A Second Visit to David and Jill's Tuesday TEAM Training Group at Stanford Last week, you “sat in” on our Tuesday training group at Stanford and learned about two of the four most important techniques in the treatment of perfectionism, or any other Self-Defeating Belief. (For a list of 23 common Self-Defeating Beliefs, click here.) The Cost-Benefit Analysis (CBA): You weight the advantages against the disadvantages of trying to be perfect. The Semantic Technique, to find out how to word your new belief if you decide that your perfectionism belief isn’t working for you The purpose of those two techniques is to provide intellectual change. Tonight, you will join us again as we aim for emotional change at the gut level. This will be our agenda for the students in the class you will observe: 1. Please describe an example of a specific time when you felt upset due to perfectionism. What were your negative thoughts? How were you feeling? What was happening? 2. Downward Arrow Technique: Suppose you weren’t perfect, or you failed or screwed up in some way. Why would that be upsetting to you? What would that mean to you. 3. Externalization of Voices (Optional: possibly we will do this, maybe just mention it, depending on time.) 4. Experimental Technique / Examine the Evidence 5. Feared Fantasy 6. Wrap-up and Teaching Points As you can see, some exercises will be performed in the large group, with everyone present and contributing, and some exercises will be in the small, breakout groups. The small groups provide more time for participants to practice. We plan on recording both of the small groups so you can observe the training techniques we use for mental health professionals. Last week our focus was motivational, so we asked: is to your advantage to aim for perfection? How will this mind set help you and how will it hurt you? Tonight, one of the key techniques will focus on TRUTH: is it TRUE that you need to aim for perfection? We will be using the Experimental Technique and / or Examine the Evidence to see if we can answer this question. In addition, we will go into an Alice-in-Wonderland Nightmare World and meet an imaginary monster who claims superiority because she or he really is perfect and really has achieved incredibly more than anyone. This can sometimes help us answer two questions: Is it possible to be or become a “more worthwhile” or “superior” human being? Would it be desirable if you could? I hope you enjoyed this new format of “dropping in” on my Tuesday training group at Stanford. Let Rhonda and me know what you think. It was just an experiment, and we want to know what you might have liked or disliked about it. Thanks! Our free weekly Tuesday and Wednesday training groups are open to therapists of all persuasions from all around the world. For information including the requirements, you can contact: Tuesday night training group with David and Jill, Contact Ed Walton: EdWalton100@gmail.com Wednesday mid-day group with Dr. Rhonda Barovsky and Richard Lam, Contact Ana Teresa Silva:  ateresasilva6@gmail.com

Tuesday TEAM Training Group at Stanford In 1980 I published an article entitled "The Perfectionist's Script for Self-Defeat" in Psychology Today Magazine, in an attempt to get some publicity for my (then) new book, Feeling Good. At the time, it was the cover feature and became the most popular article in the history of that magazine. Perfectionism is definitely one of the most common themes I have confronted in my clinical work and teaching over the past many decades. If you would like to take a look, you can check it out at this link. They had fantastic colorful illustrations, including a bleeding dart board wtih a dart in the bullseye, and sadly you'll only get the text in black an white at the link. It seems that almost everyone succumbs to this mindset from time to time, and it can cause many negative moods. But at the same time, the attempt to be perfect brings many benefits at the same time. This can be a dilemma. The next several podcasts will be based on a two-week perfectionism class I developed for the weekly Stanford TEAM-CBT training group that I direct along with my esteemed colleague, Dr. Jill Levitt. This podcast class is suitable for therapists and non-therapists alike. These podcasts will give you the opportunity to “attend” the group and witness the procedures we use to train therapists. You will have the opportunity to practice the same techniques the students will practice when we break into small groups. I would encourage you to turn off your podcast temporarily so you can practice the exact same techniques on your own when we break into small groups for practice. For example, in the first class you are about to hear, we will spend 20 minutes doing a Cost-Benefit Analysis for perfectionism. You will find a blank CBA if you click HERE. I would encourage you to practice the same thing for 20 minutes during each practice group. During the first breakout group, you can spend 20 minutes listing the advantages and disadvantages or perfectionism. Ask yourself, “how might this mindset help me? And how might it hurt me?” You can use this blank CBA. After listing the advantages and disadvantages, weigh them against each other on a 100-point scale, and put two numbers adding up to 100 in the two circles at the bottom. For example, if the advantages are greater, you might put 75 and 25 in the two circles. If they are about equal, you can put 50 and 50. And if the disadvantages are somewhat stronger, you might put 40 and 60 in the circles. Remember, it’s not the number of items in the columns, but how you feel about them overall. Sometimes, one powerful advantage might feel much more important than the five disadvantages, and sometimes one powerful disadvantage might feel more important than numerous advantages. Part of the fun (hopefully) of this podcast is that you’ll get to hear the questions and suggestions of many of the 45 or so students in the class that night. As you will hear, we have a multi-cultural rainbow group with therapists from around the world. We started Part 1 of the Perfectionism Master Class with these important two questions: What is perfectionism? How would you define it? What is the difference between perfectionism and the healthy pursuit of excellence? Then we went on to the Cost-Benefit Analysis (CBA) in small groups. I forgot to record my small group, but you will hear a long list of advantages and disadvantages discussed when the large group reconvenes. As I mentioned about, I would encourage you to do your own CBA while we are in the small group. When we reconvened in the large group, we talked about the therapeutic strategies you would use once the patient has balanced the advantages against the disadvantages of perfectionism, including Sitting with Open Hands with patients who are reluctant to give up their perfectionism. I also discussed my strategy of aiming for “average” or even “below average,” as opposed to perfection. As I’ve aged, I’ve actually lowered my standards so low that everything looks pretty awesome to me! And my productivity, as well as the quality of my work, has actually improved greatly as a result. This paradoxical strategy may seem foolish to many devoted perfectionists at first, but it has proven exceedingly powerful and helpful in my life since I screw up so often! Seeing failures and mistakes as opportunities to learn and grow, rather than signs of failure or inadequacy, has been huge for me. Joy seems to spark my creativity and productivity way better than feelings of shame and anxiety. After the CBA exercise, we used the Semantic Technique to revise the perfectionistic belief, like, “I should always try to be perfect,” or “My worthwhileness as a human being depends on my performance (or achievements, etc.). The goal, as you will see, is to reword the belief with this goal in mind: Your new belief can reduce or eliminate most or all of the disadvantages or perfectionism while preserving most or all of the advantages. We DID record Jill’s small group, so you can hear her students working on the Semantic Revision of their perfectionistic belief, but I would strongly recommend that you turn off your podcast and see if you can revise your own perfectionistic belief while we are doing our small group work. Again, this was a 20-minute exercise. I am attaching some of the feedback from the first Tuesday group on perfectionism, Part 1. Next week, you’ll hear Part 2 of the Master Class on Perfectionism. If you are a therapist, you might want to join one of our weekly training groups. The group I conduct with Dr. Jill Levitt is the Tuesday group, and we meet from 5 to 7:30 (PST) on Tuesdays. In addition, Dr. Rhonda Barovsky and Richard Lam have a Wednesday training group that meets from blank to blank PST. Both groups involve an introductory 12-week curriculum for individuals who are not familiar with TEAM-CBT. After that, you may join the advanced group, learning with 40 to 50 colleagues every week. Both groups are free, but you will be required to: Sign the consent form for group membership and agree to the terms on it. Purchase the required course materials, including my psychotherapy eBook, Tools, Not Schools, of Therapy. Purchase the Therapist’s Toolkit and use the assessment instruments with every patient / client at every session. These tools are for sale in the shop at feelinggood.com, and discounts are available for therapists who want but cannot afford the tools. Practice during sessions using role-playing techniques and receive immediate specific feedback on what you did effectively and ineffectively so as to refine your skills. Do homework and use the techniques with your patients between sessions. Attend at least ¾ of the training groups. These are NOT drop-in groups. The free weekly training is available to licensed health / mental health professionals as well as graduate students in mental health who are studying to become psychiatrists, psychologists, counselors, clinical social workers, and so forth. TEAM-CBT is immensely powerful and looks easy, but it’s not. A great deal of commitment, time, and training is always needed to develop expertise. Many of our group members have continued with the group for many years, and we encourage that. Part of the training involves live personal work, which is recommended but not required. Jill and I believe that doing your own personal work is vitally important on the road to world class therapy skills. As you probably know, Rhonda and I publish many of those sessions as two-part podcasts, but only with the permission of the participants who are in the “patient” role on one of the evenings when we do personal work. Probably 15% or 20% of the sessions feature personal work with members who volunteer and ask for help. Social anxiety and feelings that “I’m not good enough” as well as relationship problems are popular themes for the individuals doing personal work on any given night. The personal work does not involve the development of an actual therapeutic relationship. It is simply a one-session, 3.5 hour experience in front of the group which is part of your personal development, so you can experience the TEAM-CBT in action in real time. If you have loose ends or unresolved issues at the end of your session, you can continue working on them with your own therapist. Dr. Levitt and I will not be involved in the development of an ongoing therapeutic relationship with you. The focus of the class is training, not treatment. After each class, members provide negative and positive feedback. The following are selected excerpts from tonight’s group, with light editing to improve readability. I think you will enjoy reviewing the feedback, especially if you are thinking of joining one of our training groups. The feedback is used to improve the teaching methods. Contact Information: If you want to join David and Jill's Tuesday group, that meets from 5:00-7:00 pm PST, please contact Ed Walton: edwalton100@gmail.com If you want to join Rhonda and Richard Lam's Wednesday group, that meets from 9:00-11:00 am PST, please contact Ana Teresa Sliva: ateresasilva6@gmail.com Thank you for listening, David, Jill and Rhonda

Six Cool Ask David Questions from Carlos and Greg Carlos asks: 1. Are your tools available in Spanish? 2. Is there any evidence that TEAM can help patients with Borderline Personality Disorder (BPD)? 3. How do you get patients with BDP to stop jumping from problem to problem? 4. How do you get them to stop endless venting during therapy sessions? Greg asks: 5. What comes first, thoughts or feelings? 6. Can't a genuinely negative or tragic event directly cause negative feelings, without having to have negative thoughts?   Dear Dr. Burns: 1. I would like to use your BMS but I mostly work with patients in Mexico. Has there been any standardization of your tests in any Spanish speaking country? David and Rhonda address this.  You can email Victoria Chicural, who is one of the TEAM-CBT leaders in Mexico (along with Silvina Carla Bucci), at victoriachl@yahoo.com and ask her about access to TEAM-CBT forms that have been translated into Spanish. 2. I am wondering if TEAM has proven to be effective in the treatment of BPD (Borderline Personality Disorder). I use it a lot, but I have found quite a few challenging elements. David describes his published work, indicating an excellent response to TEAM-CBT in patients with BPD. 3. People suffering from BPD usually have trouble prioritizing tasks and activities. The same happens when it comes to setting objectives. Because of their emotion dysregulation, they usually decide to work on one objective, and later on, they sometimes say: "Well, this objective is not THAT important anymore. Let's do another." For them, doing the specificity part can be really challenging because their perspective changes very quickly and they usually go back to the former objective when they're being challenged by a similar situation!!! How do you get them to prioritize objectives and not to switch from one to another so quickly? Or, do you think I could be making a mistake when setting objectives? David describes the strategies he has developed for coping with this type of clinical problem, including the development of his Concept of Self-Help Memo that he required every new patient to fill out prior to their first therapy session. 4. BPD usually come up with a lot of material to the session. They may be facing complex PTSD but also dysfunctionality at work, at school, etc. They want to say everything in a single session even if we have agreed to follow one single objective. Many sessions turn into endless talking without getting anywhere - some of them argue they need to vent out what they feel - but as time goes by, they complain that therapy is not working! How do you deal with a patient who is overwhelmed with numerous factors in a session where you have a previously set objective? David describes the strategies he has developed for coping with this type of clinical problem, Carlos S Bouchanm, Clinical Psychologist David’s Response Hi Carlos, I think these would make for excellent Ask David podcast questions. If so, can we use your name and read your questions? I reported on the effectiveness of the forerunner of TEAM in the treatment of BPD is the Journal of Clinical and Consulting Psychology in the 1990s. TEAM was specifically developed for this population, since 28% of my patients in Philadelphia had BPD. In the live podcast, I will address the excellent questions you asked about treating individuals with BPD. Thanks! David From: Greg Hi David, Thanks for everything you do and for the great podcast! I have another couple questions possibly for the “Ask David” segment of the podcast. 5. Can you say some more about automatic thoughts? CBT is based on the idea that we’re thinking things that produce feelings, but with an automatic thought it just kind of pops up and is there. It’s not like actively, intentionally thinking it. Other schools of thought (for example Somatic Experiencing) posit that feelings from the nervous system occur first and that the thoughts are actually the product of that, which seems to run counter to the CBT view. This has been a little challenging and confusing. David and Rhonda discuss this, including new research on the causal links between emotions and thoughts. 6. How do you apply TEAM CBT to worries about real and true things, like a real diagnosis or a tragic event? It would seem that it’s not just one’s thoughts about it, but an actual threat or upsetting event causing feelings because that is simply how one would feel about. Maybe the thinking is accurate? This, too, has been particularly challenging and confusing, so I’d love to hear more on this. David and Rhonda discuss how thoughts trigger all of your feelings, even after a genuinely tragic event. Thank You, Greg L. David’s Response Thanks, Gary. These are great questions, and perhaps we can address them om an Ask David podcast! There are strong, clear answers that might be interesting or helpful, as nearly everyone has these questions! Best, david Thanks for joining us today! Rhonda, and David

A British Family Doctor on Burnout, Recovery and T.E.A.M in 10 Minute Consultations! Today, Rhonda and David interview Dr. Tom Gedman, a family doctor in England and one of the founders of TEAM-UK, along with Dr. Peter Spurrier who has also been a guest on a Feeling Good Podcast. Rhonda started the podcast with a kind email from an enthusiastic podcast fan who loved our podcasts with Dr. Mark Noble (#167 and #265) on the “Brainology” of TEAM-CBT. He said these podcasts were “pure gold” and appreciated a look behind the curtains to see how TEAM actually worked at the level of the brain. Tom described his burn out episodes, which started during his third year of medical school, resulting from a familiar theme—the belief that he was inferior and just not “good enough.” His inferiority complex was a severe, total body experience, with “horrible thoughts” for six months. After he recovered, he worried about going into that state again. And the stress returned again during his medical internship. He explained that as a General Practitioner (GP) in the British medical system, you only have ten minutes for each patient, and felt like all the pressure was on him to get it right, and stated that “the pressure broke me.” In Britain, you can get free therapy as a GP, and went to Dr. Peter Spurrier for help. Peter was using the TEAM-CBT he’d learned when he came to California the previous summer for one of David’s four-day intensives, and Tom described him as “a natural. We made a deep connection right away and the Positive Reframing really clicked!” Tom’s negative thoughts included: 1. I’m not good enough. 2. I’ll fail my patients. 3. I’ll do them harm. 4. I’m not smart enough. 5. I’ll never be normal. He explained that the last thought triggered feelings of hopelessness, which really was the worst emotion of all. He discovered the Feeling Good Podcasts and listened to about 200 of them in just two weeks! And after two or three hour-long sessions with Peter, he recovered and actually felt like he was on a “high” for about six months. He says, “I had almost limitless confidence!” Then he had an as-predicted relapse which disappeared after a 30-minute tune-up with Peter. Tom said that the he’d always admired Carl Rogers, who emphasized empathy, and began using the Five Secrets of Effective Communication in his medical practice. This helped him clinically, and he discovered that “you don’t always have to ‘help;’ skillful listening is often enough. For example, patients often have to wait for months to be seen medically, and they’re angry and frustrated at first. I acknowledge their frustration and let them know that I feel sad as well. This calms them down immediately.” He also gave an example of how trying to “help” a man with agoraphobia simply put the man into a state of rage. “I tried to convince him that exposure would be good for him, but we just got into an argument, and he threatened to report me to the authorities to have my medical license revoked! That experience taught me something really important about ‘helping.’ Many people have intense resistance and just want to be heard and understood.” For example, one of his patients was in tears because of her father’s Parkinson’s Disease. The patients was helped greatly by learning He that her emotional distress was actually her love for her father, and she suddenly felt proud of her “symptoms.” Another patient with a massive opiate addiction opened up about a severely disturbing childhood incident he’d never before talked about, and then was able to cut his opiate use “way down.” We also discussed Tom’s new plans for his medical practice, working with indigent individuals, and explored the possibility of testing my Feeling Good App with this population for free to see how they would take to it. He discovered that a group in England has “stolen” my names, and also have a “Feeling Good App” and a “Feeling Good Podcast,” which causes me considerable distress. We may have to rename our app the “Real Feeling Good App,” or some such name! Dr. Tom can be reached at BlueprintMedical.co.UK or at DrTomGedman.com. Tom, Rhonda, and I would also like to urge any listeners in or near England to attend the upcoming four day TEAM-CBT intensive in England from August 14 – 17th. This four day training conference will be awesome and only costs 440 pounds. Participants will receive 38 CPD points as well as credits in the TEAM-CBT certification program. For more information about the conference, go to www.TEAMCBT.UK. Thanks for listening! Rhonda, Tom, and David

Live Therapy with Veena: Part 3 of 3 Relapse Prevention Training In the last two weeks, you heard Parts 1 and 2 of our live work with Veena, a young woman who felt devastated for fear she would be unable to conceive. One week after the work with Veena, I received a request from colleagues to have a Tuesday evening session at Stanford on Relapse Prevention Training (RPT). Jill and I decided to demonstrate the RPT techniques with Veena so we could demonstrate this technique in real time with a real situation. Prior to the role play demonstrations that you will hear, I presented the highlights of RPT with four PowerPoint slides. Here are the guidelines when working with a patient who is depressed: 1. Do RPT immediately when the patient has recovered, and before you discharge the patient. This means that the patient’s scores on the Brief Mood Survey will be low and the patient is feeling terrific. If the patient’s scores are still elevated, they have still not recovered completely, and need more therapy work. 2, Inform the patient that the likelihood of relapse is 100%. Relapse is defined as one minute or more of feeling upset. By that definition, most of us relapse frequently, perhaps every day. However, these relapses do not have to be a problem if you anticipate them and know how to deal with them. 3. When they relapse, they will typically experience two kinds of negative thoughts. First, the negative thoughts that had previously will return. So, in Veena’s case, she will again be probably telling herself that “I cannot be happy without a kid,” “my in-laws will judge me and sideline me,” and so forth. Veena imagined having a relapse and prepared a Daily Mood Log prior to the training group. If you would like, you can review it here. 4. In addition, nearly everyone who relapses will have thoughts like these: This relapse proves that the therapy did not work. I’m a failure. I’m a hopeless case and I’ll be depressed forever. When I thought I’d recovered I was just fooling myself. I’ve been he same worthless person the whole time. My recovery was just a fluke. It’s crucial to challenge these thoughts with the Externalization of Voices technique ahead of time, BEFORE the patient relapses. That’s because they can easily see the many distortions in these thoughts when they’re in a good mood. But if you don’t do RPT, and wait until the patient relapses, the patient may be devastated, or even suicidal, and you, the therapist, will have lost much or all of your credibility. In contrast, when I prepare the patient for relapse, I tell them that their first relapse will actually be a GOOD thing, because when they pull out of the relapse, then they’ll know for sure that they have the tools they need to defeat their negative thoughts whenever they’re upset for the rest of their life. And that is the crucial difference between FEELING better, which is what happens the first time they recover, and GETTTING better, which is what happens when they recover from their first relapse. I had them record their role-playing with me defeating their relapse thoughts with Externalization of Voices, and tell them to listen to that recording whenever they relapse. And that if they can’t pull out of the relapse on their own, they can always come back for a session or two for a tune-up. I also tell my patients I hope they will relapse often, because if they don’t ever relapse, I won’t ever see them again, and this is a sad thought since I’ve just gotten to know them and really like them. When I was in clinical practice, relapses were rare. Only a handful of patients ever returned for a tune-up, and it was almost always one or two sessions and then they were on their way again. Of course, this was not a controlled outcome study, since I was in private practice, but  it was definitely encouraging. In summary, RPT can save you from a lot of grief when your patients relapse, and it may even save the lives of some of them. It doesn’t take long, 30 minutes or so at most, but the payoffs can be tremendous. Thank you for listening today! Veena, Rhonda, Jill, and David

Live Therapy with Veena: Part 2 of 3 Last week you heard the first half of the session with Veena, a young woman who was devastated by a medical problem that may make it difficult or impossible to conceive the child she is dreaming of. Today, you will hear the inspiring and dramatic conclusion of her story, along with the feedback comments from the individuals in David and Jill's Tuesday training group who witnessed the live work. A = Assessment of Resistance Jill asked if she felt ready to roll up her sleeves and get to work on some aspect of what she’d been telling us, and she was. Jill then asked what she was hoping to get from tonight’s session. If we could offer a “Miracle Cure,” what would that look like? She said, “I’d feel a lot less guilty and responsible, so I would no longer feel like the problem was my fault. I’d know that I did my best and that I can be okay even if people don’t like me or judge me. Jill asked the Magic Button question, and she said that she love to see her guilt go all the way to zero, but not her many other negative feelings, like depression, anxiety, inadequacy, self-consciousness, hopelessness, upset, insecurity and self-doubt. With Positive Reframing in mind, we listed many of the positives in these negative feelings, including: Sadness. This feeling shows that I care for people and want to give them the best. It shows that I also care for my own dreams of having a baby. And it shows how much I love my mother. Anxiety, worry. This is a warning signal, reminding me to be alert and do my best, and do what the doctors require. Guilt. Shows that I’m humble and willing to be accountable and examine what I’ve done and look at my own mistakes. Self-Consciousness. Protects me by making me cautious so I don’t just blurt out everything. Defectiveness. I see my flaws, and allows me to get closer to others, and to feel happy for the success of others. Hopelessness. When I told my husband I felt hopeless, he became SO supportive. Also, I gave myself some space so I could create an action plan. You can see the goals Veena set for each emotion on her Daily Mood Log if you click HERE. Veena with her in-laws M = Methods During the methods phase of the session, we used a variety of techniques, especially Externalization of Voices with the Acceptance Paradox, Self-Defense, and the CAT (Counterattack Technique.) We did quite a few role-reversals, which is typical, before Veena got to wins that were “huge.” There were lots of tears and laughter, and eventually Veena blew all of her negative thoughts out of the water. It was inspiring to observe this process, and to be a part of it. You can see her final Daily Mood Log if you click HERE. I think it is fair to say the Veena experienced a kind of enlightenment which was profound. Final T = Testing You can see Veena’s end-of-session Brief Mood Survey and Evaluation of Therapy Session if you click HERE. You can also see her final Daily Mood LOG if you click here. Our work with Veena was some of the most inspiring work that I can recall. It was tremendously mood-uplifting, and took on a spiritual quality. You will have to listen to the session to get a feel for how majestic it was. But in my opinion, Veena did not just recover, but she achieved enlightenment, which including discovering how to love herself and her extended family as well! The following is an email I sent Veena the next morning: Hi Veena, Thanks. You were totally awesome last night, thanks so much for your contribution. I am sure the podcast will reach huge numbers of people and make a big impact on peoples’ lives. I cannot remember a more exciting and loving session. We will see what the groups thinks in the feedback. I did not copy or read the chats during the session, but perhaps you or Jill did. . . We will invite you to join us on a podcast recording to get some follow-up information from you, as folks will be very interested, for the two-part podcast. Yes, I think we really were walking on holy ground last night! Thanks so much for making that happen! I am trying to recall (and will do more of this) the teaching points from last night, and a few seem important to me. They seem awfully basic and simple, but still of towering importance and have to be “seen” to be understood at a deep level. 1. In TEAM, even when a problem is “real,” it is still our thoughts that create our emotions. Our thoughts really DO create all of our feelings. 2. Those thoughts can be subtly distorted in all kinds of ways and seem determined to trick us into believing things that are not true. And even super smart people, like Veena, can be fooled. 3. We are not aiming for improvement, although that is obviously desirable, but a dramatic transformation of the human spirit and outlook. 4. Warmth, tenderness, and compassion—for others and for yourself--are important and powerful. 5. There is a strong mind-body connection, and healing your soul can often help to heal your body. 6. Good therapy can sometimes be much more than just “therapy.” Something almost magical can sometimes happen, and the change can sometimes happen rapidly. However, many people do not like hearing this, and some are even angered by this idea! This is especially true of people who have suffered and struggled for many years without success in changing the way they think and feel. 7. Recovery sometimes requires courage and trust. Just more babbling from the old guy! Apologies if it sounds ridiculous or “off.” If other teaching points come to mind, please let us know so I can add them to the list! I am betting that Jill and Veena can maybe add to this list! (and edit it as well) Warmly, david Below, you will find some excepts from the feedback that the participants provided after the session. Please describe what you specifically disliked about the training? What could have been improved? Were there some things you disagreed with or did not understand?  Nothing. It was beautiful. I wouldn't want to change anything about tonight's experience. It was so moving! Please describe what you specifically liked about the training? What was the most helpful? Were there some things you learned? I loved Veena's personal work and besides my admiration and pride of her and the gratefulness to David and Jill for sharing this wonderful work . . . I enjoy the empathy and validation as well as the trust in the process that was so beautifully demonstrated. Beautiful job by all concerned. Very impressed with Veena and how clearly she "got it" when she used the CAT (Counterattack Technique). I was very moved by Veena's story and her courage in sharing it with us. I felt as if we were witnessing a kind of history because, in the past, wives who couldn't bear children were often devalued and even rejected. Veena pushed back against that kind of thinking and instead chose to love herself. By working toward dispelling the distorted thoughts, she affirmed not only herself, but women with similar experiences now and throughout history. When she affirmed that her mother, mother-in-law, and husband would be empathetic and wouldn't actually reject her, I felt elated, thinking that the world is making progress and becoming a more compassionate place. I was also touched by the following ideas: feeling genuine sadness without distortions; locating the source of pain in distorted self-critical thoughts; painful experiences bringing loved ones closer together. The safe space that was created, the sensitivity with which the topic was handled and the respect accorded to the client. It’s incredible how the trainers (Dr. Burns & Jill), set aside their ailments, and were with Veena through her journey of anticipatory loss, and her fears and apprehensions, along with her inner battle of dealing with deeply entrenched social conditionings, that are hard to face and ward off. I loved the session. Enjoyed watching the whole team model unfold. I’m so grateful to Veena for sharing this previous part of her life with all of us. It was a huge honor. I am constantly surprised by Dr Burns’ and Jill’s mastery of TEAM and their deep empathy skills. This was moving and exhilarating…all at once. Observing two great therapists in action. I liked how Jill and David would make notes to the class about what step they were going on to next. Veena was so amazing and brave to share her experience. As a 23 year old woman with fears of fertility issues myself due to genetics, I found the experience extremely profound and impactful on a personal level. It was awesome to go from the NEWBIE group to this session whereby a lot of the skills we were learning individually were incorporated sequentially into the session. Thank you to everyone!! I liked seeing david and jill go through the entire team model. I liked the pointing out of the Emotional Reasoning distortion and even using the straight forward technique. Excellent! I really liked seeing an entire session completed in one sitting. A very beautiful night. I really felt for Veena and what she is going through, and it was great to see her recovery. David and Jill were empathic and so knowledgeable. The humor in dark moments. the tears from time to time It was exciting to see how as Veena shed the self-blame, simultaneously she was able to see the people in her life as the caring, kind people she knows them to be--and no longer to feel afraid that they would reject her. Accepting herself allowed her to see others as accepting, and not critical. What training could be better than watching David and Jill tag TEAM thru the model! Thanks to Veena's willingness to be vulnerable and her bravery doing this personal work and inviting us all into her world and her pain. It felt like we were all a web of love and support surrounding her and a privilege to get to know her. It was extraordinarily rich and illuminating. I loved everything: the incredible empathy Jill and David demonstrated and how things were turned around for Veena. I was amazed that this was accomplished in such a short period of time; I always am when it comes to live work! I also loved knowing Veena more and seeing how wonderful of a person she is; I have so much admiration for her!!! Incredible empathy and 5 secrets from both Jill & David! So much warmth and love from the group. Seamless incorporation of the steps & methods. Please describe what you learned in today’s group15 responses DML at it's best!!!! TEAM-CBT, done by skillful therapists, with open and vulnerable client, can be such a gift! I learned again how to go through the entire team-CBT process of crushing negative thoughts and helping clients to feel better. There were so many moments of subtle shifts by Jill. Each one of them were penny drop moments for me. . . Thank you both. That people have a lot of beautiful qualities. I felt I learnt anew the power of empathy and the importance of asking our clients specifically what caused the change. Thank you so much Veena. I got some therapy by proxy tonight. I felt myself take a kind of journey with you from fearful for you, and judgmental (of your aunties!) to warm and open and loving - by witnessing your transformation. A better understanding and appreciation of the entire team model and using that for a real life situation. More of the artfulness and symphony of the steps being followed with empathy being woven again and again throughout and bringing out the birth of what is really true about the self, mother, mother-in-law, and husband rather than the assumptions and self-deprecation. On how to get from T to M with E and A in the middle! I loved David's insight that this is what it means to be in a loving relationship--to hurt at times. So wonderful to get to watch Jill move through TEAM in her warm, empathic, brilliantly thoughtful way, with David interweaving his work of genius!!! So grateful to be part of this incredible community! Thanks so much! The importance of Thought Empathy and flexibility with using different techniques, as I tend to be quite rigid. For example, I love how David went right into EOV which I believe would work wonderfully with someone who knows TEAM well. It definitely did work for Veena. So very helpful to see TEAM in action in its entirety by the masters of TEAM CBT! Thank you for listening today! Veena, Rhonda, Jill, and David

Live Therapy with Veena “It's all my fault!” The star of today’s 2-part podcast is Veena Mulchandani, a 28-year old certified Indian TEAM therapist who has just learned that her difficulties becoming pregnant result from an infection in one of her fallopian tubes. Veen feels devastated and fears that she might never be able to have a child. She also fears that her husband and extended family will judge and reject her, since there is so much pressure in Indian culture for women to have babies. And although she has many medical options, including IVF, she is intensely fearful that they might not be successful. My beloved colleague, Dr. Jill Levitt, will be my co-therapist for today’s session. Jill is the Director of Clinical Training at the Feeling Good Institute in Mountain View, California (www.feelinggoodinstittute.com). Today you will hear part 1 (T = Testing and E = Empathy), and next week you will hear the exciting conclusion (A = Assessment of Resistance and M = Methods), along with some follow-up. Part 3 will be the Relapse Prevention Training we did one week after treating Veena. Jill and I treated Veena in our Tuesday evening training group at Stanford. We feel that personal work is an essential part of the training of any therapist. Veena with her two very beloved nephews who she considers being a mother to T = Testing and E = Empathy At the start of the session, we reviewed Veena's Brief Mood Survey just prior to the start of the session. You can review it if you click on it here. Veena was tearful and said that to make matters worse, her mother has been recently diagnosed with brain cancer, and although she is doing “okay,” she is not doing “great.” Veena explained that she has always dreamed of being a mother, and feels like she is lettinhttps://feelinggood.com/wp-content/uploads/2023/04/01-BMS-wt-ETS_veena-1.pdfg down the many people who love her and want to see her have a baby. She and her husband first talked about having children when Veena was 24, but they decided to defer that for a few years because of the intense demands of her graduate schooling. Now Veena is blaming herself, thinking she “should” have gotten pregnant when she was 24. I mentioned to Veena that my parents tried but were unable to create a pregnancy, so they finally adopted 3 children. Then I came along unexpectedly, after they had given up. I also said that I’ve treated many women who felt like they couldn’t become pregnant, who then became pregnant. You can listen to the dramatic podcasts featuring my session with Daisy and her husband, Zane (#79 and #80) as well as podcasts 268 and 269 featuring a session with Carly (Click here for list of podcasts with links). Both women became pregnant shortly after those sessions, and I hope we can do the same for Veena! However, the key is overcoming the tremendous despair, shame, anxiety, and disappointment that the woman feels, so that the body can heal and prepare for the pregnancy. You can see Veenas partially completed Daily Mood Log if you click here. As you can see, her negative feelings are extreme, and she is telling herself that I may never be a mother. I will ruin Sumit’s (her husband’s) life with her. My marriage may go “down the line” because of the absence of a kid. It’s all my fault for postponing the pregnancy when I was 24. My in-laws, who love me so much, may start ignoring me because I cannot give them an heir. I will always be looked down on and sidelined by my own people. My mother is ill, and I will not be a good daughter if I cannot give her a grandchild. There is no meaning to life without children. My own body cannot suffice for my baby. Her belief in these thoughts ranged from 60 to 80 or more, and she rated most at 100%. Veena with parents I asked Veena how she was feeling after opening up in front of so many colleagues in the Tuesday group. She said she felt sensitive and exposed, and was afraid they don’t understand and will also judge her for not starting earlier with attempts to become pregnant. Although we were still in the Empathy phase of the session, I suggested she might want to do an experiment to find out how they were feeling. Although this idea made her anxious, she asked quite a number of the Tuesday group members how they felt, and received an outpour of warmth, love, tenderness, and support. We asked Veena how we were doing in terms of Empathy. Did we understand how she was thinking? How she was feeling inside? And did she feel accepted. She gave us an A+, and so we were ready to move on to the A = Assessment of Resistance, which you will hear at the start of next week’s podcast. Thank you for listening today! Veena, Rhonda, Jill, and David

Making Space for Grief Featuring Thai-An Truong, LPC, LADC Today, we feature a popular podcast guest, Thai-An Truong who joins us from Oklahoma. Thai-An is a level 5 Certified TEAM therapist and trainer who specializes in post-partum problems as well as anxiety disorders, with a special focus on OCD. Today Thai-An describes a TEAM-CBT technique to help with grief. She believes that empathy is always crucial, and emphasizes that people who have lost a loved one need to be encouraged to express and accept their feelings and to make space for their grief. However, because empathy alone may not be enough, it is often helpful to go beyond empathy and offer specialized techniques to help the patient deal with feelings of grief and loss. In her work specializing in women struggling with post-partum depression, she has seen many women grieving over a loss—such as the loss of a pregnancy, or the loss of a parent when their child is young, or the loss of an infant at birth, or during the first couple months after delivery. She said that the entire TEAM model can be invaluable, including the initial Testing and Empathy, the Daily Mood Log to detect the grieving patient’s (often distorted) negative thoughts, as well as the Assessment of Resistance (the positive reframing step, and the Methods. Healthy grief is often complicated by feelings such as depression, guilt, anger, and more. These feelings can complicate and get in the way of healthy grieving. For example, Rhonda treated a woman who was struggling with guilt over the death of her son, who was in great pain because of advanced, metastatic cancer. At one point, she told him that it was okay to “let go,” and her son died shortly after that. But then, she felt guilty and blamed herself for his death, thinking he might have lived several more days if she had not said that. Thai-An said that losing a son or daughter is one of the greatest pains a parent can have. You may beat up on yourself with “I should have done X” or “I shouldn’t have said or done Y.” But these negative, self-critical thoughts and feelings will nearly always be expressions of your core values as a human being, and your love for the child you lost. This can sometimes be eye-opening, and a relief for the person who is grieving. Thai-An has struggled with grief. She told us about the loss of one of her best friends 16 years ago. He was like a brother, a young man with bipolar manic-depressive illness. At times during manic episodes, he would get high and go out “teaching” on the streets. During one of these episodes something tragic happened—Thai-An was unable to find out what—but her friend was found dead in an alley. Thai-An felt a profound sadness and regret, and to compound the problem, her friend’s mother cut ties with Thai-An, who didn’t even know if a funeral was held or was able to ask any questions about what happened to him.. Thai-An felt understandably hurt and angry,. She recently found out he was buried near a Buddhist Temple in Houston, Texas. She emphasized the value of maintaining a ritual with the person who has died so as to continue the relationship. For example, a woman had a beautiful baby boy who died of an overwhelming infection shortly after he was born. This woman loves nature, and thinks of her son whenever she gardens. For example, when she sees a little bird, she thinks, “that little bird looks just like him!” Thai-An feels that a wide variety of rituals can nurture the bond with the person who died. You might light a candle, or even bake a cake for the baby or person you have lost. The goal is not to achieve some kind of “closure” that is so often emphasized in the media, but rather to continue a positive and meaningful relationship with the person you have lost. Thai-An illustrated a therapeutic technique she calls the Grief Method that involves doing a role-play with the person who has died. The therapist first gathers messages that the grieving patient would like to share with their deceased loved one. The therapist then takes on the role of the patient as the patient takes on the role of the person who has diedThis gives the patient the chance to have a conversation with the love one they have lost. In the following role play, Rhonda played the role of Sam, the young man who died of overwhelming cancer, and Thai-An played the role of his mother, who was grieving and feeling guilty about her son’s tragic death. Thai-An (as Mother): Hi Sam, I really miss you every single day. Rhonda (as Sam): Hi Mom, you’re the person I miss the most. Thai-An (as Mother): I’m sorry we had an argument shortly before you died. Rhonda (as Sam): It’s no big deal. . . We got into little fights pretty often. . . but we always got over it. Thai-An (as Mother): I regret that I left when the doctor told me to leave the room. I should have stayed, so I could be with you when you died. Rhonda (as Sam): I understood that they pushed you to leave the room, and I know that you would have stayed if they’d let you. . . I was in a lot of pain, and I was ready to leave. You gave me a lot of reassurance. Now I’m with grandma. Thai-An (as Mother): I would have done everything for you. Rhonda and Thai-An processed the experience together, and they both cried, even though it was only a role play. Thai-An emphasized the importance of letting your negative feelings flow, and continuing your bond with the person or beloved pet you have lost. For parents who have suffered the loss of a child, Thai-An recommends the book Shattered: Surviving the Loss of a Child by Gary Roe. To access her free grief training for therapists, you can visit courses.teamcbttraining.com/grief. This summer, Thai-An will be offering a special 14-week training course (2 hours / week) which will focus on treating individuals and couples with relationship problems using TEAM. For more information on this and other TEAM training courses, go to courses.teamcbttraining.com. . Thank you for tuning in today! Rhonda, Thai-An, and David

The Invitation Step in Family Life: "Dad! Don't give me that psychology crap!" Today we are joined by our beloved Mike Christensen and his wonderful daughter, Caelyn, for a discussion of one of the humblest but most important and challenging tools in TEAM-CBT, the Invitation Step. We will focus on how this can be important in family life as well. Caelyn will be entering college in the fall, and plans to major in psychology, but she has already picked up a lot of TEAM-CBT from her dad. We’ll tell you more about her at the end of the show notes. The invitation step is the bridge from the E = Empathy phase of TEAM-CBT to the A = Assessment of Resistance, but you don’t issue an invitation until you get an “A” in Empathy from your patient. This generally takes about 25 minutes or so with a new patient if you empathize skillfully using the Five Secrets of Effective Communication. There are two types of Invitations: the Straightforward and the Paradoxical. The Straightforward Invitation is for reasonably cooperative and motivated individuals who are struggling with individual mood problems, like depression and anxiety, and it’s fairly simple. You simply say something along these lines: Jim (or whatever the patient’s name is), you’ve told me some pretty heartbreaking and painful problems you’re confronting, including X, Y, and Z, and I’d love to help you change the way you’ve been thinking and feeling. I’m wondering if this might be a good time to roll up our sleeves and get to work, or if you need more time to talk and vent, because that’s important and I don’t want to jump in before you’re ready. Typically, the person will say “I’m ready,” and you’re all set to set the agenda for the session and reduce the patient’s resistance to change using the many familiar TEAM-CBT techniques, like Miracle Cure Question, Magic Button, Positive Reframing, Magic Dial, and more. The Paradoxical Invitation is for patients who seem unmotivated or even oppositional, and is intended for patients who are struggling with Relationship Problems or Habits and Addictions. Unlike the Straightforward Invitation, your assumption is that the patient probably is NOT asking for help, but just wants to vent, so you might say something along these lines: Sarah (or whatever the patient’s name is), you’ve told me some pretty upsetting things about your conflict with your sister ever since you were young. You say she constantly criticizes you and says things that aren’t really true, and that you’ve tried everything, but nothing works. For example, she insists that you look down on her because you have a PhD, and she didn’t graduate from college, and when you tell her that’s not true she just gets enraged. I can understand how frustrating that must be for you. I’ve got some really cool tools that might help you turn things around and develop a more loving relationship with her, and I think you’d really learn these tools quickly because you’re clearly very smart, but I’m not hearing that you’re asking for that. I’m thinking that you mainly wanted to let me know how difficult and impossible she is. Am I reading you right? I’d love to work with you on your relationship, but would totally understand if that isn’t what you’re looking for. So, in the Paradoxical Invitation, you’re asking the patient to put their cards on the table and acknowledge that they’re NOT looking for help. This prevents a power struggle and you can ask them if there’s something they DO want help with. At the start of today’s podcast, Mike pointed out that the Invitation Step is not only important in therapy, but in family life as well. For example, a lot of parents ask him, “How do I help my teen?” Well, the first answer is to stop trying to help and use the Five Secrets of Effective Communication to listen and understand where your teen is coming from. This is actually hard to do, because so many parents struggle with the compulsion to throw “help” at their kids, and this usually just creates a lot of tension. At the same time, Mike emphasizes that many parents ask, “Well, what do I do when I’m doing empathizing?” Mike says, “That’s the time to issue your invitation. If I don’t do that, Caelyn gets irritated and says, “Don’t’ give me that psychology crap!” If I jump in and try to help or give advice (which is what all parents do almost all of the time) it just ends up in a power struggle. Mike sometimes asks this question: “Did you just want to get that off your chest? What do you want going forward?” Mike and Caelyn did some role-playing to illustrate how this is done, including bad parent technique and excellent parent technique. Caelyn described a disturbing interaction with an angry customer where she works, and Mike first played the “bad dad” and then the “good dad”. Caelyn was delightfully wise and skillful and is heading for a great career in counseling or psychology. For more on this topic, you might want to listen to the podcast #164 on “How to help and how NOT to help!” LINK: How to HELP, and how NOT to Help! Rhonda and I love Mike, and Caelyn as well, and were touched by getting to take a look inside of a real and beautiful father-daughter relationship! Caelyn Bio Sketch Caelyn is a keen student of psychology and is starting her university career in the fall of 2023 She loves animals (her Cat Evie and horse Tulio top the list) and has studied positive reinforcement focused training with horses, under Adele Shaw, at The Willing Equine in Texas. She has read a number of Doctor Burns's books and  implements his CBT principles into her writing. Currently she works full time in customer service at a beauty salon and part time at a garden center where she gets regular opportunities to practice  her 5 secrets skills.  She is a big fan of Taylor Swift. Thank you, Mike and Caelyn, for an awesome interview today! Warmly, Rhonda and David

The Outer Bully Featuring Matthew May, MD Today we are proud to be joined again by our old pal, Matthew May, MD. This is a special two-part edition of Ask David, focusing on two of the most important problems that trigger emotional and interpersonal suffering. Last week, Matt led our discussion of the Inner Bully that causes the lion’s share of internal suffering in the world. Feelings of depression and anxiety always result from the harsh distorted messages we give ourselves, telling ourselves we’re “less than,” or “defective,” or “unlovable,” and so forth. However, the world is also filled with Outer Bullies who can be threatening, even violent. Today we describe how you can often deal with the Outer bully with the Five Secrets of Effective Communication (LINK). Today’s podcast was inspired by a question submitted by Guillermo, one of our podcast fans: Hello, Dr Burns I’ve seen some cases of bullying lately in schools. Would the 5 secrets help a kid who is being bullied in school? (Not physical bullying). I have a son who will be going to middle school next year and wonder about this. David’s Reply Hi Guillermo, Thanks, I might read question on podcast and address it. Might have two consecutive shows on the "inner bully" and then the "outer bully." I know one thing for sure, although I am not an expert in this area, and haven't worked much with kids. But ultimately, only your thoughts can upset you. The words and criticisms of others will never upset you, unless you buy into them. So, the good old Daily Mood Log is always the first step. Once you no longer find bullying threatening, it becomes much easier to deal with it. The bully relies on getting you all scared and terrified and hurt and so forth. Warmly, david Matt began today’s podcast with a real case description working with a violent, involuntarily hospitalized, 6’6” patient weighing 300 pounds snuck into his office while Matt was dictating his notes, locked the door, and announced that he was going to kill Matt because the involuntary hospitalization was “illegal.” The man had been brought to the hospital by the police in a psychotic manic state because of bizarre behavior at his home that troubled the neighbors. Matt was terrified and said, “That was just one occasion when the Five Secrets of Effective Communication saved my life!” Link to Five Secrets Here's what Matt said to the man. I will indicate the communication technique(s) in each sentence in parentheses at the end of each sentence: “You’re right! (Disarming Technique) You served your country and fought for our freedom (Stroking) and now we’re taking away your freedom. (Disarming Technique) I feel the same way you do, (I Feel Statement). Can you tell me more about what you’ve been going through?  (Inquiry)” The man was taken aback and immediately sat down and began to open up. Matt continued to empathize, using the Five Secrets, and after a few minutes the patient fell asleep in his chair. He was then transferred to a higher security hospital ward. Essentially, Matt sided with him, rather than getting defensive or arguing, and saw the truth in what the man was saying, in spite of the fact that he was floridly psychotic, and treated the man with respect. David summarized the case of a colleague of his who was kidnapped by a violent serial rapist. She also used the Five Secrets, which transformed the entire nature of the interaction, and the rapist gave himself up to the police. He also described being bullied by two violent teenagers in a gigantic jeep when he was driving home from the drugstore, where he’d rented an enormous carpet cleaner. David’s use of the Five Secrets in response to violent threats prevented violence, but also turned a potentially hostile and abusive interaction into a joyous and warm one. We concluded with Bullying Practice, saying the worst imaginable things to each other, like “David, you’re a terrible person,” or “Matt, you’re a bad therapist,” or “Rhonda, you’re an insignificant person,” and then responding with the Five Secrets. It was an unexpectedly fun exercise, and the Five Secrets triumphed big time every time! The Outer Bully had no chance at all! However, this level of skill requires that you’ve mastered your own inner Bully, so you’re not buying into what the bully says to you. This gives you a sense of peace and confidence that makes the Five Secrets a piece of cake, so to speak! David, Rhonda, and Matt want to emphasize that we make the Five Secrets look really easy and almost magical. Nothing can be further from the truth. We do hope to inspire you with examples of what’s possible, but mastering these powerful tools takes an enormous amount of dedication, determination, and practice. If you’d like to learn more, I would strongly recommend reading David’s book, Feeling Good Together, and doing the written exercises while reading. This would be an excellent first step! (Include book cover with link to Amazon.) Here, by the way, is an interesting link to a Ted Talk on bullying that you might enjoy. One of our colleagues, Dr. Daniele Leavy, found it and shared the link with our Tuesday group. Link to Ted Talk on Bullying Daniele explains: The speaker does a good job of differentiating what is commonly referred to as bullying from assault or criminal behavior, and demonstrates how to playfully use Disarming and Stroking to deflect the bullying. Thanks for joining us today! Matt, Rhonda, and David