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

Today, Rhonda and David discuss seven great questions submitted by podcast fans like you! Are depression and anxiety states of self-hypnosis? How do you deal with somatic symptoms in TEAM? Should we forgive Hitler and Stalin? What if a patient feels stuck and unable to identify emotions? Do you still really believe that depression and anxiety, regardless how severe, can be treated even without the use of prescription drugs? Do you have to work on your negative thoughts the moment they appear? What role, from your years of practice, does spirituality have in the psychotherapy? Are depression and anxiety states of self-hypnosis? Hi David, I have two questions after listening to Corona Cast 7: “My Struggle with Covid-19! Is it REALLY True that only Our Thoughts Can Upset Us?” I was struck by thinking of anxiety as the result of hypnotizing ourselves into believing our fears. Can depression by thought of in a similar way, except that we hypnotize ourselves into believing our distorted thoughts about ourselves? How do you deal with somatic symptoms in TEAM? Can you do an episode about how to deal with unpleasant somatic situations, as Michael was experiencing during the recording, that suggest there might be some psychological distress but don't seem to have thoughts associated with them? Thanks! Hi Derek, Another great couple of questions, thanks! Will add these to the next Ask David podcast, but the short story is yes, for sure—both depression and anxiety can be thought of as states of self-hypnosis, or trances, because you believe the messages you give yourself, (eg your negative thoughts) that are not true. I think one could add other positive and negative emotions to the list as well, including anger--believing the other person really IS wrong, bad, inferior, and so forth--as well as mania and narcissism, telling yourself that you really ARE a superior person, etc. This is a hugely important topic, and "emotional reasoning" fuels these trances: I FEEL worthless / inferior, so I must BE worthless / inferior, and so forth. With regard to your second question, you might want to listen to yesterday’s live session with Sarah, (Podcast 193, https://feelinggood.com/category/dr-davids-blogs/feeling-good-podcast/) since it focuses on intense somatic sensations generated by emotions, and you can actually hear the exact moment of recovery, when the physical sensations disappeared. David Should we forgive Hitler and Stalin? Hi Dr. Burns, Do you honestly think what Hitler and Stalin did should be forgiven? Albert Ellis said one should. I disagree! Tom Hi Tom, I only help people with problems they are asking for help with. I am not an evangelist or moral authority! David What if a patient feels stuck and unable to identify emotions? A new comment on the post "Uncovering Self-Defeating Beliefs (SDBs)--For Therapists (and Interested Patients) Only!"/ Hi Dr. Burns, Awesome blog post! Your accessible and kind demeanor shine through clearly. What if a client feels stuck and unable to identify emotions? Holly Do you still really believe that depression and anxiety, regardless how severe can be treated even without the use of prescription drugs? Hi Doctor Burns, My name is Jasmine, and I just started going back to therapy about a year ago. I have really improved, and both my mom AND my therapist recommended you HIGHLY. I’m a millennial and I’m just happy you are still alive! I also wanted to ask, do you still really believe even today that depression and anxiety, regardless how severe can treated even without the use of prescription drugs? I am asking because I just bought about three of your books and want to make sure that your confidence in these theories has not wavered. Sometimes I feel like a lost cause because this is the first time in my life that I am truly dealing with and facing my own problems instead of turning the other cheek. Also, how are you doing, sir? Jasmine Hi Jasmine, Doing great, thanks! The new techniques have added even more power to cognitive therapy. Check out my free Feeling Good Podcasts, free depression class, and more on my website, www.feelinggood.com. All the best, David PS My latest book, Feeling Great, can be pre-ordered on Amazon and will be released in Sept. Check our the link below. Do you have to work on your negative thoughts the moment they appear? Hello David, My name is Shivam, I wanted to ask you a question regarding the double column technique for disputing your thoughts. Do we have to work on that moment(upsetting) immediately as it happens or we can work on it later when we get free time? How often should we do it? Its very effective but consumes a lot of time as I keep writing on and on. Any suggestions? I really appreciate that you reply me back. Thanks for everything. love Shivam. What role, from your years of practice, does spirituality have in the psychotherapy? From: Jerry Souta Subject: spirituality in psychotherapy David: Your seminar today (Psychotherapy Leading Voices) was awesome! What role, from your years of practice, does spirituality have in the psychotherapy? Is there a correlation between spirituality and between feeling good/feeling great? Thank you for time taken in response to my in questions! Blessings! Jerry Souta, Jr. (MSW/LCSW/MDIV) Thanks, Jerry. I will answer this on an Ask David, we will be recording it soon. Your question will be featured on a Feeling Good podcast. The short answer is yes. Deep and rapid change nearly always involves a spiritual dimension, for example, one of the four “Great Deaths” of the self. There’s a whole section on this in my new book, Feeling Great.

Today, Rhonda and David discuss three great questions submitted by podcast fans like you!  This thoughtful question is from our beloved Rhonda! . . . And the answer may surprise you! When something terrible happens, like being raped or having your house burn down, or being a victim of racial discrimination, doesn’t the event itself upset you? Do you really have to have a negative thought before you can feel anger, fear, grief, or worthlessness? Hi David! For example, if our house burned down and we lost everything, or we or someone we loved was raped--doesn't the event affect you directly? Do you really have to have negative thoughts before you can feel sad, depressed, anxious or angry? Do all of our feelings REALLY result from our thoughts?  What about people who have been treated unfairly or been discriminated against because of their race, religion, gender identity, etc.  Aren't their feelings a direct result of their experience  and not just their thoughts? Rhonda What do you do when patients fall in love with you? Hi David and Rhonda, My name is Ben and I live in Maryland. I started listening to the feeling good podcast about 3 years ago when I was in a period of life transition. The podcast has been incredibly helpful to me as I dealt with my childhood trauma, explored my motivations and drives for life, and reoriented my personal relationships and career, away from what I thought I should be doing, toward what I love and deeply want for my life. In part because of the podcast's inspiration, I have decided to pursue a master’s degree in social work, and hope to become a psychotherapist. Thank you for all that you do, and the amazing help you have been to me personally. I do have one question. In one past episode. You mentioned the possibility of using five secrets to defuse the situation when a patient falls in love with the therapist because they feel understood and cared for. This has happened to me a few times when I talk with a friend about their personal difficulties, and they begin to develop feelings for me. I would like to keep these relationships friendships, rather than romantic. I would love to have your advice on how best to both inoculate against and resolve such situations. Thank you again. Ben What can you if your boss is not empathic? Hi Dr. Burns, You guys are always so good at empathy. I’d love to hear one day your method about how to cope when there is lack of empathy, but you still have to keep a relation. For example: when your boss doesn’t empathize with you and his message makes you feel bad, but you still need the job. I had an experience like that and it really hurt the ego. Cheers, David. Have a great day! Andres Hi Andres, One can always learn a lot from one exchange with the boss. What did he say and what, exactly did you say next? Waiting for empathy from others is never something I have recommended! That’s a really long wait! But you CAN discover how you are provoking the very problem you are complaining about if you have the courage. This empowers YOU to change. David Questions on the next Ask David: Are depression and anxiety states of self-hypnosis? How do you deal with somatic symptoms in TEAM? Should we forgive Hitler and Stalin? What if a patient feels stuck and unable to identify emotions? Do you still really believe that depression and anxiety, regardless how severe, can be treated even without the use of prescription drugs? Do you have to work on your negative thoughts the moment they appear? What role, from your years of practice, does spirituality have in the psychotherapy? Rhonda and David

Podcast #200: Meet Linda Jackson! We celebrated our one hundredth podcast with an interview with Professor Mark Noble, who talked about TEAM-CBT and the brain. Today, we celebrate our two hundredth podcast with another special guest, Linda Jackson, the publisher at PESI Publishing and Media Company.  You may know of PESI for their work in continuing education programs as well as training products for mental health professionals. You may not be aware that PESI is the publisher of my new book, Feeling Great, which will be released in September, 2020. One focus of our interview with Linda was the teamwork that is so important between any author and his or her publisher, as well as the editor. I have been really thrilled with the incredible teamwork and support that PESI has provided on this project, under Linda’s skillful leadership. That was my strong motivation in selecting PESI, and I’m really glad I made this choice. It will be their first general public “self-help” book, and I hope it is a huge success for them, and for me! Rhonda asks how this book compares with my first book, Feeling Good. It is the first true sequel, although I have written many spin-off books based on the cognitive therapy techniques I first described in Feeling Good. But now, after 40,000 therapy sessions with individuals struggling with mild to extreme depression and anxiety, as well as four decades of research on how psychotherapy actually works, I have many powerful new techniques that you can learn about in Feeling Great. Feeling Great is based on the TEAM-CBT that has evolved in the past ten to fifteen years in my weekly psychotherapy training and development group at Stanford. My book Feeling Good was about cognitions, and how to crush distorted thoughts.  What I have learned over the past 40 years of practice, research and teaching is that cognitions, while massively important, are not the only dimension in change. Of course, it is still true that when you change the way you think, you can change the way you feel, but now there is another powerful component:  many people seem, tp get stuck in depression or anxiety and resist change. They sometimes “yes-but” their therapists and often fail to do psychotherapy homework between sessions. Why? In Feeling Great, you will discover why people resist change and you will also learn how to eliminate resistance. The developments have ushered in the era of ultra-rapid recovery from depression and anxiety. Therapists who are interested in learning these new techniques will now have a clear guide, and members of the general public who are struggling with negative feelings will have the chance to use these techniques on their own, whether or not they are in treatment with a therapist. Linda talks about her personal history and how she happened to find a career in publishing. She describes her passion for writing, journalism and editing, going all the way back to her teenage years, something that I can totally identify with. Linda also describes her background in marketing, and her appreciation of its importance. You could have the greatest book in the world, but without a strong marketing effort, it will just sit on bookstore shelves unnoticed. Linda explained that PESI has been absolutely committed to publishing practical guides that therapists can use to improve their clinical work. But now, PESI is branching into publishing books for the general public as well, because people want answers to their questions of how to deal with feelings of depression, anxiety, and inadequacy. Linda said that PESI was not looking to publish a self-help book, but when someone in their organization heard that David was looking for a publisher, they felt it was “meant to be” that they would publish his new book. Linda believes that this book is going to help so many people who want to “feel great.” Something I (David) have deeply appreciated about working with Linda and her PESI team has been the comradery of the writing, editing and publishing process. We discuss my brilliant editor for Feeling Great, Jenessa Jackson, who happens to be Linda’s daughter-in-law. I (David) felt especially lucky to work with Jenessa, who not only provided incredibly helpful editing, but her background in neuroscience as well as clinical work were tremendously helpful. She clearly “got” my message, including the special chapter on "micro-neurosurgery" by Professor Mark Noble. I also am especially grateful for the marketing support PESI is providing for my new book.  I described the complete lack of support I had from the publisher of Feeling Good shortly after it was first published. That was understandable, because at the time I was an unknown author of a book on depression, and the president of the company (William Morrow & Co.) was convinced that Feeling Good had little or no commercial potential. As a result, in those early years after it was first published, I had to do everything on my own—and it was really hard! I encountered rejection after rejection when I tried to interest magazines or radio or TV shows in interviewing me about Feeling Good. In fact, it took eight years before I finally landed a top national TV show in 1988—the Phil Donahue Show—and the book immediately jumped to the top of all the best seller lists within minutes of the airing of that show. It was like magic! With Linda’s strong background in marketing, we are hopeful that Feeling Great will also get the market support it needs to help as many people as possible. After all, you owe it to yourself to Feel Great! Rhonda and David

Today, the Cognitive Distortion Starter Kit Continues with Labeling Rhonda begins by reading two beautiful, inspiring emails from listeners, and I give a brief shout out for my new book, Feeling Great, which can be pre-ordered on Amazon now (see below for the link). Rhonda and David begin with a brief overview of Labeling. There are two types of Labeling: Self-Labeling and Other-Labeling: Self-Labeling is where you attach a negative label to yourself, such as "I'm a loser," or "I'm a failure." Self-Labeling can be further divided into Labeling your role or Labeling your "self." Here are some examples of Labeling your role: "I'm a bad father," or "I'm a bad mother," or "I'm a lousy teacher," and so forth. Here are some examples of Labeling your "self:" "I'm a loser," or "a failure," or "worthless," or "defective." Other-labeling is exactly the same, except that it's directed at some other person, as in "he's a jerk," or "she's a loser." Labeling can be extremely hurtful, causing intense depression and anxiety, as well as anger, hatred and rage. However, labeling is a distortion, because a human being cannot be captured by a label. Humans are more like rivers that flow--in this direction and that direction, without a specific "shape." We have many, many dimensions, perhaps an infinite number! Many techniques can be helpful for Labeling, but it is always necessary to use any technique in the context of working systematically with the TEAM model, and doing great T = Testing, E = Empathy and A = Assessment of Resistance before trying any M = Methods. It's almost never a good idea to throw techniques at patients without these other vitally important steps first. And if you're working on yourself, it will be vitally important to do the A step before the M step too! David and Rhonda illustrate two techniques that can be especially helpful for Labeling: Let's Define Terms and Be Specific. They do a role play to bring the first technique to life, and play an actual recording of a portion of a TEAM session to bring the second technique to life. We are nearing the end of the distortion series, but still have three hugely important distortions to discuss: Emotional Reasoning Should Statements Blame Thank so much for listening. If you like our podcasts, tell your friends, colleagues, and patients about them! This is all volunteer work, so our only marketing budget is your good will. Each month our downloads are increasing, thanks to you, and we will hit three million downloads early next year or late this year. Rhonda and David

Today, Rhonda and David discuss ten great questions submitted by podcast fans like you! I can’t find any distortions in my thoughts! What’s the cause of this? Crushing Negative Thoughts. Do you have to write them down? Can’t you just do them in your head? PTSD Question: Does the trauma have to be life-threatening and experienced in person/ How can I get over anxiety and panic? Do demons cause depression? How is Sara now? Is anger just “ossified tears?” How do you explain the basic concepts of CBT and cognitive distortions to patients who are not familiar with your work? Can I help myself as much as Rameesh did? How can I start a self-help group based on your book, Ten Days to Self-Esteem? How can I find my favorite podcast? I can’t find any distortions in my thoughts! What’s the cause of this? A new comment on the post "001: Introduction to the TEAM Model" is waiting for your approval https://feelinggood.com/2016/10/27/001-introduction-to-the-team-model/ Hi Dr. Burns, I just ordered your book and am writing my cognitive distortions daily. I ran into one I did not know how to label it. I am a 73-year-old, attractive woman, When I see a young beautiful woman having a great time, say in an ad, I feel angry, sad and jealous. This does not apply to family members only strangers. charlotte Crushing Negative Thoughts. Do you have to write them down? Can’t you just do them in your head? A new comment on the post "190: How to Crush Negative Thoughts: Overgeneralization" is waiting for your approval https://feelinggood.com/2020/05/11/190-how-to-crush-negative-thoughts-overgeneralization/ Dr. Burns, Why is writing the negative thought down important? Can’t I just pinpoint it in my head and simply switch the negative thought to positive one? I know it will not work but i am not able to convince others or myself why I have to write them down. Why is the writing process so important? After practicing for a while will you have the habit of think positively? I am wondering why some people have this way of positive thinking without even practicing? Toni PTSD Question: Does the trauma have to be life-threatening and experienced in person/ A new comment on the post "147: High-Speed Treatment of PTSD?" is waiting for your approval https://feelinggood.com/2019/07/01/147-high-speed-treatment-of-ptsd/ Hi David, I am a fan of your great work and contribution to psychology. I have a question about PTSD: does it necessarily have to be life-threatening in person or can it be caused for example by a threat via online message? Thank you! MB Thanks, MB, great question. Only your thoughts can upset you, not the actual trauma, so the answer is yes. Anything that is profoundly upsetting is profoundly upsetting, period! There is no objective way to measure the impact of any trauma other than via your own thoughts and feelings! This is so important, and yet most of the world, including those who have written the DSM-5 (and all earlier editions) / don't yet "get it." The DSM states that for a diagnosis of PTSD, you have to have some trauma that is “objectively horrific.” But there is no such thing! david How can I get over anxiety and panic? Debby asked a question about podcast 189: How to Crush Negative Thoughts: All-or-Nothing Thinking I have your book When Panic Attacks. I am at a loss at what to use to get over anxiety and panic. It is exciting because you said that you can get rid of both fairly soon; which would be great Hi Debby, Thanks for your excellent question! The Daily Mood Log described (I believe) in chapter 3 of When Panic Attacks is a great place to start. Do it on paper, and not in your head, focusing on one specific moment when you were anxious. Thanks! One teaching point is to focus on one specific moment, and not try to solve anxiety or any mood problem in generalities. A second teaching point is to record the situation, your feelings, and your negative thoughts you were having at that moment. This is always the starting point for change! You’ll find tons of resources on my website, feelinggood.com, including the show notes for all the podcasts with links, search function, and way more, all for free. You can learn a great deal if you put in the time and effort. For example, I am now creating a free class on anxiety and it will soon be available on my website! David Do demons cause depression? Brian W. commented on Podcast 189 on All-or-Nothing Thinking Hi Dr. Burns, Amazing podcast as always doctor Burns! Question: have you ever encountered anything in your patients that you might consider supernatural? I'm Catholic and there's the idea that demons can cause depression or mental illness. I know it sounds crazy, but I've seen weird things. Thank you. Brian Thank you for your question, Brian. Depression results from negative thoughts, not demons. That's good because you can learn to change the way you think and feel. The type of therapy I do is entirely compatible with all religions, including Catholicism, and there is often a spiritual dimension in recovery. All the best, david How is Sara now? Is anger just “ossified tears?” Dear Dr Burns, Though doubting that you’ll ever read or answer this, nevertheless I’ll cast it to the cloud for something-or-other! I’m an old fossilised blind British harpsichordist (good combo?!!) and a devoted fan of your podcasts, as well as selectively slowly making my happy way through the 27 hours of RNIB’s Talking Book version of ‘Feeling Good’ (Must tell you that the Braille Music Translation Programme I use invented by a great buddy in Pa. is called ‘Goodfeel’, so you guys must have something in common!). Alas I have 2 questions. First, as a ‘floating’ OCD sufferer for 70 years or so, I wildly enjoyed Sara’s ‘high speed cure’ in podcast 162. However, surely with this new Coronavirus threat – the virus remaining on cardboard for around 24 hours and other surfaces including shopping for at least 2 days or more -, her cure must have now been reversed? The fact, and I mean from much research ‘fact’ is that ‘what you touch could kill you’. Sure, it might not but, in as bad health otherwise as I am, I believe it’s imperative to be as careful as pos. which, courteously put, is screwing my brain! How about Sara?! Finally, well I suppose it’s a comment more than a question. I’ve been enjoying and, indeed, beginning to benefit from your section in the book on anger. I wonder though whether, unless I haven’t got there yet (which is eminently possible!!), you might have left out one aspect of anger? I’ve often thought that it, as well as hatred and violence could be designated ‘ossified tears’ and, believe me, in my case, if so, they’ve turned into unbreakable rocks!! Keep up the great work, Dr Burns. We all need such an unique communicator and erudite intellect as you, oh and I fervently hope you can stay clear of this virus. Very best and thanks, John Henry (Not the old American horse, . . . but rather a British, almost human John Henry!! David and Rhonda respond to both of John's questions! How do you explain the basic concepts of CBT and cognitive distortions to patients who are not familiar with your work? Hi David and Rhonda, You previously answered a question of mine on your podcast. It was quite helpful, thanks! I have a new unrelated question. While the live sessions have been very illuminating in many ways, your patients have always been trained therapists who are already familiar with the concepts of CBT and cognitive distortions. I understand this is an ethical necessity. As a family physician I struggle with that first step - how do you introduce the concepts of CBT and the cognitive distortions to non-therapist clients? I imagine it must take at least a full session just to do education on the distortions. This may be a question best for Rhonda. Thanks again! Calvin Hi Calvin, Thank you for another great question. If you prescribe the book, Feeling Good, it can help you and your patients in three ways. First, they’ll get all the concepts and some sound psychoeducation, saving you time. Second, the book is at least as effective as antidepressants, so it is prescribing something that may be very helpful with no side effects. Third, it will be a test of their motivation. Motivation appears to have a massive effect on recovery from depression. Also, there are tons of great classes in TEAM for beginners if you check them out at FGI (www.feelinggoodinstitute.com). There are also free classes on depression and other topics on my website, www.feelinggood.com. These classes may also help your patients. On the show, Rhonda will explain how she introduces these topics to her patients as well! All the best, David Rhonda’s note to Calvin: You flatter me, because all questions are best answered by David, but I will give it a try. I do ask all my patients to read David's book Feeling Good, which is superb at describing what CBT is and why it is effective. I have an intake telephone call with all my new patients before we start working together, and before they read Feeling Good. In that call I explain CBT like this, imagine a triangle that has Thoughts, Feelings and Behavior at each point. Your thoughts drive your feelings and your behavior. So, if you can change the way you think, you can change the way you feel. David gives the example of someone walking in the woods who hears a twig break. Imagine that hiker thinking that a murderer is creeping behind him or her, what do imagine he or she would feel? But imagine that same hiker thinking that his or her best friend is joining the hike? What would he or she feel then? There are lots of examples like that: two students who have studied the same amount. One walks into the test room thinking, I did a good job studying, the other walks into the test room thinking I should have studied more. Who do you think will do better on the test? This is an actual study that has been done, and if you guessed the student thinking more confidence did better, you would be correct. It makes logical sense. I don't explain cognitive distortions in my intake discussion, but when we first start working with a Daily Mood Log, after we have gone through T = Testing, E = Empathy, and after A = Assessment of Motivation, when we are going through the M = Method "Identify the Distortions" for the first time. I explain that cognitive distortions are embedded in our negative thoughts, and they are simply ways that our mind convinces us of somethings that aren't really true. By this time patients have read part of Feeling Good, so they have more psychoeducation. But I find if patients still don't understand the concept of cognitive distortions, as we go through the Identify the Distortions method, they soon understand what distortions are. I hope that makes sense, and that you find this helpful, Rhonda Can I help myself as much as Rameesh did? Hello Dr David, I saw how Ramesh changed dramatically and I want that kind of change in my life. but I am doubtful. It was you who managed to melt away his resistance using different techniques. Is it possible that we can manage to change ourselves so effectively? Shivam Hi Shivam, Thank you for this incredibly important question. Research indicates that many people have been helped by reading my books and doing the exercises, such as Feeling Good. Motivation and hard work are critically important in personal change and recovery. I am also working on a new app, and hope to get data to answer this exact question! Best of luck! Will make this an Ask David question, as it is so important! David How can I start a self-help group based on your book, Ten Days to Self-Esteem? Dr Burns, I know your book, Ten Days to Self Esteem, has a group leaders manual. Can anyone start one of those groups of do you have to be a therapist of some sort? Has anyone told you that they started one? How did they say it went? Any tips for starting one? Thanks Richard Hi Richard, Many pilot studies using this program with lay leaders have been effective. The program at my hospital in Philadelphia, also using lay leaders, was very effective. David How can I find my favorite podcast? Hi David I am a therapist and was reminded of one of your podcasts as I was listening to a particular patient. I wanted to share the episode and then couldn’t find it so felt silly. It was an episode where a father (perhaps Indian? Maybe a doctor?) empathizes and listens in a whole new way to his adult son and has a miraculous turn of events in the relationship- simply by being present and not being defensive when the son tells him how he feels about his father. It was beautiful and moving. A great example of “opposite action”- agreeing with the criticism rather than defending against it. Does that episode ring a bell and can’t you point me in the right direction to retrieve it? I know how busy you are. Thank you for your wonderful podcast and for any help you can provide. Thanks, Pam Hi Pam, It might be the follow-up to the live therapy with Mark. Use the search function on my website. He is from Iran, and is an OB-GYN doctor who has faithfully attended my Tuesday training group for years. He is one of my favorite people. Learning the Five Secrets takes lots of commitment and practice. He has formed his own Five Secrets practice group with friends and colleagues who are not shrinks. They’ve met weekly for years, so his skills are quite refined now. Thanks! David On the podcast, I emphasize the search function you can easily find on every page of my website, www.feelinggood.com. Pam’s comment on the Five Secrets is also important. Desire, commitment and ongoing practice are the keys to mastery! Rhonda and David  

Loneliness has existed since the dawn of time.  I frequently receive questions from lonely individuals wanting to know how to connect, and how to find companionship, intimacy and love.  Lonely men ask me, "How do I talk to women?"  Lonely women ask, "How can I find a good man?" Regardless of your gender or gender identity, you may struggle to find a loving romantic partner for a variety of reasons, some of which I have outlined in my book, Intimate Connections.  Although dating can be an incredibly stressful, disappointing, and time-consuming hassle, there are tremendous rewards for those fortunate enough to connect and develop an intimate relationship. So today, we address some of those issues. Our special guest today is Dr. Matthew May.  He is a former student of mine, a good friend of David and Rhonda, a regular on the podcast, and a loving wonderful man. Today, Matt brings us a wealth of information for those interested in improving their dating lives, based both on his clinical work, as well as his own experiences overcoming social anxiety, falling in love and being in a loving relationship. Matt begins with an inspiring reminder of why we would go through all the trouble, stress and disappointment inherent to dating, highlighting some of the rewards that await those who are persistent, including how good it feels to be understood, accepted, loved and cherished by someone who feels the same towards us.  The poetry of his writing is beautiful and inspirational. He also provides some common-sense guidelines for individuals who are interested in dating, so they can do so safely.  We then delve into more psychologically complex and personal matters. Here are Matt's tips on maintaining safety when you are dating someone you don't know for the first time--for example, it might be someone you may have met on the internet. Although these tips are primarily for the protection and safety of women, they may also be helpful to men who are dating. 1.      The first time you meet someone you've met on the internet, meet in a public place, like a restaurant or coffee shop, where you'll be safe. 2.      Use your own transportation. Don't let someone you've never met pick you up, because then you'll be vulnerable in case things don't go well. 3.      Tell someone you know where you're going, and when you're going to return. 4.      Get to know the other person as much as possible. What does s/he do, who are his or her friends, and so forth. 5.      Don't provide any identifying information, including your date of birth, to anyone you've just met on the internet, as you could be vulnerability to identity theft. Sometimes the most charming people are scam artists. 6.      Listen to your intuition. If you have a creepy feeling about someone you're thinking of dating, pay attention to it. Something might be "off" about the other person. 7.      Don't drink too much, as you could become a victim of date rape, especially if the man slips a sedative chemical in your drink. 8.      Give (or ask for) consent prior to any touching. Matt emphasizes that emotional vulnerability is the price tag on intimacy, and this can be frightening because we all naturally fear rejection. Matt defines emotional intimacy as being seen as our true and vulnerable self, so we are accepted for who we really are. He talks about how most of us have a deep yearning for this kind of relationship, and yet struggle to be vulnerable and open in ways that make intimacy possible. Rhonda, Matt and David describe the delicate balance between game playing--which can be crucial in the early stages of dating--and vulnerability, which can lead to a meaningful and lasting relationship. Some people try to skip the game-playing stage, thinking it is too superficial, and try to jump right into vulnerability the moment they meet someone they like. This often leads to rejection. People like to have fun, and you don't always have to be "heavy" or overly "sincere." But too much game-playing can leave you feeling lonely as well. I describe a patient I once treated who was almost unbelievably successful in the dating arena. You might even say he was an incredibly effective womanizer. But he felt tremendously lonely and anxious on the inside. He was handsome and charismatic, and got tons of sex, but wasn't really happy. Matt describes another common barrier to successful dating, especially in men: entitlement and anger. He says that he, like many lonely men, used to think that "women should like me the way I am," and "I shouldn't have to put on airs to date." Years ago, I pointed out that Matt was not dressing in a very sexy way, and suggested a change might be in order. Matt insisted that he shouldn't have to, and that women should love him just as he was! I asked Matt to fantasize about his ideal woman. Matt described a woman who's looking terrific--great clothes, nice hair, makeup, and so forth. Then I pointed out that most women are looking for pretty much the same thing--a man who dresses well and looks his best. I urged Matt to get a good "sex uniform" for dating--in other words, get some great, sexy clothes and look your best--it can make a tremendous difference. Rhonda and Matt discuss the fear of being alone, which is one of the great barriers to finding love. Overcoming the fear of being alone must be done first; then dating will become far easier because you will no longer be needy. The Neediness Problem--telling yourself that you NEED love to feel happy and fulfilled--can drive people away and lower your attractiveness. That's because of the Burns Rule: People NEVER want what they CAN get, and ONLY want what they CAN'T get. So if you're needy, you'll be desperate, and you'll be what people can get. Then they won't want you. Life works like this on many levels, and not just romance. When you think you need something, it eludes you. When you let go, and no longer "need" that thing, it tends to come to you. When you discover  that you can be completely happy when you're alone, then you won't "need" a loving partner any more. This will put you in a much stronger position, and people will be more attracted to you because you won't be so needy and available. I can show you how to overcome the fear of rejection and the fear of being alone in the first section of my book, Intimate Connections. Although it's perhaps one of my lesser books, it can be helpful if you're struggling in the dating arena. Many people have told me that this book helped them find someone to love and marry after years of frustration and loneliness. So, what's the secret of sex appeal? Some people think it's based on looks. Other people think it's based on power, status, or wealth. Well, if you're gorgeous, powerful, and wealthy, you will find that dating is a lot easier because lots of people will be attracted to you. But those are not the secrets of sex appeal, and they do not guarantee a successful marriage. I have treated many people who were gorgeous and tremendously successful, but they still suffered from severe depression and intense loneliness. Matt and Rhonda reveal the real key to sex appeal for individuals of any gender or gender identity:  self-confidence. This is pretty basic: if you think you're hot, you're hot. And if you think you're not, you're not. When you're feeling depressed, lonely, and insecure, developing self-confidence and sex appeal might  seem impossible, but we are convinced that the magic of sex appeal and happiness can happen for pretty much anyone. For those who are interested, there are lots of step by step tools to help you achieve greater self-confidence in Intimate Connections. Matt describes how I helped him with his own social anxiety when he was a psychiatric resident, and how his love life suddenly went from rags to riches. One of the techniques that helped him the most was when I gave him a homework assignment to do "Rejection Practice." This exercise helps you get over your fear of rejection. I asked Matt to collect 25 rejections from attractive women as fast as possible, so he could confront this fear and discover that life still goes on after rejection. You will be entertained and charmed by his delightful and surprising story. Dating problems and social anxiety have always been my favorite topics because of my own fairly severe social anxiety when I was a young man. In addition, when I was in clinical practice in Philadelphia, 60% of my patients were single. Some of them were divorced, and unable to get into the dating game, and some of them had never found a loving partner in the first place. I just loved working with this population. it was so rewarding to help my patients find self-love first, and then the love of another special person. In fact, that's why I wrote Intimate Connections. I just love to show people how to overcome their shyness and "singleness" and get partnered up! With love, Rhonda, Matt and David

in today’s podcast, Rhonda and David address eight fascinating questions submitted by fans like you: What’s the difference between David’s Therapist Toolkit, his eBook (Tools, Not Schools, of Therapy), and the EASY Diagnostic system? Is there a dark side to human nature? Is being “forceful” or confronting patients ever important in therapy? What’s the 5-session schizophrenia cure? How do you suddenly switch into “Sitting with Open Hands” during a session? Questions about OCD Questions about racism What if there are more advantages than disadvantages in perfectionism? What’s the difference between the Toolkit, the eBook, and the EASY Diagnostic system? I am a Licensed Clinical Social Worker (LCSW) and I am interested in either the Toolkit or the EASY diagnostic tool. It looks like the Toolkit includes quite a few questionnaires so I am wondering if I would need both. I would love to have a comprehensive checklist to give to clients during their initial assessment so I originally looked into the EASY Diagnostic tool. I’m just looking for a little guidance on which one would be the most helpful and if I would actually need both. Thanks so much! Cindy What do you think about the idea that there’s a dark side to human nature? Are humans inherently good, as so many mental health professionals seem to believe? It could be entitled, “The Dark Side of Human Nature,” or “Is there REALLY a dark side to human nature?” Jeremy Rhonda and David believe that human beings have positive loving impulses and dark violent impulses as well, and that both are an inherent and basic aspect of human nature. They discuss several aspects, including: The example of cats. They are genetically little serial killers. They love to capture and torture rodents, even if they have had a loving childhood. Many people love violent revenge movies and video games. Many people love killing animals, chopping their heads off, and mounting them on the wall, in much the same way that human serial killers get intense excitement from their killing and torturing, and they also keep trophies. David argues that it is important for therapists to recognize and address the dark side—areas where therapists will typically get in trouble due to blindness / denial / rationalization of negative motives, and excessive idealism. Problematic areas for therapists can include: the suicidal patient the violent patient—David describes a woman who was plotting to kill her husband. disability patients with a hidden agenda of remaining disabled. patients who don’t want to do their therapy homework people, for the most part, don’t get addicted because they’re depressed, anxious, or lonely, but because it’s really awesome to get plastered / high. Many, and perhaps all humans, like to judge others and feel superior to them, and also enjoy exploiting others, but our denial can be intense. People enjoy bullying people. It makes you feel powerful and generates feelings of excitement. We acknowledge that although the dark side to human nature may be strongly influenced by our genes, the environment we grow up in can also have a strong impact on our thoughts, feelings and impulses. Is being “forceful” or confronting patients ever important in therapy? This is another great question submitted by Jeremy Karmel. David gives many examples of times when it is absolutely necessary to be forceful and confrontational in therapy, but this requires a strong therapeutic relationship with the patient and perfect empathy scores and high levels of trust and mutual respect. Therapeutic examples where forcefulness or confrontation may be important include: Exposure techniques in the treatment of anxiety. The patient will nearly always “wimp out” at the last minute, and here is where the therapist needs to push—but most therapists will back off out of misguided “niceness.” Pushing the patient to view his/her own role in a relationship conflict instead of buying into the idea that the patient is the innocent victim of the other person’s “badness.” The new CAT technique in the Externalization of Voices is yet another example where gentle confrontation can often lead to rapid enlightenment. Another example is use of Changing the Focus, suddenly drawing the patient’s attention to “Have you notice what just happened here between us?” This can be helpful when there’s an awkward or adversarial or evasive dynamic going on between therapist and patient. Yet another example is the Gentle Ultimatum in dealing with Process Resistance. In all of these examples, many, and likely most therapists don’t do well, due to “niceness” and fear of conflict. What’s the 5-session schizophrenia cure? Hello David: I recall you saying in one of your trainings given in San Diego a while back that you could "cure Schizophrenia in 5 sessions" using the T.E.A.M. protocol you taught us. Is there a special protocol for this disorder? One of my clients would very much like to know. I hope that this finds you, your family and everyone at the Feeling Good Institute doing well and being healthy. Kind regards, Leslie David explains that he has always insisted that schizophrenia is an organic brain disorder that sadly cannot be cured with drugs or psychotherapy. However, drugs often plan an important role in treatment, and compassionate psychotherapy can also be extremely helpful. The goal is to help the patient develop greater self-esteem and improved relationships with others. He describes the innovative group CBT program he developed at his hospital in Philadelphia which served a large population of homeless individuals as well as individuals suffer from severe schizophrenia. He also points out how easily one can get severely misquoted, and appreciates the chance to set the record straight! How do you suddenly switch into “Sitting with Open Hands” during a session? This is yet another great question from our friend and colleague, Jeremy Karmel. David and Rhonda compare good therapy to dancing, having to often change courses instantly when the patient begins to resist and fight the therapist. Questions about Obsessive Compulsive Disorder (OCD): I hope this a place where I can submit questions for "Ask David." Are there manifestations of OCD that have common links or hidden emotions? Do you hear one person's description of their OCD and immediately have an idea of what might cause it? For example: do a majority of contamination OCD sufferers have a common reason for that specific "type" of OCD? Do sufferers of something deeply distressing like pedophile OCD all have feelings of shame that manifest in that OCD, where the "what if" would result in probably the most shame they could ever feel? David and Rhonda discuss the Hidden Emotion Technique which can be invaluable in the treatment of OCD. Questions about racism Hello David and Rhonda, Thanks for your amazing podcasts, I have listened to a lot already. And thanks Rhonda for bringing this important subject to the table. :) What if “Steve” had said that indeed he is racist and can't stand African Americans or South Americans, what would Rhonda answer to that?! It would become difficult for me to keep a friendship-like relationship with someone who is at the extreme opposite on sensitive subjects. I am open to any point of view, I don't need to be disarmed here. :) David, I'm so looking forward to your Feeling Great book!!! Rhonda and David discuss two opposite strategies for dealing with someone with strong racist tendencies. What if there are more advantages than disadvantages of perfectionism when you do a Cost-Benefit Analysis? This is a question from a user who wishes to remain anonymous. Rhonda and David talk about the fact that perfectionism, like all Self-Defeating Beliefs, has many advantages as well as disadvantages. And if the advantages outweigh the disadvantages, it’s working for you, and it’s not something the therapist would need to help you with. There’s a difference between neurotic and healthy perfectionism. Many of the great historical figures, like Edison, for example, worked relentlessly and would not settle for failure. And we are all the beneficiaries of that type of genius and intense commitment to the healthy pursuit of excellence! Therapy is all about helping people who ask for help. It’s not about evangelism! David and Rhonda    

Today, the Cognitive Distortion Starter Kit Continues with Magnification and Minimization Rhonda begins by reading two beautiful, inspiring emails from Heather Clague, MD and Dipti Joshi, PhD.  Heather and Dipti are dear friends and esteemed colleagues of David and Rhonda. Rhonda and David begin with a brief overview of distortion #6: Magnification and Minimization. Magnification is when you blow things out of proportion. This is common in anxiety and is also called “Catastrophizing.” For example, during panics patients often tell themselves—and believe—that they are on the verge of something catastrophic, like a stroke, a sudden, fatal heart attack, or losing their minds and becoming hopelessly psychotic. Minimization is just the opposite. You shrink the importance of something like your good qualities or the things you’ve accomplished. Minimization is common in depression. Magnification and Minimization almost always play a big role in procrastination as well. For example, you may Magnify the enormity and difficult of the task you’ve been putting off, and Minimize the value of just getting started on it today, even if you only have a few minutes. I sometimes call this distortion the “binocular trick” because it’s like looking through the opposite ends of a binocular, so things either appear much larger or much smaller than they actually are. Techniques that can be especially helpful include Examine the Evidence, the Semantic Technique, Little Steps for Big Feats, the Experimental Technique, the Double Standard Technique, and Externalization of Voices / Acceptance Paradox. Rhonda brings these techniques to life in a description of a depressed man she recently treated who’s been divorced for 2 to 3 years, and living alone due to the Shelter in Place orders during the Covid-19 pandemic. Although he’s lonely, he’s telling himself that he’s “too depressed and scattered” to be in a relationship. At the start of the session, he feels: sad, 90% panicky, 50% ashamed, 50% worthless 50% alone, 90% hopeless90% frustrated, 90% upset, 90%. Rhonda describes her skillful and compassionate TEAM treatment of this man, starting with the Magic Button, Positive Reframing, and Magic Dial, followed by Identify the Distortions, the Paradoxical Double Standard Technique, and Externalization of Voices (including the Acceptance Paradox, the Self-Defense Paradigm, and the Counter-Attack Technique, or “Cat”) Rhonda brings these techniques to life in a description of a depressed man she recently treated who’s been divorced for 2 to 3 years, and living alone due to the Shelter in Place orders during the Covid-19 pandemic. Although he’s lonely, he’s telling himself that he’s “too depressed and scattered” to be in a relationship. At the start of the session, he feels: sad, 90% panicky, 50% ashamed, 50% worthless 50% alone, 90% hopeless90% frustrated, 90% upset, 90%. These techniques were tremendously helpful, and at the end of the session, he no longer believed his negative thoughts about himself and his negative feelings all fell to zero. He recovered, essentially, in one extended (3-hour) TEAM therapy session. David and Rhonda discuss the impact of this type of experience on the therapist as well as the patient. Obviously, the patient feels fantastic, but Rhonda said she also felt “rejuvenated,” with much warmth and kindness. I (David) always feel this as well at the end of an amazing session. Rhonda and David

Today, the Cognitive Distortion Starter Kit Continues with Jumping to Conclusions Rhonda opens today’s podcast by reading beautiful email comments from Kevin Cornelius and Thai-An Truong. Both are dear friends and colleagues of Rhonda and David. Then Rhonda and David discuss Jumping to Conclusions, which is the fifth cognitive distortion. It’s defined as jumping to conclusions that aren’t necessary supported by the evidence. There are two common forms: Fortune Telling and Mind-Reading. Fortune-Telling: You tell yourself that bad things are about to happen. There are two common examples: Hopelessness: You tell yourself that things will never change, that you’ll never recover, or that your problems will never be solved. David explains why this distortion is impossibly distorted and virtually never true. And yet, when people are depressed, they nearly always fall victim to the belief that things will never change. It’s much like being in a hypnotic trance, because you are telling yourself and believing things that can’t possibly be true. Anxiety: You make catastrophic predictions that gradually exaggerate any real danger. All anxiety results from this distortion. For example, if you have a fear of flying, you may be telling yourself that the plane could run into turbulence and crash. Anxiety is also a self-induced hypnotic trance, because you are giving yourself and believing highly irrational messages. For example, one of David’s graduate students screamed loudly when she saw his meek little kitten, Happy, because she had a cat phobia and was telling herself that cats are extremely violent and dangerous. Mind-Reading: You assume that you know what other people are thinking when you really don’t. There are three common examples: Social Anxiety / Shyness: For example, other people are judging you and can see how anxious you are. You may also assume that other people rarely or never get anxious and that they wouldn’t be interested in you. Relationship Conflicts: You may tell yourself that the other person only cares about himself/herself and that s/he is intentionally being “unreasonable.” You may also do the opposite type of mind-reading and assume that others are quite impressed with you when they’re actually turned off or feeling annoyed with you. Anxiety: You make catastrophic predictions that gradually exaggerate any real danger. All anxiety results from this distortion. For example, if you have a fear of flying, you may be telling yourself that the plane could run into turbulence and crash. Anxiety is also a self-induced hypnotic trance, because you are giving yourself and believing highly irrational messages. For example, one of David’s graduate students screamed loudly when she saw his meek little kitten, Happy, because she had a cat phobia and was telling herself that cats are extremely violent and dangerous. Depression: You tell yourself that nobody loves you or cares about you. Many of the Truth-Based Techniques can be useful, such as Examine the Evidence, the Experimental Technique, or the Survey Technique. Motivational Techniques like Positive Reframing can be tremendously helpful. And Role-Playing Techniques like Externalization of Voices with the Acceptance Paradox can also be very useful. David and Rhonda play a short audio clip from the treatment of a severely depressed man named Bradley with a history of extreme abuse growing up. He is struggling with feelings of hopelessness, which he rated at 80 (on a scale of 0 to 100) due to these two thoughts: I’m damaged beyond repair so nothing can help. Psychotherapy homework can’t possibly help so there’s no use trying it. Prior to the audio clip, David and Bradley have done Positive Reframing asking: What do your negative thoughts and feelings show about you and your core values that is beautiful and awesome? What are some advantages, or benefits, of your negative thoughts and feelings? David and Bradley then attack his negative thoughts using a variety of role-playing techniques, with many role reversals. By the end of this approximately 13-minute excerpt, Bradley no longer believes these two thoughts and his feelings of hopelessness have dropped to zero. We are incredibly grateful to “Bradley” for giving us permission to publish this very personal and inspiring audio clip! Thanks for listening! Rhonda and David

On February 24, 2020 we published Podcast 181, "Live Therapy with Sarah: Shrinks are Human, Too!" This was a live session with Sarah, a certified TEAM-CBT therapist, conducted at my Tuesday psychotherapy training group, because Sarah was struggling with intense anxiety, bordering on panic, during  therapy sessions with her patients. It was a phenomenal session with outstanding results. The Hidden Emotion technique was the main focus of that session, bringing to conscious awareness some feelings of anger and resentment that she'd been sweeping under the rug. This is a common cause of anxiety. But a month or so after that session, Sarah relapsed in a big way, so I agreed to treat her again during the psychotherapy training group at Stanford, and Dr. Alex Clarke was my co-therapist. This time, we used very different treatment techniques. Once you've recovered, the likelihood of relapse is 100%--that's because no one can be happy all the time. We all hit bumps in the road from time to time, and when you do, your "fractal" will come into prominence again. This means that the same kinds of negative thoughts and feelings will return in an almost identical form. This can give you the chance to defeat them again and strengthen the positive circuits in your brain. That's exactly what happened to Sarah. Approximately one month after the first treatment session, she had a viral infection, and began taking large amounts of Advil to combat the symptoms. This led to severe feelings of nausea, followed by panic. Multiple trips to the doctor failed to reveal any diagnosable cause for her somatic symptoms, aside from the possibility of Advil side effects. However, the discomfort was so severe that she panicked, fearing that she had a more severe medical problem that the doctor had overlooked. She lost 13 pounds over the next two months, and requested an emergency TEAM-CBT session, which Dr. Clarke and I were very happy to provide, since live work almost always make for superb teaching. If you take a look at Sarah's Daily Mood Log, you'll see that the upsetting event was waking up Sunday morning still sick and anxious for the 100th day in a row. She circled nine different categories of negative emotions, and all were intense, with several in the range of 80 to 100. and she had many negative thoughts, including these. Please note that she strongly believe all of these thoughts: Negative Thoughts % Now 1.    I should be able to defeat my anxious thinking and reduce my suffering. 95 2.    If I can’t heal my own anxiety, I’m an inadequate hack of a TEAM-CBT therapist. 95 3.    I was strong, confident, vivacious. Now I’m fragile, weak, and self-doubting. 100 4.    My anxiety is slowing me down—I should be able to do more and take on more. 100 5.    Something serious is wrong with my stomach, but now with Covid-19, I won’t be able to get medical intervention and testing. 70 6.    I’m not as effective in my clinical work when I’m upset and anxious. 85 7.    I might get panicky during a session and screw up. 80 8.    I should always do more. 85 After empathizing, I asked Sarah about her goals for the session. She said she wanted greater self-confidence and less anxiety, and said her husband had theorized that if the anxiety disappeared, her somatic symptoms would also go away. But when we did Positive Reframing, Sarah was able to pinpoint more than 20 overwhelming benefits of her intense negative feelings, including many awesome and positive qualities and core values that her negative thoughts and feelings revealed about her. This always seems to be a shocking and pleasant discovery for the patient! At this point, we used the Magic Dial to see what Sarah wanted to dial her negative feelings down to, as you can see here. Then we went on to the Methods portion of the session, using techniques like Identify the Distortions, Externalization of Voices, Acceptance Paradox, and more. We also had to revert back to the Assessment of Resistance once again when Sarah began to fight strenuously against giving up her self-critical internal voice. We did a Cost-Benefit Analysis on the advantages and disadvantages of being self-critical and not accepting her fragileness, weaknesses, and flaws.  Once we "sat with open hands" and listed all the reasons for her to continue criticizing herself, she suddenly had a change of heart and really poured herself into crushing her negative thoughts. It was interesting that as she began to blow her negative thoughts away, she suddenly got hungry for the first time in months!  If you click here, you can see how she felt at the end of the session. It was a mind-blowing session, with much potential for learning. Rhonda, Dr. Clarke and I hope you enjoy it! Here were some "teaching points I sent to the tuesday group members after the session. This could not have been done in a single session. At least in my hands, a two hour session is massively more cost-effective than a bunch of single sessions. But even then, you have to have a plan and move quickly. Although you all said wonderfully admiring things to our “patient” during the E = Empathy phase of the session, few or none of you used Thought Empathy or Feeling Empathy, which is vitally important. I thought that Fabrizio did a magnificent job with “I Feel” Statements, expressing genuine warmth and compassion. As usual, resistance was the key, and could not have been overcome with efforts to “help” or attempts to use more M = Methods. Learning the dance of reverting instantly to A = Assessment of Resistance is key (revisiting this when the patient resists during M = Methods. But this requires “sensing” that the patient is resisting during Externalization of Voices, for example. You have to kind of “smell” what is happening, and then suddenly change direction. You also have to be able to “see” that the patient is absolutely committed to some underlying schema or belief, like “I should always be strong and vivacious,” etc. The Assessment of Resistance cannot just be an intellectual exercise, as it might then revert to “cheer-leading.” Emotion and tears are crucial, and amazing work was done by Sarah, our “patient,” during the tears. She gave herself compassion at that moment. But tears alone without the structure would not have had nearly the impact. Skillful therapy integrates multiple dimensions at the same time. It cannot be formulaic. It's an art form, based on science, and it is data-driven, based on the patient's ratings at the start and end of the session. During the Externalization of Voices, I would recommend that you NEVER settle for a “big” win. Shoot for huge, and stick with the same thought for as many sessions as necessary to get to “huge.” During the role playing I switched back and forth from Ext of Voices to Paradoxical Double Standard and then back frequently, as they both draw on different sources of pretty incredible healing power. As a therapist, I never give in to a patient’s feelings of hopelessness, because rapid and dramatic recovery is usually possible. Relapse Prevention Training (RPT) will now be necessary, since NTs always return. RPT only takes about 30 minutes. I apologize for taking over last night, but felt my strongest commitment is to provide relief for the person in the “patient” role. Sometimes what you think of as your worst “flaw” (eg being suddenly weak and fragile and fearful) can be your greatest asset in disguise, once you accept your flaw(s). But we fight against acceptance, thinking that if we beat up on ourselves enough, something wonderful will happen. And, of course, the self-criticism can sometimes reap big dividends. At the same time, I try to remind myself that self-acceptance is the greatest change a human being can make. The goal of therapy is not just feeling somewhat better, but getting to enlightenment and joy. That's what happened tonight! After the session, I received this awesome email from Sarah: Thank you from the bottom of my heart, David, Alex, and all members of our training group who were present tonight. Such beautiful contributions from all, and I appreciate so deeply this 2nd opportunity to do personal work, especially given that we are ALL going through difficulties during this Covid-19 crisis (or in general). I feel so much lighter, even enlightened, ate some pot roast for dinner (What??? I haven't had an appetite for something like that in a LONG time... and find myself looking forward to my sessions with my patients tomorrow). And I also know I'll have moments of relapse, but I really felt like I finally defeated those thoughts and especially the core belief. Stay healthy and safe everyone, I look forward to opportunities in the future when we reunite, to be in support of YOU. Best, Sarah Rhonda, Alex and I want to thank you, Sarah, once again, for your tremendous courage and generosity! David and Rhonda