The Five Secrets of Cognitive Therapy

A British Family Doctor on Burnout, Recovery and T.E.A.M in 10 Minute Consultations! Today, Rhonda and David interview Dr. Tom Gedman, a family doctor in England and one of the founders of TEAM-UK, along with Dr. Peter Spurrier who has also been a guest on a Feeling Good Podcast. Rhonda started the podcast with a kind email from an enthusiastic podcast fan who loved our podcasts with Dr. Mark Noble (#167 and #265) on the “Brainology” of TEAM-CBT. He said these podcasts were “pure gold” and appreciated a look behind the curtains to see how TEAM actually worked at the level of the brain. Tom described his burn out episodes, which started during his third year of medical school, resulting from a familiar theme—the belief that he was inferior and just not “good enough.” His inferiority complex was a severe, total body experience, with “horrible thoughts” for six months. After he recovered, he worried about going into that state again. And the stress returned again during his medical internship. He explained that as a General Practitioner (GP) in the British medical system, you only have ten minutes for each patient, and felt like all the pressure was on him to get it right, and stated that “the pressure broke me.” In Britain, you can get free therapy as a GP, and went to Dr. Peter Spurrier for help. Peter was using the TEAM-CBT he’d learned when he came to California the previous summer for one of David’s four-day intensives, and Tom described him as “a natural. We made a deep connection right away and the Positive Reframing really clicked!” Tom’s negative thoughts included: 1. I’m not good enough. 2. I’ll fail my patients. 3. I’ll do them harm. 4. I’m not smart enough. 5. I’ll never be normal. He explained that the last thought triggered feelings of hopelessness, which really was the worst emotion of all. He discovered the Feeling Good Podcasts and listened to about 200 of them in just two weeks! And after two or three hour-long sessions with Peter, he recovered and actually felt like he was on a “high” for about six months. He says, “I had almost limitless confidence!” Then he had an as-predicted relapse which disappeared after a 30-minute tune-up with Peter. Tom said that the he’d always admired Carl Rogers, who emphasized empathy, and began using the Five Secrets of Effective Communication in his medical practice. This helped him clinically, and he discovered that “you don’t always have to ‘help;’ skillful listening is often enough. For example, patients often have to wait for months to be seen medically, and they’re angry and frustrated at first. I acknowledge their frustration and let them know that I feel sad as well. This calms them down immediately.” He also gave an example of how trying to “help” a man with agoraphobia simply put the man into a state of rage. “I tried to convince him that exposure would be good for him, but we just got into an argument, and he threatened to report me to the authorities to have my medical license revoked! That experience taught me something really important about ‘helping.’ Many people have intense resistance and just want to be heard and understood.” For example, one of his patients was in tears because of her father’s Parkinson’s Disease. The patients was helped greatly by learning He that her emotional distress was actually her love for her father, and she suddenly felt proud of her “symptoms.” Another patient with a massive opiate addiction opened up about a severely disturbing childhood incident he’d never before talked about, and then was able to cut his opiate use “way down.” We also discussed Tom’s new plans for his medical practice, working with indigent individuals, and explored the possibility of testing my Feeling Good App with this population for free to see how they would take to it. He discovered that a group in England has “stolen” my names, and also have a “Feeling Good App” and a “Feeling Good Podcast,” which causes me considerable distress. We may have to rename our app the “Real Feeling Good App,” or some such name! Dr. Tom can be reached at BlueprintMedical.co.UK or at DrTomGedman.com. Tom, Rhonda, and I would also like to urge any listeners in or near England to attend the upcoming four day TEAM-CBT intensive in England from August 14 – 17th. This four day training conference will be awesome and only costs 440 pounds. Participants will receive 38 CPD points as well as credits in the TEAM-CBT certification program. For more information about the conference, go to www.TEAMCBT.UK. Thanks for listening! Rhonda, Tom, and David