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

On April 9, 2020, David and Rhonda did a live TEAM-CBT session with Dr. Taylor Chesney, a former student of David's who is now the head of the Feeling Good Institute of New York City. Her husband, Gregg, is an ER / ICU (Emergency Room / Intensive Care) doctor in New York, and she was terrified he might contract the corona virus and die. Gregg was also terrified, as he had to intubate two of his colleagues who are struggling in the ICU, and recently had trouble breathing. He is working long hours and lives in a separate apartment to protect Taylor and their three young children. The response to that podcast was extremely positive. Here's an email from a therapist in India, Nivedita Singh: Dear Dr Burns, Rhonda and Taylor, Just finished listening to your 4th podcast of the Corona series. What an emotional roller coaster learning and healing journey it's been. Can never ever thank you enough. Living far away in India and watching the Corona story unfold on the international news channels has been overwhelmingly scary for most of us, especially those who have our kids attending different schools in the United States. They share their fears and anxieties or protect us (their parents) by withholding it ... both of which makes us feel helpless and fills us with dread. The podcast today built some amazing perspective. Taylor is a Braveheart to Gregg being a Superhero. The podcast was so pure, had such integrity and absolute raw honesty! It required great courage from Taylor to allow her vulnerability to surface and an equal amount of brilliant skills set by both the therapists to communicate empathy that soothed the right spot not just for Taylor but for everyone of us across the globe who are dealing with the pandemic. When you addressed the distortions you were addressing all of us and our anxieties.The role play method had us confronting our own demons! Yes! All of us on this planet who have families stranded somewhere ... who are battling the virus ... or fighting in the front-lines, felt therapeutically addressed. I personally found myself choking when Taylor did, relaxing when she relaxed and found myself to be gripped by fear when she became vulnerable again. I was on the rollercoaster with her. By the time the podcast drew to an end I could sense my shoulders relaxing ... my breathing getting even and my fists unclenching. Something in the head or somewhere inside of me felt right. I insisted my family and friends listen to the podcast ... and the unanimous feedback was that plenty of pennies dropped for all of us at different times in the podcast. You, Dr Burns and Rhonda made all of us feel less anxious, less fearful and more in control of our emotions; and also compassionate and super, super proud of the Greggs and Taylors of the world. I am extremely grateful to Taylor (who I have met as a beautiful and driven young professional; and I got to see the devoted mum and wife in her) for letting us in to be a part of her journey. Wish her and her family lovely times ahead.This too shall pass ... Stay safe. Take care. Warmly and even more awestruck (by you Dr Burns). Thank you again for giving us TEAM. Nivedita Singh (Your biggest fan this side of the Pacific). One week after the recording of that podcast, Taylor learned that Gregg, has, in fact, been struck by the Covid-19 virus, so her worst fear has become a reality. What do you think happened? Did the monster have no teeth, as David sometimes argues? Listen to this powerful podcast and you will find out! David describes several patients he treated who had intense fears of going bankrupt, who did, in fact, go bankrupt while in treatment. What happened when their worse fears were realized--and why? The cognitive model states that only our thoughts can upset us, and that the thoughts that upset us will be distorted. Depression and anxiety, David argues, are the world's oldest cons. Could the cognitive model be correct in this era where we are fighting something that IS real and IS dangerous? During today's podcast, Rhonda asks Taylor about her romance with Gregg, how they met, what happened on their first date playing frisbee in Central Park, and how their relationship evolved. Taylor recalls the psychodynamic training she received during her graduate work in clinical psychology, which was all about listening without teaching patients to use specific tools to change. Taylor's teachers explained that there was no point in trying to change until you discovered the cause of your problems. Gregg did not agree and urged Taylor to think more about helping her patients change their lives, using specific tools. After all, a medical doctor doesn't just help patients understand why they have pneumonia--the goal is rapid cure whenever possible--understanding the causes doesn't necessarily help or lead to change. In addition, the causes of all psychiatric problems are currently unknown, so the focus on endless talk to understand the causes of depression, anxiety, relationship problems or habits and addictions could even be seen as nonsensical. Taylor had a chance to check this out when she and Gregg moved to California shortly after they were married in 2012. Gregg had a two-year Critical Care fellowship at Stanford, and Taylor joined Dr. Burns TEAM-CBT weekly training group at Stanford to prove that the rapid-change techniques wouldn't work. But they did work. She concluded that TEAM-CBT really IS all it's cracked up to be and fell in love with TEAM. The rest his history. When Taylor and Gregg returned home to New York two years later, she founded the highly acclaimed New York Feeling Good Institute. During today's interview, Taylor is caring for her three beautiful and charming children, but they all want mommy's attention. It's obviously an overwhelming job, on top of her clinical work with patients, and most moms face similar challenges. Taylor provided several tips for moms who may be listening to the show from home during these days of "Shelter in Place" orders, restricting people all around the world to their homes. 1. Emotional Intelligence Training. I try to check in with each child every day to get an emotional read on how they're doing. This varies for each child based on their age. For my 6 year old, we use the Yale Mood Meter since that's what he uses in school. For my 4 year old, I name a few emotions such as happy, angry, sad, and ask her what's a time today she felt any of those. For my 2 year old, I try to find a time where he's thrown a toy or pushed a sibling and mention an emotion he might be feeling such as happy, sad, or angry, and act it out. He often just laughs but it starts to help him develop his emotional intelligence. 2. Scheduling. Every evening I write out our daily schedule for the following day. This helps to keep me organized, but also helps my children know what to expect each day and gives us a flexible guide for the day. This includes things such as meals, brushing teeth, nap time, screen time, social time, exercise, and academics. Certain activities are required, while others are more flexible. Since my kids are just 2, 4, and 6 years old, there are fewer "requirements" but over time I plan to try to push them a little more to stick to the schedule. Since social distancing and being home is something we have not had any practice with, I want to ease into our new schedule. 3. Independent play. I schedule some time for independent play each day. This is a skill I've really been focusing on with each child, and find that it's important for them to learn to play by themselves. Social playing is great, but learning to be alone is important as well! For my 6 year old the goal is 20 mins, for my 2 year old it's 10 mins with minimal help from mommy. We make it a fun game, and they get a small reward if they are able to reach their goal. The rewards could include a hug, high-five, praise, stickers or even a new action figure. I try to switch the types of rewards to keep it fun and interesting, and also so they're not just doing it so that they get X privilege or Y toy. 4. Little Steps for Big Feets. I try to set small, manageable goals each day for each child as well as myself. Sometimes it's something I impose on the kids such as "today each of you will help me with one chore, such as taking the garbage out, cleaning up your toys, washing the table, etc." At other times it's something they want to learn. For example my daughter wants to learn to write her name so for several days her goal was to practice writing her name four times. For me it's usually a small manageable goal related to work or house-cleaning. This is similar to David's principle of "little steps for big feets!" For example, instead of saying I'll clean my entire apartment today, I focus on one small goal that I can attain. Taylor gives an awesome example of how to use the Five Secrets of Effective Communication with small children, especially when they are angry or upset. This is an example every parent might want to emulate! And it's the first example I've heard of how to do this! Thanks for tuning in, and please let us know what you thought about today's program! Rhonda, Taylor, and David

This is the first in a series of podcasts by David and Rhonda focusing on the best techniques to crush each of the ten cognitive distortions in David's book, Feeling Good: The New Mood Therapy. David and Rhonda discuss the amazing positive feedback that Rhonda received following her two recent podcasts doing live personal work. David emphasizes that being open and genuine about your own flaws and insecurities can often lead to far more meaningful relationships with others. This is a paradox, since we often hide our shortcomings, fearing others will judge and reject us if they see how we really feel, and how flawed we are. David and Rhonda begin the discussion of the Cognitive Distortion Starter Kit with a review the three principles of cognitive therapy: Our positive and negative feelings do NOT result from what happens in our lives, but rather from our thoughts about what's happening or what happened. Depression and anxiety result from distorted, illogical, misleading thoughts. What you're telling yourself is simply not true. Depression and anxiety are the world's oldest cons. When you change the way you THINK, you can change the way you FEEL. This can usually happen rapidly and without drugs. The first idea goes back at least 2,000 years to the teachings of the Greek Stoic philosophers. Although the idea that our thoughts create all of our feelings is very basic, and enlightening, many people still don't get it! This even includes lots of therapists who wrongly believe that our feelings result from what's happening to us! David describes an innovative "Pepper Shaker" game devised by George Collette, one of his colleagues in Philadelphia to make the hospitalized psychiatric patients aware, through personal experience, that their feelings really do result from their thoughts. The game can be done in a group setting, and is entertaining. Rhonda suggested that the therapists who attend David's Tuesday training group at Stanford might enjoy this game as well! There are key differences between healthy and unhealthy negative emotions. Healthy negative feelings, like sadness, remorse, or fear, also result from our thoughts, and not from what is happening to us. However, the negative thoughts that trigger healthy feelings are valid and don't need to be treated or changed. In contrast, unhealthy negative feelings, like depression, neurotic guilt, or anxiety, always result from distorted negative thoughts. David and Rhonda briefly describe each of the ten cognitive distortions, with examples. They warn listeners that the goal of these podcasts will be to learn how to change your own distorted thoughts, and not someone else's. Pointing out the distortions in someone else's thoughts or statements is obnoxious and will nearly always lead to conflict. David and Rhonda do a humorous role-play to illustrate just how incredibly annoying it is when you try to correct someone else's distortions, or when someone tries to correct your own distorted thoughts! David and Rhonda remind listeners to focus on one negative thought from a Daily Mood Log, like "I'm defective" or "my case is hopeless," and to remember that the thought will typically contain many distortions, and possibly all ten. This means that there will be lots of techniques—often 20 or more—to help you crush the thought. They also discuss the new idea that you can do Positive Reframing with cognitive distortions as well as negative thoughts and feelings. In the next podcast in this series, David and Rhonda will discuss the TEAM-CBT techniques that can especially helpful for the first distortion, All-or-Nothing Thinking. David D. Burns, MD / Rhonda Barovsky, PsyD

Recently we did a follow-up podcast with Dr. Michael Greenwald, who bravely volunteered to be the patient in the live therapy demonstration on the evening of Day 1 of the fall Atlanta intensive. My co-therapist was Thai-An Truong from Oklahoma City. Although it was a total blow-away session, we did not think the audio was good enough for a podcast, because we only recorded it on Michael's cell phone. However, our beloved colleague, Dr. Brandon Vance from Oakland, offered to improve the audio quality, so we are now presenting it to you! The audio is not quite as good as a typical podcast, but is good enough, especially after the first few minutes. The podcast includes the entire session, without commentary, as well as the 15 minute Relapse Prevention Training at the end of the workshop on day 4. Because the entire audio is about two hours long, feel free to take a break half way through, perhaps after the E = Empathy portion of the session, or the A = Assessment of Resistance, and then listen to the last half later on. If you like, you can take a look at his Daily Mood Log while you are listening. The session was incredible, and half of the audience were in tears at the end. You may be, too! And thanks, once again, for your bravery and incredible gift to all of us, Michael! Michael works in Woodland Hills and is offering free monthly TEAM therapy practice sessions at his office to therapists in the greater Los Angeles area. I am hoping these will eventually morph into the first Feeling Good Institute in Southern California. Make sure you contact Michael if you are interested joining his weekly practice group (drmichaeldg@gmail.com). He is a skillful therapist and teacher, and, as you're about to discover, a totally delightful person! Thanks for listening today, and thanks for all the kind comments and totally awesome questions you submit every day! We greatly appreciate your support! Let us know if you like these extended live therapy sessions. We can break them up, if you prefer, into shorter podcasts with commentary, or even publish them as optional extra podcasts on a different day of the week. If you would be interested in some awesome training with Thai-An Truong, ncluding free monthly TEAM-CBT webinars, you can contact her at www.teamcbttraining.com. David and Rhonda

In this engaging discussion, Dr. Jeffrey Zeig, founder of the Milton H. Erickson Institute, shares his insights on the Evolution of Psychotherapy Conference, which attracts thousands of mental health professionals. He reflects on the shift from exploring 'why' emotional issues exist to focusing on 'how' we can facilitate healing. Dr. Zeig also highlights humorous anecdotes from the therapy world and emphasizes the importance of collaboration among different therapeutic schools. Expect a blend of wisdom and light-hearted moments!

David and Rhonda are joined in today's podcast by Drs. Alex Clarke and Diane Schiano, as well as Jeremy Karmel, who are all members of David's Tuesday training group at Stanford. Alex is a clinical psychiatrist and TEAM therapist who practices at the Feeling Good Institute in Mountain View, California, and Diane is a research psychologist and licensed marriage and family therapist. All three helped in the design and analysis of the survey data. We published the survey in a blog entitled "How Are You Feeling Now?" on March 26, 2020 . To review the full report of our findings, you can click here. I (David) have been curious about occasional polls of our listeners to see if we can get meaningful results to potentially interesting questions. So this was a kind of pilot study to see if negative and positive feelings have changed in our fans since the advent of the corona pandemic. You are probably aware of the Brief Mood Survey that TEAM therapists ask patients to complete prior to and just after each session to find out how effective the session was. This tool has been incredibly powerful, because therapists and patients alike can find out right away how much improvement the patient experienced in depression, suicidal urges, anxiety, anger, happiness and relationship satisfaction in every single session. I developed an even shorter version of my Brief Mood Scale to measure similar negative and positive feelings, and all variables can range from 0 (not at all) to 100 (extremely.) So for example, a score of 25 on depression would indicate mild depression, and a score of 100 on happiness would indicate extreme happiness. In other words, high scores on the negative feelings indicate greater distress, while high scores on the positive feelings indicate greater feelings of happiness and relationship satisfaction. In the survey, we asked people like you how you are feeling right now, and how you were feeling just before learning about the corona virus. The goals of the informal survey were to answer these questions: Will people respond to the survey and can they provide meaningful information that can be analyzed statistically? Are people feeling more distress now? If so, have the negative feelings of depression, anxiety, anger and hopelessness changed more in men or women? Have the positive feelings of happiness and relationship satisfaction changed in men or women since just before the start of the pandemic? How have therapists fared, as compared with non-therapists? The five of us discussed the survey findings, which can be summarized in this way: 205 of the people who subscribe to my WordPress blogs completed the survey within a couple days. 62% of them were women and 37% were therapists. There were no gender differences in the therapists. How are You Feeling Now? Changes in Negative Feelings Since Corona Prior to the corona pandemic, the means of the negative mood variables varied from 13.2 (on a scale of 0 to 100) for hopelessness to 24.1 for anxiety. Keeping in mind that a score of 25 indicates "mild" symptoms, this means that all of these negative feelings were slightly elevated, but the elevations were minimal to mild. At the current time, all four negative feelings have increased significantly, ranging from 23.7 for hopelessness to 38.5 for anxiety, so the negative feelings are now mild to moderate. Prior to the corona pandemic, there were no significant differences in any of the negative mood variables in men vs. women. There have been significant increases in negative feelings since that time, but the greatest increases occurred in women. In fact, in women, the negative feelings approximately doubled. This means that the women who completed the survey, on average, now report feeling moderately depressed, anxious, angry and hopeless. For men, in contrast, the only negative feeling that increased significantly was anger. There were no statistically significant differences in anger levels in men vs. women before the corona pandemic and there are no significant differences now. How are You Feeling? Changes in Positive Feelings Since Corona Prior to the corona pandemic, the means of the happiness and relationship satisfaction scales were 55.6 and 58.6 (on a scale from 0 to 100), meaning they were just a tad better than moderate. This indicates that there was quite a bit of room for improvement in positive feelings prior to the pandemic. At the current time, the mean of happiness has dropped to 41,1 but relationship satisfaction has held steady at 56.8 (not a significant change.) There were no significant differences in happiness in men vs women before the pandemic, and there are no differences now. Happiness has decreased in both men and women, and the decreases have been similar in men and women. In contrast, relationship satisfaction did not differ in men vs. women at either time point, and there have been changes in relationship satisfaction in men or women since the pandemic. This is encouraging, and means that although men and women are more distressed now, feelings of intimacy and closeness to others have not diminished. In other words, social distancing has not led to feelings of isolation or emotional distancing in our population. How Are Therapists Feeling Now? Do you think that the therapists who completed the survey will have significantly different scores than non-therapists on the negative and positive mood variables? And if so, do you think the mean therapist scores will be higher or lower? Here are the findings: Therapists scored 9.85 points higher on happiness as well as relationship satisfaction than non-therapists at both time points. This was highly significant. For example, non-therapists scored 50.2 on happiness and relationship satisfaction at time 1 (moderately happy and moderate relationship satisfaction), while therapists scored 60.1 on happiness and relationship satisfaction. Of course, there's a lot of room for improvement in both groups, since these variables range from 0 to 100. Therapists also scored better than non-therapists on the negative variables at time 1, and the magnitude of the difference was 7.7. So for example, on depression, the non-therapist mean at time one was 21.2 (approaching mildly depressed), while the therapist mean was only 13.5. However, at the current time, things have changed. Now the therapists scores on depression, anxiety, anger and hopelessness are no different, on average, from the scores Open-Ended Questions: The People Behind the Numbers Dr. Diane Schiano led the charge in the discussion of several open-ended questions in our survey. The results can be summarized like this: People are feeling concerned about getting sick, dying or something bad happening to a loved one. People are coping by connecting with friends and loved ones and trying to keep up physical and mental health. People think digital therapy is a good idea, even if it's not ideal For example, one respondent wrote: "I remember hearing about the [the corona virus] when [the pandemic] first started in China, but I wasn't overly concerned. I felt like it was a bad flu and would likely blow over. Then I watched the news unfold, particularly in Italy, and realized how serious this is. Once they started shutdowns in California, I realized how serious and close to home this is." Rhonda pointed out the discrepancy between our findings and a recent UN reports of increases in domestic violence since the start of the pandemic. While our survey of podcast fans did document increases in anger in men and women since the outbreak, satisfaction in personal relationships was absolutely unchanged in men and women, and was identical in men and women. At the same time, the mean relationship satisfaction level in our group was only "moderate," which is not especially high. There are a few disclaimers. First, the findings in this survey probably do reflect the people who receive my Word Press blogs, but may not reflect the US population as a whole. The individuals who receive my blogs or listen to my podcasts are therapists, patients, and general citizens with a fairly strong interest in mental health topics as well as self-help, so the feelings in our group might easily be skewed in a somewhat more negative direction. Second, we are measuring peoples' perceptions of their feelings prior to learning of the pandemic. We did not actually measure their feelings prior to the corona epidemic. Thanks for tuning in, and please let us know what you thoughts about today's program! If you'd like me to publish more polls, suggest some interesting poll questions, if any come to mind. Rhonda, Jeremy, Diane, Alex, and David

Rhonda and David address five fascinating questions in today's podcast, including these: "I'm incredibly shy. How do you talk to girls?" How did you get over your fear of vomiting? Do you still use behavioral techniques like Exposure? Should I try to include the E and A of TEAM when trying to crush my negative thoughts on my daily mood log? And how would I do this? Please give us a podcast on how to express anger. Nandini writes: I have zero experience dating and talking to girls. I don't know how to even make girl as friend. Whenever I talk to a girl, the next day I think "How should I talk to her?" Should I go to her because now she wants me to talk to her? Which makes me very nervous. And also. if am talking to a girl I think about when I will have to go to her next time. When I'm doing my work, I think should I go to her, because she works in our office. Means I don't know how to do that! Can you help? Rhonda and David respond with some simple advice, but encourage all listeners to use the search function on his website to get lots of great links to helpful material on just about any mental health topic, including flirting, dating, shyness, or just about anything. In additon, my book, Intimate Connections, could be really helpful to Nandini, as well as my books, When Panic Attacks and The Feeling Good Handbook, that all have extensive sections on anxiety. You can find all of them at my books page (https://feelinggood.com/books/). In addition, we've recently featured several podcasts on shyness and social anxiety, including: 128: Intense Social Anxiety–I'm Losing Control! What Can I Do? 134: Smashing Shyness: Part 1 135: Smashing Shyness: Part 2 169: More on Social Anxiety–the Case for Vulnerability 142: Performance Anxiety: The Story of Rhonda, Part 1 143: Performance Anxiety: The Conclusion 088: Role-Play Techniques —Feared Fantasy Revisited How did you get over your fear of vomiting? DB, I know you probably don't remember me because it's been years since we emailed, but you helped me via your Ask The Guru section of your old website years ago and we occasionally emailed back and forth after that. Which reminds me to once again thank you for your books and how you've dedicated your life to your work. It has made a difference in my life and I would imagine literally millions of others. What a wonderful thing. I stumbled upon an article about you in the Stanford Magazine from 2013 and learned something I didn't know -- you suffered at one time from a fear of vomiting. I've dealt with that since I was a kid. It's not as severe now as it once was, but I'm wondering what CBT methods might be useful for that particular issue. (No chance I'm taking ipecac syrup!). I know you're busy so I understand if you can't answer, but wanted to reach out anyway. Thanks in advance, Steve Do you still use behavioral techniques? Dear Dr Burns, I really appreciate your efforts in this area cognitive behavioral therapy, but your efforts and techniques are so powerful and you use them so efficiently that almost no time you have to use the behavioral part of it as patients seem to be relieved enough with cognitive work. One thing I am curious about is that if you can't get enough response with cognitive work, and if you have to use the exposure model, and the patient is afraid of exposure because he or she goes into a severe state of anxiety, depersonalization or derealization symptoms and feels like gonna go crazy and lose control, would you still push him or her to the cognitive exposure and are there any risks of it? Thank you very much. Jordan Should I try to include the E and A of TEAM when trying to crush my negative thoughts on my daily mood log? And how would I do this? Dr. Burns, It would be impossible for me to heap sufficient praise over you and your podcasts because I've really gained an intangible amount of benefits and continue to learn something actionable from both on a weekly basis. I'm currently finishing Feeling Good Together and am finding the experience transformative. I wanted to see if I could ask you a question regarding the Daily Mood Log and crushing negative thoughts. I'm completely on board with the notion of fractal psychotherapy and the idea that all of our negative emotions will be captured in a single negative thought and by crushing it, we will feel substantial relief and even euphoria. I've been using the Daily Mood Log to inconsistent effect. I write down my negative thoughts, identify the distortions and then identify statements to attack that thought that are 100% true. Perhaps I am rushing through the exercise too quickly, as I try to make it a daily habit. But is it possible I'm missing an element? I've noticed in your live therapy that you allocate a sizable chunk of time to Empathy and Agenda Setting. Is it possible that the E and A in TEAM's absence in my Daily Mood Log is stunting my progress? Is there a way and should I be implementing both into the exercise? I would appreciate any input you have on this question and I look forward to continuing to listen to the podcast as new episodes come out, along with your new book and App! Best regards, Tommy Dr. Burns, Thank you! I'd be happy for you to use my first name. I'll look out for it in the upcoming podcasts. Have a great rest of the week. Tommy Please give us a podcast on how to express anger! Hey Dr. Burns, I'm loving the podcast, and my favorite podcasts are the Ask David and Live Treatment ones! Also, I can't wait for the new app and book! I did have a question, which I can go into more detail if need be. Specifically, what podcasts and book would you recommend for anger? I'm unsure how to express anger in a productive way (in my relationship), and would love more guidance and practice prior to trying to use the 5 secrets "live". Thanks in advance! Thanks for listening today, and thanks for all the kind comments and totally awesome questions! David and Rhonda

David and Rhonda are joined in today's podcast by Dr. Taylor Chesney, a former student of David's who is now the head of the Feeling Good Institute of New York City. She is a prominent TEAM-CBT therapist and trainer, and specializes in the treatment of children and teenagers. Taylor kindly agreed to do some live work today on her panic and despair because of the impact of the pandemic on her family. Her situation is especially challenging and poignant because her husband, Gregg, is a highly esteemed Emergency Room / Intensive Care physician in New York, and he is constantly working to save the lives of Covid-19 victims. Ten days ago he moved to a separate apartment several blocks away so he will not put his wife and children in harm's way in case he contracts the Covid-19 virus. But will he, himself, be struck down by this vicious virus? He told Taylor that he recently had to intubate several of his colleagues, which is horrifying. Taylor fears that she may lose her beloved husband, and that her three children may have to grow up without a father. She also feels overwhelmed because she's supporting many people now. David begins with a brief overview of the cognitive model, including several key points: All negative feelings result from thoughts, and not from what's actually happening. So even in a crisis that is as real and devastating as the Covid-19 pandemic, all of our emotions will still result from the way we think about it. Remember the teachings of Epictetus 2,000 years ago, when he wrote: "People are disturbed, not by things, but by the views we take of them." This is potentially empowering, because we usually cannot change the fact—the pandemic is real and we are powerless to make it disappear—but we may be able to change our perceptions (eg thoughts, or "cognitions") about what's happening. There's a healthy and an unhealthy version of every kind of negative feeling. For example, healthy fear is not the same as unhealthy anxiety; healthy sadness and grief are not the same as clinical depression; healthy remorse is not the same as neurotic guilt. And so forth. Our goal is not teaching you how to be happy all the time no matter what—that would be absurd—but simply to reduce or eliminate unhealthy negative feelings. Healthy negative feelings result from valid negative thoughts, and do not have to be "treated." Unhealthy negative feelings, in contrast, result from negative thoughts that are distorted and illogical. David reminds us that even in a crisis, depression and anxiety are still the world's oldest cons, and that you CAN change the way you feel. But is this possible? It just doesn't sound right! Can Taylor really change the way she thinks and feels when the crisis is so overwhelming and so real? And can you? As the session unfolds, Taylor tearfully describes her intense fears for her husband, who she loves so greatly, as well as their three young children. She says that 75% of the time, she's "okay," when she's awake and involved with caring for her kids, but 25% of the time—especially late at night when she's alone with the kids—things get pretty desperate, and sobs for 30 minutes or more while experiencing "sheer terror." What's making the situation more painful is that Gregg is temporarily living six blocks away in order to protect his family in the event he does contract the potentially deadly virus. Taylor says that "it feels like we're kicking him out. He's at war. He's fighting, struggling, suffering." She says he's passionate about his work, but she wishes he'd quit! Take a look at Taylor's Daily Mood Log at the start of the session. As you can see, she is focusing on how she is feeling every night before going to sleep. She circled seven different categories of negative feelings, and all are intense, including the depression, anxiety and frustration clusters (all are 100%), the lonely and hopeless categories (both 90%), as well as feeling "bad" (50%.) You can also see the negative thoughts she recorded. She is telling herself that: Negative Thoughts % Now 1. I shouldn't have to do this alone. 90 2. I can't handle parenting alone. 70 3. I shouldn't burden Gregg with my feelings. 70 4. I should share my feelings. 50 5. I should be strong and tough. 80 6. I'll let my patients down if I don't have enough time for them. 50 7. I'll lose Gregg. 50 - 100 8. I shouldn't have to do this. 100 9. I should be able to work and support my family while Gregg stays at home safely. 50 You can also see that her belief in these thoughts varied from 50% to 100%. After empathizing for 30 minutes, Rhonda and David asked about her goals for the session, which would be to turn down the intensity of her negative feelings. Together, Rhonda, Taylor and David do Positive Reframing, asking two questions about each negative thought and feeling: What does this negative thought or feeling show about Taylor that's positive and awesome? What are some benefits, or advantages, of this negative thought or feeling? Together, they generate an impressive list of Positives. Then Taylor decides she can use the Magic Dial and reduce her negative feelings, while not eliminating them completely, as you can see at this link. Then they use a variety of techniques to challenge each negative thought, staring with #4, "I shouldn't share my feelings." Taylor identifies many distortions in this thought, including Should Statement, Emotional Reasoning, Mind-Reading, Self-Blame, and Mental Filter. Taylor decides to think about it like this instead: "It's okay to share my feelings. It could bring us closer together. It's human to be struggling, given the circumstances. My feelings matter to Gregg." She believes this Positive Thought 100%, and her belief in the Negative Thought fell to 5%, which was enough, since there was a little truth in the thought. You might have to be thoughtful about the timing of self-disclosure. Rhonda and David continue to challenge the rest of Taylor's Negative Thoughts, using a variety of techniques such as the Externalization of Voices, Acceptance Paradox, Paradoxical Double Standard Technique, and more. The most challenging Negative Thought was #7—her fear that Gregg might die. At the end of the session Taylor recorded a substantial reduction in her negative feelings. Thanks for tuning in, and please let us know what you thought about today's program! Rhonda, Taylor, and David

My mother won't follow my advice! David and Rhonda are joined in today's podcast by Alex Clarke, MD, a former student of David's who is practicing TEAM therapy at the Feeling Good Institute in Mountain View, California, and by Zeina Halim, a TEAM therapist and student in David's Tuesday Stanford psychotherapy training group. In our last two podcasts (Corona Cast 1 and 2) (links) we focused on the impact of the corona crisis on internal feelings like depression, anxiety, panic, hopelessness, and so forth. In this week's Corona Cast 3, we will switch our focus to the impact of the pandemic on personal relationships, using a real example. Zeina was concerned that her mother, aged 72, was not being sufficiently careful about social distancing. Zeina felt panicky because she feared her mother might get the virus and die. However, Zeina's mother is very self-reliant and independent, and didn't take kindly to Zeina's frequent reminders to do this or do that so as to be safe. They ended up arguing and feeling frustrated with each other. Perhaps you've also run into problems with friends and loved ones because of the corona crisis. When people get confined into close quarters, under conditions of intense stress and uncertainty, clashes are almost inevitable. When you're angry with someone , you'll nearly always be viewing the other person in a distorted way. For example, you may be telling yourself that s/he "should" not think, feel or behave the way he or she is thinking, feeling, or behaving. Of course, this is a classic other-directed "should statement." Or you may be telling yourself that the other person is being "stubborn" or "unreasonable" (Labeling; Mind-Reading). Or you may tell yourself that you're right and the other person is wrong (All-or-Nothing Thinking; Blame). And in most cases, you'll be telling yourself that the conflict is the other person's fault and that you're the innocent victim of his or her bad behavior (Blame.) These are just a few of the cognitive distortions (link) that fuel conflict. But it's these distorted thoughts, and NOT what the other person is thinking, feeling, or saying, that actually causes your negative feelings. You are making yourself angry--the other person is NOT causing your anger or frustration! You are creating these feelings. And the thoughts that trigger these feeling are wrong thoughts. This can be a VERY hard pill to swallow. You, and not the person you're mad at, are triggering your feelings of frustration and anger. In addition, the thoughts that upset you are not valid. They're distorted, and just plain WRONG. If you don't like this message, you might want to stop reading! I get it! It is SO MUCH more rewarding to blame the other person! In today's podcast, we discuss and illustrate a sophisticated TEAM-CBT technique called "Forced Empathy" (link). Forced Empathy forces you see things from the perspective of someone you're at odds with. It will ONLY be effective if you want a closer relationship with the person you're at odds with. If you want to remain in battle--as most people do--then you're welcome to do that. Go for it. If, in contrast, you do want to feel closer and more loving, Forced Empathy can lead to a helpful shift in how you think about the person you're angry with. When you suddenly see things through the eyes of the person you're angry with, you may suddenly discover that your thoughts about the other person's motives were not correct. Alex and David describe how the technique works in a step-by-step way, and then illustrate it with a role-play between Zeina and her mother. This is a recreation of the technique they used live in the Stanford Tuesday group a couple weeks before the recording. Forced Empathy proved to be extraordinarily helpful to Zeina, and brought tears to her eyes. Once she saw things from her mother's perspective, the tone of their interactions suddenly softened, and the tension was replaced by feelings of love and acceptance. Zeina was surprised to discover that, among other things, her mother, while not wanting to die, had no fear of death, but didn't appreciate being constantly told what to do, or what not to do, and that she loved and admired Zeina tremendously. Zeina also discovered that in the highly unlikely event that her mother did die, she would want to spend her last days or weeks with her Zeina, feeling close, and loving one another, instead of arguing. Is this relevant to you and your friends and loved ones? In today's podcast, we talk about how you can improve your relationships with friends and loved ones during these challenging times using the Five Secrets of Effective Communication. We emphasized one of the important take home messages in podcast 164 on "How to Help, and How NOT to Help." Sometimes, people just want someone to care about them and listen, without having someone trying to help them or give them advice. Learning to do this can be incredibly freeing, but it's not easy, because so many of us are addicted to "helping." If you want some additional help, check out David's book, Feeling Good Together. Thanks for tuning in, and let us know what you thought about today's program! Until next time, Rhonda, Alex, Zeina, and David

With the "Shelter in Place" orders in California, we are recording these podcasts from our homes instead of from the Murietta Studios. The sound quality may not be as high as usual while we are learning to use the new technology. (I apologize for the echo in this week's podcast. It won't be there again-Rhonda) Let us know what you think! Thank you, David & Rhonda David and Rhonda are joined again in today's podcast by Jeremy Karmel, who is working with David on the new Feeling Great app. In our first Corona Cast, we promised to present an example of how TEAM-CBT can be helpful for individuals who feel depressed and anxious about the personal impact of the pandemic. Rhonda kick starts today's session by describing her treatment with a patient we're calling Alice just a few days ago. Alice woke up feeling stressed and having trouble settling in and getting to work. If you click here, you can see how she filled out the first few steps of the Daily Mood Log just before the start of her session with Rhonda. The Upsetting Event was simply waking up and feeling out of sorts. She circled and rated her negative emotions, which were fairly intense, especially the feelings of depression, anxiety, inadequacy, despair, frustration. Her anxiety was only minimal, but she was also feeling tremendously "jittery." Why was Alice feeling so upset? Her feelings didn't result from the corona virus epidemic, but from her thoughts about it. As you can see, she was telling herself: 1. This could be the new normal. 2. My life is going to waste. 3. I should be handling this better. 4. I could catch the virus and die. 5. No one is in charge. She strongly believed all of these thoughts except #4, which she only believed 40%. You may recall that in order to feel upset, two things must be true: You must have one or more negative thoughts on your mind. You must strongly believe these thoughts. How are we going to help Alice? In the old days, I would have jumped right in to help Alice challenge her Negative Thoughts, but now we have a far more powerful and systematic approach called TEAM-CBT, as most podcast fans probably already know! These are the four steps of TEAM-CBT: T = Testing. Rhonda tested how Alice was feeling at the start and end of the session. E = Empathy. Rhonda provided warmth and support without trying to "help" or "cheer-lead." A = Assessment of Resistance. This is one of the unique aspects of TEAM-CBT, and it's the secret of ultra-rapid recovery. Rhonda used the Miracle Cure Question, Magic Button, Positive Reframing, and Magic Dial to bring Alice's "resistance" to change to conscious awareness, then quickly reduced it before trying to "help." M = Methods. Rhonda helped Alice identify the many cognitive distortions in her thoughts. For example, her first Negative Thought, "This could be the new normal," was an example of All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Fortune Telling, and Emotional Reasoning. The goal of the M = Methods phase is to crush the Negative Thoughts that are upsetting you. Do you know how to do this? You have to come up with a Positive Thought that has two characteristics: It must be 100% true. Positive affirmations and rationalizations and half truths are worthless. Cognitive therapy is based on the Biblical idea the "The truth shall set you free." The Positive Thought must drastically reduce your belief in the Negative Thought you've recorded on your Daily Mood Log, and ideally your belief in it will go all the way to zero. In fact, the very instant you stop believing the Negative Thought, your feelings will change, and often quite dramatically. Rhonda helped Alice challenge her Negative thoughts with a powerful technique called the Externalization of Voices. For example, Alice was telling herself that "I should be handling this better" because she'd been having trouble adjusting to the home isolation and had been procrastinating instead of focusing on her writing, and she was also telling herself that "My life is going to waste," thinking she'd be procrastinating and feeling miserable forever: "The new normal." The Positive Thought that crushed it was, "I have a lot of experience as a self-starter, and I've got eight weeks of free time now to write, which is pretty awesome. In addition, I can give myself a break, instead of putting myself down, and give myself a little to regroup!" After all, there are hundreds of millions of people around the world who are feeling isolated and in distress, and probably most of them aren't being nearly as productive as they usually are, but clearly, that isn't going to go on forever! Instead of putting yourself down, you can give yourself some support and encouragement, in exactly the same way you might talk to a dear friend. Once Alice crushed her Negative Thoughts with strong Positive Thoughts, her feelings suddenly changed. Although the session was only one hour long, Alice experienced incredible improvements in how she felt, thanks to Rhonda's compassion and skillful guidance. Alice's depression went from 95 to 5, and her anxiety dropped from 95 all the way to zero. The rest of her negative feelings dropped to very low levels or zero as well. Did it last? Long-term follow-up isn't possible for such a recent session, but she did call Rhonda the next morning to say that she woke up Feeling Great . . . which is the name of my new book, due for release in September. You can see the cover below! If you want, pre-ordering on Amazon may be available by the time you hear this podcast. In next week's Corona Cast 3, we will switch our focus to the impact of the pandemic on personal relationships, using a real example of a young woman named Zeina who felt her mother, aged 72, was not being sufficiently careful about social distancing. Zeina felt panicky because she feared her mother would get the virus and die. They ended up arguing and feeling frustrated with each other. We will illustrate a sophisticated TEAM-CBT technique called "Forced Empathy" that brought tears to Zeina's eyes, and we'll also talk to you about how you can improve your relationships with friends and loved ones as well during these challenging times. Thanks for tuning in, and let us know what you thought about today's program! Until next time, Rhonda, Jeremy, and David

With the "Shelter in Place" orders in California, we are recording these podcasts from our homes instead of from the Murietta Studios. The sound quality may not be as high as usual until we all get the necessary recording equipment, and learn the new technology. Please bare with us during this transition. Thank you, David & Rhonda David and Rhonda are joined in today's podcast by Jeremy Karmel, who is working with David on the new Feeling Great app, and Dr. Alex Clarke, a former student of David's who is practicing TEAM therapy / psychiatry at the Feeling Good Institute in Mountain View, California. One of our loyal podcast fans, Phil McCormack, sent a heartwarming email which read, in part: In light of the pandemic taking us into uncharted territories, I thought it might be interesting to hear of some tips from you that would help folks deal with the situation, kind of like the David's Top Ten Tips podcast but this one focused on the hysteria which is prevalent as I write. I'm sure your fans would appreciate it and it might be a good jump start for your new book and app, both called Feeling Great. I realize you are incredibly busy and don't expect an answer. And if you want to tell me to screw myself, I can use your techniques to handle that! I responded like this: Thanks, Phil. I'm trying to put together at least two or three podcasts on the coronavirus from a variety of perspectives! Might read you question to kick start the first one we do, if that's okay. david Phil immediately shot back this email: You're an animal! I have no idea of where you get all your energy and motivation–obviously your techniques work (drug free!) so that must be part of it! Kudos to you for all your effort. It is so, so much appreciated!! I sincerely hope you someday get the recognition you deserve!!! I think Feeling Great might be your ticket... Hope so. Please feel free to read question and thanks for not telling me to "screw myself!" Really appreciate that! Phil How cool is that! Rhonda and I are planning several podcasts on this important topic including today's as well as a podcast on how Rhonda used TEAM to help a woman with severe feelings of depression, anxiety, inadequacy, despair and frustration about the current corona crisis in a single session. We are also planning podcasts on how to communicate with friends and loved ones during the crisis, as well as a survey to assess changes in mood (depression, anxiety, anger, relationship satisfaction and happiness) since the corona virus hit, and possibly more. When the survey is ready, we'll announce it and send you a link in case you'd like to let us know how you've been feeling, and how your feelings might have changed since the virus hit! Rhonda kick starts today's session by reading a list of negative thoughts from folks who are freaked out about the corona virus, including these: Negative Thoughts with Probable Cognitive Distortions The world will turn into an apocalypse. I'll be a carrier and won't know it and then I'll infect my partner and children who will get really sick. I'm divorced and I think my ex- will try to keep me from my kids. She won't be as vigilant as I am about keeping our kids healthy. They'll get sick and infect me. I'm looking for a job right now, but no one will be hiring for a long time and I'll never get a job. I won't have enough money to pay my rent and I'll be evicted from my apartment and end up homeless (or) my business will go out of business. I won't have enough money to have fun for several months. My parents will contract the virus, especially one of my parents who has some chronic health stuff, and get really sick or die. I'm going to get cabin fever. I will lose a sense of self/connection to reality with how surreal everything is. People in my life will die from the virus. * * * Negative Thoughts that are Probably Not Distorted The numbers of infected people are way higher than what's being reported because there's no testing The pandemic is worsening. The pandemic will get much worse than we realize now. Needier populations -- people who have lost work who really need it (restaurant workers, hotel, caterers, production staff, people with no savings, etc) — will suffer. The social fabric is going to break down. Things are going to continue worsening as climate change worsens. I live too far from my parents to help take care of them. Rhonda, Alex, David, and Jeremy begin by discussing several of the basic ideas of TEAM-CBT. We feel the way we think. In other words, the events of this world—like the corona virus—cannot have any effect on how we feel. All of our negative and positive feelings result from our thoughts, or "cognitions." This idea goes back nearly 2,000 years to the teachings of the Greek Stoic philosopher, Epictetus, who said that people are disturbed, not by the things that happen, but by our views of them. Some negative feelings are healthy and some or not. Healthy fear is not the same as neurotic anxiety. Healthy sadness is not the same as depression. Healthy remorse is not the same as neurotic anxiety. And so forth. Healthy anger is not the same as unhealthy anger. Healthy negative feelings result from valid negative thoughts, like "We are in danger because of the spread of the corona virus, and we need to be vigilant to protect ourselves and our loved ones." Unhealthy negative feelings result from distorted negative thoughts, like "The world will turn into an apocalypse." Anxiety, panic, and depression, in contrast, result from distorted negative thoughts, like many of those that Rhonda read. For example, think about this thought: "My parents will die and I may never see them again." Review the list of cognitive distortions and see if you can spot some! This thought is likely to be at least somewhat distorted since your parents probably won't die. For example, in China there have been around 3,300 deaths so far, and the epidemic has finally been slowing in the past few days. Since there are more than a billion people in China, the odds that you or someone in your family will die, while significant, appear to be incredibly low. So while there is clearly some risk, the distortion would be Magnification, Fortune Telling, and Emotional Reasoning, the three distortions that trigger all feelings of anxiety. In addition, you can see your parents right now if you like, using Skype, for example. So, while that thought also contains a grain of truth, it arguably involves Discounting the Positive as well. In spite of these considerations, TEAM therapist don't try to "fix" or "help" just because someone may have distorted negative thoughts. Trying to help without first addressing therapeutic resistance is the most common error therapists make, and the most common error most people us make. For example, you will hear politicians telling people to "stay CALM," or trying to encourage people with good news or promises which sometimes don't seem entirely honest. Instead of jumping in and trying to "help," TEAM-CBT therapists first ask the person who is upset if they are looking for help. Sometimes, people aren't asking for "help" or cheer-leading, they just want someone to listen and provide validation and support. If the person does want help with negative feelings like panic, depression, frustration, loneliness, or inadequacy, we do a little thought experiment and say: "Imagine that we had a Magic Button, and if press it, all your negative feelings will instantly vanish, with no effort, and you'll feel terrific. Will you push the Magic Button?" Most people say they'd gladly push the button! Then we say that while we don't have a Magic Button, we've got some tremendous techniques that could help them reduce or even eliminate their negative feelings, but don't think it would be such a good idea to do that because their negative thoughts and feelings may be expressions of their core values as a human being, and what is most beautiful and awesome about them, and that their may be some important benefits, or advantages of their negative thoughts and feelings. And maybe we should list those before making any decision to press the Magic Button and make everything disappear. If you're upset, you can try this right now. First, circle your negative feelings and estimate how strong each category is, between 0 and 100%. If you click here, you can see an example of this on the Emotions table of the Daily Mood Log of a woman who was upset about the corona virus scare. Then ask these two questions about each feeling: What does this negative feelings show about me and my core values that's positive and awesome? What are some benefits or advantages of this negative feelings are. How might it help me, or my loved ones? I call this new technique Positive Reframing. In other words, I want to honor your negative thoughts and feelings before we think about changing them! This is called Positive Reframing and it is the key to the incredibly rapid changes we typically see when using TEAM-CBT. Typically, we come up with a list of a long list of compelling positives. Then I point out that if they push the Magic Button, all those positives will go down the drain, along with their negative feelings. Would they really want to do that? Now you're in a trap, or dilemma. One the one hand, you are suffering and desperately want to feel better. But at the same time, you don't want to lose all of those awesome positives! Fortunately, we can resolve this paradox. Instead of trying to make your negative feelings disappear by pushing the Magic Button, imagine that we had a Magic Dial instead, and you could dial each negative feeling down to a lower level that would allow you to keep all the positives on your list, and still feel better. What would you dial each type of negative feeling down to? For example, if you're feeling 80% panic or 90% depressed or angry about the corona virus, and you could dial each emotion down to a lower level, what would you dial them down to? You can see an example of this if you click here. As you can see, this person has put these new levels in the "% Goal" column of the emotion table. Jeremy provides a touching real life example of this. He feel intense anger because his fiancé, a nurse—is working in a hospital with a shortage of protective masks. He becomes tearful when he realizes that his anger is actually an expression of his intense love for her. The change in how he feels is almost instantaneous, and touching. The group further illustrate this by using Positive Reframing with many of the negative feelings our podcast listeners like you may be having. Jeremy concludes by drawing a critically important distinction between Positive Reframing, which is nearly always helpful, and "cheer leading," which is rarely or never helpful, and can actually be downright irritating! This table below highlights some of the critical differences. Is Positive Reframing Just Cheerleading Warmed Over? by David and Jeremy Cheer Leading Positive Reframing You're trying to cheer someone up to make them feel better. You are highlighting the benefits of NOT changing. You say generally nice things about someone, like "you're a good person," or "you're a survivor," or "don't be so hard on yourself." The positives are not general but embedded within specific negative thoughts and feelings. You don't acknowledge the validity or beauty of the person's negative thoughts and emotions. In fact, you're trying to tell them that they're wrong to feel upset! This is always preceded by doing superb empathy. Positive Reframing is actually a deeper form of empathy because you're honoring the patient's core values. Cheerleading is irritating to almost everybody who's upset, because you aren't listening or showing any compassion or respect. The effect is enlightening and leads to feelings of relief, pride, peace, and acceptance. You're trying to control the other person. You're telling them how they should think and feel. There's no acceptance. You're Sitting with Open Hands. You're bringing hidden motivations to conscious awareness so they can decide where to steer the ship. Hollow praise sounds dismissive, glib, and insincere. This technique is very difficult and challenging to learn because you have to let go of the idea that you know what's best for other people. Thanks for tuning in, and let us know what you thought about today's program! Oh, if you clicked on the two links to the Daily Mood Log of the woman who was intensely upset about the corona virus, and want to find out what happened in her magical TEAM-CBT session with Rhonda, tune in to our next CoronaCast! Until then, Rhonda, Alex, Jeremy, and David