Ask David featuring four terrific Should questions, and more questions about “asinine, stupid, narcissistic, self-serving humans! “ Oliver asks: Can a thought be thought as moral or immoral? Vincent asks: I have suffered from depression for about 3 years and say to myself, "I should have gotten better sooner." Isn't this "should" appropriate? Charles says: Your concept of “no self” shot my anxiety way up and made me feel hopeless. . . . It makes me feel worse than before! Michelle asks: How is your requirement that new patients must agree to not make any suicide attempts for the rest of their lives any different to a “suicide contract” which you mention are not effective? Brian asks: I’ve done a few things that made me feel intensely guilty. . . . The knowledge that I didn’t do what I should have done led to a lot of guilt and shame, and eventually depression. Just wondering your thoughts on this Carrel asks: I'm a Democrat in Texas. How can we use disarming to heal the political rifts in our country? Natasha asks: How do I stop the dark thoughts of wishing harm to come to stupid humans who do asinine, narcissistic, self serving, irresponsible things—like driving massive, loud pickup trucks around the neighborhood, honking incessantly as they wave their 20 ft political flags; or bringing the family for a paddle boat ride in the local pond, taking delight in teaching their human offspring to paddle the boat as quickly as they can to chase after the beautiful, innocent geese and ducks trying earnestly and fearfully to swim to safety. and more.   Dear Dr. Burns, Can a thought be thought as moral or immoral? In many podcasts and articles, you use "Thou Shalt Not Kill" to demonstrate morally should statement, which is one of the 3 valid should statements in English. I'm still somewhat confused about this concept. To tell you where I get stuck, I come up with three thought experiments. Imagine the following situations in which a should statement may come to mind: Situation 1 Lisa stole some money from a grocery store. When arrested by police, Lisa said with tears, "I shouldn't have stolen money. I feel ashamed for what I have done." In this case, it is obvious that "I shouldn't have stolen money" is a morally should statement, and also a legally should statement, because Lisa did something that violates the law and her moral principle. DAVID’S COMMENT: YES, YOU ARE CORRECT. LISA’S STATEMENT CAN BE CLASSIFIED AS A LEGAL SHOULD AND A MORAL SHOULD. Situation 2 One day, Bob went to Walmart to buy a suit. When he was passing by a shelf, a thought appeared in her mind. "What would happen if I steal this suit? I really want it, but I have very little money." When he came back home, he talked to himself," I shouldn't have felt the urges to steal things. And I shouldn’t have thought about stealing the suit." DAVID’S COMMENT: THESE WOULD NOT BE CONSIDERED VALID SHOULD STATEMENTS BY MOST PEOPLE, SINCE WE HAVE FREEDOM OF THOUGHT. HUMAN BEINGS HAVE ALL KINDS OF FANTASIES AND URGES ALL THE TIME—AT LEAST I KNOW THAT I DO! AN URGE ONLY BECOMES IMMORAL OR ILLEGAL WHEN YOU ACT ON IT. HOWEVER, ALTHOUGH I DO NOT THINK THESE ARE VALID SHOULDS, BUT I TRY NOT TO IMPOSE MY VALUES ON OTHERS FOR THE MOST PART. I AM A SHRINK, SO I WORK WITH PEOPLE WHO ARE ASKING FOR HELP. FOR EXAMPLE, PEOPLE WITH OCD OFTEN PUNISH THEMSELVES JUST FOR HAVING “FORBIDDEN” THOUGHTS, FEELINGS, OR URGES. THE FIGHT TO CONTROL THEM IS THE ACTUAL CAUSE OF THE OCD. THE SHOULDS TYPICALLY MAKE THE PROBLEM WORSE, NOT BETTER. SELF-ACCEPTANCE CAN BE ONE OF MANY HELPFUL TREATMENT STRATEGIES. RELIGION CAN SOMETIMES BE A SOURCE OF OPPRESSIVE SHOULDS, ESPECIALLLY THE MORE FUNDAMENTALIST TYPES OF RELIGION. RIGIDITY MAY BE A PARTIALLY INHERITED TRAIT. FOR EXAMPLE, MANY RELIGIONS AROUND THE WORLD PROMOTE THE IDEA THAT HOMOSEXUALITY IS “WRONG” AND THAT PEOPLE “SHOULDN’T” HAVE URGES AND ATTRACTIONS TOWARD PEOPLE OF THE SAME GENDER. THIS IS AN AREA WHERE “SHOULD STATEMENTS” BECOME HIGHLY CONTROVERSIAL, AND ARE OFTEN A SOURCE OF HORRIFIC HATRED AND VIOLENCE, SOMETIMES IN THE NAME OF SOME “HIGHER POWER.” Situation 3 Lucy was buying fruits in a grocery store when she found that a man was taking an apple off the shelf and hiding it in his clothe! Obviously, the man was stealing an apple. Lucy was very angry and said, "the man shouldn't steal things from the store. It's not right!" In this case, Lucy didn't steal apples, the man did. But Lucy made a moral judgement about the man's behavior, not Lucy's behavior. Then is this should statement valid for Lucy? DAVID’S THINKING. TO MY WAY OF THINKING, YES THESE ARE VALID LEGAL SHOULDS AND MORAL SHOULDS, SINCE OUR CIVILIZATION (AND ALL CIVILIZATIONS) HAVE DECIDED THAT STEALING IS ILLEGAL, AND IS ALSO CONSIDERED MORALLY WRONG IN MOST RELIGIONS: “THOU SHALT NOT STEAL” IS, I THINK, ONE OF THE TEN COMMANDMENTS. THE GOAL IS NOT TO CLEAN UP YOUR SPEECH SO THAT YOU NEVER USE SHOULD STATEMENTS THAT DO NOT FIT INTO ONE OF THE THREE VALID CATEGORIES OF LEGAL SHOULDS, MORAL SHOULD, AND LAWS OF THE UNIVERSE SHOULDS. AT LEAST I HAVE NO INTEREST IN THAT. MY GOAL IS TO HELP PEOPLE WHO ARE SUFFERING BECAUSE OF SHOULD STATEMENTS. sincerely Oliver   Hi David, What is it with "shoulds" related to recovery from depression? I suffer from depression for about 3 years and say to myself "I should have gotten better sooner." Isn't this "should" appropriate? Because who really wants to suffer through this agony? Greetings from Geneva. Vincent Hi Vincent, "I wish I had gotten better sooner." This is a correct statement without the "should." This simple shift in language is called the Semantic Technique, and it was developed by Dr. Albert Ellis who kind of gave birth to cognitive therapy in the 1950s, along with Dr. Karen Horney about the same time. Instead of using a should, you use “it would be preferable if” or “I wish X was true.” In addition, it isn't actually true that you "should" have gotten better sooner! The universe does not always conform to our expectations. Just because we want something, it doesn't follow that it "should" happen. I'd love to have a new Tesla sports car, at least in fantasy, but it isn't true that I "should" have one. It would be “great” if you had gotten better sooner, that’s absolutely true. “I should have gotten better sooner.” That’s totally false. In addition, although one might think that no one would "want" depression, my research and new clinical work indicate that resistance is nearly always the key to recovery. In other words, people do cling to depression, anxiety, troubled relationships, and habits and addictions, but don’t realize why they are resisting change. Once you suddenly see why you are resisting, your resistance paradoxically disappears, and recovery is then just a stone’s throw away. You can learn more about this in my new book, Feeling Great, available now on Amazon. Thanks! PS let me know if you like the new book, and if you find it helpful! All the best, David   A new comment on the post "108: Do You Have a "Self?"" is waiting for your approval Author: Charles Dr. Burns, First off I want to say thank you. Your work has been helping me through my anxiety. However, I really struggled with this podcast. The concept of no self shot my anxiety way up and made me feel hopeless. It made me feel almost as if I was not real or that there is nothing worth striving for. I love helping people. But I feel like I don’t have a purpose if I don’t have a self. It makes me feel worse than before. David’s answer. Hi Charles, The “great death” of the self is a challenging concept, and while it is incredibly liberating, lots of people—most, in fact—don’t “get it.” Some get angry. Some struggle with trying to understand what this could possibly mean. And some find the concept very threatening. That’s why I deleted the chapter from my book. In fact, a couple extremely brilliant and interested colleagues totally couldn’t grasp it, and felt frustrated by my writing on the concept. sometimes, ideas are so simple and basic that people cannot grasp them. The Buddha ran into this problem 2500 years ago. People thought he was fantastic, but almost none of his followers experienced the enlightenment he was so excited to teach them. The 20th century philosopher, Ludwig Wittgenstein, ran into the same problem. He solve all the problems of philosophy, but when he was alive, it was rumored that only seven people in the world, including one of his favorite students, Norman Malcolm, could grasp what he was saying. He went in and out of intense depression and loneliness during his life, in part because of his frustration with trying to teach the obvious. In my book, Feeling Great, I teach that there are actually four “Great Deaths” for the patient, corresponding to recovery from depression, anxiety disorders, relationship conflicts, and habits and addictions. There are also four “Great Deaths” for TEAM therapists. Those sections might be helpful for you! In addition, I focus on the fact that people can never judge your “self,” only something specific that you think or do. Depression cannot exist on the specific level, only up in the clouds of abstraction. For example, Overgeneralization is one of the ten cognitive distortions I described in my first book, Feeling Good. When you Overgeneralize, you see a negative event as a never-ending pattern of defeat, and you might also Overgeneralize from some specific flaw or defect to your “self.” You will read about an attractive and vivacious young professional woman who had the thought, “I’m unloveable,” when her boyfriend of two years broke up with her. This is classic depression thinking, and “self” thinking. She thinks she has a “self” that can be loveable or unloveable. But this is simply not true, and it’s not productive, because she’ll spend all her time ruminating and feeling worthless. An alternative is to focus on why the (overall excellent) relationship didn’t work out, and what she can do to change and learn and grow, so as to make the next relationship even better. You can pick up on the details in the chapter on Overgeneralization if you’re interested! As I point out in Feeling Great, the “death of the self” is not like a funeral, it’ like an incredible celebration of life. Death of your old concept of what you are is liberating, and leads to instant rebirth. My teachings cannot make you happy or unhappy. Your thoughts about what I’m saying create all of your feelings, positive or negative. At any rate, thank you for a most important question that most of my audience will definitely related to. As an aside, I lost my “self” years ago, and what a relief that was. Sadly, it comes back to life from time to time, and then I struggle again, until I realize what’s happening. One day, what I’m saying may make sense! In the meantime, please accept my apologies concerning the “self!” If it gives you comfort to believe you have a “self,” no problem. But the “self” is just a concept, and not a “thing” that could exist or not exist. When you lose your precious and protected “self,” you lose nothing, because there was never anything there in the first place! But while you lose nothing, you do inherit the earth, as nearly all great religious leaders—Buddha, Jesus, and others—have taught us. David   Hi Dr. Burns, I’ve just listened to your podcast episode on suicide and found it really interesting and useful but I have a few questions. Firstly, how is your requirement that the patient agree to not make any suicide attempts for the rest of their life any different to a ‘suicide contract’ which you mention are not effective? Also, you talk about doing this assessment at the intake and making non-attempts a condition of therapy. If the patient/client agrees to this, why then do you continue to monitor suicidal thoughts in each session in the BMS? Presumably because the agreement is no guarantee of cessation of thoughts. Surely if you’ve told them it’s a condition of therapy with you to not make any attempts then they’d be likely to not tell you about them even if they occurred, and don’t see how setting the initial ground rule resolves the problem. And lastly, when suicidal thoughts, urges, or fantasies do come again in the BMS how do you handle it then? Do you tell them you’ll end therapy, say “but you promised”? Looking forward to your reply. Thanks, Michelle. Hi Michelle, I have scheduled your email for an upcoming ask david episode, and will use your first name unless you prefer that i use some other name. Here is a brief reply. Most patients with borderline personality disorder will become enraged by the gentle ultimatum at the initial evaluation, and if they decide this is not the type of therapy they want, so be it. The techniques I use will not be effective with patients who continue to threaten suicide. TEAM therapy requires TEAM work. Most, nearly all, patients will "get it" and will decide to continue with the therapy. They can have suicidal thoughts and urges, and we can work on them together in therapy. However, to my way of thinking, it is important that they therapist and patient be protected, in a safe environment. If the patient starts threatening to make a suicide attempt, then they will need another form of more intensive treatment like hospitalization, day care, or intensive outpatient treatment. These are options I cannot personally provide for them. I monitor suicidal urges before and after each session with every patient with no exceptions to protect the patient and to protect myself as well. Thanks! PS the suicide contract is an agreement not to attempt suicide "while we are working together." This is very weak, as the patient can suddenly decide he or she is dropping out of therapy and making a suicide attempt. And this often happens. My contract is more demanding, and intentionally so. Patients must also agree to do psychotherapy homework, too. Some patients want to make the therapist a hostage with suicide threats, which can and so work as a form of manipulation and hostility. Then the therapist is in an almost constant state of agitation, anxiety, and frustration. If I allow a patient to make my life miserable, how can I teach that patient how to be happy? We are all ONE—we go up and down together. If I allow you to make my life miserable, then I am allowing you to make your own life miserable, too. David   Hello David, Thank you so much for everything you do. I’ve listened to all of your podcasts, and read most of your books, and am very grateful for the changes you, Rhonda, Fabrice and the rest of the team have made to my life. I’ve just listened to this episode, and there’s one thing I’m struggling with, which is the concept of the moral should. I’ve done a few things that made me intensely guilty – one in particular was not standing by and supporting a friend who needed people when he was going through a particularly hard time. He was angry and disappointed with me, and, in hindsight, rightly so. He has since forgiven me but I still struggle with it. I feel that supporting him was a moral should. The knowledge that I didn’t do what I should have done led to a lot of guilt and shame, and eventually depression. You say that a moral should is valid; so therefore, I feel that my negative thoughts on this are not misguided but valid – I did something morally wrong and deserved to feel bad for it. Just wondering your thoughts on this. Thanks again, and keep up the good work! Hi Brian, thanks! Would love to include this on an Ask David, using just your first name, or even a fake name if you prefer. A quick response might be to ask how many minutes per day would you like to dedicate to feeling guilty? And for how many days, months, or years? In your spiritual or religious beliefs, is a person supposed to feel intensely guilty forever? Most of us have done things we are ashamed of, or feel guilty about. How much guilt and shame would you recommend for me, for example? And what is the goal of the guilt and shame? And how guilty would you recommend I feel, between 0% and 100%? That's one approach. Another approach would be A = Assessment of Resistance, listing what the guilt shows about you that's positive and awesome, and then asking yourself why in the world you'd want to let go of the guilt, given all the many real positives. Then you might validly decide to “dial it down” to some more acceptable level. For example, if you now feel 90% guilty, perhaps 15% or 20% would be enough. In addition, you could also decide how many minutes of guilt you would recommend. If you now feel guilty about eight hours a day, would 10 minutes be enough? If so, you could schedule your “guilt periods” ahead of time, and then really work hard at feeling guilty during those ten minutes. Then, when you’re done with your “guilt work,” you can return to joyous and loving living! Also, instead of one ten minute daily guilt binge, you could schedule, for example, three guilt binges, each three minutes long, in the morning, at lunch time, and in the evening, like three pills the doctor prescribed! David In reply to Dr. Burns. Hi Dr Burns, Thanks so much for your quick response! I really appreciate your advice; I will dedicate a bit of time today to approaching it the way you say. And also, I’d be delighted if you included it on a podcast! You can use my first name by all means. Thanks again! Brian   Comment from Carrel I'm a Democrat in Texas. How can we use disarming to heal the political rifts in our country? How does one find agreement across that ever-widening divide? Carrel David’s reply Hi Carrel, It’s really tough, for sure! Have you listened to my podcast on this topic? There is a search function on my website. If you type in “political divide,” this podcast will pop right up: “127: How Can We Communicate with Loved Ones on the Opposite Side of the Political Divide?” Let me know what you think! David David emphasizes the value of the search function. Often you can find your questions have already been addressed. In addition, the many podcasts on the Five Secrets of Effective Communication could be invaluable (links), and the emphasis would be on using the Disarming Technique to find some truth in what the other person is proclaiming and arguing for. But first, you have a decision to make, and this is always based on ONE person you may want to interact with. First, ask yourself if you do actually want a better relationship with person X, Y, or Z. There is no rule that says we have to get along better with everyone. I think that Joe Biden is doing a pretty good job of promoting unity, and not diverseness in our country. Hopefully, the forces of love and unity will win out over the forces of hatred and war, but it’s not at all clear what direction our country is heading for. And we’re seeing now that at times the tensions are become so intense, and the hatred so strong, that violence is once again on the increase. In the next Ask David we'll have a really cool session devoted to the intense anger that many of us feel when confronted by human behavior that strikes us as narcissistic, vicious, self-serving, and aggressive. This topic should appeal to lots of people! And we have a wonderful question from a woman who's feeling pretty darn enraged! David and Rhonda  

Last week, you heard part 1 of the live work with Sunny. Today, you will hear the dramatic conclusion of that session. My wonderful co-therapist is Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California. Jill also co-leads our Tuesday training group at Stanford. This session took place between 5 and 7 PM at a recent Tuesday group because we feel that personal healing is a critical part of psychotherapy training. We will begin with a summary of A = Assessment of Resistance. David will summarize  Sunny’s Positive Reframing list, as well as the “turning point” when David challenged Sunny’s first negative thought, telling himself that he shouldn’t be getting anxious again. Once again, the moment he saw that he actually should be getting anxious, and that this was a good thing, and not a bad thing, the dam kind of broke open, and Sunny suddenly saw everything in a radically different perspective. This is one of the core principles and goals of TEAM—helping the patient suddenly see that his or her suffering is not the expression of what’s wrong with you, like a “chemical imbalance” in your brain, but what’s most beautiful and awesome about you, and your core values as a human being. During this phase of the session, Sunny expressed anger about parents who tell their children they SHOULD do X, Y, and Z, and thus sowing the seeds of low self-esteem and the need for approval. We continue and conclude the M = Methods, using: Identify the Distortions The Enhanced Cost-Benefit Analysis (Enhanced CoBA) The Externalization of Voices, with Self-Defense and the Acceptance Paradox The Hidden Emotion Technique The Five Secrets of Effective Communication Final T = Testing. You can see Sunny’s end of session mood ratings on his completed Daily Mood Log, as well as his end of session scores on the Brief Mood Survey and Evaluation of Therapy Session. Here is Sunny’s follow-up email to the Tuesday group: Hi folks. Just want to give you an update of what happened after our group meeting. I was exhausted after our session. But I felt very good - even different than other times when I did self disclosure and deep-down part of me was looking for some validations from others. This time, I came out feeling very confident about myself and my ability to swim without the floating bubbles (approval from others). Most importantly enjoy life now. In fact I didn’t think talking with my mom was necessary because I was not angry with her the next day. Somehow I wasn’t blaming her anymore because I know she changed since then. And I was thankful because I wouldn’t be where I am without that push. But I did chat with her tonight. I told her how I was hurt when I felt a lot of pressure from her when I was young. And that I love her very much and now am happy that I am confident about my own life decision without needing approval from others. And she told me that she is happy that I am happy. And when we were young, she And she will always love me and support me. And she is happy that I am doing whatever I love so I don’t regret in life. And on and on... lots of loving languages that we don’t use together usually :) Net net: it was an awesome chat and we are closer. But as importantly, I wasn’t looking for any validation from her - more like giving her some good news about my personal growth. And I felt more confident and equal but loving when I talked with her. So it’s all good :) I do have an insight on self disclosure. From my experiences, there is a fine line between self disclosure vs approval seeking type of sharing. Both can have similar Immediate results - feeling good and emotional. So make sure our clients are clear of the objective of the self disclosure. And that there is no approval seeking hidden inside - if that’s not the objective. See you all next Tuesday Sunny And here is some of the feedback from members of the Tuesday group: What did you like the least about today’s Tuesday group? Nothing comes to mind Sunny was fabulous! This isn't something I disliked, but a question... I'm trying to figure out how David and Jill are able to get through the process so quickly and yet have it not feel rushed.. I suppose a lot of practice! Also curious about how Sunny will talk to his mom- thinking about doing this with my mother, I'd be worried that she'd feel like I was blaming her for something and become defensive and close down (which she typically does when anyone tries to bring up their feelings or even when they ask about hers), so I'd be curious about the specific details of the 5-secrets approach here Nothing — I loved everything about our session tonight Please describe what you specifically liked about the training? What was the most helpful? Agree with David that the learning which takes place via live personal work may be the most powerful of all. Helpful to review the various steps and methods while also watching the masters weave the art and science of It all together. Thank you to the brave Sunny for sharing this work with us tonight. This Session was also an awesome dose of relapse prevention for myself, as while I have made major strides with approval addiction this year, I still drift in and out of enlightenment, as is expected! I appreciate that Sunny's courage to share his vulnerability. His cultural background and parenting style are very similar to mine. I enjoyed the masterful use of empathy from David and Jill I share Sunny's approval need without being told by a parent, at least not obviously. The 'talking back to distorted thoughts' helped me a lot. Also, watching the flow of the therapy by David and Jill was educational in my interactions in similar situations. I loved seeing the whole process of TEAM being modeled with Sunny. I especially liked the positive reframing and empathy stages the best, but it was all so blow away to experience. I'm so grateful to be able to be a part of this group. I loved watching the whole session unfold. It was a powerful positive reframe and Jill really honed in on the hidden emotion which seemed to really resonate with Sunny. I love the live sessions. It went so deep, and was so moving and beautiful. I appreciate Sunny's courage and authenticity, and the skill of David and Jill. Feeling so grateful to be able to see the live demo of TEAM by David & Jill on Sunny. It feels like watching the very painful but beautiful grief process of letting go of this infamous approval addiction, which I relate to so much as a Chinese woman. Watching how the enhanced CBA is a very magical, powerful & dynamic uncovering tool to address outcome resistance & change his mood rapidly. I loved being able to walk patiently through each step of the therapy. I am frequently amazed at how quickly the work goes once the TEA is managed fully and effectively. I love this stuff! Thanks for allowing me to be an observer and participant in this group. I like seeing the richness of live work. It was uplifting to hear group members share with Sunny how the session affected them and how they think about their parent-child relationships. It's always great to watch a full session. This has been a wonderful session and also a surprise. I see clients and do not get to check emails before we start and was not aware we were heading for another individual work - what a treat! This has been an amazing session. Sunny is a very bright and sensitive guy and admire his eagerness to work though his challenges and open up to the group. I have learned so much from his insights and felt most honored to be an invisible participant in this process. Thank you Sunny! Jill and David you were wonderful! This has been a particularly powerful session. Thank you. It was great to see the shift in thinking and feeling in session. Sunny was so open to talk about his past and his pain; he had been reflecting about his approval addiction for some time. It seemed that through the positive reframing he was able to see his "addiction" from a different perspective. Approval addiction is something I have struggled with myself over the years and I felt so grateful toward Sunny for his vulnerability. Also really appreciated Jill's pausing to address the anger that came up in the Externalization of Voices, and David's teaching point about how important it is for the patient to really "SEE" something during the positive reframing. Loved that Sunny was willing to be truly vulnerable and authentic. I always love seeing the model from start to finish. Session tonight was exceptionally awesome. Thank you, Sunny for your willingness to work on something so painful and deep in front of the whole class. This has been one of my favorite classes. You touched my heart because you were genuine,, honest, and very very humble. Thank you! And thank you to David and Jill for their superb teaching. As always, I learn so much from them when they do live. With immense gratitude – Sara Demonstration by David and Jill. It was such an amazing opportunity for us to witness how T.E.A.M works and get through the process. Approval addiction is something I have wanted to work on myself..... I need to listen to the recording and review! I enjoyed seeing the ease in which the TEAM method was used Jill's way of connecting some dots and inquiring with sunny about his mother’s understanding of his experience. Jills ability to do this always blows my mind because I'm still trying to tap into that deep level of listening. Thank you for sharing Sunny! Love the cultural aspect that was brought in This live session was moving, insightful, and very instructive for me. It gave me insights into my own approval addiction, it moved me to see how Sunny went through his internal conflict throughout the session, and it was beautiful and very instructive to see two master therapists like David and Jill at work. Thank you so much Sunny, David, and Jill! Thank you Sunny, David and Jill. I was moved and touched by the therapy. I like David and Jill asked Sunny his feeling at an appropriate moment during the therapy instead of only at the beginning and the end. For instance, David asked, "You are opened up to us. How are you feeling now?" Jill asked how angry he was when he expressed his feeling of anger to his mom. It is very powerful. I liked how David asked Sunny to communicate with his mom. Although I am learning the Five Secret skills, it is still hard to use them in daily life. I need to practice it. Sunny can be reached at: Sunny Choi, LCSW sunny@bettermoodtherapy.com Better Mood Therapy Thanks for listening today! David and Rhonda

In today’s podcast, we will work on another common Self-Defeating Belief, the Approval Addiction. Here are two definitions: My worthwhileness as human being depends on getting approval. I need approval to feel happy and fulfilled. I thought of calling this podcast “Curing a Case of Siliconitis” because here in Silicon Valley, there is a pronounced tendency for people to measure their self-esteem based on their accomplishments, so today’s program also has some overlap with the Achievement Addiction we featured recently. Of course, you don’t have to live in Silicon Valley to struggle with the Approval and Achievement Addictions. These problems are almost universal throughout the United States as well as the entire world. In fact, for today’s special guest, Sunny Choi, the problem originated in Hong Kong when he was growing up. And although your life may be very different from Sunny’s, you may discover that you, too, sometimes struggle with the need for approval, and the tendency to base your self-esteem on your achievements. So I’m hoping that the healing Sunny experienced might be contagious and end up helping you! I want to thank Sunny for allowing his personal work to be broadcast, raw and unedited, on the podcast. Personal work is absolutely essential to becoming a world-class therapist, because you can’t really heal others until you’ve healed yourself. But sharing your inner struggles, your tears, and your shame, can be extremely frightening, making you totally vulnerable, so Sunny has given all of us an incredible gift! I also want to thank my amazing co-therapist, Dr. Jill Levitt, who helps lead the Tuesday group. She is also the Director of Training at the Feeling Good Institute in Mt. View, California. I love teaching and doing co-therapy with Jill. TEAM therapy does NOT require two therapist, but I love to work with a co-therapist whenever I do live therapy in a teaching situation, as it often makes for a richer and more dynamic session. The session will be broken into two consecutive segments. Today, you will hear the T = Testing and E = Empathy parts at the start of the session. Next week, you will hear the A = Assessment of Resistance and M = Methods parts. At the end of next week’s podcast, Sunny will join us for a follow-up so we can see how he’s been doing since the end of this session. At the beginning of the session, we reviewed Sunny’s scores on the Brief Mood Survey, which indicated minimal feelings of depression, mild anxiety, and just a touch of anger. However, his happiness score was only 22 out of 40, indicating significant unhappiness, and his Relationship Satisfaction score, thinking of his mother, was only 16 out of 30, which is also not very good. However, he said that this score is higher than it’s been, indicating longstanding dissatisfaction with his relationship with his mother. Sunny explained that he’s been seeking and getting approval since he was a small boy. He was the “good golden boy” who always wanted what his mother wanted, and he always got rewarded. In addition, since he was a boy, he always got the best food, and his sister always got the less desirable dinner. In addition, she was a rebel, and often punished and beaten by their mom, which made Sunny feel guilty. At the same time, he was good at getting approval from just about everybody, so lots of people like him. His first frightening step toward independence was coming out as a gay man in his 20s. This was an intensely anxious time in his life. After his family migrated to California, he pursued a career in high tech, which was what his mother wanted, and he was very successful and earned a high salary. But he was unhappy, because it wasn’t what he really wanted to do with his life. He wanted to help people, but because of a lisp in his speech, his mother urged him to pursue engineering, which, of course, he did, and he also graduate from Stanford University, which gave him even more approval and “success.” His second frightening step toward independence was six years ago when he decided to leave high tech to pursue a master’s degree in clinical social work. This was a bit anxiety provoking because he did his master’s work at a program that was adequate, but not at all prestigious. That was about the time he joined my weekly training group at Stanford. Sunny took the TEAM model very seriously, and mastered it, developing superb therapy skills. Following his licensure, he took a job at a local mental health clinic and worked with many immigrants struggling with depression, anxiety, and somatic complaints, and experienced tremendous success, since most of us patients recovered in just a handful of sessions. However, he was anxious and ashamed of his success, since TEAM is so radically different from the more conventional forms of therapy his colleagues at the clinic were using. He feared their disapproval, and always tried to hide or downplay his success. Recently, Sunny took a third frightening step toward independence. He decided to quit his full-time job, and take a half time job with an online startup, so he could have half of his time to do what he wanted, instead of trying to please or impress others. And although this is working out well, and he’s been feeling pretty good, and making progress, at times he gets anxious, and feels like he’s swimming in the ocean without his flotation device to keep him safe. And although he knows rationally that he can swim really well on his own now, at times he descends into spells of anxiety and self-doubt. He even yelled at himself out loud for being “stupid.” He explains: What helped was when I called my Mom and said, “I feel useless if I’m not working full-time,” and started crying. She is now 80, and was accepting, and that helped quite a bit, but in the past I’ve always been surrounded by people who approve of me because of my success. Now I feel lost and lonely, and I’m dealing with anxiety again. Sunny also said he felt frustrated because, once again, he sought and got his mother’s approval. He explained: I feel bad. I’m concerned that I will never get better. I feel sad that I’m stopping myself. My approval is my flotation device. I’m scared and lonely at times. I’m used to someone saying, “You’re doing the right thing.” I feel like I’m not good enough. Right now I want the approval of the Tuesday group, but that will just prolong my addiction. You can see Sunny’s Daily Mood Log here. Next week, Jill and I will work with Sunny on A = Assessment of Resistance and M = Methods! Sunny can be reached at: Sunny Choi, LCSW sunny@bettermoodtherapy.com Better Mood Therapy David and Rhonda

In today’s podcast, we discuss a few of the many differences between Feeling Good, my first book, and my new book, Feeling Great, which was just released. We also discuss some of the differences between the cognitive therapy that I launched in Feeling Good, and the powerful new TEAM therapy that I feature in Feeling Great. I wrote Feeling Great because there’s been a radical and enormous evolution of the treatment methods and theories in the 40 years that have elapsed since I first published Feeling Good in 1980. I now have many more techniques than I had then, and there’s been with a radical development in my understanding of the causes of depression. I also have new ideas about the most effective treatment techniques, based on my clinical experience since I wrote Feeling Good (more than 40,000 hours treating individuals with severe depression and anxiety), as well as fresh insights about what's important, and what's not, based on four decades of my research on how psychotherapy really works. Rhonda asks many questions about the unique features of TEAM including the new T = Testing techniques, the new E = Empathy techniques, the A = Assessment of Resistance techniques, as well as the M = Methods. Rhonda is particularly curious about the four “Great Deaths” of the therapist’s ego in TEAM therapy, which correspond to the four TEAM components of TEAM, as well as the four “Great Deaths” of the patient’s ego, which correspond to recovery from depression, anxiety, relationship problems, and habits and addictions. One of the goals of TEAM is not simply the complete and rapid elimination of the symptoms of depression and anxiety, but the development of personal enlightenment and the experience of great joy and a deeper appreciation of life. Toward the end of the podcast, David tearfully talks about the life of his hero, Ludwig Wittgenstein, who is viewed by many as the greatest philosopher of all time, and David, a philosophy major when he was a student at Amherst College, would definitely agree with this assessment. But Wittgenstein was very lonely, and prone to depression, because very few people understood his ground-breaking contributions when he was still alive. In fact, it was thought that only five or six people in the world “got it.” Part of the problem is that what he was saying was so basic and obvious that most people just could grasp it, or the extraordinarily profound implications of his work. His depression and loneliness, sadly, perhaps also resulted from the fact that he was gay, and living at a time when this was far less acceptable than it is today. He never published anything when he was alive, because when he was depressed, he thought he'd made no meaningful or enduring contributions. However, his remarkable book, Philosophical Investigations was published in 1950, following his death, and was soon regarded as the greatest book in the history of philosophy. Because of that book, David gave up his goal of a career in philosophy, since Wittgenstein wanted all of his students to give up philosophy and do something practical instead. So that’s what I did! My only regret is never having the chance to meet Wittgenstein and tell him, “I got it!” and thank him for his incredible contributions. If you want to learn more, check out the short read by his favorite student, Norman Malcolm, who wrote “Ludwig Wittgenstein: A Memoir.” I cry like a baby every time I read the book, and tears come to my eyes when I even look at the book, which is proudly displayed in my office. If you ever visit me at home, make sure you check out the  book. I feel so fortunate to be able to work with Rhonda and bring my message to so many of you every week. Thank you for your support!  [Note from Rhonda:  I feel extremely honored to work with David and be a part of bringing David's message, and the TEAM therapy model to our listeners!] David and Rhonda

How to Change a Self-Defeating Belief (SDB) (cont'd) Last week, you had the chance to listen to our Tuesday training group at Stanford as we worked on the "Achievement Addiction," Part 1 (Podcast 211). Although we were working with a therapist named Zeina Halim, it turned out that just about everybody in the group had this belief, and perhaps you do, too--thinking that your worthwhileness as a human being depends on your achievements, hard work, and productivity. This belief, which is also known as the Calvinist work ethic (e.g. you are what you do) is actually at the heart of Western Civilization. And while it can trigger intense achievement, it can sometimes also trigger angst, including feelings of depression, anxiety, and endless self-doubt, wondering if you and your achievements are "good enough." In last week's podcast, we played the first half of the Tuesday group's session, featuring the Cost-Benefit Analysis. In today's group, we play the the recording of the last half of the group, featuring these three additional techniques. At the end of today's recording, Zeina joins us and talks about the session, and the techniques that were the most meaningful for her. The Semantic Technique. This involves change at the intellectual level. If you decide that a SDB is not working to your advantage when you do a CBA, you can you modify it so you can keep all the advantages you listed while getting rid of most if not all of the disadvantages. This is a bit of practical personal philosophy exercise with significant emotional implications. The group members came up with a wide variety of alternate beliefs, and I critiqued several of them, pointing out the benefits and pitfalls of each new version. The Feared Fantasy. Here's where change at the gut level begins, and you also can begin to challenge the idea that high achievers really are more worthwhile. We did a version of this technique that I've often demonstrated in my workshops called the "High School Reunion." It is a humor-based technique, but the goal is to make a powerful point at the gut level, so you can (hopefully) suddenly "see" that it is simply not true that people who achieve a great deal really are more worthwhile human beings. The Double Standard Technique. Here's where change at the gut level continues, and you will hear a beautiful example in Zeina's dramatic interaction with Dr. Levitt. Dr. Levitt plays the role of someone trying to figure out if she really is less worthwhile than people who achieve a great deal more. Rhonda and I hope you enjoyed our podcasts on the Achievement Addiction. We'd also like to thank our courageous Zeina for sharing her very personal work with all of us. Live work--and showing how a technique works--is generally far more inspiring and illuminating than simply teaching how a technique works. Please let us know if you'd like more Feeling Good Podcasts like this in the future, with recordings from our weekly training group,  and also if there are additional Self-Defeating Beliefs you'd like us to feature. My new book Feeling Great, is now available on Amazon (see the link below) as a hardbound volume or as an eBook. It features all the new TEAM therapy techniques, and is geared for therapists as well as the general public. Rhonda and David

How to Change a Self-Defeating Belief (SDB) Many of you have expressed an interest in my free Tuesday training group for mental health professionals. Today, you can attend, thanks to the generosity of our group in allowing the group to be recorded on Zoom, and thanks Zeina, the group member who courageously volunteered to have us work on her “Achievement Addiction.” I also want to thank my beloved and brilliant co-teacher, Dr. Jill Levitt, who always adds tremendously to our group, on so many different levels. Last week, we taught the group members how to pinpoint Self-Defeating Beliefs that trigger depression and anxiety, and we promised to show them how to challenge and modify a Self-Defeating Belief in the group you’re about to “attend.” We decided to focus on the Achievement Addiction, which is the belief that your worthwhileness as a human being depends on your achievements and productivity. Perhaps you share this belief! Most people do. Here’s how a Self-Defeating Belief works. Let’s say that you base your self-esteem on your achievements. As long as you think you’re achieving and being successful, we would predict that you’ll feel happy and contented. But we would also predict that you may experience episodes of depression, anxiety, and self-doubt when you fail or fall short of your goals and expectations. That’s when you’ll be most likely to start beating up on yourself with distorted negative thoughts, like “I’m a loser,” or “I shouldn’t have screwed up,” or “I’m not good enough.” So, in short, the combination of an SDB (“My worthwhileness is based on my achievements”) plus a negative event, like a perceived failure, triggers distorted thoughts (like “I’m a failure” or “loser”) which trigger negative feelings, like depression, anxiety, shame, inferiority, or even suicidal thoughts. In addition, cognitive therapists believe that if you modify the SDB, it will not only help you in the here-and-now, but it can also make you less vulnerable to painful mood swings in the future. But how in the world can you do that? If you like, take a look at the list of 23 common Self-Defeating Beliefs and see if you can find any of yours! Zeina said she wanted help with her tendency to base her feelings of happiness and self-esteem on her accomplishments. In the group, we demonstrated four techniques for changing this or any SDB, including: The Cost-Benefit Analysis.  You list the advantages and disadvantages of the belief you want to change. You can find the one we worked on with Zeina during the group if you click this link. If you want a blank one you can work with, you can find one on page 2 of this link. The Semantic Technique. This involves change at the intellectual level. if the SDB is not working to your advantage, could you modify it so you can keep all the advantages you listed while getting rid of most if not all of the disadvantages. This is a bit of practical personal philosophy exercise with significant emotional implications. The Feared Fantasy. Here's where change at the gut level begins, and you also can begin to challenge the idea that high achievers really are more worthwhile. The Double Standard Technique. Here's where change at the gut level continues, and you can hear a beautiful example in Zeina's dramatic interaction with Dr. Levitt. In today's part 1 podcast, we completed the Cost-Benefit Analysis. I would urge you to do your own CBA while you're listening. When you're done, balance the advantages against the disadvantages on a 100 point scale. Put two numbers in the circles at the bottom to show whether the advantages or disadvantages are greater. For example, if the advantages of this belief greatly outweigh the disadvantages, you might put 80 - 20 in the two circles. If the advantages and disadvantages of this belief are about equal, you can put 50 - 50 in the two circles. And if the disadvantages are somewhat greater, you might put 45 - 55 in the two circles. When you do your own weightings, please note that the number advantages or disadvantages is not important--that's because one advantages could outweigh several disadvantages, and vice versa. Instead, look at the lists as a whole and ask yourself how they feel, and how this belief is working for you. In addition--and this is super important--remember that you are NOT evaluation the advantages and disadvantages of achievement. There probably aren't any disadvantages of achievement! Instead, you are evaluating the advantages and disadvantages of basing your self-esteem and feelings of worthwhileness on your achievements and productivity. At the end of the group work with the CBA, I emphasize that the goal of the CBA is simply to find out if you (or in this case Zeina) want to change your SDB. This is a motivational question. If the advantages and disadvantages are about equal (50 - 50), or if the advantages out weight the disadvantages (eg 60 - 40), then there may be no reason to change the belief. But when the disadvantages outweigh the advantages, you can then change the belief so that all the disadvantages diminish or disappear entirely, while at the same time you keep all the advantages. That sounds like a pretty good deal! In next week's podcast, you'll learn how to make this happen with the help of the Semantic Technique, Feared Fantasy, and Double Standard Technique! There are a great many additional techniques for challenging and modifying any SDB as well. The four I listed above are just a kind of “Starter Kit” for SDBs to give you a feel for how some of the techniques work. If you like this podcast, we may focus on other SDBs as well, such as the Approval Addiction, the Love Addiction, and more. Let us know if you’d be interested, and which beliefs interest you the most. We’ve already done a podcast on perfectionism, as well as a popular Live TV program on perfectionism on Facebook that features Jill and me, but there are tons of beliefs we haven’t yet addressed. To make today’s podcast more dynamic, you can do your own Cost-Benefit Analysis while you watch, and make sure you do your own weightings at the bottom, just like the therapists in our Tuesday training group. I think you’ll enjoy it, and it might nudge your thinking a little, too! Please let me know if you've enjoyed "eavesdropping" on my Tuesday training group, and if you'd like more Feeling Good Podcasts like this in the future. Let me know, too, if you'd have an interest in attending a weekly TEAM therapy training group for therapists or for the general public. My new book Feeling Great, is now available on Amazon (see the link below) as a hardbound volume or as an eBook. It features all the new TEAM therapy techniques, and is geared for therapists as well as the general public. Rhonda and David

Corona Cast 8: Live Therapy with Dan. How Could You Treat an “Existential Depression” in the Midst of a Pandemic? Today David and Dr. Jill Levitt feature live work with Dan, a licensed clinical social worker who’s been struggling with an “existential depression” for 15 years, but it has been recently exacerbated by the COVID-19 pandemic. The session took place in one hour and forty minutes on a Tuesday evening on July 23rd, 2020, in David’s and Jill’s Tuesday training group at Stanford. Live personal work is one form of training that is vital to professional growth and learning, so it is extremely beneficial for the person who volunteers for the role of “patient.” At the same time, the live work also provides superb learning for those observing the process, since you can see what is really happening during a T.E.A.M. therapy session. Hopefully, you will learn a great deal as you listen to Dan’s live and uncensored therapy session. Jill and I feel very grateful to Dan for allowing us to publish such an intensely painful and personal experience. You will likely feel grateful to Dan as well! All live therapy sessions tend to be dramatic and illuminating from a variety of perspectives. Today’s session is unique in that the A = Assessment of Resistance was outstanding and unique. The remarkable changes that occurred would not have been possible without outstanding E = Empathy and A = Assessment of Resistance, which were stellar. However, the M = Methods portion of the session was also strong, especially in the use of humor and role-reversals during the Externalization of Voices to blast Dan’s Negative Thoughts out of the water. That portion of the session confirmed by the three basic tenants of cognitive therapy: You FEEL the way you THINK. All of your negative feelings are caused by your thoughts in the here-and-now, and not by the actual events in your life. In other words, the COVID-19 pandemic cannot “cause” anyone to feel depressed or anxious. Depression and anxiety are the world’s oldest cons. When you’re depressed, anxious, or angry, the Negative Thoughts that upset you will not be valid. They’ll be distorted and illogical. Depression and anxiety are the world’s oldest cons. You can see the ten cognitive distortions I first published in my book, Feeling Good, at the bottom of Dan’s Daily Mood Log (link). You can CHANGE the way you FEEL. The very instant you stop believing your distorted thoughts, your feelings will change. Recovery is not a long, drawn-out process that requires weeks, months, years or decades, as so many people believe, including the majority of mental health professionals. Recovery happens in a flash, an unexpected “ah-ha” moment when your perceptions of the world are suddenly transformed. You will witness such an event in today’s session. Now let’s see what actually happened! T = Testing Take a look at Dan’s Brief Mood Survey (BMS) at the start of the session. He was feeling moderate to severe depression, no suicidal impulses, and just a little anxiety and anger. His Happiness score was quite low, only 7 out of 20, paralleling his depression score of 12, and his satisfaction with his relationship with his wife was a perfect 30 out of 30. He indicated he’d been doing a lot of psychotherapy homework. This, by the way, is the latest version of the BMS. We’ll ask him to complete it again at the end of the session to see what changes occurred during the session. Because the BMS asks how Dan is feeling “right now,” it’s like an emotional x-ray machine, allowing therapists to see exactly how much, or how little, a patient is changing at every therapy session. The patient’s scores at the start of the next session also allow the therapist to see exactly what happens between sessions in multiple dimensions. At the end of today’s session, Dan will also fill out the Evaluation of Therapy Session (ETS), and rate Jill and David on Empathy, Helpfulness, and Session Satisfaction, and indicate how willing he is to do psychotherapy homework, whether he had unexpressed negative feelings during the session, and whether he had difficulty filling out any of the survey questions honestly. The BMS and ETS are invaluable tools that have been game-changers in psychotherapy. To my way of thinking, it is difficult, if not impossible, to do good therapy, much less outstanding therapy, without these powerful and extremely accurate tools. They have the potential to radically transform clinical work and have been an important key in the evolution of TEAM. E = Empathy After briefly reviewing Dan’s starting scores on the BMS, Jill and David empathized while reviewing the Daily Mood Log that Dan filled out prior to the start of the session. The upsetting event was sitting at home on a Friday night with nothing to do, since his wife was studying for an upcoming exam. He points out that when he’s busy doing therapy, he generally feels fine, but sometimes when he has nothing specific to do, intense negative feelings suddenly hit him and take all the joy out of life. As you can see, his feelings on his Daily Mood Log are similar to his feelings on the Brief Mood Survey but some are far more intense, since he’s focusing on a moment of angst. If you look at his Negative Thoughts, you will see that they all revolve around a common theme that life has no meaning, since people are suffering and dying all over the world, and since all of us will also die one day. He says, “the good things that happen are just like dust in the wind,” and tells himself that “life is unfair.” Dan explains that in the last couple of years he’s experienced several painful events. He got married, but got divorced after just three months when things did not work out with his wife. But he’d sold his condo, and his practice was not going well, and he could barely pay his bills, so he had to move back home with his mother, who then died of cancer. Then, right after she died, things suddenly took a turn in a far more positive direction. He began dating and found an extremely loving and wonderful woman in 2017, whom he married last October, and his clinical practice began to blossom around the same time, so he and his wife were able to purchase a new home. But still, the Negative Thoughts kept popping unexpectedly into his mind, and they can turn feelings of joy (“Wow! I really came back”) into despair in an instant (“I’ll probably lose everything again, and it makes no difference because I’ll eventually die.") David pointed out this is a little like PTSD, when you’re suddenly reminded of a previous trauma and get overwhelmed by angst. And the frequency and intensity of these sudden despair attacks have increased since the start of the pandemic. Dan gave Jill and David an “A” on empathy after about 30 minutes of listening without trying to “help,” and this was a sign that we could move on to the next portion of the session. A = Assessment of Resistance Jill asked Dan if he wanted help tonight, or needed more time to talk and vent. He said he was ready to roll up his sleeves and get to work. His goal was to reduce or eliminate his negative thoughts and feelings, if that was possible. Jill asked if he’d press a “Magic Button,” if that would cause all of his negative thoughts and feelings to instantly disappear completely, with no effort, and he said he would. Almost everyone says they’d push it—which is completely understandable. When you’re in great pain, we all want relief! Jill indicated that we did have powerful tools, but weren’t convinced it would be such a good idea to use them to eliminate Dan’s feelings, and suggested we might first make a list of indicating: What each negative thought and feeling showed about Dan and his core values that were positive and awesome. How his negative thoughts and feelings might be helping him. Doing this skillfully is an art form, since it is radically different from the inept “cheerleading” so many therapists and family members attempt when a loved one is feeling down. You will hear this process unfolding when you listen to the audio of the session. Notice how Dan’s memories of the death of his older brother when he was just three years old and the recent death of his mother bring tears to his eyes, and help him change the way he thinks about his angst, not as something “bad,” but as something beautiful that honors his mother and his brother who passed away. But this is just the tip of the iceberg, as a long list of positives emerges during this portion of the session, which is designed to melt away subconscious “resistance” to change. The A = Assessment of Resistance is really the secret key that opens the door to the possibility of rapid, profound, and lasting change. David and Jill make it look easy, but it is, in reality, quite challenging to learn, because it goes against the very grain of our human inclination to try to “help.” Instead, Jill and David are assuming the role of Dan’s resistance, and showing him, in a gentle and loving way, that his negative thoughts and feelings are not actually symptoms of a defect or “mental disorder, but are really the manifestation of something positive and beautiful about Dan. David and Jill are selling Dan on the status quo and are still NOT trying to “help.” Paradoxically, this procedure typically has the opposite effect of greatly intensifying the patient’s determination to change. But now, the therapists have put Dan into a confusional state, and bind. On the one hand, he desperately wants to change. He doesn’t want to continue throwing cold water on the cherished positive moments in his life. But at the same time, if he presses the Magic Button, all of the positives will go down the drain along with his negative feelings. This is resolved with the Magic Dial. David and Jill ask Dan if he’d be willing to dial his negative feelings down to some lower level instead of lowering them all the way to zero. You can see his goals for each negative feeling on the “% Goal” column of his Daily Mood Log. M = Methods Now David asks Dan which Negative Thought he wants to work on first. He chooses this one: “It’s pointless in life to strive towards anything, because, in the end, we are all going to die.”  Dan believes this thought 80%. While identifying some of the many distortions in this thought, he comes up with this Positive Thought: “Some things are worth striving for!” This thought is 100% true, and his belief in the Negative Thought suddenly drops to 10%, as you can see on his Daily Mood Log (Daily Mood Log.) Next, he wants to work on this thought, which he believes 60%:  “People are dying in the world right now, so I don’t deserve to relax and have fun.” After identifying five distortions in this thought, he challenges it with this Positive Thought: “Although the deaths of so many people are tragic, it isn’t my fault that people are dying all over the world.” Dan rates his belief in this thought at 100%, and his belief in the Negative Thought drops to zero. Then he decides to work on this thought: “I’ve had so many good things happen in the last several years, but I can’t enjoy them, since it’s inevitable that I’ll lose those things.” He adds, “After all, what goes up, must come down!” After a couple of rounds of Externalization of Voices with Jill, he still couldn’t completely crush this thought, so David steps in to give it a try, with Dan playing the role of the Negative Thoughts and David playing the role of Dan’s Positive Thoughts. David interrupts Dan’s verbalization of this thought with some irreverent Buddhist humor. At that moment, Dan suddenly “gets it,” and the floodgates open up as Dan crushes the thought. Some people have called this “ah-ha” moments the “cognitive click.” It’s like waking up from a trance or nightmare, and the patient suddenly sees the world in a radically new and far more realistic light. Jill and David complete the M = Methods portion of the session by challenging the rest of Dan’s Negative Thoughts using Externalization of Voices, including role-reversals with the Self-Defense Paradigm and the Acceptance Paradox. I think you will find these exchange fascinating, and you will hear the tides coming in and the tides going out as Dan sometimes struggles and then defeats all of his Negative Thoughts. You can review Dan’s end-of-session mood ratings on his Daily Mood Log as well as his end-of-session Brief Mood Survey and his ratings of Jill and David on the Evaluation of Therapy Session. The Necessary and Sufficient Conditions for Emotional Change If you look at Dan's Daily Mood Log at the end of the session , you will see that the belief in each Positive Thought was high, and that his belief in the corresponding Negative Thoughts was drastically reduced. This is exactly why his feeling suddenly changed so dramatically. Cognitive Therapy (including TEAM) is NOT about telling yourself positive things or uttering positive affirmations. Instead, it's about crushing the distorted thoughts that trigger all of your negative feelings. The very moment you stop believing your Negative Thoughts, your feeling will instantly change. At the end of the session, Jill gives Dan a critically important “homework” assignment. Listening to the audio of a session and doing written work with the Daily Mood Log are vitally important aspects of TEAM. What happens between sessions is just as important as what happens within sessions! Thank you for listening today, and a HUGE thanks to Dan! I hope you learned a ton, on many different practical plus philosophical levels, and enjoyed today’s live therapy session! The Tuesday group at Stanford is free to all Bay Area mental health professionals as well as graduate students in some form of mental health training. The only “fees” involve a commitment to consistent attendance and the willingness to use the BMS and ETS with all patients, plus the willingness to do homework between Tuesday groups so you can really learn and master the very challenging TEAM techniques. Rhonda and David

Social anxiety has been one of our most popular topics. It seems like lots of people get anxious in social situations. and a great many have even greater difficulties talking to strangers and people they might be interested in dating. When I was in private practice, social anxiety, and “singleness,” were exceptionally common. In fact, 60% of my patients were single—they’d been divorced and didn’t know how to get back into the dating scene, or, they’d never developed romantic relationships in the first place. So today, we offer more tips and help for people who are afflicted with social anxiety. Rhonda and I are very proud and excited to be joined today by a brilliant colleague and expert on social anxiety, Dr. Jacob Towery. Dr. Towery is a Stanford-trained pediatric psychiatrist, and was a student of mine when he was a psychiatric resident, He practices in Palo Alto and helps teach our weekly Tuesday TEAM therapy training group at Stanford. Today (the day we recorded this podcast) was Jacob’s 41st birthday, so Rhonda and I sang a rousing Happy Birthday for Jacob at the start of the podcast! He kindly tolerated our fairly awful but heartfelt rendition of that classic song. Perhaps you could think of it as our own (fairly mild) Shame-Attacking Exercise. As we begin today’s podcast, Rhonda reads a sad but moving email from Davide, who desperately wants to open up and connect with people on a deeper level, but says “these things scare me like hell.” In his email below, he describes his struggles and lists his negative thoughts about talking to people he doesn’t know. He is especially afraid of Self-Disclosure—telling people that he struggles with social anxiety. To his credit, Davide has made significant progress, has worked hard on challenging many of his negative thoughts and self-defeating beliefs, and already has a girlfriend! But he wants to take his progress and growth to a new level. Here’s the email I received from Davide: Hi David! There is no month that I don't listen to your podcast and take some notes. Yes, you can read my email and use my real name as you like! I really think that your methodology is a breakthrough in self-help and coping with emotions. Also, the new technique of positive reframing is very helpful. When I started using it for myself at the beginning of every daily mood log I really noticed a faster improvement. I completely agree with your vision that it would be better if there weren't schools of psychotherapy but tools that work. Your books and works have really changed my life for better and I'm looking forward your next book Feeling Great! In these two years I have done many Daily Mood Log, I have also done every day for a month the Smile and Hello Practice and I got a girlfriend for the first time in my life! I'm still not very good at breaking my negative thoughts though. I often end up with a lengthy, verbose and not so effective positive thought. Sometimes it seems that I understand rationally that a negative thought isn't true, but I don't feel better. Also, my social anxiety is reduced, but not gone. I still have a lot of social anxiety when I'm around people. I understand the Spotlight Fallacy and Brushfire Fallacy at the intellectual level and I'm definitely improved a little, but still today I can't remember a single good conversation with a person that I don’t know and I'm not very comfortable with. I tried to use the Five Secrets but I can't think of anything good to say in real conversations. I want to do some shame-attacking exercises and also disclosure to random people on the street about my social anxiety, but these things scare me like hell and I don't have the courage to do these exercises. I know that these will help, but I feel really really scared and so far, I haven’t mustered up enough courage. I want to leave home (I'm in Italy) for work in another country in Europe next year, but for me social anxiety is a really huge obstacle. This makes me feel a little sad because I see my social anxiety like a prison. These are some of my anxiety thoughts at the idea of disclosure to random people on the street that I want to go to work abroad but I'm too shy and suffer from social anxiety: I will not be able to say what I want to say because of anxiety. I will stumble in words and an inconclusive thing will come out. The other person will think that I'm completely crazy and I will frighten him/her with my behavior. I should never scare other people with my behavior. In the future I will remember all the things that I said wrong and I will beat myself up over and over again. I will waste the other person’s time when I try to talk to them. I should never waste anyone’s time. If I stop a woman, she will think I'm crazy creepy guy who wants to sexually assault her and I will scare her. The other person won't stop to talk to me and will just go their way, pretending I didn't exist. Sorry for this lengthy email. When I read your response I exploded with joy and I decided to write a lot of things. Thank you, Davide Jacob begins with a personal story of his romantic adventure with a woman he’d just met at a Hot Springs. After talking for a while, some good chemistry seemed to develop, so Jacob asked, “Would you like a kiss?” Jacob immediately backed off when she seemed reluctant. Although he felt slightly rejected, they continued to talk and enjoy each other. Then things suddenly took a surprising and exciting turn in the opposite direction! Jacob emphasizes the value and importance of asking for what you want, and recommends getting “enthusiastic verbal consent” before touching. that’s because non-verbal consent can easily be misinterpreted by both people. In contrast, enthusiastic verbal consent is respectful and empowering toward both people. It leads to less mind-reading and a greater chance of being on the same page with the person you are interested in.  Rhonda acknowledges Jacob's tremendous respect for the person he is dating with his emphasis on "enthusiastic verbal consent." Jacob, Rhonda and David also talked about the Burns Rule: People NEVER want what they CAN get, and ONLY want what they CAN’T get,” and how you can use this rule to your advantage if you avoid being pushy or needy. Jacob used the Burns Rule skillfully, and if you listen to the podcast, you will hear the surprising conclusion! We also discussed the power of playfulness, taking risks, and sometimes being silly. In my experience (DB), people struggling with social anxiety are sometimes way too serious, and this can turn people off, particularly if you want to date. I can speak to that from personal experience, as I struggled with five different kinds of social anxiety when I was a young man! With Jacob’s leadership, we illustrated a number of techniques that might be helpful to Davide, and perhaps to you as well, including: The “Consensual Compliment.” This is a safe, non-threatening way of approaching strangers, especially people you might want to get to know better or even date. Essentially, you ask a stranger if they’d be open to receiving a compliment. Jacob and Rhonda demonstrate this technique with role-playing, and explain what to do if the person seems negative or ambivalent, or if the person says yes. I suspect that Jacob created this awesome method. Talk Show Host. This is a great, non-threatening way to make conversation with any stranger in any circumstances. David and Rhonda illustrate it in a role-play. Shame Attacking Exercises. You do something bizarre in public to make a fool of yourself, so you can overcome your fears of looking foolish. Dr. Towery is one of the world’s most creative and funny teachers of this techniques, and I recounted one of his incredible Shame-Attacking Exercises in the Macy’s Department Store near Stanford. Smile and Hello Practice. You force yourself to smile and hello to ten strangers each day. Rejection Practice. Instead of trying to get a date, you try to collect as many rejections as possible, so you can get over your fear of being rejected. I (DB) once skipped medical school classes for two weeks and did rejection practice all day long every day with a young friend, Jeff Evans (aka Spyder). We both had a 100% rejection rate, but it helped us get over our fears. The late psychologist, Dr. Albert Ellis, also emphasized the value of the rejection practice he did in New York when we was a young man. He asked 200 women in a row for a date in one week. They all said no, except for one, but she didn’t show up for the date! But he said this helped me overcome his fears as well, and he ended up with an incredibly rich dating life and even ended up writing an advice column in a men’s magazine for several years. Jacob said that he's experienced many rejections as well, and agrees on the importance of overcoming this fear! Externalization of Voices. You talk back to your Negative Thoughts. Jacob, Rhonda, and David illustrate this powerful method, using the seven Negative Thoughts in Davide’s email. Jacob strongly recommended several other resources, including podcast 197 with Dr. Matthew May as well as several of David’s FB Live videos on flirting, featuring Dr. Angela Krumm (part 1) and (part 2)and Kyle Jones. My book, Intimate Connections, is a bit dated now, but the wisdom and techniques in this book will be invaluable for anyone in the dating scene. Lots of people have told me that they started dating and got married after a long period of loneliness because of that book! Jacob has recently published a book on depression for adolescents and teenagers called “The Antidepressant Book,” which is available on Amazon. If you have or know of a young person who is struggling with depression, this book might be a great gift for him or her! My own new book Feeling Great, was released September 15, and is also available on Amazon (see the link below.) It features all the new TEAM therapy techniques, and is geared for therapists as well as the general public. If you would like to contact Dr. Towery, feel free to visit his website is www.jacobtowerymd.com . Rhonda and David

Last week you heard Part 1 of David’s TEAM Therapy session with Neil Sattin, who became pretty despondent and discouraged right after the first shut down because of the covid-19 pandemic in March of 2020. David and Neil went through the T = Testing and E = Empathy parts of TEAM, and David helped Neil develop a Daily Mood Log so he could record his negative thoughts and feelings at one specific moment at the end of a day when he was feeling like he hadn’t gotten enough work done. Perhaps you’ve had the same problem at times! Today you’ll hear the A = Assessment of Resistance and M = Methods parts of the session. As they begin, David asks Neil the Magic Button and Miracle Cure questions, and Neil says that he definitely does want help and would push the Magic Button to make all of his negative thoughts and feelings on his Daily Mood Log disappear. David cautions against that and suggests Positive Reframing, asking two questions about each negative thought and feeling. What does this thought or feeling show about you that’s positive and awesome? What are some potential benefits, or advantages, of this thought or feeling? Here’s Neil’s list of Positives: My sadness: Shows that I’m ambitious Motivates me to achieve a lot Shows that I have high standards My anxiety: Shows that I’m responsible Keeps me vigilant Fuels me to take action Reminds me that I’m doing important things My guilt: Shows that I have a moral compass My feelings of defectiveness and inadequacy: Show that I want to be a good role model Show that I’m willing to be honest about my flaws Show that I hold myself accountable Show that I’m humble My feelings of being alone show that: I value connections with others Allow me to feel close to people My feelings of embarrassment and humiliation show that: I have high standards and goals I want my life to mean something I value acceptance My discouragement shows that: I have a vision I’m realistic about the many challenges I face and the sheer volume of work I have to do I’m willing to face the truth My frustration shows that: I’ll persevere. I won’t stop and give up. Feeling annoyed and irritated: Shows that I won’t tolerate things that get in my way Gives me energy and determination Feeling overwhelmed: Reminds me that I might be taking on too much Protects me from trying and failing Shows that I’m looking for ways to take care of myself. After listing these positives, Neil used the Magic Dial and indicated that he’d like to dial down his negative feelings to lower levels, rather than getting rid of them entirely, as you can see in the “% Goal” column of his Daily Mood Log. Then they moved on to M = Methods, focusing first on Neil’s Negative Thought (NT): “I’m not capable of getting organized. After identifying a number of distortions in the thought, Neil was able to generate a positive thought that fulfilled the necessary and sufficient conditions for emotional change: The Positive Thought (PT) has to be 100% true. The PT has to drastically lower your belief in the Negative Thought. You can see this on his DML. David and Neil used a variety of techniques, including Externalization of Voices, to challenge the rest of his NTs. Neil re-rated his negative feelings at the end of the session. They all feel to zero except feeling alone, which went from 80 to 5, which was his goal. Rhonda and David

Rhonda begins with a plug for David’s new book, Feeling Great, which will be released on Amazon, on September 15, the day after after this podcast will be published. You can check it out at the link at the bottom of today's show notes. Today and next week you will hear parts 1 and 2 of a live therapy session I (David) did with Neil Sattin, host of his own terrific “Relationship Alive” podcast, which has received 5 million downloads. But as you know, we all sometimes need a little mental tune-up, including therapists. The session you are about to hear occurred on March 23, 2020, when the pandemic shut-down first occurred. Rhonda begins today’s podcast with a moving email from a fan who heard Neil's live therapy session with David on Neil’s Relationship Alive podcast. Then Neil explains how his  work on troubled relationships were born out of his work as a dog trainer, and he saw many similarities with relationship issues! In addition to hosting his popular podcast, Nel does coaching for individuals and troubled couples. Neil explains that, “I’ve always been a person who people have turned to for relationship help. I saw the struggles my parents experienced, and I have experienced my own struggles, and I wanted to figure out how we might use struggles to deepen and improve relationships, so people can thrive and get past those challenging moments. Prior to his personal work with David, Neil sought help from a cognitive therapist, but it wasn’t helpful thought. Neil thought it was too formulaic, a sentiment that David agrees with. Neil prefers working “in the moment,” the way David does therapy. Today, you will hear the T = Testing and E = Empathy portions of Neil’s TEAM therapy session with David, and next week you will hear the A = Assessment of Resistance and M = Methods portions. You can check out the Daily Mood Log that David and Neil filled out at the beginning of session. As you can see, the upsetting event was simply feeling like he hadn’t gotten enough done when evening approached. Perhaps you’ve sometimes felt like that, too! You can also see that Neil had many negative feelings. Most were intense and Neil felt overwhelmed. He was telling himself there was way too much to do, that he was incapable of getting organized, and that he was going to end up unhealthy, weak and broke. These were messages he’d heard from his dad when he was growing up: “You’ve gotta clean your room. . . You’ll never succeed.” Tearfully, Neil says, “I’ve always wanted his blessing. . . but I’ve never gotten it. I wish he could see my role in the world, the impact I’ve been making, and I wish he would admire it! . . . I love him dearly, but there are things I just don’t understand, things that have been the sources of my sadness and anger ” Tune in next week for the exciting conclusion of the session! Rhonda and David