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

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

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

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

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

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

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

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

David Meets the British TEAM Group, Part 1: Treating adolescents, Intrusive thoughts, TEAM-CBT homework, Surprises from the beta tests, and more. Greg – What were the Surprising Results of the Feeling Good Beta Test? What were the surprising results you referred to in the beta testing the new TEAMCBT App? Were there some things that weren’t effective or didn’t work in the way you expected? Rima – Is Psychotherapy “Homework” required in TEAM-CBT? I have a question about rapid recovery with TEAM CBT. Traditional CBT usually takes quite a lot of sessions and requires homework between sessions. How does this fit with a recovery in a single (two-hour) session? Do the patients still have to do homework? Paul – Treating PTSD with Intrusive Thoughts How can TEAM help an individual who has intrusive thoughts about a traumatic event in their past? Jessica – Treating Adolescents with TEAM-CBT Do you need to vary the therapy techniques when working with adolescents, as opposed to adults? And if so, how? Peter – Positive Reframing in TEAM—How much is “enough?” When you do Positive Reframing to reduce Outcome Resistance, how extensively do you have to do it? Do you have to include every emotion the patient has listed on their Dailly Mood Log? Do you also have to focus on most or all of their Negative Thoughts? What’s the best approach? The following questions will be answered next week in Part 2 of David's encounter with the British group. Tom – Burns vs. Van De Kolk After reading The Body Keeps the Score, by trauma specialist and psychiatrist, Dr Bessel Van De Kolk, it would appear that people with complex trauma require a high degree of stabilizing work, like deep-breathing, meditation, or yoga, before they can engage with effective therapy. Otherwise, they might not have the words to describe their emotions, or might have repressed memories. In addition, they might not engage or might become destabilized and highly emotional or destructive towards themselves and other people. I wonder if that’s your experience with patients you have seen with severe complex trauma in your career? Do you think the TEAM-CBT model has limitations in this area and would you refer to a trauma specialist before embarking on TEAM therapy with such a patient? Sean – Treating Somatic Symptoms with TEAM I’m curious about dealing with the somatic experiences of patients struggling with anxiety, depression, insomnia, trauma, etc. Clients can often challenge their distorted Negative Thoughts but still struggle with the somatic symptoms. I’m curious to know David's thoughts. Hassam – Treating Chronic Doubters with TEAM I’m wondering if David has had experiences with chronic doubters - obsessive doubt in which a patient might say: "Yeah, all these cognitive techniques seem good and all, but what if really I am useless and worthless, and all of this has just been a gimmick? What if it is all a lie? What if we have missed something which really would show how worthless I am ?" Basically, this is closely related to the Pure O version of OCD. OCD is known as the doubting disease, and I really want to hear David's thoughts on how he operates with extremely sticky doubting thoughts. Jacky – Treating Generalized Anxiety Disorder (GAD) with TEAM I have a question about clients with Generalized Anxiety Disorder. When they present with multiple worries, do we need to cognitively restructure every worry? Clients with GAD often have multiple worries so we could be there for quite a while if we have to work on every single worry! End of the Part 1 Questions. David will return to the British group for Part 2 in the future, since they had many additional questions. Here is a note from Dr. Peter Spurrier to all who want more information about the British TEAM-CBT training group: If you are interested in learning more about our group, or want to contact members, please visit us at: https://feelinggood.uk.com/ You will find contact details for many of us on the "Our TEAM CBT Practitioners" page. If you are interested in joining our TEAM-CBT training group, or want more information, you can email me (Dr. Peter Spurrier) at Docspurr@gmail.com.

Podcast 290: A Case of Social Anxiety: Featuring David with Dr. Stirling Moorey (Part 2 of 2) Last week, you heard the first part of this live therapy session with Anita, a woman struggling with severe social anxiety. David and Dr. Stirling Moorey, from London, are co-therapists. Last week included the T = Testing and E = Empathy portions of the session. Today you will hear the A = Assessment of Resistance, M = Methods, along with end of session Testing and follow-up. A = Assessment of Resistance David asked Anita if she was ready to roll up her sleeves and get to work, or if she needed more time to talk and be listened to and supported. Because she was eager to get to work, David asked the “Miracle Cure Question:” He said, “What would happen in today’s session if it went really great and knocked your socks off? She said that her negative feelings and self-critical thoughts would be greatly diminished. David asked the Magic Button Question, and she said she’d press it for sure! David said he had no Magic Button, but did have some powerful techniques that could be super helpful, but was reluctant to use them. Anita was puzzled, and this led to Positive Reframing. He encouraged Anita to ask the three questions about each Negative Thought and feeling on her Daily Mood Logs: Why might this thought or feeling be perfectly appropriate, given your circumstances? What are some advantages, or benefits, of this negative thought or feeling? What does this negative thought or feeling show about your core values that’s positive, beautiful, or even awesome? Although puzzling at first, Anita soon got into the swing of it and came up with the following list of Positives. If I tell myself “I have nothing to say” in a group, I’ll listen more and learn more. I won’t risk speaking and making a fool of myself. So my social anxiety is really a source of self-protection, or even a form of self-love. My self-criticisms show I have high standards. My high standards motivate me to work hard and do my best. My self-doubt shows that I’m humble. My concerns about being judged show that I care for the people in the group and want to have positive relationships with them. Shows I’m not pushy, dominating, or arrogant. When I tell myself that “They are all better than me,” it shows that I have room to learn from all the people who are ahead of me. This shows I want to grow and do better. This shows I’m honest and realistic about my limits and flaws. This shows I’m accountable. This gives me “vicarious joy” in the accomplishments of others, a Buddhist concept. This thought shows that I can appreciate the gifts of others, which is a gift to them. When I tell myself, “I wasted a year,” it shows that I value hard work, learning, and dong a good job. It shows that I value what other people think, and take their criticisms seriously. It shows that I want to be seen for who I am! David pointed out that there were many positives on the list, and if we had time many more could be added, but asked Anita if the positives were: Real? Important? Powerful? She gave enthusiastic “yes” answers to all three questions, and then david asked the Pivot Question: Why in the world would you want to press that Magic button, because if you do all these positives will go down the drain, right along with you negative thoughts and feelings Anita suddenly didn’t want to press the Magic Button, but agree to use the Magic Dial and lower her goals for each negative feeling, which you can see if you click here. This concluded this part of the session, which brought us to the M of TEAM. M = Methods During the Methods portion of the session, David and Stirling used a number of techniques, including: Identify the Distortions Explain the Distortions Straightforward Technique Externalization of Voices with Self-Defense, the Acceptance Paradox, and the CAT (Counter-Attack Technique) And more, using frequent role reversal until she got to “huge” wins, which didn’t take long. Stirling also asked gave Anita how she might test if her fears about the way others saw her were accurate, and they devised some homework to do in the Wednesday training group to find out if other group members had experienced similar doubts about their abilities as therapists. This would involve using: Self-Disclosure - Survey Technique “I stubbornly refused” Technique You can see her final Daily Mood Log if you click here (LINK). We also jumped in and tried to work with Anita’s conflict with her supervisor, but ran out of time and might pick up that thread again in a future session if she is interested. I might add that both David and Stirling also used Self-Disclosure and Story-Telling during the session, as well as some spontaneous humor, which can also be viewed as a valuable treatment method, but one that is hard to explain or teach. You can see Anita's final Daily Mood Log with the outcomes of all of her negative feelings. As you can see, she exceeded her goals in every category, which is not unusual, and was feeling pretty terrific! She had the homework assignment to listen to the recording of the session and complete her DML, so you will only see a couple of the Positive Thoughts listed. Final T = Testing You can see Anita's final BMS here, and her  Evaluation of therapy Session here  As you can see, there were dramatic reductions in depression and anxiety, but only a modest boost in happiness. It would be interesting to see if the happiness goes up further after her "behavioral experiment" at Wednesday's tuesday group. Her scores on the Empathy and Helpfulness scales were perfect. Follow-up This is the email we received from Anita three days later, right after her "behavioral experiment" in Rhonda's Wednesday TEAM-CBT training group:: Hi Stirling, Rhonda, and David, I did the survey question in Rhonda’s Wednesday training group. Here’s what I said: “I am so nervous right now. I sometimes feel like I do not have much to say and so I stay silent in the group. I get anxious and think you all are so far ahead of me in your skills, so I miss out on sharing. I was wondering if any of you sometimes feel the same way?” So many hands shot, so many affirmed my question and thanked me for asking because they get anxious too. I was a little overwhelmed. Loved the experience! Rhonda I hope I did not take too much time.  Anita Rhonda, Stirling, Anita, and David

Podcast 289: A Case of Social Anxiety: Featuring David with Dr. Stirling Moorey (Part 1 of 2) Today, David is joined by one of his first students, Dr. Stirling Moorey, for co-therapy with Anita, a woman struggling with social anxiety. You may remember Stirling from Podcast 280. Stirling was one of David's first cognitive therapy students, and they spend a month doing cotherapy tether in 1979 and again in 1980. David described the magic of their work together in his first book, Feeling Good, and today they are reunited as a therapy team again for the first time in  more than 40 years! I, David, am super excited about working with Stirling again, and hope you enjoy our work with Anita. Rhonda, Stirling, and I are very grateful for Anita's courage and generosity in letting us share this very personal and real session with you! Anita is a member of the Wednesday International TEAM Training group run by Rhonda and Richard Lam, LMFT.  She lives in Nairobi, Kenya, and has a Master’s Degree in Counseling. Here is how she introduces herself: I am Anita Awuor from Nairobi, Kenya.  I have worked as a therapist for 20 years but only recently been introduced to the TEAM Model which has changed the way I work. I work with couples, individuals and families. And recently I worked with an NGO part time.  It’s an honor for me to be here to work with David, Rhonda and Stirling. Dr. Stirling Moorey had the good fortune to be trained by two founders of Cognitive Behavioral Therapy, Dr. Aaron Beck, and our own, Dr. David Burns. Stirling and David worked together in 1979, when Stirling was in medical school in London and came to Pennsylvania for an elective with Dr. Beck. Once he arrived, Dr. Beck asked David if he would work with Stirling, and then, history was made as David created the 5-Secrets of Effective Communication after watching Stirling provide deep empathy to the patients they worked with together. Stirling is currently a Consultant Psychiatrist in Cognitive Behavioral Therapy and was the Professional Head of Psychiatry for the So. London & Maudsley Trust from 2005-2013. He is currently the visiting senior lecturer at the Institute of Psychiatry, Psychology and Neuroscience in London. He is the co-author, with Steven Greer of The Oxford Guide to CBT for People with Cancer, and co-edited the book, The Therapeutic Relationship in CBT, published by Sage Publishing. T = Testing If you click here, you can take a look at Anita’s initial Brief Mood Survey, which was completed just prior to her session with Stirling and David. As you can see, her depression and anxiety scores were in the moderate to severe range, but her anger score was minimal, only 1 on a scale from 0 to 20. Her Happiness score was extremely low, and here marital satisfaction score was fairly good, but with some room for improvement, especially in the category of “resolving conflicts. E = Empathy You can take a look at the first of two Daily Mood Logs that Anita sent to us just prior to the session. It describes her anxiety while driving to a support group. As you can see, her suffering was intense. She also brought in a second Daily Mood Log which described her feelings after receiving a poor evaluation from one of her supervisors at work. The supervision did not involve her clinical work but some management work she was doing. Stirling, with backup from David, did explored and summarized Anita’s feelings. She explained that “Sadness has been a part of my life. I’m sad more often than I’m happy. Sometimes, the negative feelings are hard to live with. . . Problems in relationships often trigger my negative feelings, especially when others criticize me, and I’ve been down the last several days because of a poor evaluation I received from one of my supervisors at work. . . I don’t like criticisms or conflicts, and sometimes I tell myself that I’ll never be comfortable in groups.” Stirling asked about Anita’s negative thoughts when criticized: I’ll never be good enough. What’s wrong with me? It’s all my fault. She described a sequence where her negative thoughts about the situation lead on to more general self critical thoughts like “I’ll never be comfortable in groups” and she then ruminates about her perceived shortcomings. She said, “when I have these kinds of thoughts, the feelings of sadness, anxiety and worthlessness get very high.” David read her two Daily Mood Logs (LINK) and she described the criticisms she received from her supervisor, who suggested that Anita’s efforts had not been helpful. Anita felt hurt and angry, especially since this was the first time she’d received criticisms from her supervisor. Anita added that when she goes into a negative spiral, everything becomes ‘huge,” and she also tells herself, “I’m a bad mom.” Stirling asked what she does to cope when she’s in pain: “I cry a lot. I beat myself up. And sometimes I share my feelings with my husband, but sometimes I just hold it all inside. Sometimes sharing with my husband helps, but sometimes it doesn’t.” David asked Anita how she was feeling now, and she said that her anxiety had already gone down a lot. To bring closure to the Empathy phase of the session, David asked Anita to grade us on Empathy and she gave us As, and Rhonda had the same idea, scoring us as A +. I commented on the idea that Stirling's superb empathy skills were based, in part, on the "nothing technique." He systematically, skillfully, and compassionately summarized her words and acknowledged the pain they conveyed, without trying to make interpretations, and without trying to help or rescue. In other words, he gave her nothing but tremendous listening, which was exactly what she needed! Although this sounds simple, and nearly all therapists will think, "Oh, I do that, too," in my experience, this skill is actually quite rare. it can be taught, and that's on eo the goals of our two free weekly training groups for therapists. But learning genuine and effective use of the Five Secrets of Effective communication requires tremendous humility, dedication, and hard work on the part of the therapists who hopes to learn. End of Part 1. Next week, you will hear the exciting conclusion of the live therapy session with Anita!