In the next two podcasts, you will hear 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. Although the facts of your life are probably quite different from Nazli’s, you may be able to identify with the almost universal theme of feeling like you are not “good enough.” The ultimate antidote to this type of suffering is simple, but so basic that you may not “see it” at first, especially when it comes to your own negative thoughts and feelings. Although we all have many flaws and shortcomings, our inadequacies are rarely or never the cause of our emotional distress. Our emotional distress, in terms of anxiety, depression, inferiority, loneliness, hopelessness, and anger, nearly always results from our thoughts, and not so much from what’s actually happening in our lives. In addition, the thoughts that trigger those kinds of feelings are almost never valid. Instead, they are loaded with cognitive distortions. As you probably know very well, I have often said that depression and anxiety are the world’s oldest cons. And here’s the really good news. The very moment you change the way you THINK, you can change the way you FEEL! Sounds wonderful. But isn’t it just a little, or a lot, too good to be true? And can you really trigger real change at the gut level by changing the way you think? Let’s find out! In today’s podcast, you’ll hear the first half of Nazli’s session, including T = Testing and E = Empathy. Next week, you’ll hear the exciting conclusion of her session, including the A = Assessment of Resistance and M = Methods, followed, of course by the final of T = Testing so we can see if Nazli really changed, and if so, by how much. We’ll also see and how she rated Jill and David on Empathy, Helpfulness, and more. If you’ve followed the Feeling Good Podcasts, you know that doing live therapy to challenge your own demons is part of therapist training in TEAM-CBT This experience greatly deepens your understanding of team and allows you to give this message to your ow patients: “I know how you feel because I’ve been there myself. And it will give me great joy to show you how to CHANGE the way you FEEL, too!” I think of this personal step as the transition from technician to healer. But you cannot take this step with credibility if you haven’t yet done your own “work.” At the start of the session, Nazli explained that she’s struggled with anxiety ever since she was a child, and that’s what triggered her interest in a career as a clinical psychologist. In my experience, this is true of many if not most mental health professionals. Although the general public often have the impression that shrinks have it all together, nothing could be further from the truth. Most went into the field hoping to find a solution to their own suffering, and a great many—probably nearly all—are still searching and hoping to find a their “cure.” After completing her master’s degree in counseling 10 years ago, Nazli got a job at a counseling center, and in spite of the fact that she received consistently good feedback, she quit after 2 and 1/2 years and took a job in administration. This was because of the intense anxiety she experienced during sessions, resulting from the constant and relentless bombardment with negative thoughts that popped into her mind when treating  patients. However, she still yearned to do clinical work, so she decide to go back to clinical work several years ago and has been doing therapy for patients being treated for cancer. But the negative thoughts and feelings still continued to haunt her. You can review them on the Daily Mood Log that Nazli showed us at the start of her session. As you can see, when she’s treating patients, she feels severe depression, anxiety, shame and inadequacy. She also feels humiliated, hopeless, and discouraged, along with some moderate feelings of anger and resentment. Nazli explained that she has no fear of public speaking, but said that when she’s working with a client, she constantly criticizes herself for fear of making a mistake and tell herself: I’m not doing a good job. This job is not for me. Should I just quit? My friends are at a better place in life. I’m 38 years old and missing out on a lot. Why am I like this? Recently, she went to visit one of her patients, a young woman struggling with lung cancer; but when Nazli entered the room, her patient said: “I don’t want to talk to you!” Nazli said, “I was devastated and felt like crying.” When you review Nazli’s Brief Mood Survey (BMS) at the start of the session, you’ll see that the only feeling that was elevated was anxiety, and that was minimal. However, her score on the Happiness Test was only 8 out of 20, indicating that she didn’t feel very worthwhile, happy, hopeful, motivated, or satisfied with her life. This meant that her negative thoughts and feelings when she was seeing patients were making a huge impact on her capacity for happiness and self-esteem. Her minimal scores on the depression, anxiety, and anger scales on the BMS also reflect the fluctuating nature of anxiety and other feelings for many people. For example, you may have little or no anxiety most of the time, and when you’re having a session with your shrink you may not feel especially anxious, either. But when you encounter the situation that triggers your anxiety, the feelings suddenly spike tremendously, along with a host of other negative feelings, and then the emotional discomfort can be overwhelming. End of Part 1 of the Nazli Session: T = Testing and E = Empathy. Next week, you will hear Part 2: A = Assessment of Resistance and M =  Methods. Thanks! Rhonda, Jill, Nazli, and David

Podcast #300: Celebrating Five Million Plus  In today’s podcast, we celebrate, thanks to Rhonda and Fabrice, our 300th podcast, featuring some of our most beloved guests since our first podcast on October 27, 2016. We began with Fabrice Nye, who describes the birth of the Feeling Good Podcast, and two of our favorite and most popular guests, Drs. Matthew May and Jill Levitt. The schedule for all of the guests appears below. The featured guests include Fabrice Nye, Matthew May, Jill Levitt, Angela Krumm, Lorraine Wong, Kyle Jones, Brandon Vance, Heather Clague, Leigh Harrington, Sarah Hester, Brian Wright, Mark Noble, Thai-An Truong, Stirling Moorey, Rose Markotic, Mark Taslimi, Sunny Choi and Elizabeth Dandenell. Time Featured Guests 1:30-1:45 Fabrice Nye, The father of us all! #177, Research in Psychedelic-Assisted Therapy Matt May, co-therapist with David: live therapy with Marilyn & me, Many, many Ask David episodes, #265, Exposure to Leeches with Danielle Kamis Jill Levitt, David’s co-therapist doing personal work with David, plus #146, When Helping Doesn’t Help 1:45-2:00 Angela Krumm (#270-losing weight & flirting), Lorraine Wong (#155-treating emotional eating & #257 Intensives), Kyle Jones (Dating strategies, #151-Treating LGBTQ, #157-Psychotherapy Training, and #267-Talking to loved ones who criticize your sexual orientation 2:00-2:10 Brandon Vance- #160 Listening to the Music of TEAM #161, Music under what someone is saying #249, Report on Feeling Great Book Clubs #260, TEAM games (with Amy Spector) Heather Clague-(All of the above except #249) 2:10-2:20 Leigh Harrington, #279, Goal setting for Habits & Addictions Sarah Hester,#181, Live therapy, treatment of panic and insecurity, #193, Relapse 2:20-2:30 Brian Wright, #235, Anger in Marriage/5 Secrets Revisited 2:30-2:40 Mark Noble, #100, The New Micro-Neurosurgery, #167, TEAM and the Brain, #275, His latest thinking on how the molecular biology of stress & learning are consistent with TEAM, plus his chapbook on TEAM Thai-An Truong, #178, co-therapist with David at Atlanta Intensive Social Anxiety Be Gone, #218, Postpartum Depression, #264, How to get laid with help from the 5-Secrets #283, The “O” of OCD 2:40-2:50 Stirling Moorey, #280, A Beloved Voice from the past, #289 & 290, A case of social anxiety, personal work with Anita 2:50-3:00 Rose Markotic, #252 & 253, Sadness as Celebration Mark Taslimi, #29-35, Live sessions with Mark, “I’m a failure as a father.” #141, 2-Year follow up “I’ve been a failure as a father.” 3:00-3:10 Sunny Choi, #214 & 215, The Approval Addiction Elizabeth Dandenell, #240 & 241, struggling with anxiety and fear of poverty.   Rhonda, Fabrice and I want to thank all of our guests who have contributed so generously to our efforts, and to all of you, who have supported us! Most of the guests today have done personal work with David, often with Jill, Matt, or Rhonda as co-therapists, and almost all had some version of “I’m not good enough” when they were upset, and all found solutions to this which expanded their humanness and deepened their skills as TEAM therapists.  Our guests who did personal work were asked how things had been for them since doing that work, and they all reported that the results have been long-lasting, even permanent! In the following email I just received, Dr. Matthew May shared some feelings about today’s show. Hi David, I like the show notes and approve of their humble nature.  Brevity is the soul of wit! If I were to edit anything, and I’m not sure that I would, it would be to list all the names of all the excellent folks who participated, in the first paragraph. My sense is that it was their vulnerability, as well as their willingness to do challenging personal work, that led to enduring improvements in mood, relationships and lives. I thought it was the personal endorsements and descriptions of how TEAM has improved their lives, that were the most compelling themes of the podcast. Adding to this, it goes without saying, that none of this would have happened without you, David.  You created this model of therapy for one thing.  You also created this community of people.  As you said before the podcast started, the most meaningful and important part of all of this has been the relationships and friendships that have developed as a result of this work.  (I’m paraphrasing and not doing a very good job of it, sadly!). In any case, I caught myself wondering if this format of therapy, one that is public and open, might be the future.  Meaning, instead of hiding our flaws and insecurities behind closed doors, if we might continue to attack the shame and stigma of “mental illness” by exposing it to the light of day, realizing that there was nothing to be ashamed of or afraid of, only opportunities to connect and be in the good company of other flawed, imperfect souls, just like us. -Matt Fabrice replied to Matt: Early Christians were doing their confessions in public—why not? ☺ Our numbers continue to grow each month, so please continue to tell your friends about us. We do not accept commercial advertising, something Fabrice suggested early in our development, so you are our only marketing team, and we thank you for sticking with us and sending us so many beautiful emails, reporting your responses to our shows, asking questions, and suggesting new topics. Our audience consists of lay people looking for personal healing as well as mental health professionals looking for new treatment tools as well as their own personal healing. Warmly, Fabrice, Rhonda, Matt and David

299: Ask David: Retirement blues; patients who refuse homework (and the therapists who love them); ADHD; David's new pooping story; and more!  We regret that our beloved Matt May, MD could not join us today due to an emergency involving his website. We look forward to him joining us next time for more exciting Ask David’s that will include: Does the “self” exist? Does God exist? And MUCH more! We open with two announcements: 1. Return of the awesome Feeling Great Book Club, with Drs. Brandon Vance and Heather Clague, will meet weekly, starting on September 13th. This will be a terrific experience, and only costs $12 per week with a sliding fee scale if you cannot afford it. You will go through the Feel Great book, learn techniques, have fun, and practice in small groups. This is a fantastic opportunity for everyone. For more information, go to:  https://www.feelinggreattherapycenter.com/book-club. 2. The TEAM-CBT World Congress, Warsaw Poland, August 18 - 21. This first of a kind event will take place live and virtually, and will be somewhat like David''s famous Intensives with teachers from around the world, many of whom have been featured on this podcast.  The CONGRESS will feature interactive sessions which participants can learn and practice the elements of the powerful TEAM system while receiving expert coaching on TEAM techniques. This event is organized by Daniel Minte, Mariusz Wirga, and Yehuda Bar Shalom. For more information, please go to:  https://teamcbt.eu Today’s questions: Retirement depression / anxiety; patients who refuse to do exposure or psychotherapy homework; treating procrastination and ADHD; David’s new pooping story, and more! 1. Paul asks: Are you planning on doing a podcast about people who are about to retire and are very anxious about the prospect and also depressed about closing that chapter in their lives? I’m in that boat. 2. M asks: My patient refuses homework and isn’t getting better. I think I’m a victim of what you’ve referred to as “reverse hypnosis.” What should I do? 3. Heather asks: Hello David! How would you treat ADHD with TEAM-CBT? 4. A asks: Hello sir, Is it okay if I do the written work by typing in my laptop on a word processor or is it must that I write on a paper? 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. In some cases, I did not have time to polish and edit my responses below. I’ve been super busy developing the Feeling Good App, which is coming along tremendously well. It has the potential to help millions around the world who are struggling with depression and anxiety, but I have to be super careful with my time these days. If interested in beta testing, you can sign up here. 1. Paul asks: Are you planning on doing a podcast about people who are about to retire and are very anxious about the prospect and also depressed about closing that chapter in their lives? I’m in that boat. David’s reply Have you read the introduction to Feeling Great? Or done any of the written exercises in that book, or in any of my books? Of listened to my free Ted Talk on my website? We can provide more specific information in the live discussion on the podcast. 2. M asks: My patient refuses homework and isn’t getting better. I think I’m a victim of what you’ve referred to as “reverse hypnosis.” What should I do? Dear Dr Burns, Many thanks for your blogs, podcasts, books and TEAM CBT. I have experienced (and I am experiencing) being hypnotized with a Panic Attack patient with Border Line PD- . I know this after the sessions. During the sessions I feel I cannot even think well. I see this client through SKYPE, And cannot see her face to face due to distances. I have try to follow your approach, but she’s resistant, I do include exposure exercises that she never completes. How to do a Shame Attacking Exercise when I cannot go with the patient to the places she needs to in order to do the exposure. I have even been in the phone and she driving, but 2 years later nothing works. Any thoughts will help! Many thanks in advance. M. David’s reply Thanks, great question! Some training or individual case consultation or both, or workshops, would help a lot. We have two free weekly training groups for therapists in California and therapists around the world. For example, the last two weeks in our Tuesday group we have focused on the negative thoughts and feelings therapists have during sessions that interfere with their ability to do excellent work. So your question is very timely and relevant! Also, the www.feelinggoodinstitute.com has free and paid training. Two of the finest teachers are Mike Christensen and Dr. Jill Levitt, and there are many others as well. Jill has just released an introductory recorded class on TEAM-CBT that you can purchase and watch whenever you like. She is a brilliant teacher! And yes, you HAVE been hypnotized during sessions! David 3. Heather asks: Hello David!! How would you treat ADHD with TEAM-CBT? Hi there! It is Heather Donnenwirth, from podcast 267. I hope you are doing well. I really enjoyed being apart of the podcast with you, Rhonda, and Kyle. Thanks again for including me in that experience. I have another question for you about the podcast you did on ADHD. I totally agree with you about ADHD not being a diagnosis and agree that is more helpful to treat the symptoms. Many of the clients that I work with have been diagnosed with ADHD or are convinced that they have it. Procrastination seems to be a common symptom of "ADHD" that people want help with and that can be treated easily with the TEAM model and with the anti-procrastination and motivational tools. The symptom that people ask for help with that I am feel less confident about helping them with is difficulty with focus and distractibility, and would love your thoughts about how to treat these symptoms? I have improved my own focus with motivational techniques and with practicing bringing my attention back to what I want to focus on when my mind starts to wonder. Also, taking notes has helped me to stayed focused, but I am curious if you have any other ideas about increasing focus? Sometimes the people I work with have distorted thoughts about focus as well, such as: "If I'm not interested in something, I can't focus on it," and "I need medication to focus," etc. Anyway, I value your knowledge and opinion and wondered if you have any tools for increasing focus? Also, do you treat hyperactivity and excessive talking? I have also noticed that parents some time play an enabling role with kids diagnosed with ADHD, and don't require their children to do schoolwork that they think is too hard or if they are bored and having a hard time focusing. Sorry this is long!!! I hope you are doing well!!! Warmly, Heather Donnenwirth David’s reply I’d just ask the person to focus on one moment when they had that problem and then do a Daily Mood Log, as you’ve pointed out, and also brainstorm with them on how to solve the problem. But first, would have to do empathy and assessment of resistance, same as with anybody! As you point out, the motivational factors can be enormous. For example, Adderall is just the same as Dexedrine, and highly addictive and euphoric street drug. If I had some right now, I’d be highly excited and write 30 pages of stuff! In addition, I can use ADHD as an excuse for not doing stuff that’s boring. Someone who is motivated can easily find a solution. The summary before college I was lucky to get a job in a bank in Phoenix. My job was filing checks by hand. Boy, that was boring! I made it a bit less boring by trying to find the most unusual names while I was filing checks alphabetically. One of the many unusual (to my young and uneducated ear) names was J. Karekin Moojian! As freshman in college, I found I had trouble concentrating and grasping what the professors were saying in lectures to large classes of a couple hundred or so students. And I had NO IDEA whatsoever what the teacher was talking about! What helped was simply asking another student as we were walking out of the class. I’d say, “What was the professor trying say?” Then the other student, who seemed way smarter than me, would just give a one sentence summary, and I’d suddenly “get it.” So, if you’re motivated, you can find a way! In medical school, I had to memorize gross anatomy. I had little aptitude and no interest. I had never even take a biology class in college, and did not know what was in the “abdomen” or “thorax.” So I made up little games, sitting for hours in the library memorizing stuff. It got me through—just barely1 David   4. A asks: Hello sir, Is it okay if I do the written work by typing in my laptop on a word processor or is it must that I write on a paper? Is it okay if I do the written work by typing in my laptop on a word processor or is it must that I write on a paper. Thank you. David’s reply Interesting question! Probably okay either way. No research on this issue! I slightly favor doing it by hand, but that is likely because I have done it that way for 40 + years! d Thanks for listening and reading today! Rhonda, and David

Today we feature Professor Hitendra Wadhwa PhD who has been a fan of David’s work for the past ten years. Hitendra has just published a new book, Inner Mastery, Outer Impact. Hitendra is a Professor of Practice at Columbia Business School and Founder of the Mentora Institute, and his class on Personal Leadership & Success is one of the most popular at Columbia Business School. He believes that the secret of leadership and success in business stems from inner mastery. He also has his own fascinating and skillfully produced podcast called Intersections where he interviews accomplished individuals from different spheres of human pursuit to draw out their insights and stories about the pursuit of success and happiness. One of Hitendra’s aims has been to integrate current psychological trends with  ancient wisdom in order to glean the most important ideas needed for happy and successful lives. He has backed this up with a daily meditation practice he began 20 years ago, seeking answers to the most basic questions about the meaning and purpose of our lives and a philosophy that leads to joy, connection, and productivity. Hitendra gives an example of how inner mastery can lead to outer impact. A colleague named Dan used to relentlessly find shortcomings and point to improved solutions every time Hitendra presented his work when he was first working as a business consultant. He said that he carried a grudge against Dan for several weeks because he was trying to impress his colleagues and felt put down by Dan. Of course, this type of attitude and defensiveness can easily trigger the very adversarial responses we fear. Then we tend to blame the “outer” and overlook how we might be inadvertently creating our own negative external reality. Fortunately, the opposite is equally true. When your attitude suddenly shifts, and your “inner” self changes, your outer reality will nearly always suddenly shift at the same time. One day, one of Hitendra’ s supervisors said to him: You should be more like Dan. He’s trying to help you take your game to the next level, but you don’t take a similar interest in helping him find ways to improve his work!” Hitendra explained the impact of his supervisor’s statement: “This comment suddenly turned on a light bulb in my head. I realized I was viewing Dan as an enemy, so if he criticized me, I thought he was against me, so I viewed him as the “enemy.” Instead, I decided to find the truth in his criticisms and began to view him as an ally, as a teacher, as someone who wanted to help me. “At that point, our entire relationship changed dramatically, and I felt empowered!” Of course, podcast fans will realize this as the Disarming Techniques, one of the Five Secrets of Effective Communication that David has popularized. Hitendra also discussed other themes in his new book, like what it means to “be true to yourself,” and how to discover the crown jewel within yourself, at your core. He also described how to tap into the five sources of core energy within yourself: Purpose, Wisdom, Growth, Love, and Self-Realization. He said that many people are afraid of Love, fearing that it is the same as weakness and will lead them to get taken advantage of. He suggested that in reality, love is a powerful force, and gave examples of the expression of love in a variety of successful business. He told many fun and inspiring stories, including his stuckness when trying to think of a way to honor his father’s 80th birthday. He couldn’t think of what he’d say at the celebration, because he’d always done the opposite of what his father had recommended. But then, while meditating, he saw that he’d been inspired all long by how his father had lived his life. He talked about the concept of transcendence as well as racism, and pointed out that we tend to label people based on some characteristic like skin color. But this can be very misleading, because two people who are Black, for example, will often have radically different backgrounds and life experiences. As an example, he described someone from the Caribbean who had no experience of racial discrimination when growing up. He emphasized that when we label people, we get lazy and do not respond to the reality and depth of who that person really is. Essentially, we are then putting people in “boxes” instead of seeing them for the full richness of who they are. He also said that our human identities are partly shared and partly unique. For example, Martin Luther King, Jr. learned a great deal from Mahatma Gandhi, who in turn was inspired by Leo Tolstoy—indicating a merger of three strikingly different cultures. Using story-telling, Hitendra addressed basic questions like: How do we integrate our (partially hidden) inner and outer selves? Who am I, really? What’s my purpose in the universe? He said that what many psychologists believe they “discover” is actually not new, but based on ancient wisdom, like the practice of gratitude in meditation, and shifting your mindsets, and tuning in to your capacity for compassion and kindness, and finding the best of yourself. Rhonda and I want to thank Hitendra for his journey and wonderful new book, and all of you as well for tuning in and joining us on our journey! Warmly, Rhonda, Hitendra, and David

297: Yuck! Homework! In today’s podcast, we discuss the important but dreaded topic of psychotherapy homework, and our featured guest is Alexis, whom some of you know from her fabulous work organizing beta tests for the Feeling Good App. Today, Alexis brings us a very special gift, by showing us how she "walks the walk."! At the beginning of the podcast, we discussed the two major reasons to do psychotherapy “homework:” First, the homework gives you the chance to practice and master the techniques you’re learning, so you can keep growing and strengthening your skills. And second, because it's an expression of motivation; motivation alone can have powerful anti-depressive effects and lead to rapid recovery. I also talked a research study I did with a friend and colleague who got depressed following the breakup of his relationship with the woman he’d been dating for several years. Each night he would partially fill out a Daily Mood Log, including a brief description of the upsetting even or moment. Then he would circle and rate his negative feelings on a scale of 0 (for not at all) to 100 (the worst), for how he was feeling at that very moment. Then he recorded his Negative Thoughts and indicated how strongly he believed them on a scale from (not at all) to 100 (completely). He was telling himself that he’d never find anyone to love, that he’d never find work, and so forth. Then he’d flip a coin to decide on one of two courses of action. If heads, he would jog for 30 minutes or so at a fairly fast clip and then re-rate his belief in each negative thought as well as the intensity of each type of negative feeling on the same scales of 0 to 100. If tails, he would work on his Daily Mood Log for 30 minutes and then rerate his belief in each negative though and the intensity of each type of negative feeling. He did this for several weeks and I was thrilled to see that he recovered on his own from a pretty severe bought of depression without any psychotherapy or medications. However, I did give him a little coaching on how to challenge various kinds of distortions. Once he recovered, we analyzed the data using Structural Equation Modeling. We discovered that the jogging had no effects whatsoever in reducing his belief in his negative thoughts. This finding was not consistent with the popular idea that exercise boosts brain endorphins and causes a “high.” I was not surprised, since jogging has never elevated my feelings, either, although some people do report this effect. In contrast, on the nights that he worked with his Daily Mood Log, there were massive reductions in his belief in his negative thoughts as well as his negative feelings. This finding was consistent with the idea that psychotherapy homework is very important, whether or not you are receiving treatment from a human shrink. The study also confirmed the idea that distorted negative thoughts do, in fact, cause depression and other negative feelings like anxiety, shame, inadequacy, and hopelessness, and that a reduction in your belief negative thoughts triggers recovery. Anecdotally, I would like to add that he maintained his positive mood and outlook following his recovery. His career flourished, and he got married. I showed him his negative thoughts years later, and he was shocked. He found it hard to believe that he was giving himself and believing such harsh and distorted messages at the time he was depressed. I’ve often said that there is a kind of hypnotic aspect to depression, anxiety, and even anger. You tell yourself, and believe, things that are simply not true! Recovery is a little (or a lot) like snapping out of a hypnotic trance! Here is another implication of the study of exercise vs the Daily Mood Log, as well as other studies that have confirmed the critical importance of psychotherapy homework in recovery from depression and anxiety. Because we know the importance of homework, if we are not asking our clients to do homework, then we may actually be impeding their progress rather than supporting them. That’s why I let people know prior to the start of therapy that the prognosis for a full recovery is very positive, but homework will be required and is not optional. If they feel like they don’t want to do the homework, I don’t encourage them to work with me. This is called the Gentle Ultimatum and Sitting with Open Hands. Oddly, enough, this approach seems to enhance patient motivation as well as patient compliance with homework between therapy sessions. The homework, in turn, speeds recovery and reduces patient drop-out. When I’m doing research, I try to create mathematical models that reveal causal factors that affect all human beings, and not some finding that only applies to this or that school of therapy. Therefore, it would seem to follow, that doing “homework” is just as important if you are working on your own without a therapist. And it would seem like it should be important in our app, as well. These hypotheses have been confirmed. Practice, and doing specific exercises that I’ve created, are just as important to the degree of recovery in beta testers who are using our Feeling Good App, as well as in people who are working on their own without a therapist. Today, we are joined by Alexis, who works on her own negative thoughts whenever (like the rest of us) she feels stressed out or upset. Alexis described an example of her homework, starting with this upsetting event at the start of the pandemic: Daily Mood Log Upsetting Event or Moment: Pandemic and moving back to my preferred city and leaving my mom to live alone.   Next, Alexis recorded her negative feelings: Feelings Now % Goal % After % Anxious, worried, panicky, nervous, frightened 75     Frustrated, stuck, thwarted, defeated 50     Guilty, remorseful, bad, ashamed 100     Hopeless, discouraged, pessimistic, despairing 20     Sad, blue, depressed, down, unhappy 80     Inferior, worthless, inadequate, defective, incompetent 80     Lonely, unloved, unwanted, rejected, alone, abandoned 75     Angry, mad, resentful, annoyed, irritated, upset, furious 20     Embarrassed, foolish, humiliated, self-conscious 10       As you can see, she felt intensely guilty, anxious, inadequate, and lonely, and had a few additional feelings that were somewhat elevated. Then she pinpointed two negative thoughts, along with her percent belief in each one. I’m a bad daughter. 100% I should move back in with my mom. 50% Then she identified the distortions in her thoughts, and explained why each distortion will not map onto reality. This technique is called “Explain the Distortions.” Explain the Distortions NT: I’m a bad daughter 100% All-or-Nothing Thinking. I’m focusing on the idea that I can be 100% good or bad , which doesn’t make sense, since nothing in this world is completely good or bad. Overgeneralization I’m calling myself a ”bad daughter,” as though this is label described my entire being. Mental Filtering Instead of focusing on some of the positive things that I do. I’m focusing on the idea that I’m not doing enough. Discounting the Positive I’m not thinking about all the loving things that I do for my mom and that I enjoy doing for her and with her. Mind-Reading I’m telling myself that my mother thinks that I am a bad daughter, but I don’t actually have any evidence for this. Fortune-Telling I am telling myself that I’ll never be good enough. Emotional Reasoning: I feel like a bad daughter so I think it must be true. Magnification and Minimization: I’m magnifying how important my conduct is to my mother (big ego). Should Statement: I’m telling myself that I should be a better daughter and that I shouldn’t have moved back to the city where I prefer to live. LAB: I’m labeling myself as “bad daughter.” Self-Blame: I am blaming myself for being a “bad daughter.” Other-Blame: I might be blaming my mother for expecting so much. NT: I should move back in with my mom. 50% All-or-Nothing Thinking. I’m telling myself that I’m either there 100% or not there 100%, which doesn’t really make sense. Even if I don’t live with my mom, I can still visit often and stay as long as I like. Mental Filtering I’m focusing only on my duty to a parent and not on my commitments to myself. Fortune-Telling I’m telling myself that something bad will happen to my mother and that she will be unable to care for herself. Magnification and Minimization: I’m magnifying my importance (ego!!!) Emotional Reasoning: I feel like I should live with her so it must be true. Should Statement: I am shoulding myself. Self-Blame: I’m blaming myself for leaving and for wanting to live on my own. Other-Blame: I am secretly blaming my mother for making me feel this way. Straightforward Technique You just try to challenge your negative thought with a positive thought (PT) that fulfills the Necessary and Sufficient Conditions for emotional change: The Necessary Condition: The PT must be 100% true, and not a rationalization. The Sufficient Condition: the PT must significantly or greatly reduce your belief in your Negative Thought. Negative thought: I am a bad daughter (I should move back in with my mom.) Write down a more positive and realistic thought: My mom is in average health for her age and can take care of herself. She has the financial resources to maintain her lifestyle without my help. Ask yourself: Is this negative thought really true? Maybe. I love my mom more than just about anyone. I do lots of things for her and with her and enjoy her company immensely. Do I really believe it? I do. Socratic Method When you use this technique, you ask yourself questions to lead yourself to the illogic of your negative thought. NT: I am a bad daughter Questions: Are you sometimes a good daughter? Yes Do most adult children feel like they are a bad kid sometimes? Yes NT: I should move back in with my mom Questions: Should adult children live with their parents? Not if they don't want to! Worst, Best, Average With this technique, you list the qualities of the opposite. Since you’re calling yourself a “bad daughter,” you can list the qualities of a “good daughter.” Then you can rate yourself in each quality, thinking of when you’re at your worst, when you’re at your best, and your average. Qualities of a “good daughter” Worst Best Average 1.        Calls their parents 80 100 90 2.        Visits their parents regularly 30 100 90 3.        Helps their parents 70 90 80 4.        Is financially responsible for self 80 100 90 5.        Respects their parents 0 90 80   When you’re done, you can review your ratings. If there’s one area where you need to improve, you can put together a 3 or 4 step plan for changing. Sometimes, as in Alexis’ case, you’ll realize that you’re actually doing just fine, and no change is needed! This technique was the icing on the cake, and Alexis decided that her thought, “I’m a bad daughter,” wasn’t actually true. These were her feelings at the end. Feelings Now % Goal % After % Anxious, worried, panicky, nervous, frightened 75 5 10 Frustrated, stuck, thwarted, defeated 50 0 0 Guilty, remorseful, bad, ashamed 100 0 0 Hopeless, discouraged, pessimistic, despairing 20 0 0 Sad, blue, depressed, down, unhappy 80 5 0 Inferior, worthless, inadequate, defective, incompetent 80 0 0 Lonely, unloved, unwanted, rejected, alone, abandoned 75 0 0 Angry, mad, resentful, annoyed, irritated, upset, furious 20 0 0 Embarrassed, foolish, humiliated, self-conscious 10 0 0   As you can see, Alexis put in some time and effort to challenge the negative thoughts that were triggering her unhappiness. We are indebted to Alexis for being so open and vulnerable, and for showing this how it works. Is it worth it? That was a lot of “homework!” That’s a decision you’ll have to make for yourself, of course. The Dalai Lama said that happiness is the purpose of life. That’s not entirely true, but there’s a lot of truth in it, for sure! So, the question might be, what would some greater happiness be worth to you? If you are interested in beta testing the Feeling Good App, you can sign up at www.feelinggood.com/app. Thank you Alexis for the very special gift of your knowledge, tremendous skill, and vulnerability! Until next time— Rhonda and David  

Podcast 296: Forced Empathy: A Master Class--Part 2 of 2 Last week you heard part ! of our work witt Zeina, a young professional woman struggling with a conflict with her mom. Zeina feels like her mother is too critical of her, and she finds the criticisms devastating. In today's podcast, you will hear my co therapist, Dr. Jill Levitt, and I, doing Forced Empathy with Zeina, and you will hear the exciting conclusion of the session. I am including the entiere show notes from last week, in case you have not yet reviewed them. Show notes from last week commence here. Today Dr. Jill Levitt and I do live work with Zeina Halim who has been experiencing some intense negative feelings because of her mother’s criticisms of her. Zeina is a member of my weekly training group at Stanford and has appeared on the podcast on several previous occasions (Please provide numbers plus link to podcast page on website.) Zeina is one of our small group leaders in our Tuesday training group.  She works with teens and adults in-person in her office in Menlo Park and also provides tele-health sessions for clients living anywhere in California. Dr. Jill Levitt is the co-leader of my Tuesday training group at Stanford and will be my co-therapist today. We hope for some more of the “magic” that frequently appears when we do therapy together. Today’s podcast will illustrate a number of teaching points, including these: Forced Empathy: We illustrate exactly how to use this powerful and sophisticated technique. When I first created this technique many years ago, I thought there would be little interest in it, so I rarely taught it in my workshops or training groups. In the past several years, an intense interest in this technique has emerged, so you will get to see exactly how it works. Five Secrets Resistance: There has been great interest in the Five Secrets of Effective Communication that are featured in my book, Feeling Good Together. When used skillfully, they can have a phenomenal effect on any troubled relationship. I am even aware of a case of a woman who was kidnapped at gunpoint by a violent serial rapist who planned to kill her. Out of desperation, she used the Five Secrets I had presented at a workshop he had just attended, and he let her go and turned himself in to the police. The Five Secrets literally saved her life. And yet, many of us stubbornly refuse to use the Five Secrets with family, friends and loved ones. Why do we fight against the very tools that would rapidly bring us peace, love and joy? And what can we do about our own internal “resistance”? The “inner” and “outer” solutions: Whenever you are involved in a conflict with someone, there are two battles raging at the same time. One is the “inner battle” with your own negative thoughts, telling you that you’re no good, or that the other person is to blame, and the voice that powerfully urges you to do battle. We approach the “inner battle” with the familiar Daily Mood Log, that helps you pinpoint the distorted messages you are giving yourself. You will see that those messages—the way you talk to yourself when you’re upset—are loaded with distortions; such as All-or-Nothing Thinking, Overgeneralizations, Mental Filtering, Discounting the Positive, Mind-Reading, Labeling, Should Statements and Hidden Should Statements, Emotional Reasoning, Other-Blame, and more.In today’s session, we do battle with Zeina’s distorted thoughts with the Externalization of Voices, arguably one of the most powerful psychotherapy tools ever created. The EAR Checklist / Relationship Journal. The “outer battle” involves the words you use when you respond to the other person’s criticisms of you. Here we use the Relationship Journal, another super powerful tools that allows you to analyze your own statements with the EAR Checklist and see the shocking reality that you are creating the very conflict that you are complaining about so vigorously. This involves one of the “Great Death” of the self, which can be profoundly painful, but it also leads to liberation from your self-created misery and the chance for renewed love and connection with the person you feel so alienated from. Two-hour sessions. You can do far more in a single, two-hour session than in many 50 minute sessions scheduled at weekly intervals. I have often said that this is how I always do therapy, and if you have some therapy skills, this model is vastly more effective and cost-effective as well. It puts you under pressure to accomplish something today, right now, and not in the vague or distant future. Uncovering Techniques. You will see how you can use the Man from Mars Technique to uncover more of your patient’s negative thoughts and core beliefs. This is just another way of doing the classical “Individual Downward Arrow Technique” that I developed way back in the 1970s. The Acceptance Paradoxes. There is a great deal of talk these days about Acceptance is being an important key in many schools of psychotherapy. But what is acceptance, and how do we teach it to our patients and colleagues? Today’s session with Zeina, who has a great interest in Buddhist philosophy and practices, illustrates one of more than 20 paths to acceptance, and this one in particular will teach you the steps in accepting others, especially when you are desperately trying to change them and you are insisting that they “shouldn’t” be the way they are! Self-acceptance is always about grasping a gigantic paradox—and that’s why I’ve always called it the Acceptance Paradox, which states: Accepting yourself as you are, warts and all, is actually the greatest change a human being can make. Can you see why this is a paradox? It’s because the very moment you accept yourself, everything about you and your world will appear to change. Now here’s another acceptance paradox we will explore today. The very moment when you accept another person exactly as she or he is, that person will suddenly change. Of course, that is the exact opposite of what we usually do when we desperately keep trying to “change” them, a strategy that actually forces them to be the very monster you are trying so hard to destroy. By the way, do you know what the plural form of paradox is, when you combine Self- and Other-Acceptance? The plural form is called the Acceptance Paradise. T = Testing is crucial! You cannot do truly effective therapy without the T = Testing. You will find out EXACTLY how effective—or ineffective—you are in every session with every patient. When you listen to the podcasts, you can ask yourself questions like these: How effective are Jill and David being? Will they get good empathy and helpfulness ratings from Zeina? Will we see any reductions in Zeina’s powerful negative feelings at the start of the session? Will she make a breakthrough in her relationship with her mother? At the end of the session, you will see the answers to these questions. And if you’re a therapist, that kind of powerful and precise information will allow you to grow and learn as a therapist, especially if you approach the information with humility and respect for yourself and your patients. There is almost no limit to the evolution of your therapist skills if you use the T = Testing model I have developed. There is almost no chance for personal growth if you do not use these or similar assessment tools. However, the price of growth is steep. You have to be willing to see your own failures and errors at every session with every patient, and this will often be painful. But this is the pain that can lead to your own personal transformation along with the blossoming of your own superb therapy skills. Today, in Part 1 of the Zeina session, you will hear the T = Testing and E = Empathy parts of the session. Next week, in Part 2, you will hear the very brief A = Assessment of Resistance, which really only included the “Miracle Cure Question: ”What, really, are you, Zeina, hoping for in tonight’s session?” You will also hear the amazing M = Methods portion, which will start with Forced Empathy, followed by Externalization of Voices and Five Secrets Practice, along with the final T = Testing and homework assignments for Zeina following the session. Rhonda, Jill, Zeina and I hope you enjoy the podcasts and learn a great deal from them. And we all want to thank you, Zeina for your courageous and brilliant work, sharing your inner self so openly and generously. I believe that sessions like the one our fans will witness today and next week have the potential to provide hope and healing to people around the world, not only today, but for decades to come. At least, that is my hope! I also want to thank you, Jill, for your extraordinary teaching and clinical skills, and for your brilliance and warmth. Thank you for tuning in! Rhonda, Zeina, and David Here is a follow-up note from Zeina Hello David, Jill, and the Tuesday group, Boy, do I have an update for you all! So, at first, I struggled, and I was very worried to have to potentially send an update to the group that may have been disappointing. On Saturday, I saw my mom, and I shared with her the insights that I had in our session. She was appreciative, but I didn't feel very connected to her. I had talked with her about this while she and I were on a walk, and I wondered if maybe walking while talking was taking away some of the intimacy or connection that might have happened if we had been looking at each other while talking. I also noticed that while I was externally behaving somewhat better if my mom criticized me, internally, I still hadn't progressed very far. I would still feel very distant from her; and I still wasn't doing the five secrets. Today, on Sunday, I saw my mom again. While she did not criticize me, we still got into a little bit of an argument. I was a bit angry, but as I let myself cool off, I noticed myself feeling incredibly sad inside--like a sadness that had been building and building over the past few weeks. I tried to talk with my mom about it, but she resisted at first. We had a project that we were working on together today and she thought it would be better if we talked on another day and got back to our project; I insisted, however, and asked that we please talk today. I did not realize it at the time, but I think I had some major hidden emotion stuff happening with my mom (more on this later, perhaps some hidden sadness that was masquerading as anger). I shared with her that I had felt incredibly sad and genuinely worried about our relationship. I recently moved in order to live closer to her and see her more often, but I had noticed that almost every time she came over to visit me at my new place, we would get into an argument at least once. I shared that these arguments had really been weighing on me and worrying me. I also told her that I noticed that we would get into arguments when we were at my place, but not as much when I visited her at her place, maybe because I am so particular about how I like things to be at my place. She, then, said in a very gentle and loving way, "I think ‘particular’ about your space is the operative word here." I realized that she was totally right, and I was so pleasantly surprised by how gentle and loving she was when she said it. Feeling encouraged by how the conversation was going, I shared more and said that I had noticed that I had become more sensitive around our arguments lately and that I was feeling very disconnected from her, and I didn't know how to get reconnected with her. I also shared that I had been feeling lonely in my life in general lately and made a guess that maybe my loneliness was making me expect more from our relationship. Additionally, I also guessed that I might be feeling more drained emotionally because I am doing more hours of therapy per week than I have ever done in my life, and maybe I had yet to find the right balance of how to recreate and regenerate my energy in my off-hours. I shed many tears all throughout this whole conversation. I checked in with myself and noticed that I was feeling more connected to my mom, but there felt like there was still more, particularly about my loneliness. This next paragraph might seem like a major tangent, but hang in there!--I promise it is all connected :) Then, I switched gears a little bit to share with her a different conversation and insight I had had in the past week or so about my recent feelings of loneliness. I had been having a conversation with my very dear friend, James, about how I had been feeling lonely, but was not feeling as drawn to connecting with most of my girlfriends, but only really drawn to my guy friends. Initially, I thought it was a male-female difference, but then I noticed that I was feeling drawn to my new friend Leigh Harrington, who is female. I realized that maybe the difference had more to do with the fact that almost all my male friends and Leigh were quite funny and playful people, whereas most of my girlfriends were more serious people. As for myself, I tend to be a more serious person and am not as funny or playful as many people. I realized that I was relying on other people for my laughter, playfulness and fun, rather than learning how to create that myself. Having just done some flirting training with Matthew May earlier that week, I saw that humor, like flirting, can be a learned skill and might have more to do with a willingness to take risks than an innate quality that people either have or don't have. I was feeling excited that I could learn to be funnier and flirtier and create more laughter in my life, instead of relying on other funny people for this. I shared all of this with my mom. She then went on to make a further connection that really blew me away. She said, "I bet if you start to be funnier and create more laughter for yourself and others, you will also start to feel less lonely." It felt so true! The times I feel most connected to people are when I am laughing with them. THIS is the kind of relationship and connection with my mom that I had been missing lately--when I share deeply with her and, because she knows me so well, she is able to further my insight and understanding of myself and help me to grow. I feel so connected to her now. I realize now that I think part of my resistance to using the 5 secrets with my mom was maybe a hidden emotion component--I had these deep feelings and worries about our relationship; I was confused if moving closer to her had actually helped our relationship or if it was harming it, and I was genuinely missing these kinds of deep, connecting conversations with her, which we had not had in a while. My mom has been hanging out at my place all day today and now I notice myself being easily loving and patient with her and my being "particular" about my things and my space has vanished--at least temporarily! There are a lot of take-aways for me from this whole thing, but one of the biggest ones is that I think I was trying to do five secrets without really fully going into my "I feel" statements as much as I needed to--I feel statements are often the secret that I neglect the most as a person and as a therapist. So, to connect to what we are doing this week in class, I think I would make a guess that when I ignore the five secret that I need to do the most and struggle with, it can hamper my ability to do the rest of the five secrets effectively and genuinely. I could write a lot more about all of this, but I think I will stop here for now. I hope this wasn't too confusing as I know I touched on a lot of different things. Thank you all for your time and attention. I'm open to comments or questions. Warmly, Zeina Here is a reply to Zeina from one of the Stanford Tuesday group members Gosh! Zeina, this is beautiful and so straight from the heart. Takes immense courage to do a deep dive in exploring oneself. I have been marveling at how meticulously you‘ve sifted through and worked towards addressing the different dimensions of the relationship between you and your mum. You are also an amazing raconteur, you’ve brought out the subtle nuances so beautifully! Your mail took me on an emotional roller coaster ride. It was such a compelling read and had me as a captive co-traveler, holding my breath, and crossing my fingers! I loved your insights on the “I feel”. Reading that was a personal breakthrough for me, where my relationship with my mum is concerned. That’s exactly what is missing in our relationship too … whoaaaaa! I just don’t share my feelings with her! I love how you were able to do that though, because I can feel this huge wave of resistance engulfing me, despite my insight. I know I’m not yet ready to take the next step! Funny, how tough it can be to be vulnerable before one’s own mom! More power to you Zeina for ‘daring greatly’ and taking the next step after the Tuesday class. Also, for keeping us posted and for sharing with us in such a detailed manner, and in the process, helping us all learn and grow. Deep regards for your mum as well. She comes across as a tenacious mother of a tenacious daughter … if I may say so. Warmly, Nivedita. Here is a second follow-up from Zeina. Hello David, Jill and Tuesday group, I just wanted to send another update as my relationship with my mom has continued to evolve in quite beautiful and magical ways since I sent this last email.  It seems to me that maybe she has stopped criticizing me entirely--I'm not quite sure.  Maybe I need to pay more attention.  Perhaps if she does criticize me, she does it in a gentler way or maybe I am less sensitive to it.  All I know is that she has been wonderfully supportive of me in these past few weeks and we have not gotten into a single argument.  Our relationship suddenly seems easy in a way that I have never experienced before.  I am so profoundly grateful.  I know that we will probably relapse at some point and this may not last forever, but, now I know this is possible.  Now, I know my way back here.  I have always wanted a relationship like this with my mother, and I always thought it wasn't possible because of who she was as a person. Little did I know that to have the mother I always wanted, I needed to do the changing. I knew that the 5 secrets were powerful, but I had thought that their power was more confined to a single interaction or the moment when you use them.  I don't know that I have been especially good at practicing the 5 secrets with my mom lately, yet the effect seems to keep lasting and lasting. I am truly speechless at the profound transformation that has happened.  Thank you. Thank you. Thank you. I would love any responses! Zeina Here is some of the feedback from the training group in the section, “What did you like the best about today’s training session?” Jill’s thoughtfulness in selecting the Forced Empathy technique over the Relationship Journal. Jill looked at what had worked in the past for Zeina and saw it as a potential strategy for her current concerns and the result was tremendously positive. I loved the training! I loved watching forced empathy and I began to empathize with a close relative simply by watching Zeina empathize with her mom. I was crying throughout. It is hard to describe how touched I was Zeina's honesty and her responses to forced empathy was amazing! Amazing personal work. Entire session was great learning experience for me. How Forced Empathy brought the shift in Zeina’s way of thinking. I really enjoy witnessing the live sessions including this one with Zeina. Seeing how the totality of the model comes together in real time with the clinician's judgment and intuition guiding the specific process is really enlightening and seeing someone's beliefs shift in real time is very inspiring and moving. It was a really nice way to re-join the larger group and I'm glad to hear that went into David's thinking in scheduling it. I really like the Forced Empathy. Zeina had a lot of resistance at the beginning. However, She shed tears during doing the Forced Empathy. I also like the role reversal when doing the Externalization voices. I can always learn how to deal with the difficulties of life from David and Jill's wisdom. The whole thing was so great. I was really moved by the forced empathy. I always LOVE seeing forced empathy modeled to get better at this complex skill, and I am also, like many others, almost always blown away with how powerful it is. I also thought this was a great example of multiple paths (individual mood and relationship work) and multiple methods being all used in one two-hour session so skillful and masterful. I loved the open ended approach and the ongoing exploration until the goal was formed/explored/ discovered. For me, it was a demonstration of trust in the process. I especially liked David's "The Man From Mars" that seemed to me an amazing tool with sorting out the mess of relationship work. I also loved Forced Empathy especially here with the work on mother daughter's relationship. I am really intrigued to explore it for myself in regard to my relationship with my parents and my daughter. Seeing the whole encounter with Zeina and seeing how Jill and David thought through it together, it was all so organic and incredible to witness Very helpful to see the progression of the session. Zeina's session has been a gift not only to us, but also to our mothers. Forced empathy felt like a pivot point in treatment and I loved that Z was able to go deep and connect with her mother's feelings. I have plans to travel and visit my mother next month and have been feeling anxious about it. I was reminded of the unconditional love of a mother that is beautiful and spiritual. David and Jill did amazing and transformational work. This is so inspiring! I liked everything and how the methods and techniques were woven together very skillfully. Personal work is really the best and so gratifying to see. David made a comment at the end about how it would help with motivation to use the skills and work more on them after seeing them in action and I do agree with his comment even if I'm totally not paraphrasing correctly. I LOVE personal work because it bring these skills to life in a way that role plays don't. and of course, it's all the better that someone gets a personal benefit, that's all good too. David and Jill did an amazing job again! However, Zeina’s honesty and vulnerability was the greatest gift during this session. I could relate to her struggle as well, so I was extra impressed about her determination to work on this issue. It was amazing personal work for me. I feel so grateful for this experience. This was another example of the "magic" of TEAM, especially when the therapists are the incredibly skilled Jill and David. What a great, vulnerable and poignant example of relationship issues with a parent. I was very impressed and moved by the power of the Forced Empathy technique. By Zeina's ability to feel into the point of view of her mother, and her insights and connections, especially around how the times of criticism can be seen as opportunities for greater acceptance and love. Moving and really beautiful personal work!!! I was moved to tears when Zeina cried her mother's tears during the Forced Empathy exercise and said "I need her to accept me as I am." Wow--that was so powerful! And as for so many others, this experience felt super relevant and helpful to me for one of my own important relationships, and I'm feeling excited to try out Sergio's approach on my own loved one. Forced Empathy: I loved all of it! So helpful and informative to witness live work. I immediately got why the “what’s my grade?” question was skipped (since the use of the Forced empathy technique had yielded such powerful results). I am eager to try this with a particular client who is having similar issues with their mom. On a more personal level, I felt extremely close to Zeina and seeing how vulnerable and open she was willing to be. This has melted away a lot of my resistance in using the 5 secrets with my own mom. Thank you Zeina! I liked seeing the "visitor from Mars" used to uncover Zeina's thoughts when David was having trouble understanding what the issue was. It was great to see David feeling a little "lost" and see how he worked through that. Watching the Forced Empathy technique was amazing! I also appreciated when Jill offered several options for which direction to go and explained her rationale. I found it to be a helpful learning moment and also liked the warmth that came across. I saw my mom's critical behavior as coming from love-brought tears. Same for my Dad Zeina did really powerful and enlightening work! It was also a great learning experience to observe David & Jill. I have enjoyed listening to and learning wonderful techniques from Jill and David. I can definitely relate to parent's/child criticism conflict myself, so I have learned some methods of effective communication, empathy skills, especially the opposite empathy (where you step into the shoes of a person you have a conflict with) and learn to empathize strongly vs feeling frustrated and having blame thoughts I love every time we do personal work. I always learn and grow so much personally and professionally. Thank you, Zeina for this amazing gift, and thank you, David and Jill for your masterful work. I loved every moment of it! Amazing personal work! I enjoyed the entire process. I appreciated the partnership between David and Jill. I so appreciated Zeina's work and vulnerability. I like David's creative way of doing the Ind. Downward arrow using "man from Mars" perspective. I liked getting to see, again, the power of Forced Empathy, as it illuminated how we create the very behavior in the other, that we then complain about. I loved how Zeina surrendered to doing the Forced Empathy exercise with such wonderful openness. I loved the seamless way Dr Burns and Jill moved between the methods. And Zeina’s courage to be vulnerable. Had an aha moment myself - of course her mother will criticize her because the last thing she wants is for Zeina to have disastrous finances like her own. It shows deep love and caring Another Master Class! I loved watching David and Jill working with Zeina. Change the Focus is just an amazing Method. I appreciate Zeina's vulnerable disclosures. Such generosity is much appreciated. This is an amazing group, and I feel privileged to learn from such sophisticated practitioners, who are so generous with their insights and decades’ worth experiences. Some days I just can't believe my luck to be with such heartfelt, dedicated, compassionate and wise folks! I very specifically like seeing a long personal work session...the big picture seeing the whole session. Thank you! I learned so very much and how things smooth into each other as session progresses. It was great seeing Forced Empathy demonstrated as I've never seen it before and learned so much from the overall training with Zeina, David and Jill. So glad Zeina was willing to be so vulnerable; really appreciated at the end when she said she felt pressure to empathize with her mom if she was vulnerable with her and mom laid it on thick, was wondering the same exact thing in that very moment! Loved how David diffused that for her and put less pressure on how she would handle it! So grateful to be part of this awesome group where I am growing and learning every moment! The hi quality demonstration of Five Secrets empathy by David and Jill Jill’s patience. David waiting for AHA MOMENTS and pointing them out and best of all ZEINA! Personal work is always insightful. I really like the forced empathy technique. I also enjoyed the display of creativity and flexibility of the team model. Amy would regularly explain that it was a model to be used creatively and it's exciting to know there is so much to learn. It can be adapted to each individual. Viewing therapy as a series of skills to learn rather than a step-by-step instructional book is what makes me really love TEAM. Loved how Dr Burns used the individual downward arrow so seamlessly during the empathy phase. Dr Burns empathy too was spot on when he said to Zeina that "she could not lean on her Mom." This one line was really powerful for me and resonated deeply. Loved Jill's internal solution as well as the forced empathy option along with the option of working on the good reasons not to do the 5 secrets. Jill was on a roll with her empathy ... "feels like you're walking on eggshells and don't know what will hurt her." I also liked Jill's disclosure about the times she gets critical with her boys are times when she is most concerned about them. Also liked Jill highlighting how Zeina practicing the Five Secrets was not working at a point because she was not using enough feeling empathy unlike as when doing the Forced Empathy  

Podcast 295: Forced Empathy: A Master Class--Part 1 of 2 Podcasts 294 (Part 1) and 295 (Part 2) Forced Empathy: A Master Class Today Dr. Jill Levitt and I do live work with Zeina Halim who has been experiencing some intense negative feelings because of her mother’s criticisms of her. Zeina is a member of my weekly training group at Stanford and has appeared on the podcast on several previous occasions (Please provide numbers plus link to podcast page on website.) Zeina is one of our small group leaders in our Tuesday training group.  She works with teens and adults in-person in her office in Menlo Park and also provides tele-health sessions for clients living anywhere in California. Dr. Jill Levitt is the co-leader of my Tuesday training group at Stanford and will be my co-therapist today. We hope for some more of the “magic” that frequently appears when we do therapy together. Today’s podcast will illustrate a number of teaching points, including these: Forced Empathy: We illustrate exactly how to use this powerful and sophisticated technique. When I first created this technique many years ago, I thought there would be little interest in it, so I rarely taught it in my workshops or training groups. In the past several years, an intense interest in this technique has emerged, so you will get to see exactly how it works. Five Secrets Resistance: There has been great interest in the Five Secrets of Effective Communication that are featured in my book, Feeling Good Together. When used skillfully, they can have a phenomenal effect on any troubled relationship. I am even aware of a case of a woman who was kidnapped at gunpoint by a violent serial rapist who planned to kill her. Out of desperation, she used the Five Secrets I had presented at a workshop he had just attended, and he let her go and turned himself in to the police. The Five Secrets literally saved her life. And yet, many of us stubbornly refuse to use the Five Secrets with family, friends and loved ones. Why do we fight against the very tools that would rapidly bring us peace, love and joy? And what can we do about our own internal “resistance”? The “inner” and “outer” solutions: Whenever you are involved in a conflict with someone, there are two battles raging at the same time. One is the “inner battle” with your own negative thoughts, telling you that you’re no good, or that the other person is to blame, and the voice that powerfully urges you to do battle. We approach the “inner battle” with the familiar Daily Mood Log, that helps you pinpoint the distorted messages you are giving yourself. You will see that those messages—the way you talk to yourself when you’re upset—are loaded with distortions; such as All-or-Nothing Thinking, Overgeneralizations, Mental Filtering, Discounting the Positive, Mind-Reading, Labeling, Should Statements and Hidden Should Statements, Emotional Reasoning, Other-Blame, and more. In today’s session, we do battle with Zeina’s distorted thoughts with the Externalization of Voices, arguably one of the most powerful psychotherapy tools ever created. The EAR Checklist / Relationship Journal. The “outer battle” involves the words you use when you respond to the other person’s criticisms of you. Here we use the Relationship Journal, another super powerful tools that allows you to analyze your own statements with the EAR Checklist and see the shocking reality that you are creating the very conflict that you are complaining about so vigorously. This involves one of the “Great Death” of the self, which can be profoundly painful, but it also leads to liberation from your self-created misery and the chance for renewed love and connection with the person you feel so alienated from. Two-hour sessions. You can do far more in a single, two-hour session than in many 50 minute sessions scheduled at weekly intervals. I have often said that this is how I always do therapy, and if you have some therapy skills, this model is vastly more effective and cost-effective as well. It puts you under pressure to accomplish something today, right now, and not in the vague or distant future. Uncovering Techniques. You will see how you can use the Man from Mars Technique to uncover more of your patient’s negative thoughts and core beliefs. This is just another way of doing the classical “Individual Downward Arrow Technique” that I developed way back in the 1970s. The Acceptance Paradoxes. There is a great deal of talk these days about Acceptance is being an important key in many schools of psychotherapy. But what is acceptance, and how do we teach it to our patients and colleagues? Today’s session with Zeina, who has a great interest in Buddhist philosophy and practices, illustrates one of more than 20 paths to acceptance, and this one in particular will teach you the steps in accepting others, especially when you are desperately trying to change them and you are insisting that they “shouldn’t” be the way they are! Self-acceptance is always about grasping a gigantic paradox—and that’s why I’ve always called it the Acceptance Paradox, which states: Accepting yourself as you are, warts and all, is actually the greatest change a human being can make. Can you see why this is a paradox? It’s because the very moment you accept yourself, everything about you and your world will appear to change. Now here’s another acceptance paradox we will explore today. The very moment when you accept another person exactly as she or he is, that person will suddenly change. Of course, that is the exact opposite of what we usually do when we desperately keep trying to “change” them, a strategy that actually forces them to be the very monster you are trying so hard to destroy. By the way, do you know what the plural form of paradox is, when you combine Self- and Other-Acceptance? The plural form is called the Acceptance Paradise. T = Testing is crucial! You cannot do truly effective therapy without the T = Testing. You will find out EXACTLY how effective—or ineffective—you are in every session with every patient. When you listen to the podcasts, you can ask yourself questions like these: How effective are Jill and David being? Will they get good empathy and helpfulness ratings from Zeina? Will we see any reductions in Zeina’s powerful negative feelings at the start of the session? Will she make a breakthrough in her relationship with her mother? At the end of the session, you will see the answers to these questions. And if you’re a therapist, that kind of powerful and precise information will allow you to grow and learn as a therapist, especially if you approach the information with humility and respect for yourself and your patients. There is almost no limit to the evolution of your therapist skills if you use the T = Testing model I have developed. There is almost no chance for personal growth if you do not use these or similar assessment tools. However, the price of growth is steep. You have to be willing to see your own failures and errors at every session with every patient, and this will often be painful. But this is the pain that can lead to your own personal transformation along with the blossoming of your own superb therapy skills. Today, in Part 1 of the Zeina session, you will hear the T = Testing and E = Empathy parts of the session. Next week, in Part 2, you will hear the very brief A = Assessment of Resistance, which really only included the “Miracle Cure Question: ”What, really, are you, Zeina, hoping for in tonight’s session?” You will also hear the amazing M = Methods portion, which will start with Forced Empathy, followed by Externalization of Voices and Five Secrets Practice, along with the final T = Testing and homework assignments for Zeina following the session. Rhonda, Jill, Zeina and I hope you enjoy the podcasts and learn a great deal from them. And we all want to thank you, Zeina for your courageous and brilliant work, sharing your inner self so openly and generously. I believe that sessions like the one our fans will witness today and next week have the potential to provide hope and healing to people around the world, not only today, but for decades to come. At least, that is my hope! I also want to thank you, Jill, for your extraordinary teaching and clinical skills, and for your brilliance and warmth. Thank you for tuning in! Rhonda, Zeina, and David Contact information for Jill and Zeina: please provide what you want to have included in the show notes. Here is a follow-up note from Zeina Hello David, Jill, and the Tuesday group, Boy, do I have an update for you all! So, at first, I struggled, and I was very worried to have to potentially send an update to the group that may have been disappointing. On Saturday, I saw my mom, and I shared with her the insights that I had in our session. She was appreciative, but I didn't feel very connected to her. I had talked with her about this while she and I were on a walk, and I wondered if maybe walking while talking was taking away some of the intimacy or connection that might have happened if we had been looking at each other while talking. I also noticed that while I was externally behaving somewhat better if my mom criticized me, internally, I still hadn't progressed very far. I would still feel very distant from her; and I still wasn't doing the five secrets. Today, on Sunday, I saw my mom again. While she did not criticize me, we still got into a little bit of an argument. I was a bit angry, but as I let myself cool off, I noticed myself feeling incredibly sad inside--like a sadness that had been building and building over the past few weeks. I tried to talk with my mom about it, but she resisted at first. We had a project that we were working on together today and she thought it would be better if we talked on another day and got back to our project; I insisted, however, and asked that we please talk today. I did not realize it at the time, but I think I had some major hidden emotion stuff happening with my mom (more on this later, perhaps some hidden sadness that was masquerading as anger). I shared with her that I had felt incredibly sad and genuinely worried about our relationship. I recently moved in order to live closer to her and see her more often, but I had noticed that almost every time she came over to visit me at my new place, we would get into an argument at least once. I shared that these arguments had really been weighing on me and worrying me. I also told her that I noticed that we would get into arguments when we were at my place, but not as much when I visited her at her place, maybe because I am so particular about how I like things to be at my place. She, then, said in a very gentle and loving way, "I think ‘particular’ about your space is the operative word here." I realized that she was totally right, and I was so pleasantly surprised by how gentle and loving she was when she said it. Feeling encouraged by how the conversation was going, I shared more and said that I had noticed that I had become more sensitive around our arguments lately and that I was feeling very disconnected from her, and I didn't know how to get reconnected with her. I also shared that I had been feeling lonely in my life in general lately and made a guess that maybe my loneliness was making me expect more from our relationship. Additionally, I also guessed that I might be feeling more drained emotionally because I am doing more hours of therapy per week than I have ever done in my life, and maybe I had yet to find the right balance of how to recreate and regenerate my energy in my off-hours. I shed many tears all throughout this whole conversation. I checked in with myself and noticed that I was feeling more connected to my mom, but there felt like there was still more, particularly about my loneliness. This next paragraph might seem like a major tangent, but hang in there!--I promise it is all connected :) Then, I switched gears a little bit to share with her a different conversation and insight I had had in the past week or so about my recent feelings of loneliness. I had been having a conversation with my very dear friend, James, about how I had been feeling lonely, but was not feeling as drawn to connecting with most of my girlfriends, but only really drawn to my guy friends. Initially, I thought it was a male-female difference, but then I noticed that I was feeling drawn to my new friend Leigh Harrington, who is female. I realized that maybe the difference had more to do with the fact that almost all my male friends and Leigh were quite funny and playful people, whereas most of my girlfriends were more serious people. As for myself, I tend to be a more serious person and am not as funny or playful as many people. I realized that I was relying on other people for my laughter, playfulness and fun, rather than learning how to create that myself. Having just done some flirting training with Matthew May earlier that week, I saw that humor, like flirting, can be a learned skill and might have more to do with a willingness to take risks than an innate quality that people either have or don't have. I was feeling excited that I could learn to be funnier and flirtier and create more laughter in my life, instead of relying on other funny people for this. I shared all of this with my mom. She then went on to make a further connection that really blew me away. She said, "I bet if you start to be funnier and create more laughter for yourself and others, you will also start to feel less lonely." It felt so true! The times I feel most connected to people are when I am laughing with them. THIS is the kind of relationship and connection with my mom that I had been missing lately--when I share deeply with her and, because she knows me so well, she is able to further my insight and understanding of myself and help me to grow. I feel so connected to her now. I realize now that I think part of my resistance to using the 5 secrets with my mom was maybe a hidden emotion component--I had these deep feelings and worries about our relationship; I was confused if moving closer to her had actually helped our relationship or if it was harming it, and I was genuinely missing these kinds of deep, connecting conversations with her, which we had not had in a while. My mom has been hanging out at my place all day today and now I notice myself being easily loving and patient with her and my being "particular" about my things and my space has vanished--at least temporarily! There are a lot of take-aways for me from this whole thing, but one of the biggest ones is that I think I was trying to do five secrets without really fully going into my "I feel" statements as much as I needed to--I feel statements are often the secret that I neglect the most as a person and as a therapist. So, to connect to what we are doing this week in class, I think I would make a guess that when I ignore the five secret that I need to do the most and struggle with, it can hamper my ability to do the rest of the five secrets effectively and genuinely. I could write a lot more about all of this, but I think I will stop here for now. I hope this wasn't too confusing as I know I touched on a lot of different things. Thank you all for your time and attention. I'm open to comments or questions. Warmly, Zeina Here is a reply to Zeina from one of the Stanford Tuesday group members Gosh! Zeina, this is beautiful and so straight from the heart. Takes immense courage to do a deep dive in exploring oneself. I have been marveling at how meticulously you‘ve sifted through and worked towards addressing the different dimensions of the relationship between you and your mum. You are also an amazing raconteur, you’ve brought out the subtle nuances so beautifully! Your mail took me on an emotional roller coaster ride. It was such a compelling read and had me as a captive co-traveler, holding my breath, and crossing my fingers! I loved your insights on the “I feel”. Reading that was a personal breakthrough for me, where my relationship with my mum is concerned. That’s exactly what is missing in our relationship too … whoaaaaa! I just don’t share my feelings with her! I love how you were able to do that though, because I can feel this huge wave of resistance engulfing me, despite my insight. I know I’m not yet ready to take the next step! Funny, how tough it can be to be vulnerable before one’s own mom! More power to you Zeina for ‘daring greatly’ and taking the next step after the Tuesday class. Also, for keeping us posted and for sharing with us in such a detailed manner, and in the process, helping us all learn and grow. Deep regards for your mum as well. She comes across as a tenacious mother of a tenacious daughter … if I may say so. Warmly, Nivedita. Here is a second follow-up from Zeina. Hello David, Jill and Tuesday group, I just wanted to send another update as my relationship with my mom has continued to evolve in quite beautiful and magical ways since I sent this last email.  It seems to me that maybe she has stopped criticizing me entirely--I'm not quite sure.  Maybe I need to pay more attention.  Perhaps if she does criticize me, she does it in a gentler way or maybe I am less sensitive to it.  All I know is that she has been wonderfully supportive of me in these past few weeks and we have not gotten into a single argument.  Our relationship suddenly seems easy in a way that I have never experienced before.  I am so profoundly grateful.  I know that we will probably relapse at some point and this may not last forever, but, now I know this is possible.  Now, I know my way back here.  I have always wanted a relationship like this with my mother, and I always thought it wasn't possible because of who she was as a person. Little did I know that to have the mother I always wanted, I needed to do the changing. I knew that the 5 secrets were powerful, but I had thought that their power was more confined to a single interaction or the moment when you use them.  I don't know that I have been especially good at practicing the 5 secrets with my mom lately, yet the effect seems to keep lasting and lasting. I am truly speechless at the profound transformation that has happened.  Thank you. Thank you. Thank you. I would love any responses! Zeina Here is some of the feedback from the training group in the section, “What did you like the best about today’s training session?” Jill’s thoughtfulness in selecting the Forced Empathy technique over the Relationship Journal. Jill looked at what had worked in the past for Zeina and saw it as a potential strategy for her current concerns and the result was tremendously positive. I loved the training! I loved watching forced empathy and I began to empathize with a close relative simply by watching Zeina empathize with her mom. I was crying throughout. It is hard to describe how touched I was Zeina's honesty and her responses to forced empathy was amazing! Amazing personal work. Entire session was great learning experience for me. How Forced Empathy brought the shift in Zeina’s way of thinking. I really enjoy witnessing the live sessions including this one with Zeina. Seeing how the totality of the model comes together in real time with the clinician's judgment and intuition guiding the specific process is really enlightening and seeing someone's beliefs shift in real time is very inspiring and moving. It was a really nice way to re-join the larger group and I'm glad to hear that went into David's thinking in scheduling it. I really like the Forced Empathy. Zeina had a lot of resistance at the beginning. However, She shed tears during doing the Forced Empathy. I also like the role reversal when doing the Externalization voices. I can always learn how to deal with the difficulties of life from David and Jill's wisdom. The whole thing was so great. I was really moved by the forced empathy. I always LOVE seeing forced empathy modeled to get better at this complex skill, and I am also, like many others, almost always blown away with how powerful it is. I also thought this was a great example of multiple paths (individual mood and relationship work) and multiple methods being all used in one two-hour session so skillful and masterful. I loved the open ended approach and the ongoing exploration until the goal was formed/explored/ discovered. For me, it was a demonstration of trust in the process. I especially liked David's "The Man From Mars" that seemed to me an amazing tool with sorting out the mess of relationship work. I also loved Forced Empathy especially here with the work on mother daughter's relationship. I am really intrigued to explore it for myself in regard to my relationship with my parents and my daughter. Seeing the whole encounter with Zeina and seeing how Jill and David thought through it together, it was all so organic and incredible to witness Very helpful to see the progression of the session. Zeina's session has been a gift not only to us, but also to our mothers. Forced empathy felt like a pivot point in treatment and I loved that Z was able to go deep and connect with her mother's feelings. I have plans to travel and visit my mother next month and have been feeling anxious about it. I was reminded of the unconditional love of a mother that is beautiful and spiritual. David and Jill did amazing and transformational work. This is so inspiring! I liked everything and how the methods and techniques were woven together very skillfully. Personal work is really the best and so gratifying to see. David made a comment at the end about how it would help with motivation to use the skills and work more on them after seeing them in action and I do agree with his comment even if I'm totally not paraphrasing correctly. I LOVE personal work because it bring these skills to life in a way that role plays don't. and of course, it's all the better that someone gets a personal benefit, that's all good too. David and Jill did an amazing job again! However, Zeina’s honesty and vulnerability was the greatest gift during this session. I could relate to her struggle as well, so I was extra impressed about her determination to work on this issue. It was amazing personal work for me. I feel so grateful for this experience. This was another example of the "magic" of TEAM, especially when the therapists are the incredibly skilled Jill and David. What a great, vulnerable and poignant example of relationship issues with a parent. I was very impressed and moved by the power of the Forced Empathy technique. By Zeina's ability to feel into the point of view of her mother, and her insights and connections, especially around how the times of criticism can be seen as opportunities for greater acceptance and love. Moving and really beautiful personal work!!! I was moved to tears when Zeina cried her mother's tears during the Forced Empathy exercise and said "I need her to accept me as I am." Wow--that was so powerful! And as for so many others, this experience felt super relevant and helpful to me for one of my own important relationships, and I'm feeling excited to try out Sergio's approach on my own loved one. Forced Empathy: I loved all of it! So helpful and informative to witness live work. I immediately got why the “what’s my grade?” question was skipped (since the use of the Forced empathy technique had yielded such powerful results). I am eager to try this with a particular client who is having similar issues with their mom. On a more personal level, I felt extremely close to Zeina and seeing how vulnerable and open she was willing to be. This has melted away a lot of my resistance in using the 5 secrets with my own mom. Thank you Zeina! I liked seeing the "visitor from Mars" used to uncover Zeina's thoughts when David was having trouble understanding what the issue was. It was great to see David feeling a little "lost" and see how he worked through that. Watching the Forced Empathy technique was amazing! I also appreciated when Jill offered several options for which direction to go and explained her rationale. I found it to be a helpful learning moment and also liked the warmth that came across. I saw my mom's critical behavior as coming from love-brought tears. Same for my Dad Zeina did really powerful and enlightening work! It was also a great learning experience to observe David & Jill. I have enjoyed listening to and learning wonderful techniques from Jill and David. I can definitely relate to parent's/child criticism conflict myself, so I have learned some methods of effective communication, empathy skills, especially the opposite empathy (where you step into the shoes of a person you have a conflict with) and learn to empathize strongly vs feeling frustrated and having blame thoughts I love every time we do personal work. I always learn and grow so much personally and professionally. Thank you, Zeina for this amazing gift, and thank you, David and Jill for your masterful work. I loved every moment of it! Amazing personal work! I enjoyed the entire process. I appreciated the partnership between David and Jill. I so appreciated Zeina's work and vulnerability. I like David's creative way of doing the Ind. Downward arrow using "man from Mars" perspective. I liked getting to see, again, the power of Forced Empathy, as it illuminated how we create the very behavior in the other, that we then complain about. I loved how Zeina surrendered to doing the Forced Empathy exercise with such wonderful openness. I loved the seamless way Dr Burns and Jill moved between the methods. And Zeina’s courage to be vulnerable. Had an aha moment myself - of course her mother will criticize her because the last thing she wants is for Zeina to have disastrous finances like her own. It shows deep love and caring Another Master Class! I loved watching David and Jill working with Zeina. Change the Focus is just an amazing Method. I appreciate Zeina's vulnerable disclosures. Such generosity is much appreciated. This is an amazing group, and I feel privileged to learn from such sophisticated practitioners, who are so generous with their insights and decades’ worth experiences. Some days I just can't believe my luck to be with such heartfelt, dedicated, compassionate and wise folks! I very specifically like seeing a long personal work session...the big picture seeing the whole session. Thank you! I learned so very much and how things smooth into each other as session progresses. It was great seeing Forced Empathy demonstrated as I've never seen it before and learned so much from the overall training with Zeina, David and Jill. So glad Zeina was willing to be so vulnerable; really appreciated at the end when she said she felt pressure to empathize with her mom if she was vulnerable with her and mom laid it on thick, was wondering the same exact thing in that very moment! Loved how David diffused that for her and put less pressure on how she would handle it! So grateful to be part of this awesome group where I am growing and learning every moment! The high quality demonstration of Five Secrets empathy by David and Jill Jill’s patience. David waiting for AHA MOMENTS and pointing them out and best of all ZEINA! Personal work is always insightful. I really like the forced empathy technique. I also enjoyed the display of creativity and flexibility of the team model. Amy would regularly explain that it was a model to be used creatively and it's exciting to know there is so much to learn. It can be adapted to each individual. Viewing therapy as a series of skills to learn rather than a step-by-step instructional book is what makes me really love TEAM. Loved how Dr Burns used the individual downward arrow so seamlessly during the empathy phase. Dr Burns empathy too was spot on when he said to Zeina that "she could not lean on her Mom." This one line was really powerful for me and resonated deeply. Loved Jill's internal solution as well as the forced empathy option along with the option of working on the good reasons not to do the 5 secrets. Jill was on a roll with her empathy ... "feels like you're walking on eggshells and don't know what will hurt her." I also liked Jill's disclosure about the times she gets critical with her boys are times when she is most concerned about them. Also liked Jill highlighting how Zeina practicing the Five Secrets was not working at a point because she was not using enough feeling empathy unlike as when doing the Forced Empathy  

May 30th, 2022 Our recent Ask David with Dr. Matthew May included a question on the Acceptance Paradox that triggered many enthusiastic email responses, and people were asking for more on this topic. Rhonda read several, including an email from Jeff who finally “got” the Acceptance Paradox and grasped the meaning of the “Great Death” of the Self. So, today, we’re dedicating the entire hour to this topic. In addition, I’m including a link to a partial draft of a manuscript I’m working on entitled “25 Paths to Self-Acceptance.” It’s fragmentary and far from complete, but does include some potentially useful ideas and techniques, including a vignette with a quiz about a woman from South Los Angeles who experienced what I call “instantaneous enlightenment” during one of my 5-day psychotherapy intensives several years ago at the South San Francisco Conference Center near the San Francisco airport. (LINK TO MS) First, here’s what a listener named Jeff wrote after the previous podcast. Ah! I F-I-N-A-L-L-Y get what you're saying. I've pondered this death of "self" for quite a while after reading Feeling Great and it finally sunk in. Saying "I want to improve myself" or "become a better person" is nonsensical. It's like there's an amorphous ghost "self" that I want to somehow "improve" or make "more worthwhile." But it's all made up. There is no actual "self." Meaning, I can improve skills I have - but my "self" won't be better. My skills might be - but there's no "self" to improve. I can improve my juggling skills but never my "self." Wow. Even when it comes to flaws, I can see that they're also very specific. I don't have a flawed "self" or a bad "self." I may have certain flaws but there's no "I" or "self" to be flawed or worthless. It took me a long time to see it - but now that I do, how awesome it is to stop having to IMPROVE myself. Instead, I can just let go of "my self." Thank you for the response and the additional information. That is so helpful! ! During today's show, a number of vignettes illustrating acceptance were shared, including a man from the CIA who was intensely ashamed because he didn’t have a sense of humor, and all of the men he worked with loved to hang out during breaks at work telling jokes and laughing. He pretended to laugh, but inwardly felt ashamed and inadequate, and was telling himself that he was inferior, or defective because he didn’t have a sense of humor. His enlightenment came during role-playing with a powerful technique called the Externalization of Voices. David played his Positive Self, and the patient, in the role of his Negative Self said this to David: Patient, in the role of his Negative Self: You know, you’re really inferior because you don’t have a sense of humor. You’re not a real man! David in the role of the Positive Self, responded like thi:s.Well, you know, you’re right. And in fact, I have tons of flaws. My lack of a sense of humor is just the tip of the iceberg! This struck the patient as incredibly funny, and he began laughing uncontrollably for several minutes and almost feel out of his chair. Then David said, “Not bad for someone with no sense of humor,” and that triggered even more laughter. That’s why it’s called the Acceptance Paradox. The very moment when you accept yourself, exactly as you are, warts and all, everything—all your perceptions of yourself and the world—are suddenly transformed, and your freed from the prison you’d been in for many years, or possibly for your entire life. Let me spell out what happened. For many years, my patient had been struggling with his lack of a sense of humor, and the harder he fought, the tighter the trap become. He could not change, and his life had become grim, and he felt inadequate and ashamed, thinking he wasn't a "real man," which seemed awful! The very moment he "gave up" and accepted the fact that he had no sense of humor, he suddenly found his sense of humor, and laughed uncontrollably for several minutes. That's what I mean when I say that acceptance is the greatest CHANGE a human being can make--and that's a gigantic paradox. Can you see that now? One important focus of the show was debunking the many reasons people have for resisting Self-Acceptance, such as: If I accept myself, I’ll just be ordinary, or below average, and I won’t be special. Acceptance is a slippery slope. If I accept something bad about myself, or some awful thing I did, I might end up doing something immoral or wrong. If I did something immoral or wrong, or even if I screwed up and failed to achieve my goals, I deserve to suffer. If people see that I’m flawed or “less than,” they’ll judge me. If I accept myself, I’ll lose my motivation to learn, to grow, and to improve myself. If I accept myself, I’ll have to lower my standards. I may be unhappy, even miserable at times, but at least I have high standards! When I beat up on myself, it shows that I’m honest about my flaws. If I accept myself, I will end up accepting the fact that I might really be inferior! In addition to addressing these concerns, Matt, Rhonda and David contrasted healthy vs unhealthy acceptance. For example, unhealthy acceptance is associated with feelings of depression, shame, hopelessness, paralysis, loneliness and cynicism. Healthy acceptance, in contrast, is associated with the exact opposite feelings of joy, pride, hope, creativity, intimacy, and laughter. Matt pointed out that most, and conceivably all people who resist acceptance are not “seeing” something potentially incredible and life-changing. David pointed out that the “Great Death” of the “self” that the Buddha described more than 2500 years ago is not really the “death” that people fear, but is really the “Great Rebirth.” When you “lose” your “self,” you actually lose nothing, because there was nothing there in the first place. But you gain the world, along with liberation from your suffering. And that’s every bit as true today as it was at the time of the Buddha! Thanks for joining us today. Rhonda, Matt, and David

293: The Five Secrets with Violent and Angry Individuals, Featuring Heather Clague, MD Heather Clague MD is a Level 5 TEAM therapist and trainer with a practice in Oakland, California and consult-liaison psychiatrist at Highland Hospital in Oakland. In addition to running an online consultation group for TEAM therapists, she is faculty for All Things CBT,  teaches for the Feeling Good Institute, and has taught the Five Secrets of Effective Communication to medical staff. Her writing can be found at psychotherapy.net. With Dr. Brandon Vance, Heather co-leads the Feeling Great Book Club, a book club for everyone, everywhere who wants to learn the magic of TEAM. In today’s podcast, Rhonda and David speak with Dr. Heather Clague who describes her working in the psychiatric emergency room at Highland Hospital in Oakland, California, and other emergency facilities including Fairmont Hospital in San Leandro, California, interacting with hostile and psychotic individuals who often have to be held against their will because they are a danger to themselves or others, or unable to care for themselves. Although today’s podcast will be of special interest to mental health professionals, it will also be of great interest to anyone having to interact with strangers, friends or family members who are angry and abusive. She explained that In these types of settings, we often have to give patients the opposite of what they want. For example, if they’re involuntarily hospitalized for dangerous behavior, we have to restrain them, or keep them in the hospital, when they desperately want out. Or, if they want to stay in the hospital, we may have to discharge them. Many of these patients are psychotic and lack judgment, so they may shout and act out in anger and frustration. The Five Secrets (LINK) have been a godsend, and when it works, the results are amazing. For example, if a patient is screaming for us to release them, the natural instinct to get defensive just agitates them more and is rarely or never effective. If in contrast, you say, “You’re right, we are holding you against your will and you have every right to be angry,” they usually feel heard and calm right down. In one recent case, an agitated and confused homeless woman needing dialysis was near death because she was refusing treatment and refusing to take her medications. She was manic, agitated, and talking rapidly, non-stop. I said, “I think you’re really upset because we’re keeping you against your will.” The patient shouted “Yes!” Then I said, “And you’re telling us that you do have a place to go to if we let you out.” The patient said, “yes,” in a softer voice, and let the nurse come in and give her her medications, which she took. Heather described phrases she uses to get into each of the Five Secrets in high-secrets situations when you don’t have much time to think and have to respond quickly, including these: For the Disarming Technique: “You’re right,” followed by a statement affirming the truth in what the patient just said. Thought Empathy: “What you’re telling me is” followed by repeating what the patient just said. This is helped greatly by writing down what the patient said. Without writing things down, this technique tends to be impossible for mental health professionals OR the general public. In spite of this, most people refuse this advice! Feeling Empathy: “Given what you just told me, I can imagine you might be feeling X, Y, and Z” where X, Y and Z are feeling words, like “upset,” “anxious,” or “angry,” and so forth. Inquiry: Heather emphasizes two productive lines of Inquiry: “Am I getting it right?” “Can you tell me more about how you’re feeling?” “I Feel” Statements: “I’m feeling X, Y, and Z right now,” where X, Y, and Z are feeling words like sad, concerned, awkward, and so forth. When done skillfully, this technique adds warmth and genuineness, and facilitates the human connection. Heather cautions against saying “I feel like you . . . ” since this ends up not as a statement of your own feelings, but a criticism of the other person. “I feel that . . . “ has the same problem. Stroking: This conveys caring, liking and respect, but cannot be done in a formulaic way. You might say things like “I care about you and I’m really concerned that you’re struggling right now,” or ‘What you are saying is very important, and I want to understand more.” For example, you might say this to an angry patient being held against his or her will: “You’re right, I am holding you against your will, and insisting that you stay, and I don’t like it either. But I’m very concerned that if I let you out now, you might get hurt, or do something to hurt yourself, and your life is precious. I don’t think I could forgive myself if I did that.” Of course, all of this has to come from the heart and has to be done skillfully, or it will not work. Heather described other inspiring stories of challenging patients she’d worked with, and we took turns modeling Five Secrets responses to ultra-challenging patients, including one who was brought into the ER by police on a gurney in leather restraints who took one look at her doctor and said, “Boy, are you ugly!” On another occasion, she walked into the room of a male patient, introduced herself, and asked if they could talk.  He replied provocatively, “Sure, if you get into bed with me, baby.” Rhonda and Heather reminisced about their meeting at one of my four day intensives for mental health professionals several years ago at the South San Francisco Conference Center, and became best of friends. They have traveled together to India and Mexico teaching TEAM-CBT and spreading the gospel according to Burns! I also reflected on my two years of internship and residency training at Highland Hospital, and my profound gratitude and admiration for that hospital and the many dedicated and talented health professionals who serve there. Thanks for tuning in today! Heather, Rhonda, and David

David Meets the British TEAM Group, Part 2: Burns vs. Van de Kolk, Treating somatic symptoms, chronic doubters, GAD, and more! Last week, David answered four questions posed by the British TEAM-CBT group. Today, he answers five more questions, including one on controversies in the treatment of PTSD. Peter – Positive Reframing in TEAM—How much is “enough?” When you do Positive Reframing to reduce Outcome Resistance, how extensively do you have to do it? Do you have to include every emotion the patient has listed on their Dailly Mood Log? Do you also have to focus on most or all of their Negative Thoughts? What’s the best approach? Tom – Burns vs. Van De Kolk After reading The Body Keeps the Score, by trauma specialist and psychiatrist, Dr Bessel Van De Kolk, it would appear that people with complex trauma require a high degree of stabilizing work, like deep-breathing, meditation, or yoga, before they can engage with effective therapy. Otherwise, they might not have the words to describe their emotions, or might have repressed memories. In addition, they might not engage or might become destabilized and highly emotional or destructive towards themselves and other people. I wonder if that’s your experience with patients you have seen with severe complex trauma in your career? Do you think the TEAM-CBT model has limitations in this area and would you refer to a trauma specialist before embarking on TEAM therapy with such a patient? Sean – Treating Somatic Symptoms with TEAM I’m curious about dealing with the somatic experiences of patients struggling with anxiety, depression, insomnia, trauma, etc. Clients can often challenge their distorted Negative Thoughts but still struggle with the somatic symptoms. I’m curious to know David's thoughts. Hassam – Treating Chronic Doubters with TEAM I’m wondering if David has had experiences with chronic doubters - obsessive doubt in which a patient might say: "Yeah, all these cognitive techniques seem good and all, but what if really I am useless and worthless, and all of this has just been a gimmick? What if it is all a lie? What if we have missed something which really would show how worthless I am ?" Basically, this is closely related to the Pure O version of OCD. OCD is known as the doubting disease, and I really want to hear David's thoughts on how he operates with extremely sticky doubting thoughts. Jacky – Treating Generalized Anxiety Disorder (GAD) with TEAM I have a question about clients with Generalized Anxiety Disorder. When they present with multiple worries, do we need to cognitively restructure every worry? Clients with GAD often have multiple worries so we could be there for quite a while if we have to work on every single worry! End of the Part 1 Questions. David will return to the British group for Part 2 in the future, since they had many additional questions. Here is a note from Dr. Peter Spurrier to all who want more information about the UK TEAM-CBT training group: If you are interested in learning more about our group, or want to contact members, please visit us at: https://feelinggood.uk.com/ You will find contact details for many of us on the "Our TEAM CBT Practitioners" page. If you are interested in joining our TEAM-CBT training group, or want more information, you can email me (Dr. Peter Spurrier) at Docspurr@gmail.com.