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

Audrey Kodye Sunny Choi Diversity: Trauma and Training featuring Sunny Choi and Audrey Kodye Rhonda and I are proud to feature Audrey Kodye, a psychologist with a private practice in Canada, and Sunny Choi, LCSW, who specializes in the treatment of underserved populations in the San Francisco Bay Area. In today’s podcast, these beloved TEAM-CBT therapists bring us an important discussion on the impact of racial, gender, religious and sexual bias, including tips on how to incorporate relevant questions into our initial evaluations of all new patients, as well as illuminating ideas on how to maximize treatment effectiveness with TEAM-CBT. Both Audrey, who was born in Mauritius, and Sunny, who was born in Hong Kong, describe their experiences with bias and violence, both when growing up, and as adults, and how these experiences shaped core feelings of not being “good enough.” Sunny explained that how he incorporated the negative messages that were triggered by his traumatic experiences: I grew up in a privileged family in Hong Kong, and was favored as a male child. When we came to the United States, I was 12 years old and undocumented. I got beaten up because I had slanted eyes, and I was hated because I was gay. I worked super hard, getting a degree in engineering from UCLA and a master's in management from Stanford, and became successful, but got more and more depressed due to my belief that I “wasn’t good enough.” Now I work with marginalized populations, the poor, people of color, LGBTQ, immigrants, and abused women. Audrey said: I’ve also felt like I wasn’t good enough. . . . I’m a light-skinned black woman from Africa, from a lower-class family in Mauritius. . . . My ancestors had to be very resilient due to prejudice, and I’m very proud of them. I’ve also struggled with social anxiety and depression due to the racial trauma I’ve experienced. Sunny and Audrey have both been helped by TEAM-CBT, and feel it has a great dealt to offer and have appreciated that diversity is celebrated in the personal work so many people do in David and Jill’s Tuesday training group. They say that “TEAM has helped us and our patients as well!.” They gave some valuable tips on how to incorporate diversity awareness in to treatment with TEAM, but the same tips would be helpful to anyone interacting with a friend or colleague who may have been the victim of abuse. Sunny added: “I got scared and anxious when thinking about this topic prior to today’s podcast. What I’ve been through has definitely shaped my behavior, my thinking, and my feelings, and the hatred is still happening today.” He tearfully described the experience of his cousin who has a Chinese restaurant in Oakland, and someone threw a rock through the window to act out on their hatred for Asian Americans. Audre said: "I also felt sad and anxious while preparing for the podcast. It’s not easy to talk about racism and discrimination, and I felt a lot of self-doubt about my own experiences with racism and discrimination before the podcast, because they have so often been invalidated. People get defensive and are often incredulous. They don’t believe it. So you run into conflict and opposition and defensiveness when you try to speak out." David agreed and emphasized how sensitive and defensive people can be when our “blind spots” are confronted, especially when we’ve been in a state of denial, thinking of ourselves as totally innocent when we’re not! They discussed three keys in thinking about racism and discrimination: Systemic racism: the Five Secrets of Effective Communication can be helpful. For example, it is important to acknowledge the anger your patients may feel because of the injustices they experience. Micro-aggression: These are subtle put-downs that may sound like compliments, and might even be intended as such, but are really hurtful. For example, when learning that Sunny is gay, someone may say, “Well, Sunny, you certainly don’t act gay!” This statement, which might sound innocent, actually implies that you’re “less than” or “less of a man” if you’re gay! Internalized oppression: This is when the person who is being targeted turns against himself or herself, and internalizes the message that “I’m not good enough,” or “I’m defective.” David points out that this is similar to Freud’s model of depression, which he thought of as “anger turned inwards.” Although Aaron Beck railed against this construct, I have to admit that the negative thoughts of people who are depressed nearly always do have a hostile, bullying tone. David also compares racial discrimination and hatred to the three components of “Abuse Contract” he often explains in his work with abuse victims. There are three parts to the contract: I get to abuse you, physically, psychologically, sexually, or financially for my please. We have to keep it secret. If you ever tell on me, or even imply that I’m doing something wrong, I’ll REALLY hurt you. It’s all your fault. You’re the dirty bad one, and you deserve what I’m doing to you. I’m a god who is superior and without fault. And in spite of the absurdity and cruelty of this “contract,” human beings seem to have the capacity to buy into it, and this includes children and adults as well. Sunny also emphasized that Asians especially are told NOT to be angry, and that’s why it can be so helpful to use the Five Secrets with trauma patients as well as Positive Reframing to encourage acceptance of anger and seeing that it can be entirely healthy and justified. Sunny and Audrey provided additional tips on working with marginalized groups. The most important thing is to ask about trauma and encourage the person to talk about it, as opposed to keeping these experiences hidden, even in therapy. He They said that many patients will open up immediately, and will often use the entire therapy hour just venting. The experience of being heard and supported can be deeply appreciated, and can also provide important clues to the origins of the patient’s feelings of depression, shame, and anxiety. Simple, obvious questions are all that are needed, such as: “Have you ever experienced racism, rape or sexual trauma, or homophobia. Have you ever been bullied or beaten? Sunny gave many additional examples of subtle racism when he was working in Silicon Valley as a manager. But colleagues he didn’t know often thought a person he was supervising was the manager, and he was the person being supervised. Audrey described similar experiences when people told her she was super smart, and that was probably because she was “mixed”--that is, not purely of African descent--or because she’d worked “really hard,” implying others who belong to her ethnic group do not. Again, an apparent compliment which is really a subtle put-down. Sunny tearfully described how he took years and years of voice training, trying to change his accent to sound “less Chinese.” Now he says, “I finally feel okay with who I am!” Although, I think Rhonda and David might say, Audrey and Sunny, we love you, and you’re way more than “okay” in our eyes. You’re our teachers and you’re showing us the way, and making us aware of our own many errors and biases, in a kindly and loving way. Thank you!” Thanks for listening today! Rhonda, Sunny, Audrey, and David

TEAM-CBT with children and teens, featuring Jeffrey Lazarus, MD Tics, Irritable Bowel Syndrome, Chronic Pain, Bedwetting, Fears, Phobias, Performance Anxiety, and more In TEAM, we usually conceptualize four categories of problems: depression, anxiety disorders, relationship problems, and habits and addictions. Although there are similarities in the treatment of each of these targets, there are also important differences. Today’s guest, Jeffrey Lazarus, MD, is a pediatrician who specializes in a fifth category, somatic complaints, which can include physical symptoms like chronic pain, dizziness and fatigue without any known medical cause. This category also includes as irritable bowel syndrome, headaches, tics with and without Tourette syndrome, bed wetting, and a wide range of other problems which are common in kids and sometimes in adults as well. Dr. Lazarus also works with anxiety disorders, such as test anxiety, sports performance anxiety, public speaking anxiety, school phobia and more. Although Dr. Lazarus worked as a general pediatrician for the first 27 years of his career, he switched to hypnotherapy when the painful plantar warts on his feet were unexpectedly cured following a single hypnotherapy session from a colleague. Dr. Lazarus was so impressed that he began studying hypnosis and incorporating it into his work with children, teens, and adults. He now works from a TEAM perspective, incorporating Testing, Empathy, Paradoxical Agenda Setting (also called Assessment of Resistance), and a variety of cognitive methods, along with hypnosis. He began today’s podcast with a case of a young man he was treating for persistent bed wetting, and was surprised when his patient slammed him in the written feedback on the Evaluation of Therapy Session form following the session, labeling Dr. Lazarus as a bit “narcissistic.” At the start of the next session, Dr. Lazarus responded non-defensively with the Five Secrets of Effective Communication. This won the boy over, leading to a successful outcome. Jeff said that the Evaluation of Therapy Session form and the Five Secrets have “saved him” on several occasions with disgruntled patients. Jeff then presented several fascinating cases where motivational factors and resistance played a major role in the treatment, and emphasized that treatment failure would probably have been inevitable if these factors had not been brought to conscious awareness. For example, a teenager who frequently had to go home from school because of somatic symptoms listed, at Dr. Lazarus’ suggested, the many advantages of his symptoms, such as “I don’t have to go to school,” “I get extra attention this way,” and more. After this intervention, the boy decided that it just wasn’t worth it, because there were lots of fun things he was missing out on at school, and his symptoms rapidly subsided. In another case of bed-wetting, Jeff discovered that a 10-year old knew that he wouldn’t be permitted to go on sleep overs at his cousin’s house until he outgrew his bed-wetting problem. But when he “listened” and encouraged the boy to talk about his distress, the boy explained that his cousin had a “creepy dog” that frightened him, so he actually didn’t want to go on sleepovers. Jeff encouraged the boy to tell his parents what was really going on, and when his mother said he wouldn’t have to go on any sleepovers unless he wanted to, his bed-wetting suddenly disappeared. He described many additional cases where motivational factors dominated his patient’s problems, including a promising teenage tennis star who suddenly developed a fear of flying which made it impossible to go with her parents to important weekend tournaments. But with Dr. Lazarus’ support, she confessed that her life was dominated by school, study, and going to tennis tournaments, with no free time to be a “normal teenager.” She finally confided that she was just “tennissed out” and wanted to have more fun in life, to have dates, and so forth. By subconsciously developed a flying phobia, she was subtly going on strike, and saying “I don’t want to do this anymore.” But by developing a symptom, she could continue to be nice and say “I can’t do this,” rather than saying “I don’t want to do this anymore.” These subconscious maneuvers are not manipulative, but automatic. When brought to conscious awareness, the patient finds himself or herself in control, and can decide to go in a different direction. This patient mustered up the courage to tell her parents and her coach, who were understanding, and her fear of flying suddenly disappeared as mysteriously as it had first appeared. Dr. Lazarus emphasized that the child’s complaints are real—they’re not making up the symptoms, and they need empathy and support, and the chance to tell their story. Parents are nearly always focused on “pushing” and “helping,” efforts that just make the problem worse because the child pushes back. Although parents do this out of love, their misguided efforts to “help” can actually be a barrier to successful treatment. Jeff said he often does what he respectfully and affectionately calls a “parentectomy,” which means encouraging the parents to stay out of the picture regarding the individual patient problem and homework he assigns. I have called this tendency of symptoms to be hiding the patient’s actual motives the “Hidden Emotion Phenomenon,” and it’s equally common and powerful with adults with anxiety disorders as well. Essentially, anxiety prone individuals, including children, teens and adults, tend to be exceptionally “nice,” and are often people pleasers. So, they may not always listen to their feelings, which then turn out indirectly, as this or that type of anxiety or somatic complaint. Essentially, the symptoms are saying what the patient’s mouth cannot say! Instead of trying to solve the problem, you can view the symptoms as a subconscious solution to a problem that’s being suppressed and not verbalized. Bringing the problem to conscious awareness can make it possible for adult and young patients to express their needs and feelings directly, which typically leads to a rapid disappearance of the initial complaint. If you’d like to learn more about Jeff’s fascinating clinical work, and perhaps learn more about this ‘Hidden Emotion” phenomenon, and how he integrates hypnosis with TEAM-CBT, you can view a number of resources, including video clips from actual therapy sessions, at his website, JeffLazarausMD.com And, if you’d like, you can contact him directly at JeffLazarusMD@gmail.com. Thanks for listening today! Rhonda, Jeff, and David

Ask David: Featuring Matt May, MD 1. Roy asks: How can I challenge my core belief that there is something wrong with me? 2. Lynn asks: Do you have any recommendations for someone with health anxiety? Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1. Roy asks: How can I challenge my core belief that there is something wrong with me? Hello Dr .Burns, Regarding podcast 294, I had a few quick questions/suggestions on acceptance. Is it possible to do a podcast with you and Matt and Rhonda on one specific core belief? The belief: There is Something Wrong With Me Let me explain. I have dated and had relationships with some very physically attractive women in the past. In the last year I have not been able to duplicate these past successes and I suspect it's because I am at least 10 years or more older than these women ( 23-28). Let's say I NEVER EVER date or have a relationship with my specific type EVER again? This has caused a ton of frustration and some depression ( low) but has been a bit to my self image and self esteem Thoughts? Thanks Dr. Burns Roy David: At my request, Roy provides more information on his Core Belief: There is something wrong with me. Why believe it? 1. My parent said "What's wrong with you?" whenever I got in trouble in school ( infers there IS something wrong with me) 2. It feels like there is something wrong with me 3. I make mistakes and am not perfect so there MUST be something wrong with me I believe this Core Belief to be 100 % True David: I asked Roy to provide a Daily Mood Log. DML Activating Event: 3 specific events A) My ex girlfriend dumped me and ended our relationship B) A woman I suspect is a super model said No to my request to go out on a date C) I have recently struck out with the last 5 women I REALLY want to date. They ALL rejected me Feelings: Depressed/Down/Unhappy (70%) Worthless/Inadequate/Defective (80%) Unloved/Rejected (95%) Hopeless/Discouraged (99%) Frustrated/Defeated (99%) Resentful/Irritated/Upset (99%) Negative Thoughts 1.There is something wrong with me (100%) 2. I must get this specific woman's love and approval to feel good about myself (80%) 3. If I am a sexy charming guy then this woman would find me attractive. I must not be very attractive (100%) 4. If I played in the NBA or NFL then this woman would be attracted to me (100%) 5. The sex would be amazing if I were to be intimate with this woman (100%) 6. I would be so much happier if I was to have a relationship with this woman (100%) 7. Women like her with incredibly sexy attractive bodies only go for high status millionaires. I am not a millionaire. It's awful I am not a millionaire (100%) 8. I am 10 years older than these women and therefore my age turns them off (100%) David wrote back, suggesting that Roy list the benefits of his belief that “there’s something wrong with me.” Positives of believing There is Something Wrong With Me Very easy explanation why these specific types of women reject me I don't have to make any changes about myself ( clothes) or behaviors ( more charming) Familiar feeling and comfort in familiarity I can feel sorry for myself and have a pity party Gives me something to complain about with my friends lol My fantasy ( sexual and relationship) of these specific women remains unchallenged and is a great distraction when bored Shows I accept I am not perfect and defective I accept responsibility for my failings Don't have to get angry or upset about my mother's poor parenting skills Incredibly easy cop out whenever I fail to achieve any type of goal Can quit working towards a goal when face adversity Next, Roy identified some distortions in this belief. Distortions in believing There is Something Wrong with Me -emotional reasoning -self blame -overgeneralization Why? Feels like there is something wrong with me. I am assuming 100% blame. I am not focused on any positive things done in my life I am stuck because my mother said what's wrong with you when I was a kid. I concluded there must be something wrong with me. Whenever I get rejected this core belief surfaces. Is this what you had in mind? All the Best and THANKS Roy David’s response Hi Roy, Thanks for the email. Everything about you and me could be improved. Is that all you mean when you say “there’s something wrong with me?” Or are you saying you have a “self” that is somehow damaged.? If so, was your “self” always damaged, from the time of birth? Or did it “become damaged” at some point? If the answer is yes, at what point did your “self” become “damaged?” To me, conversations about “selves” have no meaning. Conversations about specific flaws or problems do have meaning. You are kind of kicking your dating problem up into the clouds of abstraction, to my way of thinking, when you obsess about a “damaged self.” Lots of colleagues who used to come to my Sunday hikes had dating problems, in your age range, and most eventually solved them. But talk about “damaged selves” was never part of the dialogue that I can recall. I wrote a book on dating, Intimate Connections. Just my thinking! d More from David after an email exchange I don’t think you answered, or attempted to answer, my question. One problem is that you would like to date and have sex with more younger women who are in great shape. That is something specific and clear. I understand it, anybody can make sense of what you are saying. When you say, “In addition, I believe I have a ‘self’ that is defective (or whatever), I don’t “get” what you are talking about. Can you explain this at the fourth-grade level? Do you mean that you get upset when you get rejected? Is that all you mean? Or do you mean that you get frustrated and disappointed when you cannot get a date with X, Y, or Z woman? Nearly all men have these reactions at times. Does this mean there is “something wrong” with their “selves?” There are lots of reasons why woman A might not be attracted to man B. Do you agree? Which reason makes the man’s “self” not good enough. She may not be attracted to him because he is chasing her, for example. This means that his dating style needs some fine tuning, and perhaps that he needs to learn to be happy when he is alone, and that he does not “need” love or her love, etc. Those are specific things, easily changed. But I don’t get the “self” bit! We all having varying qualities and ratings. Take math. Everyone has a certain skill in math. 50% of people are above average, and 50% are below average, in math. Do you agree? Is there some skill level that means that there is something “wrong” with your “self?” Thanks! D On today’s podcast, Rhonda, Matt and David discuss effective and ineffective approaches to dating, including a mind-set that may be a huge turn-off to women. They also illustrate how to challenge some of Roy’s distorted thoughts using three strategies: Self-Defense The Acceptance Paradox The CAT, or Counter-Attack Technique Matt and Rhonda speculate that Roy may be harboring some anger toward his mother, and toward women in general. David is less convinced, but more focused on change in the here-and-now, regardless of causes, which can sometimes be difficult to prove. At any rate, if Roy’s goal is to develop more loving and rewarding relationships., there are many available tools. 2. Lynn asks: Do you have any recommendations for someone with health anxiety? I am a long time fan of your work, and I have a long history of health anxiety. My therapist tells me that this is really death anxiety. I'm not sure I agree...but do you have any recommendations for someone with health anxiety? ( imaginal exposure therapy has not been helpful) I'd be eternally grateful for any insight. David’s reply Thanks for the kind words, Paul. I will try to include this in an upcoming Ask David segment! Matt’s reply: Using uncovering techniques, like the ‘What if’ technique, Hidden Emotion, Downward Arrow and Interpersonal Downward Arrow could help answer this question.  If you had a problem with your health, what would you worry about, most?  If you were having a problem with your health, what would you worry about, in terms of how other people would treat you?  What would it mean, about you, if you had a problem with your health.  Identify the specific negative thoughts behind your suffering will help your therapist identify methods that could help you.  As far as Death Anxiety, you could consider a chapter in Feeling Good, where David breaks this fear down into more specific parts.  Are you afraid of the process of dying?  The moment of Death?  What comes after?  If so, what are you afraid of, specifically?  Most people don’t fear Death, it doesn’t really exist, like a shadow, just the contrast to something real, Life. In the podcast, Matt, Rhonda, and David emphasize the role of the Hidden Emotional Model in the treatment of Health Anxiety, and describe two dramatic cases involving rapid recovery, one of them personal—David’s belief he had a lymphoma in his armpit shortly after completing his psychiatric training. The other involved a college student with a long history of health anxiety who David and Matt hypnotized. While in the trance, she suddenly “remembered” what she was actually upset about, and burst into tears. This was a life-changing moment! Thanks for listening today! Matt, Rhonda, and David

313: People who “yes-butt” you. People who resist exposure. Does God exist? Does the “self” exist? How to you justify Ellis?  "Should" we care about Putin's war on Ukraine? " 1. Rhonda asks: How can you respond to someone who yes-butts you? 2. Thomas asks: Do we have a self? Does God exist? 3. Thomas also asks: Ellis said we should upset ourselves over someone else’s problems, but how about Putin, and Russia? Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways. 1. Rhonda asks: How can you respond to someone who yes-butts you? David’s Reply Thanks, Rhonda. We can demonstrate this with Matt on the podcast recording later today! Matt’s Reply: The answer is to fall back to Empathy and try to see how we are creating the problem.  For example, when we are giving advice, we may have fallen into a trap, in which we are getting ahead of their resistance and would want to get behind it. As often happens, the question, and its answer, went in an unexpected direction. Rhonda, like many therapists, noticed that one of her social anxiety patients was subtly resisting exposure—facing her fears. Matt and Rhonda model how to respond to patients who keep putting off the exposure. This answer illustrates how therapists and the general public alike can improve your use of the Five Secrets of Effective Communication (LINK) with the use of “Deliberate Practice,” with role reversals and immediate feedback on your technique. Rhonda starts with a low grade, and then rapidly achieves an A grade! Click here for the Five Secrets of Effective Communication 2. Thomas asks: Do we have a self? Does God exist? Thank you for giving me your time and attention. I appreciate it, even if we don't agree. I have talked about whether or not God and the self exist. David Hume made the argument about not having a self, only perception. Of course, questions arise if we don’t have a “self.” Thomas Thomas also comments on Nathaniel Brandon: Why do we use the words who? Him? Her? He she they.?? I certainly don't believe Nathaniel Brandon’s horseshit. He talks about a teenage self, a father self, and a child self And all that is just horseshit. But do we have any self? David’s response: Hi Thomas, Thanks for your question! You ask, “But do we have any self?” You ask about God, too. People have been asking for my chapter on the “Death of the Self,” and my efforts to debunk the idea of a “self.” I have not had the time and motivation to bring that chapter back to life, since it is so hard for people to “get” what I’ve been trying to say, which is exactly what Wittgenstein and the Buddha were trying to say. But I will try to share one idea with you, in the hopes that it might make sense. As I have previously suggested, these questions about some “self” or “God” have no meaning. For example, how about this question: ‘What would it look like if someone had no ‘self?’ What, exactly, are we talking about? I know what this question means: “So you think Henry is too high on himself.” This means that we think some person named Henry is arrogant or narcissistic, something like that, and we want to know if someone agrees with us. I understand this question, it makes sense. There is a distinct difference between people who are quite humble and folks who are overly impressed with themselves. So, we are talking and using words in a way that has meaning and makes sense. However, I cannot answer the following question because it does not make any sense to me: “Does Henry have a ‘self’?” So, this question, to me, is language that is out of gear, like a car in neutral gear. No matter how hard you press on the accelerator, it will not move forward or backward. If you cannot “see” or “grasp” the difference between my examples of a meaningful question and a nonsensical non-question, that’s okay. In my experience, few people can grasp or “get” this. But to me, the difference is quite obvious. Is it okay if I use your email as a somewhat edited “Ask David?” I can change your name if you prefer. I don’t think people will “get” my answer, but hope springs eternal! David Matt’s Response Many brilliant minds have addressed this question in more eloquent and thorough ways than I could, including the Stanford-trained neurologist and philosopher, Sam Harris, in his book, ‘Free Will’ and Jay Garfield in his book, ‘Losing Ourselves’ There’s very little I can say, about this topic, that hasn’t been said more eloquently by individuals like these and many others. Meanwhile, I’m glad that this question has arisen on the podcast because I see clinical utility in the implications of this question, including in the treatment of depression, anxiety, anger, narcissistic pride and relationship problems. For example, I might be thinking, ‘I’m so mad at my (bad) self for eating all those cookies’.  Or, I’m so proud of myself for making a million dollars’.  I might start to think I deserve more, because of my special self and feel superior and angry, ‘that persons (bad self) shouldn’t have cut me off in traffic!’. When we take the ‘self’ out of the equation, we realize that these thoughts don’t make sense.  If our brains are just following the laws of physics, without any self, jumping in there to influence the process, then we couldn’t have done differently, with the brains we had, and neither could anyone else. Hence, the idea that people have ‘selves’, which can be good or bad, make decisions and the like, is a setup for suffering.  In the cookie example, I would have to train my brain, through practice with therapy methods, to develop a different set of habits, rewiring of my brain, to reach for a salad rather than a cookie.  I can’t simply insist that my ‘self’ rewire my brain for me.  I’d have to practice and do my TEAM therapy homework! Anger and Narcissism are some of the hardest-to-defeat problems.  However, realizing other people are simply doing what their brains are programmed to do, takes away the anger and blame.  Just like we wouldn’t hold a grudge for years against a wild animal that bit us, we could also forgive and accept a person who bit us.   and we can’t feel unnecessarily superior or proud of our ‘self’ if we accomplish something wonderful, because we don’t’ have a ‘self’ that did those things, just a brain and the right environment, neither of which we can take credit for. This approach is called ‘reattribution’ in TEAM, which is useful for defeating ‘self-blame’ and ‘other (self) blame’. Here are some other methods to leverage the no-self concept and free your mind of this hazardous way of thinking: 1. Experimental Technique:  Try to define what a ‘self’ is.  Then conduct an experiment to see whether the self is capable of doing the things you think it can do.  For example, can your ‘self’ stop understanding the words you are seeing on this page?  Or does your brain helplessly decipher the shapes of these letters into meaningful sounds and language?  Can your self exert its free will to decide to focus exclusively on one thing for one minute, like your breath or a point on the wall?    It can’t.  If your self can’t do such simple tasks, what can it do?  One can see meditation as a kind of ‘experiment’ to see whether our ‘self’ is calling the shots, using its free will, or if our brains are just doing what brains do. 2. Socratic Questioning: You can ask questions that can’t be answered to show that the ‘self’ is more like a ‘unicorn’ than a cat.  For example, how big is the ‘self’?  What’s it made of? Where is it located?  Can you see it on a MRI?  No radiologist has ever visualized a ‘self’ and you probably realize you can’t answer these questions, any more than you can, ‘what do Unicorns like to eat?’, bringing us closer to understanding that it’s probably a made up thing. 3. Examine the Evidence: What evidence is there that there’s a Self?  What evidence is there that there is no self? On the latter side, Consider Occam’s Razor, which suggests that the better hypothesis is the simpler one which still explains the observations.  One hypothesis is we have a brain generating consciousness.  Another hypothesis is that we have a brain that generates consciousness and a self that is having those experiences, operating the brain.  Based on Occam’s Razor, the better hypothesis is the former, that we have a brain creating consciousness. 4. Outcome Resistance: People get scared off by the idea that there’s no self or free will, that their brain is making decisions, without a self intervening.  In Christian Tradition, for example, Thomas Aquinas essentially invented the concept of ‘free will’ so that God’s punishment of Adam and Eve could be explained, morally. Otherwise, God would seem rather cruel, to create a system where he knew that would happen.  This is an example of how ‘free will’ and the ‘self’ are linked to blame and anger. Even if you don’t believe in God, you might be concerned that the idea that there is no free will would mean that the criminal justice system would fall apart.  Criminals could say, ‘I had no choice’.  Talking back to these elements of ‘resistance’ could help free one’s mind. For example, without free will, it’s true that blaming other people and retaliatory justice wouldn’t make sense.  However, one could still enforce laws, only in a compassionate way, for the sake of protecting others making the same mistake.  A murderer, if they realized this, could mind meaning in fulfilling their sentence, realizing they were doing a service to humanity, rather than being punished for their bad self.  Instead of seeing other people as having ‘bad’ selves, we can have a sense of sadness, connection and concern, even with a murderer, when carrying out justice, understanding that, ‘there but for the grace of God, go I’. David mentions, in passing, a mild red flag with the concept of "free will." He points out that this is another concept, like "God" or the "self," that has no meaning, if you really grasp what Ludwig Wittgenstein was trying to say in his classic book, Philosophical Investigations. One way to "see" this, although it is admittedly almost impossible to "see:" because it is so simple and obvious, would be to ask yourself, "What would it look like if we "had" something called "free will?" And what would it look like if we "didn't?" The question is NOT "do we have free will," but rather, "Does this concept have any meaning? Once you suddenly "see" that the answer is no, you will be liberated from many philosophical dilemmas. But as they say, enlightenment can be a lonely road! the Buddha, as well as Wittgenstein, ran into this problem that people could not "grasp" the simple and obvious things they were trying so hard to say! As humans, we get spellbound by the words we using, thinking that nouns, like "self," must refer to some "thing" that either exists or doesn't exist! To my way of thinking the question is NOT "Does god exist" or "do human have free will," but rather, do these questions make sense? Do they mean anything? The answer, to my way of thinking (DB), is no. However, . . . you might not "get" this! 3. Thomas also asks about Dr. Albert Ellis Hi David, Do you agree with Ellis that one is better off without making oneself upset over other people's problems? What about Putin and Russia and all the violence, another mass shooting, and trump running for president again? Ellis didn't think one should be disturbed about these things. Or at least upset. What do you think? David’s reply Hi Thomas: Here’s my take. Healthy and appropriate negative feelings exist! One SHOULD be upset by horrific war crimes. I suspect that if Beck and Ellis, were they still alive, they would both strongly agree, but of course, I cannot speak for them! Thanks for listening today! Matt, Rhonda, and David!

How to Master the Five Secrets: If You Dare! In our recent podcast surveys, one of the highest rated show topics was learning therapy techniques, both for therapists and for the general public. That’s why today we’re going to take a deeper dive on some of the fine points of the Five Secrets of Effective Communication. We’ll show you how to use them with individuals who are angry and hostile, including some patients with Borderline Personality Disorder as well as kids who may be ticked off at a parent. These topics were specifically requested by people who completed the podcast survey. Link to Five Secrets The Five Secrets are like a fantastic musical instrument, capable of working magic for troubled relationships. You can’t just sit down at a fine grand piano and pound on the keys and expect great music to emerge. You’ll just get cacophony. To learn the Five Secrets, you need: Great determination and desire The willingness to endure the “Great Death” of the “self,” or pride. Tons of ongoing practice with immediate feedback and deliberate practice involving role reversals until you get it “right,” or receive an “A.” To get started, Rhonda and David made a list of a few of the most challenging criticisms a therapist might hear from a patient, or a parent might hear from a teenager. Criticisms from patients included: You don’t care about me! I’m not getting better. You’re not helping me! You charge too much! All you care about is your darn techniques. That’s not my child’s name! You’re not listening to me! And this one, from a first time patient referred by the courts: I got anxious last night and masturbated to your image, which I found on the internet, and it really helped! These are some criticisms from kids: Stop nagging me! Stop giving me advice. I don’t want any advice! We demonstrated the “Intimacy Exercise” I have created for our training programs. You can use this exercise to work on conflicts with patients and conflicts with loved ones. It works exactly the same way in both situations. You’ll need someone to practice with. Step 1. One of you agrees to play the critic and the other plays the role of the person being attacked (therapist or parent, for example.) Step 2. The person playing the role of the critic verbalizes the hostile comment. Step 3. The person playing the role of the therapist / parent responds as effectively as you can, using the Five Secrets of Effective Communication. Now you must STOP. The exchange is done. No further interaction in the role playing format is permitted. Step 4. The person who played the role of the therapist / parent gives himself / herself a grade between A and F. Ask yourself, “How well did I do just now?” Step 5. The person who played the role of the critic gives the therapist / parent a letter grade, and then provides the following specific kinds of feedback using Five Secrets language. Positive Feedback: Here’s what you said that worked pretty well. Your Thought Empathy was great, and your Disarming Technique was fairly good. Your Stroking was excellent, especially when you said X, Y, or Z. Negative Feedback: Here’s what you said that needs a little fine tuning: Your Feeling Empathy was completely missing—you did not acknowledge how the other person was feeling. Your “I Feel” statements were also missing, and there was no Inquiry at the end. Then you can suggest ways to include the Five Secrets elements that were missing or “off,” and demonstrate how you might improve the response to the criticism with a role reversal, followed by another round of grading and positive and negative feedback. Continue using role-reversals until both parties can get an A on the exercise, always using the same harsh criticism that you’re trying to learn how to master. Don’t try something new until you’ve mastered the thing you’re working on. The practice is powerful but hard, and requires the philosophy of “joyous failure.” This means welcoming the chance to get immediate feedback about your skills, or lack of skill, instead of getting blown away, defensive, or “yes-butting” the person who’s trying to correct your technique. You will hear some pretty dramatic examples of this on today’s podcast! The Five Secrets can be life-changing, but the price of learning is fairly stiff. If you want the rewards, the exercise we demonstrate in today’s podcast can be incredibly helpful—but scary! Also, you can read my book, Feeling Good Together, and do the written exercises while reading if you’re a therapist or a general citizen. This helps a lot. Dr. Jill Levitt said she kept Feeling Good Together on her nightstand for more than a year when she first joined by training group at Stanford. Her dedication and hard work have clearly paid off for her. If you’re a therapist, you can also read the chapters on E = Empathy in my Tools, Not Schools, of Therapy book, and make sure you do the written exercises while reading! Thanks so much! And good luck if you’re brave enough to try our “Intimacy Exercise!” David and Rhonda

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

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

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

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

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