Accept this Sh__? Hell No! Rhonda and David  are joined in today’s podcast by two dear friends, Dr. Matt May, a popular regular on our show, and Matt Pierce, a co-founder of the soon-to-be-released Feeling Great App Brief bio sketch of Matt Pierce goes here, should you wish to include it in the show notes. Matt,. A pic would also be great, but not required. People get tired of the same pics each week, so a fresh face to illustrate this episode would be cool! You’ve probably heard about acceptance. It’s a popular buzzword in the mental health space these days. In fact, some experts claim that it’s THE key to happiness and enlightenment. It’s NOT, but it can be incredibly helpful. I wanted to learn more about Acceptance and put some numbers on it’s effectiveness, or lack of effectiveness, so I recently sent an invitation to the 45,000 people on my mailing lists to complete a new survey on acceptance and resistance. More than 1,000 quickly responded, which was great. I hoped the data could provide some answers questions like these:  What is acceptance? How interested are we in accepting themselves, other people, and the world? Many people, and perhaps most of us, strenuously resist acceptance. Why? What are the things that we have the most trouble accepting about ourselves and others? Is all the hype about acceptance justified? Does it actually have meaningful effects on how we feel? Can money buy happiness? And if so, how much, exactly, does it cost? Why are single people more depressed and unhappy than people with partners? And if so, is it because of the lack of a loving partner? Or was there some other reason?  Thanks for listening, David, Rhonda and Matt

386: The Acceptance and Resistance Survey, Part 1 of 2

Do we have a &quot;Self&quot;? Or &quot;Personality&quot;? What&#39;s the best way to combat Should Statements?  Is TEAM effective without a therapist?  What&#39;s the Difference between Positive Reframing and Positive Thoughts?  Note: The answers below were written by David prior to the podcast, just to give some structure to the discussion. Keep in mind that the actual live discussion by Rhonda, Matt and David will often go in different directions with different information and opinions. So, please listen to the podcast for the more complete answers! Questions for today’s Ask David Podcast:  Stefan asks if we have a “self” or a “personality.” Slash wants to know how to combat a “Should Statement.” Magellan asks about the effectiveness of TEAM without the guidance of a therapist. Werner asks about the differences between Positive Reframing and the Positive Thoughts you record on the Daily Mood Log.    1. Stefan asks if we have a “self” or a “personality.” What is the so-called “Great Death” of the “self,” referred to in Buddhism? Hi David, I really love your work, both the books and the podcast you’ve created. Lots of great tools there. I think your down-to-earth approach is effective and great in de-mythologizing mental health care. Still, one thing has been bugging me about your approach: the fact that you quite casually seem to discount the existence of the self. As a theologian I understand this position. In discounting the self as a construct, you’ll open the way to less resistance and more acceptance. I studied both Christianity and some Buddhism, and in that tradition the self is essentially something to let go of as an illusion. I think you called this the death of the ego, and it’s common in many mystical currents both within and without the major religious traditions. However, by embracing this tradition in a therapeutic setting, I think there’s a great risk to gloss over long-held implicit beliefs or patterns in the construction of a personality that might hold people back from reaching their full potential. More specifically, I’m talking about schemas or Lifetraps (in the terminology of Jeffrey E. Young and Janet S. Klosko). I know Aaron Beck supports their work to address these “chronic self-defeating personality patterns” that are usually considered the be part of the self. What’s your take on their work? Kind regards, Stefan David’s reply Hi Stefan, Personality, like &quot;self&quot; is not a &quot;thing,&quot; but just the observations that different people have different behavioral patterns. So, some are more outgoing, for example, while others are more introverted and shy and insecure. The only meaning of &quot;self&quot; is the context in which the word appears. So, &quot;behave yourself&quot; simply means that you are misbehaving and need to stop! Can you come to the Sunday hike is a question. It does not need the add on, &quot;and do you plan to bring you &#39;self.&#39;&quot;

385: Ask David: Do you have a "self" or "personality?" And more.

Can You Treat ADHD with TEAM? Does Humor Play a Role in Therapy? What&#39;s the Difference between Rejection Practice and Shame-Attacking Exercises? Featuring Dr. Matthew May Note: Not all of the information covered here is in the podcast, and much of what we discuss in the podcast is not covered here. Questions for the next two Ask David Podcasts:  Rich asks how you treat ADHD in TEAM. Hwa-Chi Qiu Alvarez asks about the use of humor in therapy. Rima asks about the differences between Rejection Practice and Shame-Attacking Exercises.     Rich asks: How do you treat ADHD?  From Richard: How about a podcast concerning ADHD? I feel that applying TEAM would work. No? I mean “disorders” arise from distortions…so what does a distraction “disorder” arise from? Thanks for all you do David, Rich David’s reply: Hi Rich, I don’t treat “disorders,” I treat individuals at specific moments when they’re struggling and wanting help! Hope that helps. As an aside, if you or a friend, colleague, or patient have ADHD and you can describe a specific moment when that person was struggling, I would love to hear about it! Then you’ll see how TEAM works it’s magic by focusing on individuals, and not “problems” or “disorders,” etc. TEAM is a “fractal psychotherapy.” I will explain! Warmly, david Matt’s Take: Thanks for the question, Rich! I love what David is saying, about treating the individual, not the diagnosis. There are a lot of things that can interfere with focus and attention, such as. medical problems, sleep difficulties, toxin exposure, substance misuse, and relationship problems. In addition, depression and anxiety can interfere with concentration and contribute to ADHD symptoms. Below, I’ve listed many of the distracting thoughts that my clients have had. Along with a list of some good things about being Distracted. Hope you enjoy! Matt’s A – Z List of Distracting Thoughts:  I don’t feel like doing this This is boring and no fun I never get to do what I want It’s not fair I’ll do it later There’s plenty of time Best not to rush things I might be missing out on something interesting or important I’ll check my phone one more time, real quick, and then get right back to work This time will be different. Seriously. I mean it. Actually, I’m feeling too tired to concentrate I’ll just take a quick, 5-minute nap I’ll get to work when I feel more rested and motivated I’ve had a hard day and deserve a little break and some fun Tomorrow’s going to be really hard, so I need to rest up I just *can’t* concentrate, at all There’s something seriously wrong with me I lack willpower / I have no ambition I shouldn’t have to do this There’s no point doing this I’ll never be able to do this I need to be doing important, interesting things It would be really exciting and fun to … x, y, z, instead I need to tidy up a bit before starting this big project I don’t know where to get started / don’t want to

384: Ask David: ADHD; Humor; Rejection Practice

Transgender Issues Featuring Dr. Robin Mathy Emily Dickinson, from Amherst, Massachusetts, was one of the greatest American 19th century poets, and after hearing one of our Amherst professors explain her life and work, I fell in love with her incredible poetry. When she attended Mt. Holyoke College as a freshman, she was obligated to sign up as a “Christian,” a “Non-Christian with hope,” or a “Non-Christian without hope.” She was the only student who had ever signed up as a “Non-Christian without hope,” and she was given one semester to change her registration category. When she refused, she was asked to leave, and spent the rest of her life living in Amherst, baking cookies for children and writing her fabulous poems, which were sometimes included in her cookie packages. Her poetry was all about loss, which was much the story of her life. However, she was not self-pitying, which is part of what makes her poetry so sad and magical. Emily Dickinson always dreamed of visiting the west, but never got the chance to travel much beyond the outskirts of Amherst. She once wrote, To make a prairie, It takes one clover, and a bee. One clover and a bee. And reverie. The reverie alone will do, if bees are few. Tears come to my eyes every time I think about that poem! When I was a student at Amherst, we used to visit her grave, and I once actually knocked on the door of the house where she once lived. I explained I was a huge fan and actually got the chance to look around. I actually found a poem scribbled on a scrap of paper on a window ledge. Today we interview Dr. Robin Mathy, who describes herself as “A human who hopes.” Robin is a well-published expert on LGBTQ issues, with a specialization in transgender research and political activism based on science to debunk hateful myths about sexuality. She is also a new member of our Tuesday training group at Stanford! In addition to studying to become a TEAM therapist, Robin is a Doctor of Social Work student at Tulane University.  She is a researcher and activist who has published four books and more than 50 peer-reviewed articles or book chapters.  She is a beloved member of David and Jill’s Tuesday TEAM CBT group. Rhonda kicked off today’s podcast by reading two very moving endorsements from people who heard part 1 of the live work with Jessica, “Living with Regrets,” which we had published just prior to our interview with Robin. Then Rhonda kicked off our dialogue with Robin by asking if there are any special treatment considerations when you are working with trans individuals. Robin said that there really aren’t—TEAM-CBT is already highly personalized and individualized, so we let the patient set the agenda. Robin emphasized the importance, of course, of being warm, affirming, and supportive. In addition, do not assume that the patient is there because of gender identity issues, or automatically refer them to a support group on that topic, because the patient’s issue may

383: Transgender Issues, Featuring Dr. Robin Mathy

Overcoming Loneliness Part 2-- A Master Class on the Feared Fantasy Technique Featuring Dr. Orly Marmur This is the second of a two-part series on loneliness, featuring the courageous personal work of Dr. Orly Marmur with Drs. David Burns and Jill Levitt as co-therapists. After Orly shared her story, we worked on helping her learn to use the Five Secrets, especially the Disarming Technique and Inquiry, to develop closer relationships with others. Jill described the philosophy of this approach as learning to be ”interested” in others—encouraging them to talk about themselves—rather than trying to be “interesting&quot; or &quot;impressive,&quot; which is usually a losing battle. We also worked with the Feared Fantasy technique to help Orly deal with her fear of rejection. Essentially, we explained that we would enter an Alice-in-Wonderland Nightmare World where there were two weird rules:.  If you think people are judging you or looking down on you, they really are! In this Nightmare World, people are not polite but get right in your face and tell you all the negative thoughts they’re having about you.  We asked Orly to describe the worst criticisms she thought her friends might have about her. Here’s the list:  We’re not really interested in you. You don’t really say or create anything interesting. You are by yourself. We have families. You’re not funny enough. You’re not fun enough. You’re too intellectual. You’re too political. You’re a liability.  Orly bravely took the role of herself to kick things off, and Jill and David played the role of the “friends from hell,” and verbalized these criticisms to Orly. At first Orly struggled to respond effectively to the critical statements. She got stuck defending herself at times, and forgot to express interest in the critic and the specific criticisms. David and Jill modeled more effective responses, using the Five Secrets of Effective Communication, including  The Disarming Technique (finding truth in the criticisms), Inquiry (ask for more information with a spirit of curiosity) Thought and Feeling Empathy (acknowledging how the critic was thinking and feeling) “I Feel” Statements (sharing feelings like sadness, shame, and loneliness in an open, respectful way) and Stroking (expressing positive regard for the critic, even in the heat of battle).  Orly did a fantastic job, as you’ll hear on the podcast, and we did some role reversals to refine certain responses. The goal of the Feared Fantasy is not so much to prepare for rejection in the real world, since very few people would ever say these things in such a harsh and open way. The Feared Fantasy “Monster” actually exists primarily in your own mind. But since most of us never think about the thing we fear, we don’t realize or discover that the monster has no teeth. That is to say that by engaging with your greatest interpersonal fears, you discover that if someone were to attack you with over the top vague cr

382: Overcoming Loneliness, Part 2 of 2

Overcoming Loneliness Part 1-- How to Develop Loving Relationships Featuring Dr. Orly Marmur This is the first of a two-part series on loneliness, featuring the courageous personal work of Dr. Orly Marmur with Drs. David Burns and Jill Levitt as co-therapists. Orly is a clinical psychologist from Southern California and member of our Tuesday TEAM-CBT training group at Stanford. She loves to hike, and recently went on a 25 mile solo hike from the North to the South Rim of the Grand Canyon, an arduous hike that she planned for a long time  She happened to be hiking on October 7, 2023, the day of the Hamas invasion of Israel. The hike was a huge victory for Orly, but when she arrived at the top of the South Rim, her cell phone was instantly bombarded with news and emails about the Hamas invasion and brutal murder, beheading, and rape of many innocent Israeli citizens. For the next several days, Orly’s mind was flooded with flashbacks of her life, growing up in Israel when the country was still young, and living through four wars. Her father and brothers were in one war together, and her brother was wounded, but survived and recovered. Orly felt guilt and shame because she was not there to help. She said that she wanted to go to Israel to help her brother with his farm, but was conflicted because she did not want to abandon her clinical practice in Southern California. She explained: I grew up with the people who started the State of Israel. Those were idealistic, heroic times. My grandmother left Europe when she was 17 and settled in Israel. The focus was on building. We learned to be heroic. A few days later, in the Tuesday group, David noticed that I was feeling down and lonely unable to focus and “checked out.” I had  a hard time feeling my feelings. I had shut down. I began being flooded with memories of sexual molestation at my grandparents’ house when I was a girl in Israel. I remember standing next to a tree, and feeling like I was “different” from the other kids, I started feeling sad and guilty about losing so many relationships over the years. I’ve alienated so many people, and now I want to accept responsibility for that. When my daughter was 1 year old, I became friends  with other parents at the day care center. We became like an extended family as our kids grew up, getting together on Fridays for dinner, celebrating holidays together and being there for each other. However, during the pandemic, I began to feel rejected by them. And sometimes there were individual rejections. We had often camped out together over the years, but all of a sudden, I was not invited. I was the only single person. The rest of the group are couples. Over the years, I was told a few times that, at times, my presence makes things difficult. Since then, I’ve been invited to some but not other functions of our group. I haven’t felt like people are interested in me, or like me. I also want to feel my feelings and develop a sense of empathy for

381: Overcoming Loneliness, Part 1 of 2

The Anxious Child— Three Common Errors Parents Make, and How to Avoid Them!  Featuring Dr. Taylor Chesney Today we interview Dr. Taylor Chesney who is the Director of the New York office of the Feeling Good Institute. She specializes in the treatment of children and teens, and today will tell us about the three biggest errors parents make in dealing with anxious kids. Dr. Chesney has been a guest on several of our podcasts in the past (episodes 107 and 263, and Corona Casts 4 and 6) and is a terrific teacher and therapist. She recently taught a 12 week course for therapists working with teens and children (ages 6 to 18) and their parents and brings us some of the highlights today. She always begins treatment by interviewing the child and the parents and pinpoints what they want help with. Then she assesses how hard they are willing to work to bring about that change. The goals may be quite different for the child and the parents. It’s crucial to develop a meaningful therapeutic contract with the children, as well as the parents, as opposed to thinking your role is to “fix” the child for the parents. If the child is less than 11 years old, she meets with the parents first. If the child is 12 and up, she meets with the child first. Either way, she empathizes with the child and encourage them to tell their side of the problem. During or after empathizing, she does Positive Reframing, to show the child what their negative feelings, like depression and anxiety, show about them that’s positive and awesome. For example, if you’re sad about not being invited to a birthday party, it shows that you value friendships, and that you care a lot about other people. If the child is anxious, she will teach them how their anxiety can be helpful. For example, if the child is a good athlete or student, anxiety can be an important motivating force in their success. But sometimes we might get too anxious and feel intensely anxious about something that is not actually dangerous. Then you might experience your anxiety as trouble eating, a belly ache, trouble sleeping, or some other symptom that gets in the way of your optimal functioning. The most important question with parents and children is usually: “Do you want to learn some tools and skills to help you change the way you feel?” She also teaches children and teens what different kinds of emotions are, and the kinds of thoughts that trigger them. For example, if you feel anxious, you’re probably telling yourself that you’re in danger and that something bad is about to happen. If you feel guilty, you’re probably telling yourself that you’ve done something bad, or that you hurt someone you love; and if you’re feeling angry you may be telling yourself that someone is trying to hurt you or take advantage of you. Taylor brings the core cognitive therapy ideas to life with examples that children can understand.  Here’s how she explains the idea, taught by Epictetus nearly 2,000 years ago, tha

380: The Anxious Child, Featuring Dr. Taylor Chesney

Personal Work with Dr. Tom Gedman-- Overcoming Performance Anxiety The Triumphant Conclusion Last week you heard Part 2 of our personal work with Dr. Tom Gedman, which included T = Testing and E = Empathy. This week you will hear the dramatic and inspiring conclusion of the session, including A = Assessment of Resistance and M = Methods.  Dr. Tom&#39;s beloved pal   Start of Part 2 A = Assessment of Resistance We began with the Invitation Step, asking Dr. Gedman what he hoped to accomplish in today’s session. His list included:  Develop some clarity on the direction of my business. Become more authentic in my video recordings promoting my clinical work. Increase in self-confidence. Feel accepted by David and Rhonda. My ability to push ahead during recordings instead of stopping and backing down because it isn’t “good enough.”  Dr. Gedman said that he’d gladly push the Magic Button to make his negative thoughts and feelings instantly disappear, but agreed to look at some of the positives in them first by asking these types of questions of each negative thought or feeling.  Is there some truth in this negative thought? Could this negative thought or feeling be appropriate or even healthy, given my circumstances? How might this negative thought or feeling be helping me? What does this negative thought or feeling show about me and my core values that’s positive and awesome? Could there be some negative consequences of giving up this negative thought or feeling?  The Positives in My Negatives Negative thought: “I can’t be authentic on videos. I look like such s smug phony.”  I want to be other-centered, and focused on how I might be able to relieve the emotional struggles and health problems of my patients. I value being authentic and genuine. I want to help people who resonate with my message. I don’t want to hide. I want to be open with my flaws. I value honesty and integrity. I value humility. I value compassion.  Negative feeling: sadness  I care a great deal about my dream. I don’t want to fail and let my family down.  Negative feeling: shame  Motivates me to work harder Shows my love for my family. I’m aware that I’m letting down the very people I want to help.  Negative feeling: inferior, inadequate  Show that I respect and admire the many people who have superior skills at talking live in front of a camera. Shows that I’m aware of what others have accomplished. Shows I don’t feel superior to others.  The idea behind the Positive Reframing is to help the patients see that their negative thoughts and feelings are not the expression of what’s “wrong” with them, but what’s right with them. This paradoxically reduces the resistance to change and opens the door to the possibility of rapid recovery. You can see Dr. Gedman’s goals for each of the negative feelings on his Daily Mood Log  if you click here. As you can see, instead of trying to eliminate his negative thoughts and feelings by pushing the Magic Butt

379: Performance Anxiety, Part 2 of 2

Personal Work with Dr. Tom Gedman-- Overcoming Performance Anxiety Have you ever struggled with Performance Anxiety? That can include public speaking anxiety, as well as anxiety when having to perform in an athletic or musical event, or speak on the radio, TV, or internet , etc. This is one of the most common forms of anxiety that we see in mental health professionals, as well, of course, in general citizens, including children, teens and adults. Today you will hear Part 1 of the live work with Dr. Tom Gedman, a British physician struggling with intense performance anxiety, including the initial T = Testing and E = Empathy. Next week, you’ll hear Part 2 of the session as David and Rhonda do the A = Assessment of Resistance and M = Methods portions of the work with Dr. Gedman. You may recall Dr. Gedman from our previous podcast (# 348). Recently, Dr. Gedman has wanted to promote his new programs on health and mental health in brief videos he plans to publish on social media sites, but finds himself crippled by negative thoughts that make him freeze up in front of the camera, like these:  I’m not good at this. 100% I can’t be authentic. 100$ I’ll look like a robot! 100%  Tom practices in England as a family practice doctor, but has decided to work part time for the national health service while he establishes his clinical practice because he is only permitted to spend 10 minutes with each patient. He has developed a love affair and expertise with TEAM-CBT, and wants the freedom to practices in the way he wants, offering two-hour individual and group sessions, where he emphasizes the integration of physical with mental health. But this means having to advertise his clinical practice to solicit patients, and this is a bit of a treadmill because of the rapid changes he sees in so many of his patients. Hence, his urgent need to overcome his public speaking / performance anxiety. I have a soft spot in my heart for anyone who’s struggle with these types of anxious thoughts and feelings, because I have encountered them on many occasions in my professional career when I had to present my work in conferences, or even when attending receptions that included other mental health professionals. In fact, I am the “voice” on the Feeling Great App that I’ve been developing over the past several years, and it took me some time to get comfortable with the recordings, since I told myself that I “had to sound natural, spontaneous, and inspiring.” Of course those internal and external demands caused the exact opposite—feelings of tension, insecurity, pressure, and intense self-doubt, resulting in “robotness” as opposed to spontaneity! Yikes! It was a dreadful battle for a while! So, I KNOW how Tom has been feeling. And our beloved Rhonda has been there, too, especially when she took over from Dr. Fabrice Nye as host of the Feeling Good Podcast that you’re listening to right now. If you recall, she was feeling pretty darn insecure! (See Podca

378: Performance Anxiety, Part 1 of 2

Rhonda Describes the GRIP Program and Interviews GRIP Graduate, Shakur Ross The Guiding Rage Into Power (GRIP) Training Institute serves incarcerated men and women in California.  Their mission is to create personal and systemic change to turn violence and suffering into opportunities for learning and healing. I (Rhonda) was introduced to the GRIP program when two of my dearest friends, Steve Zimmerman and Vicki Peet, invited me to a yearly celebration of the GRIP Training institute.  I was blown away by who I met and what I learned that I wanted to share it with the Feeling Good Podcast listeners.  Thank you, David, for letting me deviate from our typical subjects. The GRIP program is a different subject for the Feeling Good Podcast, because it is not about TEAM-CBT.  What the GRIP Program and TEAM-CBT have in common is that they are both evidence-based programs that incorporate CBT theory and methods into their treatment methodology.  But the main thing they have in common is that people who engage in these two therapies experience profound, enlightening changes in their lives. From their program: “The GRIP program is an evidence-based methodology developed over 25 years of work with 1000’s of incarcerated people and many victim/survivors. Rooted in Restorative Justice principles, the program’s trauma informed model integrates cutting-edge neuroscience research.  Students engage in a yearlong, in-depth journey to comprehend the origins of their violence and develop skills to track and manage strong impulses rather than acting out in harmful ways.  They transform destructive beliefs and behaviors into an attitude of emotional intelligence that prevents revictimization.” The GRIP Training Institute was started in 2011.  As of October 2020, nine years after running its first group, 915 students have graduated.  Of the 915 graduates, 369 were released from prison.  Only 1 graduate in nine years returned to prison, which is a recidivism rate of 0.3%, which is very impressive considering the recidivism rate for California is between 44-46%.  Many, if not all of the graduates, say that GRIP saved their lives.  Something many people who have benefitted from TEAM-CBT echo. At the GRIP celebration, I was standing in line waiting for the buffet.  A man got in line behind me.  It was confusing where the line ended, which was not directly behind me. In another circumstance I might have mentioned to him that the line ended somewhere else, but he was kind of scary looking, big, buff with obvious prison tattoos on his neck so I didn’t say anything.  But the line moved slowly and I was curious so I asked him what his connection to GRIP was.  He told me he was a graduate of the program and then politely asked me the same question. It has been my experience that often people love to talk about themselves more than they are interested in other people so I was immediately impressed that he was as interested in me as I was in him.  When

Special Episode #1: The GRIP Program

Jessica Malvicino Live Work With Jessica-- Living with Regrets Rhonda and I recently did live work at a TEAM-CBT intensive in Mexico City. Our “patient” was a 40 year old mental health professional named Jessica with many years of unhappiness because of a decision she made when she was just 17. Perhaps you’ve also looked back on your life and thought, “If only I would have . . . “ done something I didn’t do,” as well as, “I wish I hadn’t done X, when I was young.” Last week you heard the initial Testing and Empathy portions of the session with Jessica. Today you&#39;ll hear the Assessment of Resistance, Methods, and final Testing..        Part 2 of the Jessica Session A = Assessment of Resistance Jessica said her goal for the session was learning to accept life and move on, and not have such constant feelings of emptiness, with so many “I should have” thoughts running through her brain. Although Jessica, like most people, said she’d press the Magic Button to make all of her negative thoughts and feelings disappear, we decided to do some Positive Reframing first, to see if there were some positives hiding in her negative feelings. We asked the following questions about a number of her negative feelings and thoughts:  Why might this thought or feeling be appropriate and healthy? Why might this thought or feeling be helpful to you? Why does this thought or feeling show about you and your core values that’s positive and awesome. ?  As you probably know, the goal of there are two goals for this paradoxical exercise: First, we want to bring the patient’s subconscious resistance to conscious awareness. Second, we want her to see that her struggling and suffering is NOT the result of what’s WRONG with her, but rather, what’s RIGHT with her. The moment that people really “see” and “get” this, there’s often a sharp and sudden reduction in feelings of shame, and a strong burst of motivation to crush the negative thoughts at the heart of her misery. Here are some of the Positives we listed: SADNESS My sadness shows my passion and love of dancing. It shows my dedication to the idea of having a fulfilling career. It shows that I’m a very loving person. ANXIETY, WORRY, NERVOUSNESS These feelings  show that I’m responsible motivate me to complete tasks help me avoid procrastination make me vigilant and protect me from danger  SHAME  These feeling show that I’m concerned about others I’m human I want to please others with my career I admire my mom and want to make her proud I want her to admire me I’m humble I want to feel close to others  ANGER  These feelings show that I’m a caring and passionate person I have character I have a moral compass I’m feisty and strong I’m accountable My anger also empowers me  After listing these and other positives, Jessica decided to use the Magic Dial to reduce her negative feelings to lower levels, but not necessarily all the way to zero, as you can see in the goal

377: Living with Regrets, Part 2 of 2

Live Work With Jessica-- Living with Regrets Rhonda and I recently did live work at a TEAM-CBT intensive in Mexico City. Our “patient” was a 40 year old mental health professional named Jessica with many years of unhappiness because of a decision she made when she was just 17. Perhaps you’ve also looked back on your life and thought, “If only I would have . . . “ done something I didn’t do,” as well as, “I wish I hadn’t done X, when I was young.” Today you&#39;ll hear the initial Testing and Empathy portions of the session, and next week you&#39;ll hear the Assessment of Resistance, Methods, and final Testing..      Part 1 T = Initial Testing DAVID WILL SUMMARIZE SCORES ON BMS AND DML You can also see her scores on the emotions table of her Daily Mood Log here.    Emotions % Now % Goal % After Emotions % Now % Goal % After   Sad, depressed, unhappy 90     Foolish 100       Anxious, worried, nervous 90     Discouraged 97       Bad, ashamed 95     Frustrated, stuck, defeated 100       Inadequate 90     Angry, mad, resentful, annoyed 95       Lonely 92     Other            As you can see, these negative feelings were all incredibly intense. E = Empathy Jessica, who grew up in Florida, explained that she started ballet dancing at the age of 3, and when she was 17, she won a prestigious full scholarship to study and have the chance to join a world renowned ballet company. Jessica was incredibly excited, but her mom did not see ballet as a “true career.” In addition, her mother was quite protective, which was not uncommon in the Cuban community, and told Jessica she could only accept the scholarship if she agreed to live with her grandparents in New York. Jessica angrily rebelled and turned down the offer. Although she continued to dance professionally until her first daughter was born 14 years ago, she battled with feelings of anger and regret the entire time, while also blaming her mother for her. unhappiness. She eventually got a bachelor’s degree in journalism, and worked in television for a period of time. Then she got a master’s degree in counseling, and found that she loves clinical work and helping people. However, she continued to live with feelings of regret and anger directed at her mom from age 17 to her current age of 40, for a total of 23 years, and explained that she frequently “takes it out” on her mom during periods of irritability. She also has feelings of grief about what she’s lost when she see her young niece dancing ballet beautifully now. This statement brought tears to her eyes. Jessica described all the sacrifices she’d made when growing up in order to become a top dancer, including periods of bulimia to maintain the thinness that her teachers always stressed. She explained that “everyone did it—they weighted us frequently and would grill us if we were even a little bit overweight. . .” and this was all in order to fulfill her ultimate dream of becoming a world cl

376: Living with Regrets, Part 1 of 2

Today&#39;s special guest, Brittany. Podcast 375. I&#39;m Struggling! Ask David Live: a New Podcast Twist We start today’s podcast with a visit from Dr. Jacob Towery. You might recall that one year ago he offered an amazing and (almost) totally free two-day workshop for shrinks and the general public on overcoming social anxiety. Roughly 90 people attended, and it was a huge success. The only “cost” was a $20 contribution to a charity of your choice, including Doctors Without Borders and several others.  Dr. Jacob Towery This year, Dr. Towery will be repeating this incredible program on March 16 and 17, 2024, which will be on a Saturday and Sunday, in Palo Alto. Once again, the title will be “Finding Humans Less Scary.” Jacob and Michael Luo will lead the program and will be assisted by 10 - 20 expert therapists who will lead the break-out groups. Last year, people described the program as “transformative” and “life-changing.” Social anxiety can have a significant impact on your life, so you owe it to yourself to attend if you or a loved one has struggled with any of the five common forms of social anxiety:Shy Bladder Syndrome  Shyness in social situations Public Speaking Anxiety Performance Anxiety Test Anxiety  You’ll learn and practice tons of awesome anxiety-busting techniques, including Smile and Hello Practice, Flirting Training, Rejection Practice, Talk Show Host, Shame-Attacking Exercises, and much more. Social anxiety rarely exists alone, but is nearly always associated with other mood problems, such as loneliness, shame, depression, and substance misuse with alcohol and benzodiazepine pills to try to combat the symptoms, to name just a few. How do you sign up? It’s easy! Just go to FindingHumansLessScary.com If you attend, let us know how it worked out for you, what you learned, and how you grew. Thanks so much, Jacob, for making this kind of world-class experience available to everyone who’s looking for some help, and some wild, life-changing and zany fun in March! Brittany, an enthusiastic podcast fan, asked for help with a conflict with her husband. She wrote: Hi Dr. Burns, I’m struggling a bit. My husband reads a ton of articles and feels that the media has been portraying a lot of the current events incorrectly, especially the horrifying Israel/Palestine conflict. He is extremely frustrated by this and has become depressed because none of his friends or family seems to want to talk about it. He says he feels alone &amp; isolated. I have never been much into politics, abd I don’t know enough to have a real opinion on things to say who is right. I try to be a good listener to whatever he says. For example, I may say “yeah, that sounds really frustrating,” and then I agree with what he says. But I’m obviously doing a bad job at the empathy because he says the support he gets from me is not satisfactory at all. Sometimes I feel like a parrot, just repeating back what he says. I think you had an exa

375: Ask David Live: I'm Struggling!

Featured photo is Mina as a child (more pics below!) 374 Anger, Part 2 You Have Always Hated Me! In the Anger Part 1 podcast (371 on November 20), Rhonda, Matt and David discussed the fact that when you’re feeling angry, there’s always an inner dialogue—this is what you’re saying to yourself, the way you’re thinking about the situation—and an outer dialogue—this is what you’re saying to the other person. In Part 1, we focused on the inner dialogue and described the cognitive distortions that nearly always fill your mind with anger-provoking inner chatter about the ‘awfulness” of the person you’re mad at. Those distortions include All-or-Nothing Thinking, Overgeneralization, Labeling, Mental Filtering, Discounting the Positive, Mind-Reading, Fortune Telling, Emotional Reasoning, Other-Directed Should Statements, and Other-Blame. That’s a lot—in fact, all but Self-Blame. And sometimes, when you’re ticked off, you might also be blaming yourself, and feel mad at yourself at the same time. Matt suggested I add these comments on Self-Blame or it&#39;s absence:: Another possible addition would be when you identify the absence of Self Blame when we’re angry. For me, it’s been easier to think of that as a positive distortion, because you are blind to, or ignoring, your own role in the problem. In other words, when I’m blaming someone else, it’s me thinking my poop smells great and tit&#39;s all the other person&#39;s fault.. I’ve wondered if we fool ourselves like this because of the desire to have a special and perfect “self,” which we then defend. Because nobody’s perfect, our &quot;ideal self,&quot; as opposed to our &quot;real self,&quot; is just a pleasant, but potentially destructive, fantasy. Still, we try to preserve and project the fantasy that we are free of blame and the innocent victim of the other person&#39;s &quot;badness,&quot; , and we imagine there we have a perfect “self” to defend. Or, as you’ve said, at times, David, “anger is often just a protective shell to hide and protect our more tender and genuine feelings.” We also discussed the addictive aspect of anger, since you probably feel morally superior to the “bad” person you’re ticked off at when you’re mad, and this makes it fairly unappealing to change the way you’re thinking and feeling. Your anger also protects you from the risk of being vulnerable and open and genuine. Today we discuss the Outer Dialogue, and how to express angry feelings to another person, as well as how to respond to their expressions of anger. The main concept is that you can express anger in a healthy way, by sharing your anger respectfully, or you can act out your anger aggressively, by attacking the other person. That’s a critically important decision! Toward the start of today’s podcast, Rhonda, Matt and David listed some of the distinctions between healthy and unhealthy anger. The following is just a partial list of some of the differenc

374: Anger, Part 2: You Have Always Hated Me!

Why Therapy Fails One of the most common reasons patients contact me is to find out why the therapy isn&#39;t working. They may be TEAM-CBT patients or patients of therapists using other approaches. Therapists also ask for consultations on the same problem--why am I stuck with this or that patient who isn&#39;t making progress? In the Feeling Good App, my colleagues and I have been looking into this as well. Most app users report excellent and often rapid results, but some get stuck, in just the same way they might get stuck in treatment with a therapist. I have tried to organize my thinking on this topic, because if you can diagnose the cause of therapeutic failure, you can nearly always find a solution. Of course, the app is not a treatment device, but a wellness device, but the same principles apply. So today, Rhonda, Matt and I discuss a couple reasons why therapists and patients alike sometimes get stuck. Matt described a patient who was misdiagnosed with a psychotic disorder who turned out to have sleep apnea. When the proposer diagnosis was made and treated, the patent suddenly recovered. Rhonda described a patient who jumped from topic to topic and always brought up a new problem before completing work on the previous problem. This problem was solved when Rhonda explained the importance of sticking to one problem for several sessions, until the problem was resolved. The patient then began to make progress. David described a depressed woman from Florida who was stuck in treatment, and not making progress, and then the therapist said &quot;I just can&#39;t help you,&quot; This hurt and confused the patient who wrote to me. There were essentially two problems--the patients depression what brought her to therapy in the first place, and her unresolved hurt feelings when the therapist &quot;gave up&quot; on her. This problem reflected many failed relationships is the patient&#39;s life. This was resolved when the patient took the initiative to schedule a session to talk about the conflict more openly with excellent results. In addition, the patient had heard that she &quot;should&quot; accept herself, but didn&#39;t know how to accept her constant self-critical troughs and intensely negative feelings. I suggested she make a list of the benefits of her negative thoughts and feelings, as well as the many positive things they showed about her and her core values as a human being. She came up with an extremely impressive and long list! For example, her criticisms showed her high standards, her humility, her dedication to her work, her accountability, and much more. In addition, she&#39;d achieved a great deal because of her relentless self-criticisms. I asked her why in the world she&#39;d want to accept herself, given all those positive characteristics She decided NOT to accept herself, and was delighted with her decision. She said she felt profound relief! An unusual, but awesome, path to acceptance! In other words, she ACCEPTED her &quot;non-acc

373: Why Therapy Fails

At Last! An Outcome Study!  One of the wonderful things about TEAM-CBT is the dramatic and rapid changes we see in so many of our patients. But we&#39;ve had a huge problem-no published outcome studies. And that has definitely limited the general acceptance and recognition of TEAM-CBT. Today, that era has come to an end, thanks to Dr. Elise Munoz, who joins our beloved Feeling Good Podcast to discuss a remarkable outcome study conducted at her Feeling Good Psychotherapy clinic in New York City. She wanted to evaluate the effectiveness of TEAM-CBT with teens and young adults. Dr. Munoz is the Founder and Lead Therapist at Feeling Good Psychotherapy and Adjunct Assistant Professor at New York University. She is also a Level 4 Certified TEAM-CBT Therapist &amp; Trainer, and specializes in the treatment of anxiety, depression and life transitions. Elise conducted a “naturalistic” study of data from 116 teenagers and young adults aged 13 -24 years of age who were treated by 15 therapists between 2017 and 2022. In a “naturalistic” study, you simply analyze all the data from your patients to evaluate the effectiveness of  the treatment. This is in contrast to a “controlled outcome study” where patients are randomly assigned to two treatments to see which treatment delivers the best results. Elise conducted the research study as part of her work for a Doctorate in Clinical Social Work at the University of Pennsylvania in Philadelphia. &quot;The results,&quot; she says, &quot;were encouraging.&quot; That&#39;s perhaps a humble description of her findings. David and Rhonda might say that the results were pretty awesome! Elise told us that although the average number of treatment sessions was 27, most of the patients made maximal gains after just 10 weeks (2.5 months) of treatment, and many achieved maximal improvement by the 5th session.  Specifically, by the tenth session. 80% of the patients scored in the &quot;subclinical&quot; range on the depression scale of my Brief Mood Survey (with scores of 0 to 4) and 87% scored in the subclinical range on the anxiety scale (scores from 0 to 4) . These scales range from 0 (no symptoms) to 20 (extremely severe.) Prior to the study, only 30% were in the subclinical range. According to Elise, the rapid improvement suggested that most patients will not need long-term treatment, although some will need more time to incorporate their gains following their initial improvement, and many will want to remain in treatment to deal with other problems, such as relationship issues that are so important in this (or any) age range. Prior to the study, Elise trained the therapists in a weekend TEAM-CBT &quot;boot camp,&quot; along with two hours per week of group training and 1 hour per week of individual consultation/supervision. My own view (David) is that learning TEAM-CBT is very challenging, requiring a minimum of one to two years of intensive training. However, the fact that therapists can get excellent

372: At Last! An Outcome Study! 

Anger, Part 1 You suck! Screw you!   Jay asks: Are you EVER going to do a podcast on anger? Dr. Burns, Also are you EVER going to do a podcast on Anger with Rhonda and Matt? You have done many podcasts on depression, anxiety, interpersonal relationships YET there is not one podcast addressing anger. Given the world we live in right now maybe it&#39;s time to address Anger from a TEAM-CBT perspective and give it the attention you have given anxiety and depression. All the Best, Jay In today’s podcast, Rhonda and David address this important but neglected topic that is perhaps more important than ever in today’s angry and violent world. David began by pointing out that in the feeling Good App, anger improved as much as six other negative feeling clusters, with fairly dramatic reductions in just a few days. This was completely unexpected and exciting, and has been replicated in numerous beta tests. Maybe there IS a small glimmer of hope in this troubled, angry world! David pointed out that anger is addictive  Depression is not addictive because in depression you are thinking I am no good, and you have negative and painful distortions about yourself. Anger, in contrast, is addictive because you are directing the distortions at other people, telling yourself that they are no good, and they will never change, and so forth. These distortions directed at others trigger feelings of moral superiority and those feelings are intensely addictive.  Any group that is at war tends to feel morally superior and sees the “other” as scum, the enemy, and these distortions give you justification for hurting and killing them and feeling good about what you are doing. What makes the treatment of anger fairly challenging is that most angry people are not looking for help.  Distortions directed at others are key in conflicts with friends and loved ones as well as racial and religious hatred, and war and violence.  How do you treat a patient who is angry? You always start with T = Testing. David’s research on therapist accuracy indicates that therapist accuracy is recognizing anger in their patients is incredibly poor. If you want to assess and deal with patient anger,  the Brief Mood Survey at the start and end of every session can be invaluable, and the Evaluation of Therapy session at the end can also help. E = Empathy comes next. However, empathizing with someone who is angry can be challenging because they are often provocative, or want the therapist to align with them in their belief that the person they are angry with is to blame. We want the client to feel accepted, and have a warm relationship with their therapist so the therapist can easily get sucked into the patient’s blaming mind-set. David calls this “reverse hypnosis,” and this can sabotage the chance for effective treatment. Empathy can be challenging if the anger is directed at the therapist, or if the client is saying they are so angry they want to hurt someone. That can be ethically ch

371: Anger, Part 1: You SUCK!

Ask David The fear of ghosts; the truth about nutritional supplements; the fear of fear; how does anxiety treatment work? And more.  Today, David and Rhonda answer six cool questions submitted by podcast listeners like you!  Joseph asks: How would you use exposure to confront your fear of ghosts? Salim asks: What herbs and supplements will help me become more zen and relaxed? Peter asks: How do you stop fearing the fear and discomfort of anxiety? Jillian asks: How does cognitive therapy work to help reduce anxiety? Sanjay asks: How do you give up wants, needs, and desires? Dana asks for help with the Disarming Technique.  In the following, David’s reply was David’s email response to the person prior to the podcast, just suggesting some directions we might take on the podcast. The Rhonda comments were based on notes she took during the live podcast. For the full answers, make sure you listen to the podcast! Joseph asks: How would you use exposure to confront your fear of ghosts? Hi David and Rhonda, Thank you again for your wonderful replies and the amazing podcast. If you would humor me, I have another question -- I know David talked about exposure therapy in overcoming fears, but I wonder how this could apply to some fears like the fear of ghosts where it is caused by an over-active imagination (in which case, what should one be exposed to?) Regards Joseph  David’s reply Cognitive flooding would be one approach. Will give details on podcast. Thanks! David  Rhonda’s notes Find out what is happening in the person’s life, and treat that specific problem. Maybe someone developed a fear of ghosts after the death of a loved one, so the idea of being around death or dead things may also cause intense anxiety. Going to a cemetery may be part of their exposure. Other examples of exposure for overcoming the fear of ghosts could be:  Approaching a scary, abandoned house Watching a scary movie about ghosts  Fear of darkness may accompany fear of ghosts so staying in the dark may be part of your exposure. Fear of sleeping alone may also accompany fear of ghosts so sleeping alone in your home may be part of your exposure. Salim asks: What herbs and supplements will help me become more zen and relaxed? Hello Mr. David D Burns, I want to tell you that i loved &quot;Feeling Good&quot;, your book helped me a lot in improving my life, I have a question, can you recommend herbs or supplements that help me be more Zen and more relaxed? I would be eternally grateful. 🙏. Thank you so much. Salim David’s reply. Hi Salim, I don’t believe in the efficacy of herbs etc. except for their placebo effect. However, the written exercises in the book, like writing down your negative thoughts, can help a lot. You’ll find lots of free resources on my website. At the same time, the use of herbs and supplements is kind of a “cult” thing, and as you know, cult followers don’t like to have their views challenged! And our field of mental health is, to my way

370: Ask David--the fear of ghosts, do nutritional supplements work? and more!

369 The Invisible Racism We All Deny, Featuring Drs. Manuel Sierra and Matthew May Today we’re joined by Drs. Manuel Sierra and Matthew May on the sensitive topic of racism. Manuel Sierra MD is a child and adolescent psychiatrist practicing in Idaho, one of the places where he grew up (he also spent time in Oregon). He was a classmate of Matt May during his residency training days at Stanford, and they remain close friends today. Rhonda begins today’s podcast with this mail we received from Guillermo, one of our favorite podcast fans: Guillermo asks: How do you respond to family or friends who make racist comments? Hello, Dr Burns Not sure if you have addressed this in any of the podcasts (I don’t recall it being a topic) but: I was recently in a group chat with some cousins, and I read some really disappointing racist comments about a particular group. Many people ignored it (as I did) and a couple AGREED with the comments. How can we balance not judging not just any people but our longtime friends and family about overtly racist actions/comments and the thinking that it is not the event but our thoughts that create our emotions? I don’t care about “judging them” (in the sense that I don’t think it is my place to “change” their views) but just hearing/reading comments like this bothers me when they come from people close to me. When I see it on tv or the internet, I don’t get affected because I feel it is beyond my control. I don’t believe they will change their views so do I just remove them from my life? I apologize, the topic is too wide, but I’ve been thinking about this. Sincerely grateful for all you do, Guillermo Manuel kicked off our answer to Guillermo by saying that he has been personally familiar with racism within families and communities, and says that he and Matt have talked about this topic “a lot.” He explained that: Although I am proud of my Mexican-American heritage, I was born and grew up in Oregon and Idaho, where I’m currently practicing. I encountered considerable racial bias when I was a kid, and later in life as well. I clearly cannot speak for all Mexican-American people, I can only speak for myself and what I’ve personally experienced, and I am extremely aware of how difficult the current times are. My grandparents didn’t teach my mom Spanish. She was a single mom, and we lived in a small town in Idaho. I also have family through marriage who live on Native American lands. In grade school I began hearing jokes about Mexican Americans, and this was very awkward, painful, for me. I also got ridiculed for not speaking Spanish.  Even my grandfather asked me, “why aren’t you speaking Spanish?” There were also gangs where the racial bias got worse and frequently turned violent. After learning more about Manuel’s experiences, we modeled various ways of talking to a friend or family member who has made hurtful racist comments. Manuel cautioned that it might be best to do provide the fe

369 The Invisible Racism

A Strange Paradox-- The Incredible Impact of Compassion + Accountability Featuring Adam Holman, LCSW We want to remind our listeners about the upcoming Mexico City TEAM intensive from November 6 – 9, 2023, organized by Level 5 TEAM therapist, Victoria Chicural, and Level 4 TEAM therapist Silvina Bucci. The Intensive will be held in a beautiful part of Mexico City (Sante Fe) at the Hotel Camino Real. There will be lots of opportunities to practice every aspect of TEAM-CBT along with many excellent, internationally renown TEAM-CBT trainers. I (David) will do a keynote address on Day 1,  On Day 2 Rhonda and I will do a live TEAM demonstration with a volunteer attending the conference. On Day 3 everyone will have the opportunity to practice the TEAM model from start to finish.  And on Day 4 Leigh Harrington and I will answer questions about the TEAM treatment model. This promises to be an Intensive not to be missed!  To learn more and register, please visit their website: https://teamcbt.mx, Today we are joined by Adam Holman, LCSW, whose podcast 288 on April 22, 2022 was a big hit. He shared his strategies for working with kids with video game addictions, and his no-nonsense, patient-focused approach made good sense and resonated with many of our podcast fans. Today, he talks about what he calls a “Strange Paradox,” which is: If you treat people like they’re fragile, they act and behave like someone who’s fragile. If, in contrast, you hold them accountable, with compassion, they will discover their strengths. He began by commenting on hearing David talk about how therapists often get hypnotized by our clients without realizing it. When that happens, we buy into the clients’ beliefs that they’re helpless and hopeless. And, I (David) might add, worthless. When that happens, we start to treat them as if the beliefs are true, further proving to them that they’re helpless, hopeless, and worthless. This became incredibly evident after Adam had a unusual encounter with a child  while on a hike with his partner near Prescott, Arizona. The child was shrieking in terror at the top of his lungs. As they got approached the child, they saw that he was paralyzed by fear of a swarm of flies near his head. They also realized that his family had already walked past, and were about 45-seconds down the trail, hoping that he would become brave and walk through the flies and catch up with them.  But that clearly wasn’t happening. Adam walked past the flies and stood next to him before saying, “I know you’re scared, that’s okay. I just walked past the flies and it’s safe. You can walk through.” Then, the boy immediately stopped crying and walked past the flies on his own. The boy willingly chose to walk past them the moment that his suffering was acknowledged. He heard the message that there was nothing wrong with him or the fear that he was feeling. In other words, the acknowledgement of his fear send the message: “It IS scary, and yo

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