382: Overcoming Loneliness, Part 2 of 2

This is the second of a two-part series on loneliness, featuring the courageous personal work of Dr. Orly Marmur with Drs. David Burns and Jill Levitt as co-therapists.

After Orly shared her story, we worked on helping her learn to use the Five Secrets, especially the Disarming Technique and Inquiry, to develop closer relationships with others. Jill described the philosophy of this approach as learning to be ”interested” in others—encouraging them to talk about themselves—rather than trying to be “interesting" or "impressive," which is usually a losing battle.

We also worked with the Feared Fantasy technique to help Orly deal with her fear of rejection. Essentially, we explained that we would enter an Alice-in-Wonderland Nightmare World where there were two weird rules:.

1. If you think people are judging you or looking down on you, they really are!
2. In this Nightmare World, people are not polite but get right in your face and tell you all the negative thoughts they’re having about you.

We asked Orly to describe the worst criticisms she thought her friends might have about her. Here’s the list:

1. We’re not really interested in you.
2. You don’t really say or create anything interesting.
3. You are by yourself. We have families.
4. You’re not funny enough.
5. You’re not fun enough.
6. You’re too intellectual.
7. You’re too political.
8. You’re a liability.

Orly bravely took the role of herself to kick things off, and Jill and David played the role of the “friends from hell,” and verbalized these criticisms to Orly.

At first Orly struggled to respond effectively to the critical statements. She got stuck defending herself at times, and forgot to express interest in the critic and the specific criticisms.

David and Jill modeled more effective responses, using the Five Secrets of Effective Communication, including

• The Disarming Technique (finding truth in the criticisms),
• Inquiry (ask for more information with a spirit of curiosity)
• Thought and Feeling Empathy (acknowledging how the critic was thinking and feeling)
• “I Feel” Statements (sharing feelings like sadness, shame, and loneliness in an open, respectful way)
• and Stroking (expressing positive regard for the critic, even in the heat of battle).

Orly did a fantastic job, as you’ll hear on the podcast, and we did some role reversals to refine certain responses.

The goal of the Feared Fantasy is not so much to prepare for rejection in the real world, since very few people would ever say these things in such a harsh and open way. The Feared Fantasy “Monster” actually exists primarily in your own mind. But since most of us never think about the thing we fear, we don’t realize or discover that the monster has no teeth.

That is to say that by engaging with your greatest interpersonal fears, you discover that if someone were to attack you with over the top vague criticisms, you would survive, and it would reveal something terrible about the other person, not about you!

The Feared Fantasy Technique brings this to life in a dramatic, emotional, and vivid way.

At the end of the session there was a dramatic reduction in all of Orly's scores on the Emotions Table of her Dailly Mood log. Her

• Unhappiness dropped from 40 to 0
• Anxiety dropped from 100 to 5
• Shame went from 85 to 0
• Worthlessness dropped from 95 to 0
• Loneliness fell from 100 to 10
• Self-consciousness fell from 8 to 5
• Hopelessness fell from 100 to 5
• Stuck and defeated fell from 100 to 0
• Resentment fell from 90 to 0
• Disappointed in myself fell from 100 to 0

As you can see, there was a dramatic reduction in all of her scores.

We asked Orly what the most important healing elements during the session were. What techniques were that were most helpful.

Orly said that the empathy from Jill and David was really  important as she felt heard and accepted. The Feared Fantasy Technique also made a huge difference, as it taught her what she wanted, which was to feel intense feelings without doing anything about them. Orly felt that this is the continuation of earlier work that made her realize that she struggles with Emotophobia (which means “the fear of feeling your emotions), and she wanted to increase her capacity to simply feel.

Rhonda, Jill, and David want to give a shout out and virtual hug to Orly for a most fantastic session and learning opportunity for all of us.

Teaching Points

Here are a few teaching points for therapists as well as the general public.

1. The secret of meaningful relationships is to be interested in others instead of trying to be “interesting” or impressive. You do not need to add more accomplishments to the list in order to feel close and loved by others.
2. The Disarming and Inquiry Techniques (which are parts of the Five Secrets of Effective Communication) are extremely important in calming troubled relationships, if used skillfully, because they open the door for the other person to be heard and validated, and hopefully interested in healing and repairing the relationship.
3. When you use the Feared Fantasy Technique, you discover that the rejecting “monster” you feared has no teeth, and you may also discover that you are the one who created it. In other words, the “monster” you’ve feared was always just the projection of your own self-criticisms!
4. The Feared Fantasy is an intense method that can be helpful when the patient feels “trapped” or intensely afraid of rejection. However, it requires a strong foundation of trust between the therapist and the patient, especially when you respond to the “monster’s” criticisms with acceptance and vulnerability.
5. The more “over the top” the criticism is in the feared fantasy, usually, the more successful the method is, because you discover two things: 1) that the extremely harsh criticisms reveal something negative about the critic, rather than about you, and 2) specific criticisms (e.g., “you haven’t read enough books”) are very easy to agree with and disarm and do not have to hurt your ego!
6. Rhonda pointed out that during the early empathy phase of the session, Jill and David did “very basic, simple empathy” without any attempt to cheerlead or “help.” Very few therapists can do this, and most therapists don’t even realize that their empathy / listening skills are poor.
7. The use of David’s empathy scale at the end of every session with every patient can be extremely eye-opening for therapists who are brave, because you will see how your patient really sees you and rates your empathy skills.
8. Effective therapy is highly individualized and rarely or never formulaic. Orly started out by asked for help with symptoms of PTSD that started the day of the horrendous slaughter of many Israeli citizens by the invading Hamas fighters. But the session evolved into something entirely personal involving Orly’s relationships with herself and with other people.
9. In the end, Orly worked on accepting herself, connecting with others, and reducing her own perfectionism and perceived perfectionism, a therapeutic agenda that emerged as David and Jill empathized and collaborated with Orly. This led to Orly feeling less lonely, isolated, and numb, and more able to feel her feelings!

Follow-up (many weeks later)

Orly reported that she has felt “calm and quiet” since her session. She has definitely attempted to use the Disarming and Inquiry Techniques in several relationship situations, but said that the most important change has been her feelings of “inner calm and peace of mind.”

She said that she is no longer so invested in doing for others or attempting to show people that she is there for them. She simply lets things unfold naturally and is now able to let go and accept it when things she hoped for don’t happen.

This may be related to reducing her underlying beliefs around perfectionism and perceived perfectionism that were targeted in the feared fantasy work that she did during the session. Instead of thinking that she has to be impressive in order to be loved, she has learned to accept herself, which is arguably the greatest change a human can make!

For those who might be looking for a bottom line, I (David) might summarize Orly’s subtle but remarkable change as a boost in acceptance of self and the world—a result that is easy to explain, but difficult for most people to comprehend, and even harder implement in our own lives.

A big thanks to you, Orly, for teaching all of us through your own courageous personal work as the New Year unfolds and hopefully offers more world peace and increased love and connection.

Thanks for listening!

Warmly,

Rhonda, Jill, Orly, and David