Check it Out!  The September, 2022 Podcast Survey  Dear Podcast fans. Thank you for your responses to our podcast survey yesterday, asking about your likes and dislikes, as well as your suggestions for the future of our podcast. The following report is based on 355 responses we received the first day of the survey. A link to the survey report will be included in spots so you can examine it for more information! LINK TO SURVEY RESULTS Thanks So much! Rhonda and David PS Rhonda is now our official Host and Producer! Demographics Gender: 58 / 42 = female / male Age: 21 to >70. None under 21. Education Grad school: 64% College: 29% High school, grammar school, other: the rest Comment: high average education level is likely due to high number of therapists Therapist No 56% Yes 33% TEAM certified therapist Yes 15% No 85% Podcast Interests Listen to improve your therapy skills? Yes 47% No 53% Listen for personal healing? Yes 90% No 10% How many episodes have you listened to? All 26% A lot 37% About half 16% Just a few 21% What elements do you value the most? Teaching Therapy Techniques 86% Live Work 72% Story Telling 58% Critical Thinking 57% Inspiration 54% Warmth 46% Laughter 42% Guest Interviews (36%) Under 30%: Tears (23%), Banter (29%), Controversy (17%), What types of podcasts appeal to you the most? Therapy Methods 194 Live work 184 Anxiety Help  168 Ask David 163 Self-Help  158 Depression Help 156 Relationship Problems 154 TEAM Training 126 Habits and Addictions 107 Procrastination  94 Guest Experts 88 Weight Loss 51 Other What do you think about paid ads? Hate it 28% Love it 20% Unsure 52% Would you recommend the podcast to a friend? Yes 96% No 4% What grade would you give the podcast? A 77% B 20% C 3% D 0% F 0% Written Responses Elements you like the best (selections 356 responses) Learning about techniques to help patients from experts in the field! Realistic and humorous portrayals and disclosure Always pick up a new concept Brilliant teaching and great techniques The idea that long- lasting change can happen quickly The use of Paradox There is done sort of therapy by proxy that seems to happen during live therapy work. Even when situations are different, amazingly meaningful. I enjoy the Q&A podcasts where you cover 4 to 5 great questions. Having Rhonda and Matt (and, of course, Dr. Burns!) give their viewpoints on topics that can be helpful to everyone is very useful. Learning how to retool my brain. I love the feeling of comfort I get from hearing your stories, both personal and from guests. I was particularly touched by Rhonda’s openness when she first joined the podcast and worked through her feelings of inadequacy. I think about those episodes a lot because I relate to them. Feel less alone The live therapy sessions. Hearing Dr. Burns, Jill, Rhonda and others do externalization of voices, positive reframing, and other techniques is SO incredibly powerful. Hundreds more! (link) Elements you like the least (selections 356 responses) The long intros sometimes before the topic gets started Boasting, rambling on and on. Sometimes the attitude towards other practices and theories is condescending and fails to appreciate the contributions different approaches make to understand and alleviate suffering. endorsement emails Something I've noticed in live coaching is that there seems to be a strong focus on externalization of voices as a method. In Feeling Great, I love your 50 methods - but I wonder why it feels like 80% of the time you focus on externalization of voices vs other methods. Honestly, that's super nit-picky. But I felt like I had to include something in the "liked least" section. Otherwise, I think the Feeling Good podcast is A+++ Not a fan of the hokey -- the weird Hello Rhondas, etc. Ditto for the four letter words. IMO these detract from the content, dumb down/lessen the credibility of the presenters and content. Distracting and make me cringe. I won't quit listening... just unprofessional and low class. Hard to complain about something this good Hundreds more (link) What other topics might interest you? Trauma work. Meaning - I find that MANY people are talking about "Childhood Trauma" as if it's a separate thing. "Trauma-Informed Therapy" seems to be a new hot topic. Wondering what you feel about trauma and this seeming growth in trauma-focus. Use 5 secrets in relationship with someone with borderline personality disorder 5 secrets training How to make friends How TEAM principles can help you raise happy/healthy kids! Discussion of how to manage anxiety when it’s hard to pinpoint the direct cause, making it hard to challenge our thoughts. Also topics on panic attacks. integrating the buddha dharma with cbt Definitely PTSD (I have PTSD from finding my partner dead after a suicide), body image, more about dating and relationships. How to treat low self esteem. How to increase happiness. How to make touch decisions about careers or other things that have pros and cons. For example, doing the decision making form and having the scores be around 0 or both negative scores. How to heal after a break up and how to manage rejection while dating (e.g., someone rejects you after a few dates) I would love to see more episodes on habits and addictions and also a life episode on shame attacking exercises! Hundreds more (link) Comment: Some of these excellent suggestions have been covered already, and you can find them on my website by using the search function and / or the list of podcasts with links. For example, we’ve already had a five part series on boosting happiness (link) as well as boosting self-esteem (link) and how to use each of the 5 secrets (link), and much more. Take a look! (link to list of podcasts) What other topics might interest you the least? Anything related to organized religion. (Disorganized religion, I'm okay with!) lol) ;) Weight loss/eating disorders promoting other therapists "worried well" privileged patients. Anxiety and phobias Can’t think of any Why TEAM CBT is superior to all other forms of therapies. Nothing it is all helpful to make me realize I am not alone and we all have our own internal struggles I love it all Therapist workshop announcements Hundreds more (link) Suggestions for improving the podcast (194 responses) Keep doing listener questions and answers and case examples.. the Buddhist perspective of not having a self and bigger picture etc Hidden emotion technique examples ongoing as I think that helps to know what common pressures people have experienced in Davids practice that we might also see etc. Maybe fewer judgy comments, including more guest speakers, more inclusivity. Always love the live work Keep bringing in therapist from around the country in the world to talk about what they do with team No, just please keep making it. DON'T CHANGE A THING! I mention above but I think getting David out to more of the enormous self-help podcasts would really help spread the word and open a lot of people’s eyes. A big one that I think would be a great fit is the Tim Ferriss podcast Comment: Thanks. I’d love to be on any podcasts with large audiences. Please contact them and tell them to invite me! I’m not comfortable and don’t have the time to do this or the resources to hire a PR / marketing person, but they might respond to suggestions from listeners. It seems like a majority of the live therapy patients are TEAM CBT therapists so sometimes that can make me wonder if the techniques are as helpful to someone who doesn't already believe in the efficacy of the treatment. I'd like to see more treatment with people who are unfamiliar with TEAM CBT, although I realize that may not be possible. Comment: I do not generally work with the general public because that would be tantamount to entering into a therapeutic relationship and would expose me to liability issues. Since I work for free, I cannot and will not take this chance, and liability insurance is costly. When I work with therapists, it is personal work in the context of their training, and is not construed as the start of a therapeutic relationship. I have done extensive research with large numbers of people, comparing the ease and nature of treating shrinks vs the general public, and there is absolutely no difference in the types of problems they have, the intensity, or the speed of recovery. If anyone would like to volunteer to indemnify me, which would be immensely costly for you, I’ll happily work with anyone! Hundreds more (link) Why would you or wouldn’t you recommend it to a friend? I already have multiple times. Because the advice is different to what I hear elsewhere, it’s compassionate, blunt, and takes an inward look with a huge dose of kindness. It can change the way you live life Rhonda and David are so genuine together, smart, funny and informative It would help them, especially friends with depression or anxiety It is the highest quality methodology delivered by the highest quality therapists!! It helped and encouraged me too much advertising and plugging Because it offers real practical information that could be useful to anyone It helped me get out of a black hole It’s entertaining and informative. Life skills everyone should learn! Read both Feeling Good and Feeling Great. Dr. Burns’ content has saved my life! The five secrets has rewired my brain and helped me save my relationship, too! And Dr. Burns’ personality and sense of humor is just the icing on the cake. Hundreds more (link) Thank you to all who responded!  We appreciate you! David and Rhonda

Dr. David Burns and Jill Levitt discuss overcoming social anxiety through cognitive strategies, exposure therapy, positive reframing, and desensitization to rejection. They share engaging techniques, case studies, and the impact of therapy methods on improving quality of life for individuals struggling with social anxiety.

Professor Mark Noble Shares his Thinking on the Uptick in Loneliness. Rhonda starts today’s podcast with a beautiful podcast endorsement from Eduardo, a fan who loved our recent podcast 303, featuring the dramatic, humble, and inspiring Jason Meno, a data scientist and software engineer who is making superb contributions to the Feeling Good App. Eduardo was especially interested in how to bring non-verbal, difficult-to-access negative thoughts to conscious awareness with the Stick Figure Technique. Today we interview Professor Mark Noble on the topic of loneliness. Mark is best known for his pioneering research on stem cells, but he has become an active and beloved member of the TEAM-CBT community since joining one of my Sunday hikes back in (date?) Mark is currently an active member and small group leader in Rhonda’s Wednesday TEAM training group. He generously wrote brilliant chapter for my most recent book, Feeling Great, and has also written the Brain Users Guide to TEAM CBT which you can download for free from https://www.feelinggreattherapycenter.com/resources Mark begins by dedicating today’s podcast to listeners who may be struggling with feelings of loneliness, and explains that loneliness appears to be on the increase, along with virtually all types of negative feelings, especially since the onset of the pandemic. He emphasizes that there are many roads to loneliness, including: Loss of a loved one, including friends, family, colleagues, or even a beloved pet Betrayal by someone you trusted Being trapped in an abusive relationship Being abandoned or neglected as a child Not being accepted by your family due to sexual orientation, religious preference, choice of life partner, or other factors Feelings of isolation due to COVID A dead marriage Infidelity And more. Of course, Social anxiety is one of the most common causes of loneliness, and last week we interviewed two individual, Cai Chen, MD, and Chan Mary Soeur, RN, BSN, who have fallen in love. Both were lonely and struggled for years with social anxiety. Their work with TEAM-CBT has not only helped them greatly with their anxiety and loneliness, but has brought them intense romantic love! Not bad! People struggling with loneliness often think there’s something “wrong” with them. For example, you may feel unlovable, and fear that you’ll be alone forever. In addition, the belief that we “need” love to feel happy and fulfilled often leaves the lonely individual feeling like they’re doomed to endless unhappiness and a lack of fulfillment if they’re alone. Mark explains that the scientific definition of loneliness is the distress you feel when you think that your ”needs” for connection and relationships differ from what you have. In addition, he believes that loneliness is not abnormal, but is rather an indication of healthy brain function that has been important to the survival of the human race. For example, feelings of loneliness motivate us to connect with others. In fact, feelings of loneliness prompt babies to cry for their mothers when they feel hungry, hurt, or alone, and this process begins within seconds of being born. We raised the question of whether the cure for loneliness is internal or external. The internal solution involves changing the way you think, and your relationship with yourself. The external solution involves trying to find a loving partner or becoming more involved in activities with others. Although this is the solution most people pursue, it often falls short. David emphasizes the important of the internal solution, and discovering that you can feel completely happy and fulfilled when you’re alone. In fact, this is the first step in overcoming loneliness that he emphasizes in his book, Intimate Connections. Mark, Rhonda and David also discuss some of the paradoxes of TEAM-CBT, and how the “need” for love often drives others away, since you are asking people to give you something you can only give yourself. In contrast, when you feel happy within, and no longer “need” the love of others, love will often pursue you. We hope you enjoyed today’s podcast, and want to thank our buddy, Professor Noble, who has made so many in our TEAM-CBT community feel less lonely and more connected! Warmly, Mark, Rhonda, and David

Swimming in the River of Love Rhonda starts today’s podcast with a beautiful podcast endorsement from a fan named Vicky, from Australia, who was thrilled with the two recent live therapy podcasts with Nazli (podcasts 301 and 302). She wrote that she felt so lucky to hear someone with the exact same negative thoughts, and same feelings of depression and anxiety, that she’s had since she was 10 years old. I have often said that when therapists have the courage to do their personal work in public, you not only heal yourself and learn cool techniques first-hand and experientially, but you also heal many others who are touched and inspired by you. Thanks to all of our fans for your frequent loving comments and cool questions for future Ask David podcasts. We then give a little promotion for several upcoming group events, involving: May 2, 2022. Dr. Jill Levitt and I will be teaching an exciting, full-day workshop on “Smashing Social Anxiety: Shame-Attacking and Beyond.” It will be open to shrinks and the general public alike. The focus will be on learning to treat social anxiety, including your own! For registration and more information, please go to CBTforSocialAnxiety.com. September 13, 2022: Drs. Brandon Vance and Heather Clague start two new Feeling Great Book Clubs. For registration and more information, please go to www.feelinggreattherapycenter.com/book-club. September 14, 2022. Drs. Heather Clague and Brandon Vance will start their weekly “Deep Practice” group for training in the Five Secrets of Effective Communication. This type of practice is absolutely needed if you want to use these fantastic techniques to greatly boost your clinical effectiveness or enhance your relationships with the people you care about. For registration and more information, please go to www.feelinggreattherapycenter.com/5-Secrets. Date (to be announced). Zeina Halim soon begins the first-ever book club for When Panic Attacks. This terrific group could be helpful if you’ve ever struggled with phobias, social anxiety, chronic worrying, panic attacks, OCD, PTSD, and more. For registration and more information, please go to https://feelinggood.com/2022/08/08/anxiety-book-club/ Date (to be announced). Zeina Halim will collaborate with our Feeling Good App development team in an experiment to test a month’s use of the Feeling Good app with or without a weekly practice group to supplement your work with the app. This exciting project is currently in the planning stage, but if you think you might be interested, please contact Zeina at Zeina Halim so she can contact you once we’re ready to start. As an aside, the app will be free since we’re still involved in beta tests, but the weekly practice groups will involve an additional charge. Today we feature a love story involving Dr. Cai Chen, a young psychiatrist who did his residency training in Texas and now has moved to California to be with his love, Chan Mary Soeur, RN, BSN. Both have been members of my TEAM-CBT training group at Stanford. Cai practices at the Feeling Good Institute in Mt. View, California, and Chan Mary who is pursuing a master’s degree as a Psychiatric Nurse Practitioner. Cai explains that he’d felt socially anxious and lonely for used, and used the tools in my book, Intimate Connections, when he got tired of dating sites. One crucial thing he learned is that you have to stop “chasing” if you want to find love. Then he met Chan Mary in one of the breakout groups in our weekly training group. Chan Mary said, “I also used to struggle with social anxiety. Even now, on this podcast I have thoughts that I won’t be as impressive as Cai. Cai is much better at expressing himself and being vulnerable in front of others. “I’ve been on a personal journey to get over my intense social anxiety. I’ve always held back in groups, and have never been the first one to reach out. “After listening to the Feeling Good Podcast’s episode on how to overcome social anxiety, I decided to challenge my fears and reach out to Cai. I contacted him and told him I really admired the courage he was showing in his transparency about his feelings, and in his courage to challenge his fears with the many Interpersonal Exposure Techniques we were learning about in our training. “I also decided to try another technique, Flirting Training. I told him that I thought everything he was doing was inspirational, and that I felt close to him.” Rhonda asked about the importance of taking risks if you struggle with social anxiety. Chan Mary explained it like this: “I was extremely anxious about reaching out to someone I didn’t know. For me, a simple thank you email and introducing myself was anxiety provoking because I had never done that before. I was also worried about asking too many questions because I didn’t want to come off as intrusive or even bothersome.” Chan Mary continues: “After conquering my initial fears of reaching out, I went even further, I invited him to join me for a week in Hawaii as our first date in 2021 for my vacation. I usually went on a medical mission to Cambodia, but couldn’t because of the pandemic. So I did the boldest thing ever—I met him in person in Hawaii!” Cai describes the fears he had: “I was scared. I thought, ;what if we get too close and our relationship falls apart.’ In fact, after accepting the invite, I called and told her that I’d changed my mind. She got angry, and I realized I had mixed feelings, so I turned to David’s Decision-Making Tool. (You can get it for free at the free chapter link on the bottom of the home page of David’s website.) “This tool helped me see why I was stuck, so I called Chan Marie back and asked for her forgiveness. I’d been hiding my feelings, so I told her I really liked her and had been afraid of ruining a great relationship.” Chan Mary said: “I was scared, too. But I told myself to trust myself, and that it felt safe to trust him, too.” The rest, as they say, is history. The date was terrific, and after some initial hesitation, Cai decided to move from Texas to California to be with “the love of my life!” Was it all roses from then on? All relationships, I’m pretty sure, have difficulties, and Cai and Chan Mary explained that they both have trouble expressing negative feelings. Cai explained it like this: “I always try to be nice, so I push my negative feelings down, and automatically sweep them under the rug. Chan Mary helps me with this. She pushes me to tell her what I’m upset about. And although it’s frightening at first, once we express our negative feelings they kid of fizzle out. Chan Mary has become an expert in David’s five Secrets of Effective Communication, and that has helped tremendously.” Chan Mary explained her difficulties with negative feelings like this: “The Hidden Emotion Technique has been helpful for me when I start to feel anxious or upset. I have to reflect and ask myself, ‘What’s the deeper issue here?’ Often, I don’t even know what I’m upset about!” Chan Mary added: “Thank you to David and Rhonda and everyone who made the Feeling Good Podcast possible. I’m just like many of your listeners, and this podcast has been life-changing. The techniques, you shared on the podcast have transformed my life! If I did not take the steps to conquer my social anxiety, Cai and I probably would not be here today.“ Cai and Chan Mary are delightful, and their obvious love is an inspiration in this time of increasing violence in the world and such intense political divide and hatred here at home. I asked where their relationship is heading and Chan Mary hinted that Rhonda and David might be getting invitations to a wedding one day soon! Cai and Chan Mary are two of my favorite people in the whole world. It’s a privilege and a blessing to know them and share a little of their lives. This is Rhonda…. "I love Cai and Chan Mary, too. I was in the Tuesday Stanford TEAM Training group for years with Chan Mary, and feel really close to her for lots of shared experiences. I am lucky enough to see Cai every Wednesday in our International TEAM Therapy Training Group, and I always look forward to reading the wise comments he writes on the TEAM certified listserve. Next week, we’ll look at the other side of the coin, as Professor Mark Noble leads a discussion on the recent rise in loneliness, which is often associated with social anxiety. Warmly, Cai, Chan Mary, Rhonda, and David

TEAM-CBT Celebrates Diversity Today's featured image is Sean Williams, co-founder of the BAD Group Rhonda starts today’s podcast with a terrific endorsement from Steve, from England. He really liked Feeling Great, and said he benefited from the personal work with Dr. Mark Taslimi that we published as the first live therapy on the Feeling Good Podcasts (see podcasts 29-25 and 141.) Steve wrote that the live work, and the teaching points that Dr. Jill Levitt and I made during the podcasts to explain our strategies, is the best learning by far. Rhonda and I strongly agree, and I feel fortunate to have been able to publish many additional live TEAM-CBT sessions since that time. It is my hope that some day these live therapy podcasts will be used in teaching graduate psychology classes so that future practitioners can pick up where we left off and benefit from the rapid treatment techniques we’ve developed. Today we interview Amber Warner, LCSW, Sean Williams, LCSW and Chelsea Dorcich, MFT. Amber is a Level 3 certified TEAM therapist, living and working in Lake County, where she provides mental health care in a rural community. She has a private practice that includes a virtual practice for anyone in the State of California. Amber has been a member of our Tuesday TEAM-CBT group for the past year. Chelsea is also a Level 3 Certified TEAM therapist with a private practice for anyone in the State of California. Both Chelsea and Amber work at the Feeling Good Institute in Mountain View, California. Sean is a Licensed Clinical Social Worker and also Level 3 TEAM-CBT therapist and co-founder of the TEAM CBT Clinicians of BAD, for Black African Descendants, along with Amber and Chelsea. He is a long-time and beloved member of the Tuesday training group at Stanford. He currently resides in Colorado and works for the Ohio State University where he works with active duty and retired soldiers regarding their PTSD suicidal ideation and trauma. He treats patients and also supports the Ohio State University’s research. He also has a part-time private practice for people who live in Indiana. Amber got our podcast going by saying: “My introduction to TEAM-CBT was in 2017, while at a Sunday workshop about 1 1/2 years ago. I’d been struggling with grief after accidently finding out my employer had hired others at a higher salary, so I started a Daily Mood Log and did a downward arrow (this is an uncovering technique) using one of my negative thought. I discovered that my Self-Defeating Belief (SDB) was not included in David’s list of 23 common SDBs. “I felt like all the weight of the world was on my shoulders because my employer had hired white people with less experience at higher salaries. I asked myself what I was going to do. “Do I care to stand up for myself? It felt like a heavy dilemma. I decided to face my fear and talk it over with my employer. It took some time, but things eventually turned out in my favor.” Way to go, Amber! Amber mentioned that Philip Lolonis, LCSW, a member of our TEAM-CBT community, urged us to create and teach an introductory TEAM-CBT course for African-American clinicians in 2021. Amber reached out to Sean and Chelsea and asked if they'd be interested in creating a “Clinicians of Color” group on Facebook. And that got the ball rolling. Rhonda asked, “What kinds of challenges have you faced?” Sean said that one barrier was the whole process of getting licensed. It requires a lot of time and money, nearly always meaning large loans and years of training. One goal of their group is to assist interested people through from initial training through the licensing clinicians, as well as introduce TEAM therapy to the larger therapeutic community. There are very few Black mental health professionals within the TEAM community. Amber explained that one of their goals is to provide support and encouragement to young Black men and women who might want to enter the counseling profession by attending medical school, or a doctoral or graduate school in counseling or psychology, or obtaining a certified coaching diploma. Amber also stated that TEAM-CBT has made a powerful impact on her, Chelsea and Sean, so they formed an affinity group, TEAM CBT Clinicians of B.A.D. Their primary goal is to support and encourage clinicians of color to learn and practice TEAM-CBT and explore culturally responsive methods to enhance the therapeutic alliance and improve treatment outcomes. Sean explained that he was introduced to TEAM and David’s work around the year 2000. He was looking at books in the self-help section of a Barnes and Nobles bookstore, but most of them were too expensive. He said, “Most of them were too expensive, but then I saw Feeling Good lying on a table, and it was only $8.95, so I purchased it and read about the list of cognitive distortions that David had created. That book changed my world view and changed me as a clinician. I realized that I really wanted to disseminate this information to clinicians of color.” Sean explains why he resonated with Feeling Good: “Many of the cognitive theoretical principles were extremely empowering to me. In “Feeling Good” there was a diagram of a man where it demonstrated how human beings process their experiences through thoughts, beliefs and assumptions. The whole idea of my thoughts impacting my emotions and behaviors was mind blowing to me and still is. It made me recollect on all my past struggles such as relationship break ups, job losses, public speaking anxiety, and so forth, and my reactions towards those situations unbeknownst to me at the time were primarily based on my thoughts about those events. I believe that it’s important that all people have access to these powerful therapeutic interventions regardless of race, ethnicity or culture. The reason why it’s important to disseminate these powerful tools to people of color is because people of color are reporting high rates of psychological distress but are less likely to get treated for it. “According to webmd.com ‘…African Americans are more likely to report feelings of sadness, hopelessness, and worthlessness than are adult whites. Still, in 2018, 18.6% of white Americans received mental health services, compared to less than 9% of African Americans.’ “I think TEAM-CBT can even help alleviate suffering related to racial stress. Although racism is a non-distorted reality the concepts in “Feeling Good” and the whole TEAM framework can orient a person to adopt the healthiest possible perspective when moving through those realities.” Chelsea said she learned about TEAM-CBT when she moved to the Bay Area in 2017. She says, "I also found that TEAM was a roadmap and a blessing. I could really connect. This is an amazing framework for everybody!” We also discussed one pitfall that some clinicians fall into. The idea that our thoughts, and not events, create all of our feelings can be liberating. But it can also be used to invalidate genuine, healthy anger. Racial bias and cruelty are real. "They are NOT cognitive distortions," she says. "Racial bias is very real. But TEAM-CBT can free us from the inner prison of depression and anxiety and self-doubt that results from distorted perceptions. Of course, sometimes perceptions are totally valid, and sometimes it’s time to fight and stand up for what’s right." David added that "We had to do a lot of fighting and protesting in the 1970s, when the Viet Nam war was waging, and the forces of darkness were powerful and destructive. Now, it seems, we have many more battles to fight, and we are lucky to have crusaders like Chelsea, Amber, and Sean. "Thank you for what you are doing!" Thank you all for listening today. Chelsea, Amber, Sean, Rhonda, and David Following the show, Sean kindly emailed me with some information addressing some of my questions about black people and the mental health system in the United States. He wrote: Although I was super anxious, I really enjoyed doing the podcast with you two. I used the “Dare to be Average” principles in Feeling Good to help me relax and it worked! Here’s a few additional notes about black people and our mental health system. I hope it helps! Insights into Diversity By Sean Williams, LCSW Why is it important to disseminate TEAM-CBT to people of color? Data from the American Psychiatric Association (APA) shows that only 2 percent of the estimated 41,000 psychiatrists in the U.S. are Black, and just 4 percent of psychologists are Black. On college campuses, close to 61 percent of counseling center staff are White, and 13 percent are Black, according to a 2020 Association for University and College Counseling Center Directors survey. he shortage of psychiatrists and counselors of color has severe implications for all Black individuals needing treatment. A 2019 survey by the Substance Abuse and Mental Health Services Administration (SAMHSA) found nearly 5 million, or 16 percent, of Black Americans reported having a mental illness. However, only one in three Black adults who needs mental health care receives it. Because of the scarcity of mental health professionals of color, it can be difficult for Black Americans to find a practitioner with whom they feel comfortable enough to share any race-related trauma. One 2016 study in the Journal of Black Psychology found that African American therapists and their patients often had relationships marked by a “distinct sense of solidarity … as evidenced by having a better understanding of the context of Black clients’ lives. For more information, see https://www.insightintodiversity.com/addressing-the-lack-of-black-mental-health-professionals/

306: Ask David: Featuring Matt May, MD 1. Kevin asks: Hi David, Is it possible to have a healthy relationship with someone who can be classed as “Borderline Personality Disorder”? 2. Brittany asks: How do you deal with the injustice of people who rip you off without giving you credit? 3. Paul asks: Is there a way to know if I have done the Hidden Emotion Technique correctly? Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1. Kevin asks: Hi David, Is it possible to have a healthy relationship with someone who can be classed as “Borderline Personality Disorder”? Hi David, Is it possible to have a healthy relationship with someone who can be classed as “Borderline”? What are keys to being in a relationship with someone that exhibits some of these characteristics? Is it a lost cause? Is borderline personality disorder bullshit and simply a result of assumptions such as “I need love to be worthwhile” as indicated in your books? Best, Kevin David’s reply Great question, here are a couple brief responses off the top of my head: "Healthy" exists on a continuum. In my experience, the therapeutic relationship with a patient diagnosed with BPD exists on a continuum, it is not all-or=nothing, and you can have excellent interactions, but this often requires great diligence and skill in the use of the five Secrets of Effective Communication. I have not observed any unique relationship between the Love Addiction and BPD. That's because the "need" for love is pervasive in our culture, and is, in fact, one of the most common Self-Defeating Beliefs. I do believe that Other-Blame (along with Self-Blame) is a common feature of BPD, along with the unwillingness to be accountable and to have tow work hard and consistently for recovery. I have had a number of patients with BPD threaten suicide if I asked them to do psychotherapy homework, for example. At my clinical in Philadelphia, we diagnosed the ten personality disorders prospectively, at the intake evaluation, and depressed patient with and without BPD improved at almost the same rate during the first 12 weeks when treated by the forerunner of TEAM-CBT, when controlling for severity of initial depression. I published this surprising finding in the top journal for clinical psychology research, the JCCP, but it got little attention for some reason, and some of the reviewers of the article were critical of this finding which they found difficult to believe or accept. DBT has been the "go-to" method for BPD, and BPD therapists may think that CBT / TEAM-CBT would or could not be helpful. Still, I am grateful for DBT welcoming such patients and helping them, when so many therapists avoid these patients! At my clinic in Philadelphia, something in the range of 28% of our patients were diagnosed with BPD at intake. david Matt’s Reply: I’m really just guessing, but perhaps Kevin is feeling quite sad, worried and hopeless, about his relationship. Perhaps he’s been treated badly and is also angry and scared that this will continue to happen in his current relationship. If so, he might be having thoughts like, ‘This relationship will always be terrible’ or ‘They will continue to hurt me and disrespect me and treat me badly’ of maybe, ‘This is their fault, they have Borderline Personality!’. This is only a guess, but if it were the case, I would imagine Kevin could use a great deal of empathy and listening, right about now. It is possible he has been treated terribly or even abused. His partner may indeed meet the criteria for BPD, in which case they would be tremendously sensitive and frequently reactive and prone to unhealthy expressions of anger. Perhaps Kevin has displayed tremendous patience and tried very hard in the relationship, which would be admirable, but only amplify his disappointment when the same hurtful patterns continue. Kevin may even feel worthless, if he believes that the way he is being treated by others is an indicator of his worth as a person. I feel for you, Kevin, and hope you’re getting the Empathy you need. I think there is a lot we could offer someone in this situation, in addition to Empathy, as well. We certainly have the technology, in TEAM, to alleviate the worthless feelings, the anxiety and worry, the feelings of anger and hopelessness, etc. and to replace these with a sense of confidence, joy and optimism. We could also offer skills that that one could use to substantially improve the quality of their relationship. Meanwhile, there are many reasons why someone would prefer to maintain very high levels of hopelessness, anger and worry and low self-esteem in this context. For example, as a protection against getting hurt again. Or they might not want to like and admire themselves if their partner is dissatisfied with them. We’ve also discussed, on the podcast, how tempting and seductive Blame can be. When we tell ourselves, ‘It’s their fault, they have Borderline Personality Disorder’, this type of thought can give us pleasant feelings of superiority. Kevin may not have any of these thoughts or feelings. My point is that, before trying to ‘help’ someone in Kevin’s shoes, I’d certainly want to explore all the good reasons he would want to continue to feel extremely upset and all the good things this says about his sensibilities and values. In addition to Empathy and an exploration of Resistance, one tool that is sometimes helpful in this situation is the Decision Making Form. This is a simple but powerful tool, available online, thanks to David’s generosity, which one can use to compare and consider, with great care, the three options they have in a relationship: continue the status quo, end the relationship or take personal responsibility for improving the relationship. There would be pro’s and con’s to each of these options. Meanwhile, you will notice that there’s one option that is NOT on that list, which is to change the other person. Trying to change the other person, blaming them, is the cause of relationship problems and another version of the ‘status quo’. For the sake of argument, let’s imagine Kevin, or someone like him, is convincingly talking back to the resistance. Maybe he also does the ‘Relationship Journal’ and he experiences the death of the blaming self, witnesses how his behavior is causing the problem, etc., this would be a tremendous achievement, but, I would still have some questions: Would they want to feel better, now, or would they want to wait until after they have a better relationship? Would they want to embrace and accept and love their partner, now, flaws-and-all … or would they prefer to keep their guard up, until things improve? Are they still needing the other person to change, in some subtle way? The reason I’d have to ask these questions is because of my own limitation: I can only help someone feel better in this moment, the way things are, right now. Similarly, I can only help someone improve their relationship, in this moment, while their partner is still treating them badly. When people are open to these terms, their lives and relationships can transform in beautiful ways. They can come to appreciate and love themselves and others, just as they are. David, you’ve said that’s the paradoxical first step towards improvement, I think. 2. Brittany asks: How do you deal with the injustice of people who rip you off without giving you credit? Hi Dr. Burns! I hear you say often how it upsets you that people use your work and don’t give you acknowledgment or credit for it. I wondered how you deal with your thoughts like the unfairness or injustice of it. Or maybe you don’t want to deal with those thoughts because the anger helps you in some way? Like it motivates you to create more content & host more trainings etc. so people know the ideas come from you. I was just curious. I deal with similar issues at work where I work really hard for an outcome and then once it happens other employees will take credit for it or just plain ignore the fact that I played any role. I think hearing how you deal with not getting acknowledged would help me too. Thank you, Brittany David’s reply Thanks, Brittany, and good to hear from you again! Maybe we can make this an Ask David. I've been ripped off so much that I try to ignore it, since it would consume a great deal of energy. We may take legal steps once we raise money for our Feeling Good App. For the most part, I always have so much to do, and try to keep moving the ball forward. But yes, I DO get ticked off at people. Plagiarism was considered a severe violation when I grew up, and I still view it that way. Of course, all around the world we can see a tremendous amount of horror and evil being perpetuated by humans. I once asked Dr. Albert Elis a similar question, since Wayne Dwyer ripped him off. His answer was: "I just tell myself that Wayne Dwyer was an asshole, so he was just doing what he SHOULD do, since that's what assholes do! David D. Burns, MD Matt’s Reply: This question is for David, not me. However, I would like to express my deepest and most sincere gratitude to David. David has dedicated his life in the service of improving the lives of others. He has published over a hundred scientific articles and revolutionized the practice of psychotherapy in the form of the TEAM model, as well as publishing at least 12 books, including Feeling Good, the most-prescribed book for depression. He has traveled the globe to offer training seminars to therapists, as well as offering free training to countless students, trainees, residents, PsyD’s and psychologists in his groups, including his ongoing Tuesday training group. It is disturbing and upsetting that someone like David, who has offered so much, would be a target for plagiarism and theft and I admire him for continuing his work, despite all of that. 3. Paul asks: Is there a way to know if I have done the Hidden Emotion Technique correctly? Hi Dr. Burns, It blows my mind how simple yet logical TEAM CBT is. And I am really excited about potential of the app, and I sincerely hope that this will be a revolution in field of psychology and psychotherapy. I really enjoy reading Feeling Great, but some techniques I find complicated. I would like to ask, is there a way to know if I did Hidden Emotion Technique correctly ? Also, I would like to ask if fear of mental illness does count as hypochondriasis as well. At the end I would like to say, that I really appreciate your work Dr. Burns, and I hope that your work will spread around the world and get recognition it deserves, so even more people can be healed. Paul David’s reply Thanks for the kind words, Paul. I will try to include this in an upcoming Ask David segment! Matt’s reply You asked if you did the Hidden Emotion technique correctly. They say that the proof is in the pudding. Do you feel better? Are you experiencing relief? Keep in mind that the Hidden Emotion technique is one of many and may not be the correct method for some individuals. Also, for it to ‘work’ will require not only revealing the hidden emotion, but discovering how to address that emotion. Will you use cognitive techniques to untwist the thinking that is causing this emotion? Will you use the 5-Secrets to respectfully communicate that emotion in a productive way? Will you make a decision about your future that will correct the problem? There are lots of options, but the outcome, if the Hidden Emotion is successful, will be relief. You also asked if worrying about having a mental illness counts as hypochondriasis. The nice thing about this model is that I get to admire you for having all kinds of hypochondriacal worries about your mental health and point out how it’s a ‘solution’ rather than a ‘problem’ and how such worrying speaks highly of you, how responsible you are, how much you care and how much you value your mental health. I’d need you to convince me that it’s a problem!

Ask David: Featuring Matt May, MD 1. Nick asks: “What if you want a positive relationship with someone who does not want the same thing?” 2. Debbie asks: Hi David, I can't stop ruminating and obsessing about weird states of minds or when I was afraid of harming someone or remembering. Everyone says to let go but why do I hang on. Where in your book can you help me? 3. Dean asks: I’m having trouble sleeping. What should I do? 4. Kathy asks a question about social anxiety / panic and the hidden emotion technique. Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1. Nick asks many general relationship problems that all need specific examples. Dear David, Thank you for all the amazing work you do. Your books and podcasts have helped me to understand and start to transform a lot of negative and unwanted frames that I carry around. I'm also working with a Level 3 therapist who I found through the Feeling Good Institute. One area I'm working on is building my empathy skills using the Five Secrets model. I see how powerful it is in situations where both people are open to a positive relationship. But I struggle with the idea that each of us creates our own interpersonal reality, and can always create a positive outcome regardless of the other person. Can you help me understand how to apply the technique to some challenging situations? - What happens if you want a positive relationship with the other person, but they fundamentally do not? I find that this situation leads the other person to react to the Five Secrets with anger or indifference. Or they view you as weak for exposing your emotions and vulnerability, and try to exploit them for advantage over you. Is it even worth trying to have a positive relationship with such a person? David’s reply I try not to impose on people who do not want a positive relationship with me. You could also provide a specific example, as I always insist on having! These vague questions to my ear are kind of useless. Matt’s reply David, you’ve said that the cause of all relationship problems is Blame.  I agree with this and sense that Nick’s question is driving at that point, as well.  If someone doesn’t want to participate in our definition of a ‘positive’ relationship, the approach that is most in line with the 5-Secrets and Empathy is to let go and stop demanding the other person change.  That’s the cause of the problem:  trying to force people to do things, our way, regardless of what they want.  This will cause them to resist and will damage the relationship. David, you have also talked about the opposite mindset of blame, where we can wield 5-Secrets honestly and effectively, the concept of ‘Open Hands’.  When we have the attitude of ‘Open Hands’, we can welcome other people and receive them or gracefully let go. This mental state avoids conflict and the ‘blame game’ in a healthy, non-avoidant way. For example, if someone says, “I don’t want to have a relationship with you”.  We might reply, using the 5-Secrets, ‘You’re right, I’ve been disrespectful and inappropriately pushing you too hard in the direction of having a relationship with me.  I appreciate your letting me know, clearly, that this isn’t something you want.  While I can imagine you might be angry with me, I’m sure you don’t want to talk about that, but prefer, instead, to end the relationship as quickly as possible.  I’m feeling awkward and would like to get out of your hair as soon as possible, too.  What can I do to facilitate ending this relationship in a way you would be satisfied with?” To put it another way, while you can maximize your chances of having a positive interpersonal experience with someone, using these communication skills, the 5-Secrets, they are not ‘mind control’ and trying to use them that way will only make matters worse, hence the importance of the internal mindset of ‘open hands’, accepting others’ preferences and being willing to let go, perhaps grieve, refocus our attention elsewhere, if that’s not what they want.  Otherwise, we are in the ‘chasing’ and ‘blaming’ role, which is doomed to fail, as has been discussed on previous podcasts. It may also be useful to consider whether it’s actually possible to ‘not have a relationship’ with someone.  My sense is that there is, in fact, a relationship, even between total strangers and between people who have decided, mutually, to end their relationship.  We could point out how those two types of relationships might differ, say, if you were to bump into each other in a grocery store.  In the latter example, you might be expected to try a bit harder to avoid contact, with an agreed-upon, ‘ex’ than you would, with a stranger.  There are rules and expectations and ways in which both people think about the other person and define their ‘relationship’, even if you are saying that it has ‘ended’.  The conflict comes when we don’t have the same agenda and don’t agree on the terms and rules of the relationship. There are many other related topics, including the ‘gentle ultimatum’, ‘interpersonal decision making’ and ‘blame CBA’ which could be useful for Nick. Nick continues - What if you believe the other person does have a fundamental desire for a good relationship, but they are so attached to their anger, fear or depression that their only reaction is hostility and defense? Perhaps such a person can't or won't admit to their emotions, and rejects the empathy. Should you keep trying, and at what point if any should you give up? David’s reply Need a specific example! I may have mentioned that! Matt’s reply:  A specific example sure would help!  The problem seems related to the ‘blame game’ which we just talked about.  We are demanding the other person change, and stop being so hostile and defensive.  Instead, consider using Interpersonal Decision Making and look at the three options that are available, in any relationship.  If you decide to take responsibility for the relationship, try the Relationship Journal, so you can see through the blame that is causing the problem.  You could also use positive reframing to admire their hostility, defensiveness, anger, fear and depression. Nick continues: Perhaps there are mistaken or lying about the facts, and unwilling to admit it. Or you disbelieve what they say because it doesn't match their actions or is calculated to deflect blame. For example, you may have a conflict over who cleans the house. The objective fact is that you do this 80% of the time and have done it the last 5 times in a row, while the other person has consistently left garbage lying around. Yet the other person says "I feel like you never do housework and I am always the one cleaning, and I'm sick of it". How can you find truth in such a statement? David’s reply Work this out on a Relationship Journals. Write down what you said next, and follow th steps clearly spelled out in Feeling Good Together. Or, I could send you one. Matt’s Reply Disarming is really challenging because it requires us to let go of our version of the ‘truth’, at least temporarily, in order to see the other person’s truth.  People often don’t want to do that, even for a moment!  Furthermore, if the other person is angry, they are likely to distort the truth in their statements, for effect, to be more persuasive.  The problem with this, is that it will call our attention to the lies they are telling, tempting us away from seeing their truth.  Without knowing more about the situation, I could only guess at what their ‘truth’ is.  Here are some possibilities, though:  Is it possible that they have some reasonable expectation for us to do more of the cleanup than them?  Are they offering something else in the relationship that offsets their lack of cleaning?  Do they do the majority of the cooking?  Do they do the shopping?  Do they pay more of the bills?  Also, were they the last one to do the cleaning?  When they clean, do they spend more time on it or do a more thorough job?  When they clean, do they clean up their things as well as yours?  Do you do that?  You stated that they leave their ’garbage lying around’.  Is that how they see it?  Is it possible that they put their things precisely where they wanted them to be and didn’t want you ‘tidying up’? The point is that disarming requires seeing the bigger picture, not just the one data point that best supports your blaming them.  Try to see past this and, if you can’t, considering Interpersonal Decision making and the Blame CBA, where you would write down the good reasons to blame the other person and insist that your version of the truth is complete and correct and that theirs is wrong and bad. Nick carries on - What should you do in situations where you both have attachments to other incompatible goals? In Lee's case on episodes 96-98 of your podcast and Chapter 27 of Feeling Great, both Less and his wife had the same fundamental values with regard to raising their daughter. So once he applied the Five Secrets, they were able to move past their ego defenses and share the same perspective. But what if there is a zero-sum situation where both of you have different core values? For example, choosing a grade school for your child. One parent sincerely believes in their core values that their child will benefit from attending a rigorous school where they will be challenged and grow. The other parent sincerely believes in their core values that children should be in a relaxed environment where they can play as much as possible. Can the Five Secrets help with this type of conflict? David’s reply Read the chapter in Feeling Good Together on the idea that the attempt to solve the problem IS the problem, and the refusal to solve it is the solution. I think you’ve got some work to do! Now we’ll see if you do it! Matt’s Response In this case, you could agree to disagree and let a professional decide what would be best for your child.  Studies conducted longitudinally by Chess and Thomas showed that no one parenting style was ‘best’ overall, but rather that outcomes for human being were determined primarily by how well the parenting style suited the child. 2. Debbie asks: Hi David, I can't stop ruminating and obsessing about weird states of minds or when I was afraid of harming someone or remembering. Everyone says to let go but why do I hang on? Where in your book can you help me? David’s reply You can read my book, When Panic Attacks. You can use search function on website for many illuminating podcasts on anxiety and OCD. You can sign up for the free anxiety class. Go for it. Then ask specific questions about something you're working on based on these resources. Matt’s reply Well, you’re not alone!  Nobody can ‘stop ruminating’.  Try a mental experiment, where you try to ‘stop ruminating about a blue-eyed tiger’.  Tell yourself, ‘I must stop ruminating about a blue eyed tiger!  I must stop ruminating about a blue eyed tiger!’.  You will come to realize that it’s Impossible and the harder you try, the more you obsess.  One possible solution is to find something else, something better, to become the focus of your attention.  Imagine a ‘Miracle Cure’ were possible.  What would you most wish to see happen in your life? You could then use the Decision Making Form, to weigh different options, comparing the miracle cure to the status quo, for example.  There are, after all, real advantages to ruminating and obsessing.  You might have a sense that you’re being responsible, protecting others, preventing yourself from going into weird states of mind and harming people.  This is part of your moral nature, doing no harm, being considerate and thoughtful, sacrificing your needs for others.  That’s a good thing!  Also, you might be afraid of committing to pursuing your dreams, for good reason.  There are real disadvantages of doing that.  The risk of failure, humiliation, conflict, disappointment and defeat, for example.  Until you are convinced that you would want some other version of your life, despite the many advantages of rumination and the disadvantages of change, other methods are unlikely to be effective.  If you firmly decide and are committed to change, meaning that you have convinced yourself that this is what you want, on the Decision Making Form, then there are lots of methods that could be helpful. For example, you could use the Get Specific method and an assessment of Process Resistance.  When do I want to be cured?  What would I be willing to do, to have my dreams come true?  What are some small steps I  could take to get there (Anti-Procrastination / Little Steps for Big Feats).  What time will I do these tasks?  Sit down and schedule time in your day to pursue your dreams (Activity Scheduling).  If intrusive thoughts come in, try ‘Self Monitoring and Response Prevention’.  If temptation is especially tenacious, try the Devil’s Advocate Technique.  I’d recommend looking into things like the ‘Hidden Emotion’.  Is ruminating a form of ‘niceness’, an avoidance of a conflict?  For example, who are you angry with?  Have you told them?  If you go live your best life, who would object?  You can also give yourself a certain amount of time, per day, to obsess, wholeheartedly (worry breaks).  How much time would you like to spend ruminating?  Schedule this time and if you’re ruminating outside that time, remind yourself that you have plenty of time to ruminate later.  Again, there are a lot of methods that could help and finding the right ones will be a bit of trial and error! 3. Dean asks: I’m having trouble sleeping. What should I do? Hi Dr. Burns, I picked up a copy of 'Feeling Great' and am excited to start reading it. I have been battling anxiety, depression, and severe chronic insomnia for the past year. Do I start with TEAM-CBT for anxiety/depression and deal with that first, or do I supplement with CBTi-for Insomnia and do both at the same time? I met with the Mayo Clinic last fall and they said the root cause of the Insomnia is some depression. I have been to a lot of doctors, specialists, and therapists and so far no one has been able to help. Thank you! David’s reply I am not familiar with the insomnia app but it can likely give you some of the basics of sleep hygiene in case you do not already know them. TEAM can be helpful, to say the least, for the mood or relationship issues that may be triggering the troubles sleeping. Often, we may have trouble sleeping because we are upset about something. Sleep difficulties are a non-specific manifestation of being upset about something. There is no special relationship with depression, however. It could be anxiety, anger, anything. Let me know what evolves for you! And, of course, sleep difficulties do not always result from emotional disturbance, but this is often the case. For humans, problems don't usually just come from out of the blue, but from your life! David Matt’s reply The best response to the question, ‘How do I get to sleep at night’, that I’ve heard is, ‘try to stay awake’. Meanwhile, I have a couple of thoughts on diagnosis and treatment planning. Having a diagnosis of ‘anxiety’ or ‘depression’ is like having a ‘diagnosis’ of ‘cough’ or ‘fever’.  Our feelings are symptoms, not the source.  g.  if someone has symptoms of a cough and fever, that could be the result of any number of different underlying causes:  bacteria, viruses, fungi, allergic reactions, autoimmune disease, toxin exposures, etc., etc.  To make more accurate guesses about an appropriate treatment regimen, we need greater specificity.  In the treatment of symptoms like depression, anxiety and insomnia, we would need to know much more about a specific moment in time when you were having these symptoms, what you were doing, what you were thinking and details about the feeling state you were in before deciding how to prioritize the methods that would be part of a treatment plan, which we call a ‘recovery circle’ in TEAM. In medical school, they train physicians to ‘cast a very wide net’, when considering all the possible causes of the symptoms a patient is experiencing. This list of possible causes is referred to as a ‘differential diagnosis’ by physicians.  The idea is to organize this list according to what is statistically most likely given all the information we have on hand and to conduct various tests to narrow down these options, in order to prioritize a treatment strategy that is most likely to be effective.  Meanwhile, we want to keep open in our minds that our diagnosis could be wrong and that we will need to monitor the outcome carefully, with frequent testing, rather than assume we know the ‘root’ problem with 100% certainty, so we can modify the treatment strategy based on results. While it’s tempting to try to try to optimize treatment results by matching the diagnosis with a ‘school’ of therapy, (ERP for OCD, EMDR for trauma, DBT for BPD, etc.), there are several problems with this ‘schools’ vs. ‘tools’ approach to therapy. For one, the reality is that people are quite complex beings and diagnostic labels are quite imprecise and limited.  Even when we have an accurate diagnosis, we can’t predict precisely which specific set of methods will be required to help someone recover.  Furthermore, even if someone has the exact same set of upsetting negative thoughts related to their anxiety, depression and insomnia, perhaps their thoughts circle from ‘I must get some sleep, I’ll never get to sleep, I’ll feel terrible tomorrow, Everything will go wrong, I’m a hopeless case, I’m a loser…I must get some sleep (repeat)’, even if the thoughts are the same in multiple different people, we can only make informed guesses, rather than predict, perfectly, what method(s) will suit that individual best.  Will it be the double standard technique, or cognitive flooding, sleep restriction, the hidden emotion, the Socratic technique or memory rescripting, self-monitoring or response prevention, something else? The solution to this uncertainty is the Recovery Circle. The ‘recovery circle’ is a customized list of at least twenty methods, that are selected based on the specific feelings, thoughts or behaviors someone would like to see change.  Each of these methods will have some reasonable chance to help an individual, with their particular thoughts and feelings and behaviors.  The idea is then to ‘fail our way to success’, using trial-and-error, with measurement in between, to discover, scientifically, what is the best method for that individual.  Once we do, we focus on practicing that method regularly to gain skill with it, until our patients are not only cured, but able to recover from relapses on their own, because they know the methods that are most helpful to them. Another consideration is that, in general, folks benefit from an approach that is kind, empathic, respectful, grounded in science and measurement, and attentive to resistance and motivational barriers to change. One reason I would recommend TEAM to a family member or friend is that it contains each of these necessary elements of therapy and also has the greatest diversity of tools to help someone, as well as a customized approach to treatment.  I think that’s why TEAM has been shown to be much more effective than other forms of therapy. All that said, it’s important to realize that TEAM itself is incomplete and we would want to continue to expand up the model and, when you’re in treatment, know that it’s fine to get a second, third or fourth opinion on what methods and approaches are most likely to benefit you. 4. Kathy asks about social anxiety, panic and the hidden emotion technique. Hi Dr. Burns, Thank you so much for all the great information you put out there! I had a question about hidden emotion. If I experienced dizziness in a social setting ten years ago and now I panic whenever I am in a similar situation anticipating the dizziness. Is there still a connection to the original emotion that is still hidden or is it a habit at this point? Thank you so much David’s reply Were you upset with somebody or something in that situation? Matt’s reply: You could use uncovering techniques, like the ‘What If’ Technique and the ‘Interpersonal Downward Arrow’, among others, to figure that out. For example, ‘what if you got dizzy?  What’s the worst that could happen? You can write down your answer, and continue to ask yourself, ‘what if that happened, what would I be anxious about?’.  Then, as yourself, if that happened, what would other people think about me?  How would they treat me?  What kind of people are these people, I’m imagining?  How do I feel about people like that?

304: TEAM-CBT, Spirituality, and Beyond: Featuring Angela Poch Rhonda begins today’s podcast, as usual, by reading two touching emails from podcasts fans, including Coach Teddy, who said that Podcasts 295 and 296 featuring live work with Zeina were incredible, and Carol who was equally enthusiastic about Podcast 297 (on “Homework—Yuck!). Carol also strongly recommends David’s book, Ten Days to Self-Esteem which is a simplified version of Cognitive Behavioral Therapy that can be used as a manual for therapy or self-help groups. https://www.amazon.com/Days-Self-Esteem-David-Burns-M-D/dp/0688094554 Today, we interview Angel Poch, a certified life coach, registered professional counselor, and certified Level 4 TEAM therapist and trainer. She lives two hours north of Glacier National Park in British Columbia, but teaches therapists and treats people virtually from around the world. Her new booklet, “The Truth Shall Set You Free,” integrates TEAM-CBT with a Christian perspective and is available for free on her website. https://www.angelapoch.com/. She is a regular in David’s weekly virtual psychotherapy training group at Stanford and assists in the teaching. She has also worked tirelessly and selflessly behind the scenes making David’s work way more accessible to lay people as well as mental health professionals wanting to learn more about TEAM-CBT. For example, she adds links to every new Feeling Good Podcast on David’s website, so you can easily find and link to more than 300 podcasts. Check it out! She has also transformed a massive amount of David’s work into electronic tools for shrinks, accessible in David’s online shop: Recently, she has created two amazing new documents you can link to. One is a spreadsheet that lists 138 of David’s TEAM-CBT tools and techniques, like the “Anti-Procrastination Sheet” and many others, with page links to the descriptions of how to use each tool in David’s books, like Feeling Good, Feeling Great, David’s TEAM-CBT therapist eBook, and many others. Check it out! This data base will be invaluable to interested lay people, therapists, and teachers who want clear instructions on how to use the Daily Mood Log, Relationship Journal, and numerous additional tools and techniques. Derek Gurney and Angela are working on an equally awesome database for the Feeling Good Podcasts: Check it out as well! Angela begins her personal statement in today’s podcast by describing her struggles with depression and irritability, including some very dark days in 2006. Her doctor recommended an SSRI antidepressant, and she went to integrative health program, “Depression: the Way Out” that required participants to read Feeling Good https://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380810336 Although she didn’t love the book, she resonated with the idea that all of our feelings, positive and negative, result from our thoughts, or perceptions, and her depression cleared up. She liked that when she read Feeling Good, she got many new tools she could use to change her negative thoughts and feelings. She also appreciated the ideas in the book didn’t go against her belief system, which many fear about psychology. David pointed out his own father, a Lutheran minister, worried about this, and was very suspicious of psychiatrists. Angela’s thinking, which resonates with David’s, is that the core ideas of religion and psychotherapy are actually high compatible, and even synergistic. Angela explains that when she was a young child, she didn’t fit in socially or even in her own skin. “I felt like I was a boy in a woman’s body. I felt like I was in the wrong body, and prayed for help.” She started to see in a very limited, childlike way, her thoughts were distorted, that a body was just a body and she could trust God wouldn’t give her more than she could bear. These new realistic, counter thoughts relieved the negative body dysmorphia she’d been struggling with. She reports, “I decided it was okay to be flawed and not fit in.” The rest of her young childhood was mostly joyful. In middle school she was the target of mean-spirited bullying because she was a tomboy. She developed intense social anxiety and was relieved when her mom took her out of school. She was homeschooled for a few years and studied Karate to exercise and develop some confidence. High school brought new challenges. She describes responding with her version of the Five Secrets of Effective Communication to an aggressive bully who threatened her with brass knuckles and challenged her to fight her. However, the girl backed off and started telling people that Angela was her friend! After a bad relationship, Angela started to struggle with depression and described her suicide attempt when she was 18 because “I wanted the pain to stop.” She explains that: I met my husband, moved home, and started reading the Bible. I was impressed by the passage, “the truth shall set you free.” I realized I had to control my own thoughts rather than look for the approval of others, but she still didn’t totally recovery from my anxiety. The cognitive piece in Feeling Good helped Angela a lot. She states, “I pursued a lot of careers, never holding down a job for more than 6 months, and one day someone asked if I’d considered a career in counseling. . .” She went on to take one of David’s four-day live intensives in Whistler BC where she learned TEAM-CBT and hasn’t looked back since! After learning and applying TEAM, Angela was able to crush her social and other anxieties. Angela has a deep love for her Creator and has done a great deal of thought about the integration of her Christian faith with TEAM-CBT. David also has a strong interest in the overlap between TEAM-CBT and virtually all religions and spiritual paths. He described an unusual and overpowerful spiritual experience he had as a medical student crossing the Nevada desert that made a strong impact on him. Angela would like to mention, “I have a profound gratitude for David’s work. He makes things so clear and relatable. His approach is applicable to all faiths or no faith if one is truly ready to give up their negative thoughts and feelings. As we aim for the truth, and let go of the so called “self,” we find peace and joy. I will forever be indebted to him because I would not be able to help people without TEAM and that brings me joy every day!” I, David, would like to thank Angela for her intense and tireless devotion to helping spread the “gospel” of TEAM-CBT in so many ways! Thanks for listening today! Angela, Rhonda, and David I

The Dramatic Journey of Jason Meno In today’s podcast, we interview the amazing but humble Jason Meno, who has been doing incredible programming for the Feeling Good App for the past year. Like everyone on our app development team, Jason was driven to TEAM-CBT and the Feeling Good App by his own personal struggles, and also by his training in Buddhism and his commitment to doing something to help relieve the enormous suffering endured by so many people in the United States and around the world who are struggling with depression and anxiety. The podcast notes will focus first on how he recently came to join our app team, and then on Jason’s amazing early years in his search for meaning and a solution to his personal suffering and tragedies. Jason’s journey to the Feeling Good App Jason began the podcast by describing how he became familiar with David’s work. Then he described his own personal journey and search for enlightenment. I’ll summarize some of both in these show notes. He said: I was struggling with severe depression in 2020. I felt like my body was falling apart because I’ve been afflicted with type 1 diabetes since I was five years old. I didn’t have the resources to work with a therapist and felt hopeless, so I searched the internet, looking for a way of overcoming depression on my own. I first turned to apps for help, but my experience was not great. I eventually found David’s book, Feeling Good: The New Mood Therapy. Through that book, I discovered that depression and anxiety are cons and that I was tricking myself. However, I didn’t use the tools or do the written exercises in the book. I started listening to the Feeling Good Podcasts and waited for the new book, Feeling Great. Often, when listening to the podcasts I would start crying. I am not a crier, and this often happened in public, so it was pretty embarrassing! I was also practicing meditation every day, but that didn’t provide much help. It does have its benefits and was a solace for me when I had nothing else, but after years of practicing, it still didn’t give me the tools to combat the thoughts that trigger depression and suicidal urges. But then I had an “ah-ha” moment when David talked about resistance and the power of positive reframing. It was a tremendous relief to see that it was reasonable to feel the way I was feeling. I devoured the Feeling Great book but still wanted to die since I was still not doing the written exercises that David repeatedly urges the reader to do. Then, on one of the podcasts, someone said, “you can’t challenge your negative thoughts in your head.” I resisted that message and told myself that I had no negative thoughts. Many of my negative thoughts are quiet since you learn to empty your mind when you meditate. But then I realized that negative thoughts are just the top layer of your consciousness and that the concept of “cognitions” not only includes thoughts like “I’m a loser,” but also your daydreams, beliefs, and perceptions. Then, once I sat down and wrote down my negative thoughts, identified their distortions, and challenged them with more realistic thoughts, I began to feel a lot better within five minutes! If you, the podcast listener, are feeling down, there’s a step-by-step guide in Feeling Great that could be enormously helpful to you. I started following this guide, and then I really started to feel great. After using it a few times, I had the thought, “Wow, this could be a pretty amazing app!” One of the first questions you ask yourself, “do I really want to feel better?” had a massive impact on me and, of course, is one of the unique elements of TEAM-CBT. And although I made mistakes while using the tools on my own, they still helped more than anything else I’ve tried. Eventually, I saw a non-TEAM therapist who provided me with some great empathy and valuable perspectives while I used the TEAM-CBT process and daily mood log on my own. Then I suddenly realized that I had no more suicidal thoughts. TEAM-CBT is a way for you to rapidly train your mind and develop a new mindset that reduces suffering. This is an important ethical issue to me, given all the suffering that remains throughout the world, and it reminded me of my Buddhist vow to help others. So, I signed up to be a beta tester for David’s Feeling Good App. However, I was disappointed in the early version I tested and created a 12-page document listing my complaints. Then I reached out to Jeremy Karmel, the CEO of the Feeling Good App, and he invited me to join the development team. I was so excited that I left my job as a data scientist working on an automated insulin device and joined the app development team. And although I was not familiar with the computer language Jeremy was using, I learned it quickly, and now I’m programming all kinds of cool things for the app! Jason’s early years You may or may not be familiar with Herman Hesse’s famous 1922 novel, “Siddhartha,” which traced the journey of the young Buddha as he was searching for personal enlightenment and unlocking the key to human suffering. (https://en.wikipedia.org/wiki/Siddhartha_(novel)) I have not read many books, because I am a slow reader, but that one is short and has always been one of my favorites. Jason’s intense and dramatic journey reminds me of Siddhartha’s path. Jason’s road to TEAM-CBT, his current passion, was not a direct one at all. Like myself (David), he was raised in a strict Christian home but found himself attracted to exciting and controversial topics when he was in high school, like astral traveling and “lucid dreaming,” which means becoming aware when you are dreaming so you can take charge of your dreams and do things in your dream world that you may not be permitted to do in real life. For example, Jason has been treated for type 1 diabetes since the age of 5 and has to monitor his blood glucose levels 24 hours a day. Things like fresh orange juice are dangerous because they cause a spike in blood sugar, but in a lucid dream you can drink all the orange juice you want! I can identify with Jason’s yearning for fresh squeezed orange juice, because I grew up in Phoenix, Arizona, and we had many orange trees in our yard, so the orange juice was plentiful and incredibly delicious! When Jason was a teenager, there was a magic / occult shop near his high school that he would joyfully and curiously explore after school, but his parents were dead set against it. They told him that he was exploring ideas promoted by the devil and threatened to kick him out of the house! I also identified with these memories, as I also used to hang out in magic stores in Phoenix when I was in high school. But these were more the kinds of shops that sold tricks of various kinds that magicians could use. Although Jason studied biomedical engineering in college, he continued to be fascinated by his more exciting “alternative” occult pursuits, and dropped out of college to join a cult in Sedona, Arizona. The cult members insisted that he could cure his diabetes simply by believing he could, so he obediently stopped taking his insulin and monitoring his blood sugar for one day and nearly died. Jason described that his mother struggled with emotional issues. After running away with him twice when he was 10, she lost custody and disappeared to Santiago, Chile. Jason had not heard from her since. But one day, out of the blue, his brother called him and said that their mom had suddenly returned home, and there was some talk of starting a family bakery. Jason was thrilled and purchased a plane ticket to fly from Indiana to Hanford, California, to surprise his mom after not seeing her for 10 years and offer to help with the bakery. But then right before leaving, his sister called and asked if he had heard the news. At first, he thought she was talking about the family bakery, but his sister said, “No, mom just committed suicide.” Jason was devastated and sadly flew home out for the funeral. Although his mother’s body was not present at the funeral, he looked and suddenly thought he saw her standing in the church during the service. This jolted him, understandably, until it dawned on him that it was his mother’s twin sister. His aunt offered him a new life, a car, and a beautiful home in Carmel-by-the-Sea, California, but he was still obsessed with the cult, so he returned to the cult in Arizona. He spent all his savings of $3,000 for special training to become a cult leader and ended up living as a homeless person in Boulder, Colorado. However. he started running out of his diabetes medications and having panic attacks. He eventually found work in a Buddhist retreat center in the mountains of Colorado and started studying Buddhism, making friends with the monks, and began doing traditional mediation. He said that mediating intensified his negative feelings, and he became suicidal, and even tried a special “suicide meditation” that he’d learned from the cult in Arizona. They claimed that if you did this meditation, you would disappear and end up in a kind of different universe, but after trying it several times, he realized it was all bunk and gave it up, along with the other crazy cult things he’d been taught. However, he did make a sound connection with traditional Buddhism, and lived at the retreat center for about a year. He described a special meditation where you ask yourself, “what doesn’t need to change?” The goal is to discover that the answer is “nothing” since everything is in constant flux, and this meditation is intended to lead to a kind of acceptance. But, he says, “at first I resisted.” He said he did experience feelings of pleasure and euphoria during some of his mediations, but that this was not a permanent cure for his depression. That’s because the meditation was a distraction or escape from his negative thoughts, a kind of temporary trance-like state, but when you finish meditating, you are back to your normal life, so your negative thoughts and feelings return. Jason has become an enthusiastic advocate of TEAM-CBT, and described two ways of challenging negative thoughts based on David’s Externalization of Voices Technique. One approach is highly rational, and it reduces your negative feelings but does not flood you with feelings of joy or enlightenment. The other approach reduces your negative feelings AND energizes you with feelings of joy. The second involves using David’s Externalization of Voices Technique along with the three strategies for crushing negative thoughts: Acceptance Self-Defense The CAT, or Counter-Attack Technique. David asked Jason to discuss one of the traditional Buddhist definitions of enlightenment. You are “enlightened” if you are free of greed, ignorance, and delusions. However, he sent this delightful email following the podcast recording: Hi David and Rhonda, Thank you so much again for having me on the podcast! It was a blast! I wanted to clarify an important mistake I made: A commonly accepted Buddhist definition of enlightenment is to be completely free of the three root poisons of greed, hatred, and delusion. These are considered to be the source of suffering / negative thoughts / mind states (Buddhists refer to these as Kleshas). I can't remember exactly what I said in the podcast, but I think I may have incorrectly listed the three poisons as greed, delusion, and ignorance. Delusion and Ignorance are considered to be in the same category, so I think I forgot Hatred. Oops! Looks like I'll have to brush up on my studies again! Hopefully, we can help make this clear in the show notes as well. If you or anyone you know is at all interested in learning more about Buddhism, its philosophies, and history, I highly recommend the YouTube channel Doug's Dharma. Candidly, Jason I am very grateful for the creative and life-changing contributions that Jason is making in our Feeling Good App, and I feel tremendously lucky to know Jason on a personal and professional level. His quite humility speaks loudly and boldly about the kind of loving and genuine person he is, and if you decide to beta-test our app, you will have the chance to benefit from his personal journey and his professional genius! If you’re interested, you can sign up to beta test the app at www.feelinggood.com/app. If you would like to contact Jason, you can reach him at asonmeno@feelinggoodapp.com. After reviewing the draft of the show notes, I got this link from Jason: Also, if you are interested in reading a little more of the story, I wrote this article a few years ago about some scary health challenges I had and how I ended up leaving the Buddhist retreat center and returning to school: Buddhist Enlightenment or Just Life with Diabetes? Thanks for listening today! Thanks! Rhonda, Jason, and David

Today, you will hear the the second half of the live therapy session that Dr. Jill Levitt and I did with Nazli, a young woman from Turkey, at our recent “David Burns Live” workshop on May 22, 2022. Nazli has been struggling with intense performance anxiety and generalized anxiety, and generously who volunteered to be a “patient.” Jill and I are very grateful for Nazli’s courage in sharing herself so courageously with all of you, and hope you enjoy the session and learn from it. Last week, we played the first half of the therapy session, including the initial T =Testing and E = Empathy. Today, you will hear the exciting conclusion, including A = Assessment of Resistance and M = Methods, and final T = Testing. As a reminder, you can review the Daily Mood Log and Brief Mood Survey (BMS) that Nazli filled out at the start of the session. Part 2 of the Nazli Session: A = Assessment of Resistance and M =  Methods After a period of empathizing, Nazli gave Jill and David an A in Empathy, so we moved on to the Assessment of Resistance portion of the session. This often involves the following steps: Invitation Step Miracle Cure Question Magic Button Positive Reframing Pivot Question Magic Dial Jill issued a Straightforward Invitation, asking Nazli if she was ready to get down to work, or if she needed more time to vent. She said she was ready to go to work, so Jill asked what changes she was hoping for during the session. This is the so-called “Miracle Cure Question.” This helps to focus the session on something specific. Nazli said that her hope was to reduce or eliminate the negative thoughts and feelings that were making her clinical work so stressful. And like nearly everyone, she said she’d eagerly press the Magic Button. Then Jill and David pointed out that although we didn’t have a Magic Button, we did have some powerful techniques that could help, but it might not be the best idea to use them. That’s because there might be some positives hidden in her negative thoughts and feelings, and perhaps we should first take a look. David and Jill asked Nazli these three questions: 1. Given your circumstances, why might this negative thought or feeling be totally appropriate and understandable? 2. What are some benefits, or advantages of this negative thought or feeling? 3. What does this negative thought or feeling show about you and your core values that’s positive, beautiful, or even awesome? This technique is called Positive Reframing. The goal of Positive Reframing is to reduce the patient’s subconscious resistance to change, along with their feelings of shame about their symptoms.. Paradoxically, the moment patients see the beautiful and awesome things about their negative thoughts and feelings, their resistance to change typically disappears. Positive Reframing is one of the unique features of TEAM-CBT and it opens the door to the possibility of rapid change. As an exercise, see if you can find some positives in five of Nazli’s feelings, Anxiety Ashamed, bad Inadequate Hopeless Angry Please do this on paper, and NOT in your head, using the blank Positive Reframing Tool you’ll find at the end of the Daily Mood Log. Getting it “right” isn’t important. What is important is trying. This will get your brain circuits firing in a new way. Then, when you see the work that we did with Nazli, you might have your own “ah-ha” moment, as well as a powerful new skill that may be helpful to you as well. Okay. Did you do that yet, or do you plan to look at the answer without doing the exercise? Oh! I see! You’re planning to look at the answer. If you want to learn at a deep level, whether you’re a therapist or lay person, do the exercise first! It may be challenging at first, but it will fire up your brain circuits, so when you look at the answer, you’ll suddenly have a new and deeper understanding of Positive Reframing. When you’re done, you can check this link to see the work that Jill and I did with Nazli. But either way, I’m grateful that you’re listening to these podcasts and reading the show notes! If you click on this link, you can find the Emotions table from Nazli's Daily Mood Log showing her goals for each negative feeling after we use the Magic Dial. After we finished the Magic Dial, we went on to the M = Methods portion of the TEAM-CBT session, and helped Nazli challenge some of her negative thoughts using a variety of techniques including Explain the Distortions, the Externalization of Voices, Examine the Evidence, the Acceptance Paradox, and more. One of the thoughts she wanted to work on first was this one: “If I don’t fix this patient or make him/her satisfied, then she/he will judge me and think poorly about me.” Together with Nazli, we identified a number of distortions in this thought, including a couple more that popped into my mind while doing the show notes: Fortune-Telling: Making a negative prediction without good evidence. Mind-Reading: Assuming that I know how my patients are thinking. Hidden Should Statement: Telling myself I should be doing better. Mental Filtering: Selectively noticing the times sessions have not gone well. Discounting the Positive: Overlooking the positive feedback I typically get from patients and supervisors. Magnification and Minimization: Magnifying the importance or “awfulness” of negative feedback from patients, and overlooking the potential value of processing their negative and positive feedback with them at the next session. Emotional Reasoning: Thinking that my feelings of inadequacy and anxiety mean that I really am screwing up with patients Self-Blame: Beating up on myself constantly when I’m seeing patients. Nazli’s belief in this thought went down from 80% to the range of 10% - 20%, since there was some truth in the thought. Sometimes you’ll want to smash a negative thought, so your belief in it goes all the way to zero. Sometimes, it’s okay just to reduce your belief in a thought substantially, but not all the way to zero. We also encouraged Nazli to begin using the Brief Mood Survey (BMS) and Patient’s Evaluation of Therapy Session (EOTS) with every patient at every session so she can get immediate and accurate feedback of how she’s doing, and so she can fine-tune her therapeutic strategies based on this information. This practice is vastly more effective than Mind-Reading, since therapists’ perceptions of how patients feel tend to be wildly inaccurate most of the time. If you are a therapist, T = Testing at start and end of every  is a vitally important key to personal and professional growth, although it takes courage because sometimes—or even often—you will have to confront some information that may threaten your feelings of pride! You can see Nazli’s final ratings of her feelings on the Emotions table her Daily Mood Log at the end of the session. Since the changes in all of her negative feelings were dramatic, we asked Nazli two questions: 1. Are these ratings valid, or are you just trying to please David and Jill? 2. If so, what were the effective ingredients of your session. What, more than anything else, accounted for the significant and rapid changes you experienced? You will hear how she answered these vitally important questions on the podcast, and you can see Nazli’s BMS and EOTS after her session if you click the link. Thanks for tuning in last week and today! Once again, Rhonda, Jill and I want to thank our wonderful and courageous Nazli from the bottom of our hearts! We hope you enjoyed this session, and the chance to look behind closed doors to see how psychotherapy actually works in a real session with a real human being who, like nearly all of us, struggles at times with that ancient belief that “I’m just not good enough!” In fact, we’re all, in many ways, “not good enough,” and will probably never be “good enough.” But that is never the cause of our problems, especially our lack of self-esteem. Do you know what the actual cause is? Do you know what the solution is? Take your best shot, make a guess, and then you can click on this link. Thanks! Rhonda, Jill, Nazli, and David