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

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

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

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

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

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

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