Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

This discussion tackles the delicate dynamics of caring for a demanding elderly relative, emphasizing the importance of empathy in family relationships. Strategies for communicating effectively with loved ones are shared, highlighting the impact of acknowledging emotions. The conversation also navigates challenging interactions with people holding extreme views, urging listeners to cultivate compassion even in difficult circumstances. With real-life examples, the hosts inspire a deeper understanding of human behavior and the transformative power of kindness.

Is friendship a basic human need? The podcast dives into this question, exploring the psychological effects of loneliness and the vital role relationships play in our happiness. Personal anecdotes reveal the joy that solitude can bring, drawing parallels to historical figures. A fine line between need and desire in friendships is discussed, emphasizing the importance of self-discovery. The conversation also highlights overcoming external approval addiction, showcasing paths to inner fulfillment.

In this lively discussion, neuroscientist Mark Noble, a recently certified TEAM CBT coach who combines his love for music with therapy, and Angela Poch, an international TEAM CBT trainer and therapist, explore the therapeutic power of music. They dive into how songwriting can enhance emotional resilience and self-acceptance. Topics include the intersection of music and mental health, personal growth through emotional expression, and the innovative use of AI in creative processes. Expect original songs that humorously capture identity and feelings!

Mike Christensen, a Canadian TEAM therapist, shares his inspiring personal journey from feelings of betrayal and hopelessness to helping others navigate the same struggles. He explores innovative approaches to treating hopelessness, emphasizing the need for empathy and understanding rather than quick fixes. The conversation delves into the significance of vulnerability in therapy and celebrates failure as a catalyst for growth. Mike's insights about authenticity and connection highlight how embracing one's imperfections can lead to a more fulfilling life.

In this engaging discussion, psychologist Jill Levitt shares her expertise on defeating perfectionism and embracing self-acceptance. She explores powerful techniques like cognitive distortion identification and the externalization of voices. Listeners will learn to confront their fears through the 'feared fantasy' approach, highlighting the humor in harsh self-judgment. The conversation also emphasizes valuing love and connection over flawlessness, offering practical strategies to boost motivation and enhance therapeutic skills.

In a thought-provoking discussion, Dr. Jill Levitt, a leading figure in cognitive behavioral therapy, joins to tackle the challenging topic of perfectionism. She delves into how perfectionism fuels feelings of anxiety and inadequacy, and highlights the emotional pain that often accompanies those beliefs. Listeners learn about Positive Reframing and Cost-Benefit Analysis, powerful tools to combat perfectionistic thought patterns. The conversation also emphasizes the balance between striving for excellence and the need for self-acceptance.

Explore the intriguing dynamics between perfectionism and procrastination, as hosts share strategies to tackle self-sabotage. Learn how to harness positive reframing with the magic dial technique for better mental health. Discover effective methods to motivate procrastinators through actionable steps and personal accountability. The discussion dives into the delicate balance of confronting emotions linked to procrastination and the importance of supportive therapy. Friendship and its necessity are also woven into the conversation, emphasizing community and growth.

Ask David-- The Fear of Happiness! Although we had five questions for today’s Ask David episode, we spend the entire podcast on the first question from a man with an intense fear of happiness. He wrote: How can I use exposure to overcome my fear of happiness? Hi David, How would you do exposure for the fear of happiness? Whenever I feel happy I immediately feel afraid because I had a very strict religious upbringing where many harmless forms of fun and enjoyment were completely forbidden. Even though I'm no longer a religious believer, the fear remains. Feeling good then makes me afraid, anxious and insomniac. This often goes on for days after something good happens and it almost seems as if I AM being punished after all! How can I recover when feeling good makes me feel so bad? Love your work and all that you do. Best regards, Tomas David’s reply As I have said on numerous occasions, I do NOT recommend “methods” (like exposure) for “problems” (like your “fear of happiness.”) I think your problem is very treatable, but I work with patients systematically, and that doesn’t mean starting out with a “method,” like exposure or any other method. I use a step by step approach, using T = Testing, E – Empathy, A = Assessment of Resistance, and M = Methods in a sequence. In addition, when I work with anxiety, I always incorporate these four approaches with every patient I work with: The Motivational Model: I bring Outcome and Process Resistance to conscious awareness and melt them away, if possible, using a variety of TEAM CBT approaches. The Cognitive Model: This involves a well-done Daily Mood Log to identify and challenge the distorted negative thoughts at one moment in time. The Exposure Model: Facing your fears, or testing them with an experiment. This is frightening, but required of every anxious patient. The Hidden Emotion Model: This is based on the idea that only “nice” people struggle with anxiety, with only a few exceptions, and that an unacknowledged problem is often hiding right behind the anxiety. The cure requires the Detective Step: identifying what the hidden emotion or feeling is. The Action Step: Expressing the suppressed feeling and or dealing with the problem you are avoiding. Your fear of happiness is an interesting problem for sure. One of my favorite movies, “Babette’s Feast,” involves this theme. If you want some help, you could send me a partially completed Daily Mood Log. You will discover that you are the only one who is doing the punishing! It is that belittling, intimidating voice in your own head that is causing 100% of your suffering. I look forward to helping you challenge those voices! In the meantime, I’ll add this to the latest Ask David podcast questions, in the hopes you might send the DML, and then Rhonda and I can comment in greater depth on the live program. Best, david Tomas kindly sent a Daily Mood Log, which you can see if you CLICK HERE As you can see, the Upsetting Event is simply “studying mathematics,” something he loves. However, he has the belief that if he allows himself to enjoy this or any activity, something terrible will happen to him. He traces this to a strict religious upbringing, and perhaps also to bullying he endured as a kid. You can see that this is intensely upsetting to him. If you look you will see that in 8 of the 9 categories of emotions on his Daily Mood Log (DML), he scores in the range of 80 to 100, which is intense and severe to extreme. The only emotion category that is not extremely elevated is the anger cluster, which he rated at only 40. You can see as well that his negative thoughts all involve the theme of punishment and destruction if he allows himself to feel happiness and enjoyment of life, or if he advances himself in life. In some of the emails he sent me, he traces this back to being bullied when young. . . possibly by kids who were jealous of his high IQ. As mentioned above, I don’t throw methods (like exposure) at people based on a problem or diagnosis (in his case a phobia, the fear of happiness.) I also mentioned that I go through the T E A M model in a sequence, starting with Testing and Empathy, followed by the Assessment of Resistance and culminating in Methods. In addition, I always treat anxious patients with four powerful models, including the Motivational Model, the Cognitive Model, the Exposure Model, and the Hidden Emotion Model. I described these models above. The Motivational Model The Outcome Resistance has to do with the fact that Tomas may resist treatment because of his fear of the consequences of successfully achieving happiness. We will deal with that with Positive Reframing, including the Miracle Cure Question, the Magic Button, Positive Reframing, and the Magic Dial. In addition, we’ll have to deal with Process Resistance. At some point, we will have to use exposure techniques, and we will want to find out if he’s WILLING to do exposure even though it may be extremely anxiety provoking at first. We can dangle the carrot, letting him know that we anticipate a positive outcome, but also understand that facing his worst fears may be terrifying at first, and very uncomfortable. I will not try to persuade him to use any of the many versions of Exposure. He will have to persuade me that he’s willing to do it. I suspect he will be, because he is asking for exposure, but if he says he wants to be treated without exposure, I will have to let him know I am not a good choice as a therapist for him! That’s because I don’t know how to defeat any form of anxiety without exposure. Of course, I cannot treat Tomas, or anyone, through an Ask David, but can only make teaching points. But I am teaching self-help techniques that have been helpful to many people. In an email, I asked him the Magic Button question, and he said he didn’t think he’d push it. This indicates some understandable resistance that has to be dealt with. Positive Reframing is one way to deal with Outcome Resistance. The goal is not only deeper empathy but also helping patients “see” that the negative thoughts and feelings they are struggling so desperately to overcome are actually positive in many ways. Once they “see” this, it is kind of a pleasant shock to the system, and their resistance to change typically disappears. Then we ask them to set goals for each negative feelings—a lower level of each feeling that would allow them to feel better and not lose all the wonderful positives we have discovered. That’s why it’s better NOT to push the Magic Button. To help Tomas or anyone see and list the positives in their negative thoughts and feelings, we ask two key questions about each one: What are some possible advantages, or benefits, of this negative thought or feeling? How might it help me? What does this negative thought or feeling show about me and my core values as a human being that’s positive and awesome? Typically, this leads to list of 10 to 20 positives that have three characteristics. To give you an example, his intense loneliness is an expression of his love for people and the great value he sees in meaningful relationships. And his anxiety serves to protect him from danger, and is therefore an expression of self-love. And his feelings of inferiority—in spite of his tremendous intelligence—show humility, which is not only a spiritual quality, but also can make a person of great intelligence more accessible, more vulnerable, and more attractive. Inferiority may also be an expression of his honesty and willingness to acknowledge his shortcomings, as well as his accountability. We could easily go on and on, and it might be a great exercise for you to try find the positives in several other of his negative thoughts and feelings by asking those two questions. Once my patient and I have listed 10 or more positives, I ask if these positives are True and valid? Powerful? Important? Nearly always, I get a resounding YES to each question. Then I use the Magic Dial to see what they might want to dial each negative feeling down to in the % Goal column of the Daily Mood Log. Is this Positive Reframing process straightforward? Easy? Not really. I make it look easy, because when I teach I want people to understand, but “seeing” these positives is, in reality, incredibly challenging for most people. In fact, You can see the Positive Reframing that Tomas completed on his own if you CLICK HERE As you can see Tomas almost completely missed the boat when he tried to identify the positives in his negative thoughts and feelings. I mention this because it is a CRUCIAL step in TEAM CBT, and people often have a tremendously hard time “seeing” the positives in their negative thoughts and feelings. A big part of the reason is that society teaches us the opposite. In fact, negative feelings are Labeled as a bewildering array of more than 200 so-called “mental disorders” by the American Psychiatric Association in their “bible,” the DSM (Diagnostic and Statistical Manual of Mental Disorders.) But here’s something even MORE surprising. Rhonda—a highly respected and admired TEAM CBT therapist and teacher—also struggles to find the positives during today’s podcast. Once someone has pointed them out, you can suddenly “see” them. But on your own, you may have a lot of trouble at first with Positive Reframing, which is anything but simple, but extraordinarily powerful once you “get it.” I recently told my weekly Tuesday psychotherapy training group at Stanford that TEAM CBT is extraordinarily difficult to learn and master—nearly always requiring years of study and practice—and perhaps the most challenging form of psychotherapy ever developed. She was angry and told me I’d have to do large controlled outcome studies to validate that claim! Yikes! I may be wrong, and there could be other more difficult forms of therapy, but I still believe what I’m saying because I see it every single day. Many of the most powerful and helpful concepts, such as the four “Great Deaths” of the “self” for the therapist and for the patient in TEAM, and the Acceptance Paradox, and more are hard to learn! But worth it, IF you take the time to learn this method. And if you wish to use TEAM CBT, on yourself (for self-help) or with your patients (if you’re a therapist) you will have much greater success after you master this powerful but elusive skill. The Cognitive Model After Rhonda and I worked with Positive Reframing, we went on to the technique that usually starts the M = Methods section, called “Explain the Distortions.” This powerful method includes answering three questions about one or several of the distortions you can find in one of the thoughts you want to work on first. First, select the thought and identify all the distortions in it, listing them by abbreviations in the Distortion column on your Daily Mood Log. For example, if it is an example of All-or-Nothing you can put AON in that column. And you can put OG for Overgeneralization, and so forth. Often, you will find five or even ten distortions in a single negative thought. Let’s say you work on, “If I’m happy, I’ll be destroyed.” This alarming thought includes AON; LAB, FT, DP, and ER. And it’s also a Hidden SS. Choose the distortion you want to work on first. Let’s say it’s Fortune Telling (FT). Why is this distortion, FT, considered a thinking error in general? Why does the FT distortion your specific thought pretty much make the thought unreasonable? In other words, Why does the FT in your thought NOT map onto reality? And finally, why is the FT is this thought unfair? As an exercise, turn off the podcast for a moment and write down your answers to those three questions. Once you’re done, you can check the answers at the end of the show notes. It’s a great skill to practice and learn, because it will usually make it really easy for you to generate positive thoughts that satisfy the necessary and sufficient conditions for emotional change. Do you know what they are? Write them down before you look at the answers at the end of the show notes. Just take a guess, but WRITE SOMETHING DOWN before you look! But DON’T look until you’ve written down your own answers! Hey, did you peek, or did you write down the answers first? I get it! And I forgive you! However, you missed out on a great opportunity for learning if you skipped the written exercise. Or, to put it positively, I try to make the exercises fun and interesting. And if you do them, you’ll learn some cool and helpful things rapidly. It’s like riding a bicycle. You’ve got to get on and ride to learn how to do it! But here’s what’s really interesting. You’ll notice that Rhonda, once again, really struggles with this exercise during the podcast. Although I think of Explain the Distortions as a really easy TEAM CBT method, experience with real people has over and over again provided abundant evidence that it’s NOT easy for many, or possibly most, people at first. So, what’s the point? Here’s the point. If you’re a therapist, this method is powerful, and will richly reward you for the time and effort you spend in learning how to do it! But you cannot take it for granted if you want to use it in an actual therapy session. And if you are simply looking for self-help, the exact same thing is true: the method is incredibly helpful and well worth some time and effort to “get it!” In addition, to challenging the obviously distorted thoughts on his Daily Mood Log, what other methods might be helpful to Tomas? The Exposure Model Well, there are a great many, including the Exposure techniques he was asking for. For example, he could intentionally make himself happy, and then fantasize some horrible punishment using Cognitive Flooding. The idea would be to make himself as anxious as possible for as long as possible, until he finally gets bored with the fantasy, which will definitely happen eventually, and the anxiety disappears. Exposure is terrifying at first, and it is supposed to be. That’s whey and how it works! The Hidden Emotion Model There are many helpful variations on the Exposure front, and the Hidden Emotion Model might also be key. Is there some problem or issue in his life that Tomas is not dealing with? The Class on this technique in the (now entirely free for the summer of 2025 app) Feeling Great app has many details and exercises and examples to show how this mind-blowing technique works. That’s it for today’s podcast. I want to thank you, Tomas, for providing us with a fascinating problem, and all of you who send in your questions. We are SO GRATEFUL that you are bouncing back, Rhonda, after your ordeal with radiation therapy for your lymphoma, and send you all our love and best wishes for joyful and complete healing and liberation from your nightmare! Warmly, Rhonda and David Answers Here is my answer to first exercise on the necessary and sufficient conditions for emotional change from a positive thought. . The necessary condition for emotional change: The Positive Thought must be 100% correct. The sufficient condition for emotional change: The Positive Thought must reduce your belief in the disturbing negative thought. Sometimes you’ll want to reduce it all the way to zero. Sometimes, that’s not necessary, especially with Should Statements. Here are my answers to the three questions about Explain the Distortions above. In general, FT is a thinking error when you are making arbitrary alarming predictions without strong evidence that supports those predictions. In particular, there is no evidence that supports the claim that people who feel happy rapidly become the victims of some horrific disaster or punishment. This thought is very unrealistic because the ONLY punishment that Tomas has experienced is the result of his own negative thoughts! This thought is unfair because it puts Tomas in handcuffs so he will be unable to enjoy his life.

Part 2 of Our Personal Work with Rhonda The Surprising Conclusion of Rhonda's Session with Matt and David Last week, you heard Part 1 of our personal work--a single two hour therapy session--with Rhonda, focusing on her recent shocking diagnosis of a cancerous and potentially fatal lymphatic tumor in her neck. We did initial T = Testing and E = Empathy. Today we do the A = Assessment of Resistance and the M = Methods, and of course, the final assessment of symptoms and teaching points. A = Assessment of Resistance How DO you help someone facing a terrifying diagnosis of cancer? What's the best method to use? How do you cheer them up, or is it impossible to do so and foolish to try? Or is there no correct answer to these questions? Well, there IS a "correct" answer, at least according to the gospel of TEAM. You ASK the person if they want help, or if listening is enough. And if they want help, you ask them what they want help with. This personalizes the treatment and brings it alive for the patient. Rhonda said she had difficulties accepting help, and extreme fears of being a burden on others. She specifically wanted to stop comparing herself to her friend, Jack, who has so far survived for four years after a severe diagnosis of disseminated cancer requiring whole body radiation. She also wanted help feeling less guilty about her anger and her complaint about pain and side effects. Because we didn't want the session to run overly long, we did some streamlined Positive Reframing, listing 11 positives embbeded in her negative thoughts and feelings, such as "I have no right to complain." What does each negative thought and feeling show about her that's positive and awesome? And what were some benefits of them? The we asked Rhonda about her goals for each negative feeling on her DML, which you can see if you CLICK HERE As you can see, her desired reductions for most of her negative feelings were only modest, perhaps indicating some acceptance of her situation and the negative feelings that seemed inevitable. However, this can sometimes indicate some residual resistance that has not been addressed. We'll have to wait and see what happens next to find out! M = Methods We worked with Rhonda using several methods, especially the Externalization of Voices with frequent role reversal until she got to huge. My memory of the session is that the Counter-Attack Technique compared with the Acceptance Paradox got her to HUGE wins. You can see Rhonda’s ratings for each negative feeling at the end of the session if you CLICK HERE And were these rating genuine? Or was she just being "helpful" to us for the sake of the podcast? At the end, Rhonda estimate her gratitude was 1,000,000%! Thank you, Rhonda. We all love you for your incredibly important gift to all of us today, teaching us how to love, and to laugh, when we all have to face our inevitable fate of letting go and experiencing the "true Great Death" of the "self." And we are 1,000,000% grateful to your wonderful doctors at Stanford that this cancer will NOT get the last word! Teaching Points The first take home message is that you can’t effectively treat anyone with any kind of emotional problem without asking them to write down their negative thoughts. If you do this, you can find out exactly what's going on, and you'll know the only real cause of all the negative feelings that person is struggling with. That’s why you can’t treat depression with “tips” or advice, like “spend time in nature,” or “spend time with friends.” That’s just junk and cheap advice and it will not work, above and beyond a possible placebo effect. Second we don’t treat problems, like “cancer” or "depression" or any “mental disorder” with packages developed for just that problem. We treat people who are struggling, and find out what their negative thoughts are! You CANNOT know what someone is thinking without asking them. Everyone’s thoughts are different and unique. That's why packages, including ALL the so-called "schools" of therapy, will ALWAYS fall short. There are, of course, common themes, like “I’m not good enough,” but we all put our own unique spins on these themes when we’re hurting. And third, measure what you're trying to treat, with brief accurate scales worded in the hear and now at the start and end of each session. That's the ONLY way to know if you've been effective. And finally, events no matter how traumatic, do NOT cause feelings. Only your thoughts can have impact on how you feel about yourself, other people, and the world. That statement is not intended to blame you for how you feel, but to liberate you from the traps you've fallen into. Thanks for listening today! Matt, Rhonda, and David

Part 1 of Our Personal Work with Rhonda The doctor said I have cancer!  Are feelings of depression, fear, anger, hopelessness, and more inevitable if you have experienced a severely traumatic event? Nearly all human beings would say it IS inevitable. But are they right? If your doctor just told you that you have a serious form of cancer, is it possible--or even desirable--to avoid intense distress and despair? Today, Matthew May MD and I sit down with our beloved Rhonda who was diagnosed roughly six weeks ago with a cancerous follicular lymphoma. This is a type of lymphatic cancer that allows for a reasonably long life expectancy, but is almost universally fatal. With one exception—if you find and treat it super early. And that is where Rhonda finds herself. And today, she received her (hopefully) 12th and final radiation treatment to her neck, right under her right ear. She was told that the probability of a cure is 95%, but the effects, including painful side effects, of the radiation would be cumulative and increasing for a while after the series of treatments has been concluded. And she IS in considerable discomvort. Which was good news, great news, actually, for all of us! Still, it’s been a rocky and highly emotional road for Rhonda. So Matt and I sat down with her early this morning to see if we, with the help of TEAM CBT, might be able to bring her some accurate empathy and comfort. In the session, Matt and I went through the T E A M sequence with Rhonda. T = Testing You can see Rhonda’s initial Brief Mood Survey if you CLICK HERE As you can see from her Brief Mood Survey, which was completed before the session began, she was only mildly elevated in depression, anxiety, and anger, but her positive feelings of happiness were very low (only 8 our of 20, with 0 being not happiness at all in any category and 20 being the highest possible happiness. in all categories.) E = Empathy However, as Matt and I empathized with Rhonda, we reviewed her partially completed Daily Mood Log, which you can see if you CLICK HERE This tool painted a radically different picture. Rhonda's scores in nearly all categories were extremely elevated, indicating about the most intense feelings of depression, anxiety, guilt, shame, inadequacy, hopelessness, frustration, anger, and shock, as you can imagine. She was also moderately self-conscious and embarrassed. Four radically important question came to mind: What was causing these intensely negative and almost unbearable feelings? Is there any realistic hope of reducing them during today's session? And if you did want to "help," how in the world would you attempt to do this? And how much "help" could you realistically hope for? If you're serious about these topics, I would strongly recommend that you take a piece of paper and jot down your answers to these questions right now, before you listen to the rest of session. Then, after you listen to the conclusion next week, you can compare what happened with your own ideas about the situation. , During the empathy phase, Matt and I used the Five Secrets of Effective Communication to understand exactly how Rhonda was think, and how she was really feeling inside. We also did a What-If / Downward Arrow Technique to find out what she was the most afraid of. If you haven't already listened to that portion of our work with her. What do you think she was most afraid of in having cancer? And why, do you suppose, she was feeling so guilty? And so angry? We also explored the impact of the side effects of the radiation therapy, and the impact of the cancer on her personal and family relationships, the errors others made in trying to "help" when she was feeling down, and her fears of the future. At the end of the empathy phase, we asked Rhonda to grade us in three categories: How well did David and Matt understand your thoughts? How well did David and Matt understand how you were feeling inside? How well did David and Matt so in creating an atmosphere of trust, warmth, and acceptance? If you're a mental health professional and you do psychotherapy, I have another question for you before we continue: What % of your patients do you ask these three questions part way through your sessions? Raise your hand if the answer is "most, if not all, of my sessions." Yikes! I don't see many hands going up! I don't want to upset you, and you may not take me seriously, but you might be missing the boat! At any rate, Rhonda gave us a triple A +. That's definitely a passing grade, and she gave us the green light to go on to the final two steps of the TEAM session(/the A and the M steps), which you'll hear in their entirety on our very next podcast! Thanks for listening today! And make sure you tune in next week for the awesome conclusion of our work with our beloved Rhonda! Rhonda, Matt, and David