198: Ask David: What if Your Negative Thoughts Aren't Distorted? Do Demons Cause Depression? And more!

Today, Rhonda and David discuss ten great questions submitted by podcast fans like you!

1. I can’t find any distortions in my thoughts! What’s the cause of this?
2. Crushing Negative Thoughts. Do you have to write them down? Can’t you just do them in your head?
3. PTSD Question: Does the trauma have to be life-threatening and experienced in person/
4. How can I get over anxiety and panic?
5. Do demons cause depression?
6. How is Sara now? Is anger just “ossified tears?”
7. How do you explain the basic concepts of CBT and cognitive distortions to patients who are not familiar with your work?
8. Can I help myself as much as Rameesh did?
9. How can I start a self-help group based on your book, Ten Days to Self-Esteem?
10. How can I find my favorite podcast?

1. I can’t find any distortions in my thoughts! What’s the cause of this?

A new comment on the post "001: Introduction to the TEAM Model" is waiting for your approval https://feelinggood.com/2016/10/27/001-introduction-to-the-team-model/

Hi Dr. Burns,

I just ordered your book and am writing my cognitive distortions daily. I ran into one I did not know how to label it.

I am a 73-year-old, attractive woman, When I see a young beautiful woman having a great time, say in an ad, I feel angry, sad and jealous. This does not apply to family members only strangers.

charlotte

2. Crushing Negative Thoughts. Do you have to write them down? Can’t you just do them in your head?

A new comment on the post "190: How to Crush Negative Thoughts: Overgeneralization" is waiting for your approval https://feelinggood.com/2020/05/11/190-how-to-crush-negative-thoughts-overgeneralization/

Dr. Burns,

Why is writing the negative thought down important? Can’t I just pinpoint it in my head and simply switch the negative thought to positive one?

I know it will not work but i am not able to convince others or myself why I have to write them down. Why is the writing process so important?

After practicing for a while will you have the habit of think positively? I am wondering why some people have this way of positive thinking without even practicing?

Toni

3. PTSD Question: Does the trauma have to be life-threatening and experienced in person/

A new comment on the post "147: High-Speed Treatment of PTSD?" is waiting for your approval https://feelinggood.com/2019/07/01/147-high-speed-treatment-of-ptsd/

Hi David,

I am a fan of your great work and contribution to psychology.

I have a question about PTSD: does it necessarily have to be life-threatening in person or can it be caused for example by a threat via online message?

Thank you!

MB

Thanks, MB, great question.

Only your thoughts can upset you, not the actual trauma, so the answer is yes. Anything that is profoundly upsetting is profoundly upsetting, period! There is no objective way to measure the impact of any trauma other than via your own thoughts and feelings! This is so important, and yet most of the world, including those who have written the DSM-5 (and all earlier editions) / don't yet "get it." The DSM states that for a diagnosis of PTSD, you have to have some trauma that is “objectively horrific.” But there is no such thing!

david

4. How can I get over anxiety and panic?

Debby asked a question about podcast 189: How to Crush Negative Thoughts: All-or-Nothing Thinking

I have your book When Panic Attacks. I am at a loss at what to use to get over anxiety and panic. It is exciting because you said that you can get rid of both fairly soon; which would be great

Hi Debby,

Thanks for your excellent question!

The Daily Mood Log described (I believe) in chapter 3 of When Panic Attacks is a great place to start. Do it on paper, and not in your head, focusing on one specific moment when you were anxious. Thanks!

One teaching point is to focus on one specific moment, and not try to solve anxiety or any mood problem in generalities. A second teaching point is to record the situation, your feelings, and your negative thoughts you were having at that moment. This is always the starting point for change!

You’ll find tons of resources on my website, feelinggood.com, including the show notes for all the podcasts with links, search function, and way more, all for free. You can learn a great deal if you put in the time and effort.

For example, I am now creating a free class on anxiety and it will soon be available on my website!

David

5. Do demons cause depression?

Brian W. commented on Podcast 189 on All-or-Nothing Thinking

Hi Dr. Burns,

Amazing podcast as always doctor Burns! Question: have you ever encountered anything in your patients that you might consider supernatural? I'm Catholic and there's the idea that demons can cause depression or mental illness. I know it sounds crazy, but I've seen weird things.

Thank you.

Brian

Thank you for your question, Brian. Depression results from negative thoughts, not demons. That's good because you can learn to change the way you think and feel. The type of therapy I do is entirely compatible with all religions, including Catholicism, and there is often a spiritual dimension in recovery.

All the best,

david

6. How is Sara now? Is anger just “ossified tears?”

Dear Dr Burns,

Though doubting that you’ll ever read or answer this, nevertheless I’ll cast it to the cloud for something-or-other!

I’m an old fossilised blind British harpsichordist (good combo?!!) and a devoted fan of your podcasts, as well as selectively slowly making my happy way through the 27 hours of RNIB’s Talking Book version of ‘Feeling Good’ (Must tell you that the Braille Music Translation Programme I use invented by a great buddy in Pa. is called ‘Goodfeel’, so you guys must have something in common!).

Alas I have 2 questions.

First, as a ‘floating’ OCD sufferer for 70 years or so, I wildly enjoyed Sara’s ‘high speed cure’ in podcast 162. However, surely with this new Coronavirus threat – the virus remaining on cardboard for around 24 hours and other surfaces including shopping for at least 2 days or more -, her cure must have now been reversed? The fact, and I mean from much research ‘fact’ is that ‘what you touch could kill you’. Sure, it might not but, in as bad health otherwise as I am, I believe it’s imperative to be as careful as pos. which, courteously put, is screwing my brain! How about Sara?!

Finally, well I suppose it’s a comment more than a question. I’ve been enjoying and, indeed, beginning to benefit from your section in the book on anger. I wonder though whether, unless I haven’t got there yet (which is eminently possible!!), you might have left out one aspect of anger? I’ve often thought that it, as well as hatred and violence could be designated ‘ossified tears’ and, believe me, in my case, if so, they’ve turned into unbreakable rocks!!

Keep up the great work, Dr Burns. We all need such an unique communicator and erudite intellect as you, oh and I fervently hope you can stay clear of this virus.

Very best and thanks,

John Henry (Not the old American horse, . . . but rather a British, almost human John Henry!!

David and Rhonda respond to both of John's questions!

7. How do you explain the basic concepts of CBT and cognitive distortions to patients who are not familiar with your work?

Hi David and Rhonda,

You previously answered a question of mine on your podcast. It was quite helpful, thanks! I have a new unrelated question.

While the live sessions have been very illuminating in many ways, your patients have always been trained therapists who are already familiar with the concepts of CBT and cognitive distortions. I understand this is an ethical necessity.

As a family physician I struggle with that first step - how do you introduce the concepts of CBT and the cognitive distortions to non-therapist clients? I imagine it must take at least a full session just to do education on the distortions. This may be a question best for Rhonda.

Thanks again!

Calvin

Hi Calvin,

Thank you for another great question. If you prescribe the book, Feeling Good, it can help you and your patients in three ways. First, they’ll get all the concepts and some sound psychoeducation, saving you time. Second, the book is at least as effective as antidepressants, so it is prescribing something that may be very helpful with no side effects. Third, it will be a test of their motivation. Motivation appears to have a massive effect on recovery from depression.

Also, there are tons of great classes in TEAM for beginners if you check them out at FGI (www.feelinggoodinstitute.com).

There are also free classes on depression and other topics on my website, www.feelinggood.com. These classes may also help your patients.

On the show, Rhonda will explain how she introduces these topics to her patients as well!

All the best,

David

Rhonda’s note to Calvin:

You flatter me, because all questions are best answered by David, but I will give it a try.

I do ask all my patients to read David's book Feeling Good, which is superb at describing what CBT is and why it is effective.

I have an intake telephone call with all my new patients before we start working together, and before they read Feeling Good. In that call I explain CBT like this, imagine a triangle that has Thoughts, Feelings and Behavior at each point. Your thoughts drive your feelings and your behavior. So, if you can change the way you think, you can change the way you feel. David gives the example of someone walking in the woods who hears a twig break. Imagine that hiker thinking that a murderer is creeping behind him or her, what do imagine he or she would feel? But imagine that same hiker thinking that his or her best friend is joining the hike? What would he or she feel then? There are lots of examples like that: two students who have studied the same amount. One walks into the test room thinking, I did a good job studying, the other walks into the test room thinking I should have studied more. Who do you think will do better on the test? This is an actual study that has been done, and if you guessed the student thinking more confidence did better, you would be correct. It makes logical sense.

I don't explain cognitive distortions in my intake discussion, but when we first start working with a Daily Mood Log, after we have gone through T = Testing, E = Empathy, and after A = Assessment of Motivation, when we are going through the M = Method "Identify the Distortions" for the first time. I explain that cognitive distortions are embedded in our negative thoughts, and they are simply ways that our mind convinces us of somethings that aren't really true. By this time patients have read part of Feeling Good, so they have more psychoeducation.

But I find if patients still don't understand the concept of cognitive distortions, as we go through the Identify the Distortions method, they soon understand what distortions are.

I hope that makes sense, and that you find this helpful,

Rhonda

8. Can I help myself as much as Rameesh did?

Hello Dr David,

I saw how Ramesh changed dramatically and I want that kind of change in my life. but I am doubtful. It was you who managed to melt away his resistance using different techniques. Is it possible that we can manage to change ourselves so effectively?

Shivam

Hi Shivam,

Thank you for this incredibly important question. Research indicates that many people have been helped by reading my books and doing the exercises, such as Feeling Good. Motivation and hard work are critically important in personal change and recovery.

I am also working on a new app, and hope to get data to answer this exact question!

Best of luck! Will make this an Ask David question, as it is so important!

David

9. How can I start a self-help group based on your book, Ten Days to Self-Esteem?

Dr Burns,

I know your book, Ten Days to Self Esteem, has a group leaders manual. Can anyone start one of those groups of do you have to be a therapist of some sort?

Has anyone told you that they started one?

How did they say it went?

Any tips for starting one?

Thanks

Richard

Hi Richard,

Many pilot studies using this program with lay leaders have been effective. The program at my hospital in Philadelphia, also using lay leaders, was very effective.

David

10. How can I find my favorite podcast?

Hi David

I am a therapist and was reminded of one of your podcasts as I was listening to a particular patient. I wanted to share the episode and then couldn’t find it so felt silly.

It was an episode where a father (perhaps Indian? Maybe a doctor?) empathizes and listens in a whole new way to his adult son and has a miraculous turn of events in the relationship- simply by being present and not being defensive when the son tells him how he feels about his father. It was beautiful and moving. A great example of “opposite action”- agreeing with the criticism rather than defending against it.

Does that episode ring a bell and can’t you point me in the right direction to retrieve it?

I know how busy you are. Thank you for your wonderful podcast and for any help you can provide.

Thanks,

Pam

Hi Pam,

It might be the follow-up to the live therapy with Mark. Use the search function on my website. He is from Iran, and is an OB-GYN doctor who has faithfully attended my Tuesday training group for years. He is one of my favorite people.

Learning the Five Secrets takes lots of commitment and practice. He has formed his own Five Secrets practice group with friends and colleagues who are not shrinks. They’ve met weekly for years, so his skills are quite refined now.

Thanks!

David

On the podcast, I emphasize the search function you can easily find on every page of my website, www.feelinggood.com. Pam’s comment on the Five Secrets is also important. Desire, commitment and ongoing practice are the keys to mastery!

Rhonda and David