Ask David: Featuring Matt May, MD 1. Roy asks: How can I challenge my core belief that there is something wrong with me? 2. Lynn asks: Do you have any recommendations for someone with health anxiety? Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1. Roy asks: How can I challenge my core belief that there is something wrong with me? Hello Dr .Burns, Regarding podcast 294, I had a few quick questions/suggestions on acceptance. Is it possible to do a podcast with you and Matt and Rhonda on one specific core belief? The belief: There is Something Wrong With Me Let me explain. I have dated and had relationships with some very physically attractive women in the past. In the last year I have not been able to duplicate these past successes and I suspect it's because I am at least 10 years or more older than these women ( 23-28). Let's say I NEVER EVER date or have a relationship with my specific type EVER again? This has caused a ton of frustration and some depression ( low) but has been a bit to my self image and self esteem Thoughts? Thanks Dr. Burns Roy David: At my request, Roy provides more information on his Core Belief: There is something wrong with me. Why believe it? 1. My parent said "What's wrong with you?" whenever I got in trouble in school ( infers there IS something wrong with me) 2. It feels like there is something wrong with me 3. I make mistakes and am not perfect so there MUST be something wrong with me I believe this Core Belief to be 100 % True David: I asked Roy to provide a Daily Mood Log. DML Activating Event: 3 specific events A) My ex girlfriend dumped me and ended our relationship B) A woman I suspect is a super model said No to my request to go out on a date C) I have recently struck out with the last 5 women I REALLY want to date. They ALL rejected me Feelings: Depressed/Down/Unhappy (70%) Worthless/Inadequate/Defective (80%) Unloved/Rejected (95%) Hopeless/Discouraged (99%) Frustrated/Defeated (99%) Resentful/Irritated/Upset (99%) Negative Thoughts 1.There is something wrong with me (100%) 2. I must get this specific woman's love and approval to feel good about myself (80%) 3. If I am a sexy charming guy then this woman would find me attractive. I must not be very attractive (100%) 4. If I played in the NBA or NFL then this woman would be attracted to me (100%) 5. The sex would be amazing if I were to be intimate with this woman (100%) 6. I would be so much happier if I was to have a relationship with this woman (100%) 7. Women like her with incredibly sexy attractive bodies only go for high status millionaires. I am not a millionaire. It's awful I am not a millionaire (100%) 8. I am 10 years older than these women and therefore my age turns them off (100%) David wrote back, suggesting that Roy list the benefits of his belief that “there’s something wrong with me.” Positives of believing There is Something Wrong With Me

• Very easy explanation why these specific types of women reject me
• I don't have to make any changes about myself ( clothes) or behaviors ( more charming)
• Familiar feeling and comfort in familiarity
• I can feel sorry for myself and have a pity party
• Gives me something to complain about with my friends lol
• My fantasy ( sexual and relationship) of these specific women remains unchallenged and is a great distraction when bored
• Shows I accept I am not perfect and defective
• I accept responsibility for my failings
• Don't have to get angry or upset about my mother's poor parenting skills
• Incredibly easy cop out whenever I fail to achieve any type of goal
• Can quit working towards a goal when face adversity

Next, Roy identified some distortions in this belief. Distortions in believing There is Something Wrong with Me -emotional reasoning -self blame -overgeneralization Why? Feels like there is something wrong with me. I am assuming 100% blame. I am not focused on any positive things done in my life I am stuck because my mother said what's wrong with you when I was a kid. I concluded there must be something wrong with me. Whenever I get rejected this core belief surfaces. Is this what you had in mind? All the Best and THANKS Roy David’s response Hi Roy, Thanks for the email. Everything about you and me could be improved. Is that all you mean when you say “there’s something wrong with me?” Or are you saying you have a “self” that is somehow damaged.? If so, was your “self” always damaged, from the time of birth? Or did it “become damaged” at some point? If the answer is yes, at what point did your “self” become “damaged?” To me, conversations about “selves” have no meaning. Conversations about specific flaws or problems do have meaning. You are kind of kicking your dating problem up into the clouds of abstraction, to my way of thinking, when you obsess about a “damaged self.” Lots of colleagues who used to come to my Sunday hikes had dating problems, in your age range, and most eventually solved them. But talk about “damaged selves” was never part of the dialogue that I can recall. I wrote a book on dating, Intimate Connections. Just my thinking! d More from David after an email exchange I don’t think you answered, or attempted to answer, my question. One problem is that you would like to date and have sex with more younger women who are in great shape. That is something specific and clear. I understand it, anybody can make sense of what you are saying. When you say, “In addition, I believe I have a ‘self’ that is defective (or whatever), I don’t “get” what you are talking about. Can you explain this at the fourth-grade level? Do you mean that you get upset when you get rejected? Is that all you mean? Or do you mean that you get frustrated and disappointed when you cannot get a date with X, Y, or Z woman? Nearly all men have these reactions at times. Does this mean there is “something wrong” with their “selves?” There are lots of reasons why woman A might not be attracted to man B. Do you agree? Which reason makes the man’s “self” not good enough. She may not be attracted to him because he is chasing her, for example. This means that his dating style needs some fine tuning, and perhaps that he needs to learn to be happy when he is alone, and that he does not “need” love or her love, etc. Those are specific things, easily changed. But I don’t get the “self” bit! We all having varying qualities and ratings. Take math. Everyone has a certain skill in math. 50% of people are above average, and 50% are below average, in math. Do you agree? Is there some skill level that means that there is something “wrong” with your “self?” Thanks! D On today’s podcast, Rhonda, Matt and David discuss effective and ineffective approaches to dating, including a mind-set that may be a huge turn-off to women. They also illustrate how to challenge some of Roy’s distorted thoughts using three strategies:

• Self-Defense
• The Acceptance Paradox
• The CAT, or Counter-Attack Technique

Matt and Rhonda speculate that Roy may be harboring some anger toward his mother, and toward women in general. David is less convinced, but more focused on change in the here-and-now, regardless of causes, which can sometimes be difficult to prove. At any rate, if Roy’s goal is to develop more loving and rewarding relationships., there are many available tools. 2. Lynn asks: Do you have any recommendations for someone with health anxiety? I am a long time fan of your work, and I have a long history of health anxiety. My therapist tells me that this is really death anxiety. I'm not sure I agree...but do you have any recommendations for someone with health anxiety? ( imaginal exposure therapy has not been helpful) I'd be eternally grateful for any insight. David’s reply Thanks for the kind words, Paul. I will try to include this in an upcoming Ask David segment! Matt’s reply: Using uncovering techniques, like the ‘What if’ technique, Hidden Emotion, Downward Arrow and Interpersonal Downward Arrow could help answer this question.  If you had a problem with your health, what would you worry about, most?  If you were having a problem with your health, what would you worry about, in terms of how other people would treat you?  What would it mean, about you, if you had a problem with your health.  Identify the specific negative thoughts behind your suffering will help your therapist identify methods that could help you.  As far as Death Anxiety, you could consider a chapter in Feeling Good, where David breaks this fear down into more specific parts.  Are you afraid of the process of dying?  The moment of Death?  What comes after?  If so, what are you afraid of, specifically?  Most people don’t fear Death, it doesn’t really exist, like a shadow, just the contrast to something real, Life. In the podcast, Matt, Rhonda, and David emphasize the role of the Hidden Emotional Model in the treatment of Health Anxiety, and describe two dramatic cases involving rapid recovery, one of them personal—David’s belief he had a lymphoma in his armpit shortly after completing his psychiatric training. The other involved a college student with a long history of health anxiety who David and Matt hypnotized. While in the trance, she suddenly “remembered” what she was actually upset about, and burst into tears. This was a life-changing moment! Thanks for listening today! Matt, Rhonda, and David