept to life with a dramatic description of his treatment of a young man named Sam who’d been struggling with intense PTSD—Post-Traumatic Stress Disorder— for six months following a traumatic interaction with two sadistic gunmen.

    David and Fabrice also discuss metaphors for understanding how healing actually occurs. Most therapists think of depression and anxiety as mountains that have evolved slowly, over years or decades. They sometimes also believe that treatment and recovery will also requires years and years of treatment, with very slow progress. Of course, if the therapist and patient believe this it will function as a self-fulfilling prophecy.

    In sharp contrast, David describes a new way to think about recovery, as something extremely rapid, a personal transformation that happens suddenly, within a very brief time period within a therapy session. But this remarkable phenomenon is only possible when the patient’s resistance to change has been skillfully and compassionately addressed by the therapist. At that point, the patient and therapist are on the same TEAM, working together collaboratively. Then, amazing changes can often unfold quickly.

    Plans for future Feeling Good Podcasts will include a series of fascinating podcasts that will feature an actual live therapy session, with David and his colleague, Dr. Jill Levitt, acting as co-therapists, including commentaries on how each step of T.E.A.M. is being implemented. This will give you the unique opportunity to look behind closed doors so you can observe actual healing taking place.

    In addition, a future “Ask David” podcast is planned, as well as a podcast on “The Truth about Benzodiazepines,” plus podcasts featuring more treatment methods for anxiety such as Interpersonal Exposure Techniques and Cognitive Flooding. Dr. Burns also promises a fascinating Feeling Good Podcast on the use of the Five Secrets of Effective Communication with violent individuals who are threatening, hostile, and dangerous.

  • 027: Scared Stiff — The Hidden Emotion Model (Part 5)
    Mon, Mar 13, 2017

    David reminds us about the differences between healthy fear and unhealthy, neurotic anxiety, or an anxiety “disorder” like a phobia, or OCD, and so forth. He explains that negative thoughts, and not events, trigger all our emotions, healthy or unhealthy. However, healthy fear results from negative thoughts that are valid and undistorted, and does not need treatment. For example, if you are walking around Chicago in an area dominated by gangs, you may have the thought, “I could get shot. I better be careful because it’s dangerous here!” Your fear is healthy and can keep you vigilant and alive in a genuinely dangerous situation.

    In contrast, neurotic, unhealthy anxiety results from thoughts that contain the same ten cognitive distortions that cause depression, such as All-or-Nothing Thinking, Jumping to Conclusions (e.g. Mind-Reading and Fortune-Telling), Emotional Reasoning, Magnification, Should Statements, and more.

    David explains that the Hidden Emotion Model is radically different from CBT, exposure therapy, and most other current treatments for anxiety. The theory behind Hidden Emotion Technique is that “niceness” is the cause of (almost) all anxiety in the United States at this time. In other words, people who are prone to anxiety typically think they have to be nice all the time, and please other people, and not have certain kinds of forbidden feelings, such as anger, or loneliness, or even wanting something you are not supposed to want.

    David brings this powerful treatment technique to life with a vignette involving Terry, the woman with ten years of terrifying panic attacks described in previous podcast. When David asked about her very first panic attack, ten years earlier some amazing and illuminating information emerged.

    David gives tips on how therapists can use the Hidden Emotion Model,

    1. The hidden emotion or conflict is buried in the present, and not in the past.
    2. It is something very ordinary, such as not liking your job, or your major in college, or a conflict with a friend, family member or colleague.
    3. The anxiety is nearly always a symbolic expression of the feeling or problem the patient is not bringing to conscious awareness. David gives listeners an exercise to see if they can pinpoint the symbolic meaning of Terry’s panic attacks.

    Fabrice asks the important question—what do you do when the anxious patient insists that there aren’t any hidden feelings? David explains that most anxious individuals will say that, and describes how to bring the hidden feeling or problem to conscious awareness.

    He emphasizes the three things he really likes about the Hidden Emotion Model:

    1. It explains the timing of anxiety attacks, so it has tremendous explanatory power. Freud said that anxiety is the mysterious emotion, that comes out of the blue, and strikes like lightning, without rhyme or reason. David disagrees, and emphasizes that anxiety rarely or never comes from out of the blue.
    2. The Hidden Emotion Model can have powerful and rapid healing effects for patients with every type of anxiety, as well as individuals struggling with hypochondriasis and those who go to medical doctors with complaints of pain, fatigue, or dizziness that does not appear to have a valid medical cause.
    3. The Hidden Emotion Model teaches us that the ultimate cause of most anxiety is the fear of the self, of our emotions and how we genuinely feel as human beings.
    4. The Hidden Emotion Model teaches us that recovery from anxiety does not involve recovery from some “defect” or “mental disorder,” but rather the discovery of what it is like to be human being, with all of our feelings, and that it is okay to have an express those feelings.

    Finally, David explains that while this technique traces to the teachings of Freud, Freud might turn over in his grave and find it superficial or silly, since David simply tells anxious patients that they are suppressing or repressing something that’s bothering them, and insists they bring it to conscious awareness right away. David accepts this criticism, but also adds that the Hidden Emotion Technique works and frequently triggers complete recovery with patients who are only partially helped by the skillful use of cognitive techniques and exposure techniques.

    However, the “niceness” phenomenon only seems to affect about 75% of anxious patients; sometimes, a phobia is just a phobia, with no hidden feeling or conflict. Those individuals will not be helped by this technique. Fortunately, we have dozens of other powerful techniques that will be curative!

     

  • 026: Scared Stiff — The Exposure Model (Part 4)
    Mon, Mar 06, 2017

    We begin by describing the three different deaths of the ego that are required for recovery from depression, anxiety, or a relationship conflict, respectively. For depression recovery often results from the “Great Death,” A Buddhist concept that involves the discovery that there is no such thing as a “self” that could be worthless, or inferior, or judged by another person. David and Fabrice only touch on this theme and promise an entire future podcast on this fascinating and helpful spiritual notion that can lead to recovery from depression.

    For anxiety, the death of the ego is quite different, and involves surrendering to the monster the patient has always feared and avoided using a wide variety of exposure techniques. David traces the origin of Exposure Therapy to teachings in the Buddhist hold scriptures, the Tibetan Book of the Dead, more than 2,000 years ago. David describes the amazing and hilarious phenomenon of “laughing enlightenment,” which often happens when anxious individuals confront their fears.

    David describes how he used Flooding, an extreme form of exposure, to get over his own blood phobia, which he’d had since childhood. His fear of blood caused him to drop out of medical school at Stanford for a year on two separate occasions. He finally decided to confront his fear by working for a month in the Emergency Room of Highland Hospital, a major trauma treatment center, in Oakland, California. David explains what happened when a totally bloody man on the verge of death was rushed into the ER after a bomb he was building in his basement blew up.

    In the podcast David forgot to mention something fascinating about his experience at Highland. David had had a blood phobia since he was child, and blood phobia is thought to have genetic causes, and perhaps be inherited. And yet, David was totally cured in roughly 15 minutes without any medication at all. The important point is that even if things are biologically caused, they can often be treated with psychological techniques.

    Most therapists hate the word, “cure.” David explains why he sometimes uses this term when treating anxious patients, and also explains the difference between a 100% cure and a 200% cure.

    David emphasizes the importance of motivation and resistance in the treatment of anxiety, since few patients, if any, will want to use exposure techniques, because it is so terrifying. David and Fabrice will describe the Motivational Model in the next podcast.

    David and Fabrice raise questions about the mechanism of recovery during exposure. Why does it work? Is it due to the change in thinking, or is there some other healing mechanism at work?

    Fabrice asks about patients who resist exposure and protest that it won’t work. For example, a patient with the fear of heights might say, “Oh, exposure can’t possibly help, because every time I get in a situation where I’m exposed to heights, like when I’m in looking over a railing on the third floor of a building or hiking on a mountain trail, I get terrified. This has happened hundreds of times and it never helped!”

    Finally, David describes a humorous but real example of his 8-minute treatment of a therapist with 20 years of failed therapy (several times a week of psychoanalysis) for her elevator phobia.

    David and Fabrice end by talking about the enormous amount of information they have to share with listeners, including large numbers of creative exposure techniques that fall into three categories:

    1. Classical Exposure
    2. Cognitive Exposure
    3. Interpersonal Exposure

    They promise future podcasts describing these fascinating techniques with more amazing vignettes based on patients Dr. Burns has treated, as well as his treatment of his own many fears and phobias!

  • 025: Ask David — How do you handle a patient you don't like (or who bores you)?
    Mon, Feb 27, 2017

    David answers these questions: How do you deal with a patient (or friend) who is boring? How do you deal with a patient (or friend) you don’t like? How do you get patients to do their psychotherapy homework?

    1. How do you deal with a patient (or friend) who is boring? David describes a technique he learned from a mentor, Dr. Myles Weber, during his second year of psychiatric residency at Highland Hospital in Oakland. The technique works instantly 100% of the time, and is guaranteed to make any boring interaction with any patient instantly exciting! David and Fabrice emphasize that the same technique can be used with a friend, colleague, or loved one who seems boring, including someone you are dating and can’t seem to connect with at anything other than a superficial level.David also describes powerful, shocking and illuminating experiences he had when attending psychodrama marathons sponsored by the Human Institute in Palo Alto during his medical school years, and what he learned about the differences between the off-putting “outer” selves we display to others and the more genuine “inner” selves we often try to hide.
    2. How do you deal with a patient (or friend) you don’t like? David describes a method he always used with patients he didn’t like, including one who he found intensely offensive—even disgusting. He explains that the patients he disliked the most almost always became the ones he liked the most, and ended up feeling the closest to, once he used this radical technique. The technique can also be effective with friends or colleagues you’re at odds with.Fabrice reminds us that the approaches David describes in this podcast involve several of the Five Secrets of Effective Communication discussed in previous podcasts. He warns us that they require considerable training, skill and practice, and are likely to backfire if done crudely.
    3. How do you get patients to do their psychotherapy homework? Every therapist who assigns psychotherapy homework is keenly aware that many patients, perhaps most, “forget” or simply refuse to do the homework. And these are the patients who don’t improve much, if at all. Dr. Burns explains how he tried dozens of techniques that didn’t work early in his career, and finally discovered an approach that was almost always effective.

     

  • 024: Scared Stiff — The Cognitive Model (Part 3)
    Mon, Feb 20, 2017

    The cognitive model of anxiety is based on three powerful ideas:

    1. Anxiety always results from negative thought (NTs) that involve the prediction of danger. For example, if you have public speaking anxiety, you are probably telling yourself something like this: “I just know I’m going to blow it. My voice will tremble. People will know I’m anxious. My mind will go blank. I’ll mumble and make a total fool of myself.” Or, if you struggle with panic attacks, you probably have thoughts like this: “I think I’m about to die. I can’t breathe properly. I’m about to pass out!” Or, “I’m about to lose control and go crazy.”
    2. The NTs that trigger anxiety are always distorted and illogical. In contrast, valid NTs cause healthy fear.
    3. When you put the lie to the distorted NTs, the anxiety will disappear. This can sometimes happen in an instant.

    Dr. Burns describes his treatment of a woman named Terry who had suffered from ten years of incapacitating panic attacks and severe depression prior to contacting Dr. Burns. During each panic attack, Terry would experience tightness in her chest and tingling skin and tell herself she was about to pass out, suffocate, or die of a heart attack. Multiple emergency room visits, medical tests, and reassurances from doctors did not help. In addition, years of medication and psychotherapy were not at all helpful.

    After trying a number of cognitive techniques that did not help, Dr. Burns persuaded her to let him induce an actual panic attack during an office visit so he could use the Experimental Technique, which is arguably the most powerful technique ever developed for the treatment of anxiety, and he televised the session. What happened next will blow your mind!

    In the next podcast, Drs. Burns and Nye will describe the Exposure Model of treatment, and Dr. Burns will describe his personal struggles with his fear of blood during medical school.

  • 023: Scared Stiff — What Causes Anxiety? What’s the Cure? (Part 2)
    Mon, Feb 13, 2017

    There are 4 powerful treatment models for anxiety, including

    • The Cognitive Model
    • The Exposure Model
    • The Motivational Model
    • The Hidden Emotion Model

    Each approach has a completely different theory about the causes of anxiety and utilizes completely different treatment techniques. For example, cognitive therapists believe that distorted thoughts trigger all anxiety, and that the most effective treatment involves challenging these distortions. In contrast, exposure therapists argue that avoidance is the cause of all anxiety, and that exposure is the only effective treatment. Those who adhere to the Motivational Model emphasize the role of resistance. In other words, anxious individuals are reluctant to let go of the anxiety because they secretly believe that the anxiety will protect them from danger.  And those who adhere to the Hidden Emotion Model claim that “niceness” is the true cause of all anxiety in the United States at this time, and that hidden problems and feelings may need to be brought to conscious awareness before the patient can recover.

    Dr. Burns argues that, in fact, all four theories are correct, and that if you skillfully integrate all four approaches, you will often see a rapid and total elimination of anxiety in the great majority of your patients.

    Dr. Burns describes how he created the Hidden Emotion Model when he was treating a woman with mysterious and intractable case of Panic Disorder. Every time her boss walked past her desk, she became nauseous and panicky, and had the overwhelming urge to vomit on him. Then she would have to rush to the ladies’ room to rest until the nausea and panic diminished, and she sometimes had to go home because the symptoms were so severe. This was all the more puzzling because she insisted she had the best boss in the world and that there were no problems at work. She explained that her boss constantly praised her and gave her promotions and generous raises, and that she had no complaints whatsoever.

    Cognitive and exposure techniques were only partially effective, until an unexpected discovery suddenly emerged during a therapy session that led to a surprising outcome. What do you think the hidden emotion was? Tune in and you’ll find out!

    In the next several podcasts, Drs. Burns and Nye will bring these four models to life, using real life examples, including some of Drs. Burns’ personal struggles with anxiety early in his career.

     

  • 022: Scared Stiff — What Is Anxiety? (Part 1)
    Mon, Feb 06, 2017

    David and Fabrice answer these questions:

    • What is anxiety?
    • How does it differ from depression?
    • Do anxiety and depression always go hand in hand?
    • How does anxiety differ from healthy fear?
    • What are the most common forms of anxiety?
    • How common is anxiety?

    Anxiety, like depression, has been called the world’s oldest con. That’s because you are always fooling yourself, and buying into negative thoughts that aren’t true, when you’re feeling anxious and insecure. Dr. Burns highlights the most common cognitive distortions that trigger anxiety, and discusses the powerful role of shame in anxiety.

    In the next several podcasts, Dr. Burns will describe powerful, fast-acting, drug-free treatment methods that can help you defeat every type of anxiety, Including

    • Chronic worrying
    • Phobias
    • Social anxiety
    • Public speaking anxiety
    • Shyness
    • OCD (Obsessive-Compulsive Disorder)
    • PTSD (Post-Traumatic Stress Disorder)
    • Panic attacks
    • Agoraphobia
    • BDD (Body Dysmorphic Disorder)

    So stay tuned!

  • 021: Ask David — Shameful Sexual Fantasies
    Mon, Jan 30, 2017

    A listener with OCD is plagued with intrusive and shameful sexual fantasies. David discusses his treatment strategies for a young man from Argentina who was struggling with forbidden fantasies of Jesus having sex with the Virgin Mary in all positions of the Kama Sutra, but the harder he tried to control them, the more intense and tantalizing they became. Being a good Catholic lad, he was terrified and tearful he would burn in hell if he didn’t overcome this problem.

    If you’ve ever struggled with shameful sexual fantasies, you might be intrigued by this fascinating discussion of Cognitive Flooding, therapeutic resistance, and the Hidden Emotion Technique!

  • 020: The Truth About Antidepressants?
    Mon, Jan 23, 2017

    Discussion of recent startling and disturbing research studies by Dr. Irving Kirsch and others that suggest that the chemicals called “antidepressants” may, in reality, have few or no true antidepressant effects above and beyond their placebo effects. Dr. Burns illustrates the placebo effect with a thought experiment, and explains why it is so confusing to researchers and the general public alike.

    In addition, David and Fabrice discuss additional troubling research by Dr. David Healey and others that indicates that the chemicals called “antidepressants” appear to cause a doubling or tripling of the likelihood that a depressed individual will commit suicide or become actively suicidal, as compared with depressed individuals treated with placebos. David concludes with a discussion emphasizing that the needs of marketing are in conflict with the needs of sciences, and proposes some solutions to this serious problem.

    Dr. Burns emphasizes that he is only providing his interpretation of some extremely controversial studies, based on his research training and clinical experience. He urges listeners to do their own research and critical thinking on this disturbing topic, and emphasizes that many may come to different conclusions.

  • 019: Ask David — The Defiant Child: A Secret All Parents Should Know
    Mon, Jan 16, 2017

    Can the EAR techniques help a listener deal more effectively with a defiant, oppositional child. Dr. Burns reveals a fantastically helpful secret that he and his wife stumbled across in raising their own children. If you have ever struggled in your attempts to deal with an oppositional child or adolescent, you will find this podcast enlightening!

  • 018: Ask David — Overcoming the Fear of Death
    Mon, Jan 09, 2017

    David and Fabrice address this question submitted by a listener:

    Dear Dr. Burns,

    I read Feeling Good twenty years ago. It was a wonderful relief and help to me. Your book has helped me live a better and balanced life. The best part was passing the knowledge on to my daughter. I thought I read a wonderful description of how to handle death anxiety in the book. I was describing it to a friend, but could' find it in the book.

    Is it in another book?

    Your reply would be considered an act of generosity.

    Thank you! Mary

    Existential Therapists believe that the fear of death is universal and is at the root of most emotional problems. Dr. Burns argues that the fear of death is actually quite rare, but does occasionally occur and is extremely treatable. In this podcast, David’s describes his quick, three-part “cure” for the fear of death.

    Oddly, every patient he treated in this way insisted at the end of the session that it didn’t help. And even stranger is the fact that 100% of them returned the next week and announced that they actually had been cured and were, in fact, no longer afraid of death!

  • 017: Ask David — Dare to be “average”—The perfectionist’s script for self-defeat
    Mon, Jan 02, 2017

    David answers a challenging question posed by a listener:

    Dear Dr. David:

    In your Feeling Good Handbook, you suggest that the reader just allows himself or herself to be an ordinary person instead of trying to be perfect. Contrary to your opinion in the book, you're an outstanding therapist in reality. You’ve studied in one of the world’s top colleges, you’re well-educated with a doctor degree, and successful in your career and life. How can I believe your claim? I'm quite confused!

    Sincerely, XXX

    David first distinguishes perfectionism from the healthy pursuit of excellence, and then describes a painful incident when he was a Stanford medical student. One afternoon, he attended an afternoon Gestalt encounter group at the home of a friend and mentor in Palo Alto. During the group he was ripped to shreds by the other participants. At the end of the group, the other participants seemed elated, but he felt intensely humiliated, ashamed, and discouraged. This led to an unexpected interaction with his mentor that helped to change his life.

    David also discusses his clinical work years later with a depressed and anxious professional who had never experienced even one minute of happiness in spite of a life of fabulous success and achievements.

    At the end, David and Fabrice promise a future podcast on this topic: “Self-Esteem: What is it? How do I get it? How can I get rid of it once I’ve got it?” 

  • 016a: Special Interview: Can Depression and Anxiety Be Treated in a Two-Hour Therapy Session? with Lisa Kelley
    Wed, Dec 28, 2016

    David and Fabrice are joined by Lisa Kelley, a certified TEAM-CBT therapist and former journalist from Littleton, Colorado. Lisa interviews David about an interview / blog David has just published on this website.

    Lisa begins by asking how people responded to a survey on David’s website asking this controversial question: “Do you believe that a depressed individual could experience a complete elimination of symptoms in a single, two-hour therapy session?” More than 5,000 individuals completed the survey and most were extremely skeptical.

    David states that ten years ago, he would have felt exactly the same way, and would have dismissed anyone making such a claim as a con artist. However, he has now changed his mind and believes that sometimes it is possible.

    David explains that he has done more than 50 live demonstrations in workshops and other teaching settings with individuals who are struggling with severe feelings of depression, anxiety, shame and anger. Many of these individuals who volunteer to be the patient have experienced horrific personal traumas. This gives David the opportunity to demonstrate how TEAM-CBT works with someone who is really suffering, and not just a role-playing demonstration. Usually, these live demonstrations are the highlight of a workshop because they are intensely emotional and real. Surprisingly, in the vast majority of these sessions, the individuals who were in the patient role experienced a complete, or near-complete, elimination of symptoms in roughly two hours.

    David emphasizes that while we would not expect this to generalize to a clinical practice situation, it does seem to suggest significant improvements, or even breakthroughs, in psychotherapy. Many of the new developments have to do with helping patients overcome their resistance to change. Although David makes these techniques look easy, they are challenging to learn, and require a radically new and different way of thinking about why patients sometimes resist change and fight the therapist.

    Lisa, Fabrice, and David explain exactly how the new techniques work, using as an example an Asian-American woman who had experienced decades of domestic violence and rape.

     

  • 016: Ask David — How can I cope with a complainer? How can I help a loved one who is depressed?
    Mon, Dec 26, 2016

    How can you help a depressed friend or family member? You may be surprised to discover that the attempt to “help” is rarely effective, and may even make the problem worse. In contrast, the refusal to help is nearly always helpful. But to understand that paradox, you’ll have to give a listen to this fascinating edition of "Ask David!"

    David and Fabrice also address a related problem nearly all of us confront from time to time: How do you deal with a friend who is a relentless whiner and complainer? When you try to help them or suggest a solution to the problem, they just say, “That won’t work” and keep complaining. You end up feeling frustrated and annoyed, because the other person just won’t listen! David and Fabrice illustrate a shockingly easy and incredibly effective solution to this problem.

    Finally, David discusses some disturbing recent research indicating that the ability of therapists—as well as friends or family members—to know how suicidal someone is, is extremely poor. David and Fabrice explain how to assess how suicidal someone actually is, and what to do if you discover that he or she really is at risk of a suicide attempt.

  • 015: The Five Secrets of Effective Communication (Part 2)
    Mon, Dec 19, 2016

    If used skillfully, the Five Secrets can resolve nearly any relationship conflict and transform hostility, resentment and mistrust into intimacy and warmth, often with amazing speed. And although this may seem easy when you first learn about the Five Secrets, it’s extremely difficult in real world situations.

    In this Podcast, David and Fabrice discuss a number of predictable emotional and mental errors nearly everyone makes when trying to use the Five Secrets to get close to someone he or she is at odds with.

  • 014: The Five Secrets of Effective Communication (Part 1)
    Mon, Dec 12, 2016

    Practically all of us have a friend, colleague, client, customer or family member we aren’t getting along with very well. Perhaps the difficult person in your life is excessively critical of you, complains constantly, won’t express his or her feelings, always has to be right, or never listens to you. Does anyone come to mind?

    In this podcast, David and Fabrice discuss five communication secrets that can rapidly transform conflict and misunderstanding into intimacy and trust. David describes an experience that suddenly changed the direction of his life and career when he was working with an insecure medical student from England early in his career. The Five Secrets of Effective Communication can be remembered using the acronym, EAR:

    E = Empathy

    • The Disarming Technique: You find truth in what the other person is saying, even if it seems illogical, self-serving, distorted, or just plain “wrong.”
    • Thought and Feeling Empathy: You summarize what the other person just said (Thought Empathy) and acknowledge how he or she is probably feeling, given what he or she just said (Feeling Empathy)
    • Inquiry: You as gentle, probing questions to learn more about what the other person is thinking and feeling.

    A = Assertiveness

    • “I Feel” Statements: You express your own feelings and ideas openly according to the formula, “I’m feeling X, Y, and Z right now,” where are X, Y and Z refer to any of a wide variety of feeling words, such as anxious, attacked, hurt, or sad.

    R = Respect

    • Affirmation (formerly called Stroking): You convey warmth, caring and respect, even in the heat of battle

    David and Fabrice also describe the Five Secrets of Effective Communication and emphasize the incredible power of the Law of Opposites, with a vignette about a severely depressed patient who told David that he was “too young to be my doctor.”

  • 013: Ask David — Is Anxiety Inevitable?
    Mon, Dec 05, 2016

    A fan points out that many of the examples in David’s book, When Panic Attacks, are high functioning individuals with lots of education and good jobs. She asks Dr. Burns if depression and anxiety are inevitable among people who are poorly educated and without many assets. Dr. Burns again addresses the ancient but persistent question of whether our suffering results from the actual problems in our lives, or rather by our distorted thoughts about them.

  • 012: Negative and Positive Distortions (Part 3)
    Mon, Nov 28, 2016

    Discuss of "Should" Statements, Labeling, and Blame. Dr. Burns brings these distortions to life with a case of a severely depressed woman who felt profoundly guilty and devastated after her brother’s tragic suicide.

  • 011: Negative and Positive Distortions (Part 2)
    Mon, Nov 21, 2016

    Three common distortions: Jumping to Conclusions (including Mind-Reading and Fortune-Telling), Magnification and Minimization (also called the Binocular Trick), and Emotional Reasoning.

  • 010: Negative and Positive Distortions (Part 1)
    Fri, Nov 18, 2016

    Common thought distortions that trigger negative feelings: All-or-Nothing Thinking, Overgeneralization, Mental Filter, and Discounting the Positive.

  • 009: Should I Try to Be Happy All the Time? Healthy vs. Unhealthy Emotions
    Tue, Nov 15, 2016

    When we’re feeling depressed, anxious, or angry, should we accept our feelings or try to change them?

  • 008: M = Methods (Part 2) — You Can CHANGE the Way You FEEL
    Sat, Nov 12, 2016

    A session with a severely depressed, suicidal, hospitalized woman with rapidly cycling bipolar illness, who’d had 15 years of failed treatment with drugs and psychotherapy.

  • 007: M = Methods (Part 1) — You FEEL the Way You THINK
    Wed, Nov 09, 2016

    The three basic principles of CBT:

    1. Negative feelings, like depression, anxiety, and anger, do not result from what happens to us, but rather from our thoughts about what’s happening. In fact, our thoughts, or “cognitions,” create all of our emotions, positive and negative.
    2. When you’re depressed or anxious, the negative thoughts that trigger your distress, like "I’m no good," or "Things will never change," are distorted or illogical. In fact, depression is the world’s oldest con.
    3. When you change the way you THINK, you can change the way you feel.

  • 006: Ask David — Identity Crisis; Finding a CBT Therapist; Love Me the Way I Am
    Sun, Nov 06, 2016

    Responses to questions submitted by listeners:

    • What causes an “identity crisis?” And how do you treat it?
    • Why is it so hard to find a therapist trained in cognitive therapy?
    • In a relationship, should you change yourself in order to get along with someone?

  • 005: A = Agenda Setting (Part 2) — How to Overcome Therapeutic Resistance: “Dr. Burns, I think I need help with my low self-esteem!”
    Thu, Nov 03, 2016

    Dr. Burns suddenly abandons the role of healer and instead assumes the role of the patient’s angry, paranoid and defiant resistance.

  • 004: A = Agenda Setting (Part 1) —The Eight Most Common Forms of Therapeutic Resistance
    Mon, Oct 31, 2016

    What is therapeutic resistance? You will find out that therapeutic resistance is NOT what you were taught in graduate school or read about in the writings of Sigmund Freud! You will also discover why overcoming therapeutic resistance can be the key to high-speed, dramatic recovery for many depressed and anxious individuals.

  • 003: E = Empathy — Does It Really Make a Difference?
    Sat, Oct 29, 2016

    • How an encounter with a patient with paranoid schizophrenia dramatically changed the course of his career
    • The 5 Secrets of Effective Communication
    • How to talk with your EAR

    Dr. Burns also discusses what therapists can do when

    • you are angry with a patient
    • you don’t like a patient
    • or when a patient is angry with you

     

  • 002: T = Testing — A Boring Topic with Exciting Implications
    Fri, Oct 28, 2016

    In this podcast, Dr. David Burns describes the “Testing” part of the T.E.A.M. model. Topics include:

    • The shocking results of a study of therapist accuracy at Stanford
    • Why therapists who don’t test usually get it wrong
    • How session-by-session testing can revolutionize your practice

  • 001: Introduction to the TEAM Model
    Thu, Oct 27, 2016

    In this podcast, Drs. Fabrice Nye and David Burns discuss an exciting breakthrough in psychotherapy.

    Leave your questions and comments below. Also, let us know if you’d like to see certain topics addressed in future podcasts.

     

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