Redefining Mental Health: Beyond Labels

Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information!

Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field  Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.

Special Announcement #2

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

Today's Podcast Practical Philosophy Month Part 2, Do Humans have “Selves”?

This is our second podcast in our Practical Philosophy Month. Last week, in our first episode, we focused on the “free will” question. As humans, we all feel like we have “free will,” but is it just an illusion, especially if all our actions are the result of the physical processes in our brains and the laws of the universe?

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

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

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

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

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

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

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

Here’s my thinking. There are many key questions you could ask about the concept of the “self?” including:

1. Do we have a “self?”

2. And if so, what is it?

3. Does the first question even make sense?

I’m sure you would agree that if a question doesn’t make sense, then it isn’t a “real” question, and there really isn’t anything to talk about. Then we can just stop feeling frustrated and perplexed, and move on with our lives.

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

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

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

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

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

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

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

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

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

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

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

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

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

Now, does this discussion have anything to do with emotional problems, or TEAM therapy? It absolutely does. That’s because nearly all depression results from some version of “I’m not good enough,” including:

• I’m inferior.
• I’m a loser.
• I’m a “hopeless case.”
• I’m a failure.
• I’m unlovable.
• I’m a bad parent.
• I’m defective.

And so forth.

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

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

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

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

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

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

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

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

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

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

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

Yikes! No fun!

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

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

She why we would celebrate?

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

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

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

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

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

“No Self? No Problem!”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thanks for listening today. We love all of you!

Rhonda, Fabrice, Matt, and David