033: Live Session (Mark) — Methods Phase (Part 5)

Part 5—M = Methods



Podcast 33: Live Therapy Session with Mark: “I’ve been a failure.”

M = Methods, part 1

So far, the therapy with Mark had focused on

T = Testing: David and Jill review Mark’s feelings at the start of the session

E = Empathy: David and Jill listen and provide empathy as Mark describes his feelings of shame and discouragement because of his failure to develop a loving relationship with his oldest son.

A = (Paradoxical) Agenda Setting: David and Jill find out what, if anything, Mark hopes to get out of this session, which appears to be complete relief from his negative thoughts and feelings. Then the bring his subconscious resistance to change to conscious awareness, and melt it away using the Magic Dial, Positive Reframing, the Acid Test, and the Magic Dial.

In this session, David and Jill began using M = Methods to challenge the Negative Thought Mark wants to work on first: “There must be something defective in my brain that prevents me from forming a loving relationship with my oldest son.” You may recall that Mark believed this thought 90%.

Do you know what the necessary and sufficient conditions are for feeling emotionally upset? The necessary condition is that you have a negative thought in your mind, such as “I’m a failure as a father,” or “There’s something defective in my brain,” but the mere presence of a negative thought will not generally trigger shame, depression, or anxiety. The sufficient condition for emotional upset is that you believe the negative thought. And if you review his Daily Mood Log from the last session, you’ll see that Mark does have a high degree of belief in all his negative thoughts. When you’re feeling depressed, anxious, inadequate, or hopeless, I suspect that your mind is also flooded with negative thoughts that seem entirely true to you.

Do you know the necessary and sufficient conditions for emotional change?

The necessary condition is that you can challenge the negative thought with a positive thought that is 100% true. Rationalizations and half-truths will never help anyone, at least not in my experience. But having a valid positive thought is not sufficient for emotional change. For example, Mark could tell himself that he’s a very high powered physician in a world-famous medical center, and that thought would be 100% true. But that thought won’t help Mark because he’ll still believe there’s something defective in his brain that prevents him from having a loving relationship with his son.

The sufficient condition for emotional change is that you can generate a positive thought that is 100% true, and in addition it has to crush the negative thought. In other words, the very moment you stop believing the negative thought that triggers your angst, in that very instant you will experience emotional relief, and the change will usually be dramatic.

But how can we challenge Mark’s belief in the NT. Remember, he is incredibly intelligent, and he’s been hooked on this NT for decades. So we can’t just tell him to cheer up, or encourage him to think more positively, or reassure him that his brain is A-Okay. Not only will those simplistic approaches fail, they would likely annoy him because they sound patronizing and might convey the message that’s he’s an idiot for believing something so ridiculous.

Instead, as a TEAM-CBT therapist, I think of 15, 20 or even more powerful and innovative techniques that I can use to gently guide the patient to his or her own discovery that the negative thought is simply not true. That’s what we do during the M = Methods portion of a TEAM-CBT session.

You will listen as David and Jill generate Next, Jill and David generate a Recovery Circle, selecting 16 techniques they could use to help Mark challenge the Negative Thought in the middle of the Recovery Circle. To see the Recovery Circle, CLICK HERE. David and Fabrice discuss the rationale for the Recovery Circle–you never know what technique is going to work, since people are quite different. One of the many unique and arguably powerful aspects of TEAM-CBT is the use of more than 75 techniques drawn from more than a dozen schools of therapy.

One of the first methods we use is so basic that it is programmed right into the Recovery Circle, and it’s called Identify the Distortions. Fairly early in today’s recording, Jill and David will ask Mark to identify the distortions in his Negative Thought (NT), “There must be something defective in my brain that prevents me from forming a loving relationship with my oldest son.” At that point, Fabrice will ask you to pause the recording and see how many distortions you can identify in the thought. You can write them down on a piece of paper, or simply print the linked PDF and identify them with check marks on the list of 10 cognitive distortions from my book, Feeling Good: The New Mood Therapy. CLICK HERE FOR TEN COGNITIVE DISTORTIONS

After Mark identifies the distortions in his Negative Thought, Jill and David encourage him to challenge it, using a variety of techniques on the Recovery Circle, starting with the Paradoxical Double Standard Technique. This is a gentle technique that is often effective for people who are compassionate. Because this technique seems to be helping,  they ask Mark to record his positive thought in the Daily Mood Log, and to indicate how strongly he believes it. Then you will see that Mark’s belief in the Negative Thought is reduced to zero if you CLICK HERE.

In the next podcast, David and Jill will continue with the Methods portion of the session using additional techniques on the Recovery Circle. This will be a unique opportunity to hear many of these techniques in real time with a real person, as opposed to simply reading about them in a book. So–stay tuned to our Feeling Good Podcasts–and thank you so much for your enthusiastic support!

David, Jill, Mark and Fabrice

4 thoughts on “033: Live Session (Mark) — Methods Phase (Part 5)

  1. Hi David,
    I have really been enjoying these podcast. You are always doing such interesting work. I was wondering if you having any information about follow-up testing. It is clear that there is a change within the session, which is great, does this change last?
    Has anyone developed a group version of the TEAM approach? I hope to join you in B.C in July. I would love to see you when you come to Atlanta in November but cannot get those days off due to leaving the next week for the annual meeting of the International Society for Traumatic Stress Studies. I will be presenting some data about Prolonged Exposure.
    I love the beard. You look great.


    • Hi David, great to hear from you! Once you’ve listened to the podcast on relapse prevention training, you will probably find the answer to your question, but check back again if the answer is still not clear. Thanks! Haven’t had a chance to hang out for some time now! d

  2. Thank you so much for making these sessions live. I’m learning a great deal, which is lifting my sense of hope as a therapist. Speaking of hope, how you inspire hope in clients? You mention here that creating a list of techniques that you will try out can inspire hope. You also mention elsewhere that hopelessness/pessimism is sometimes protective – if you expect the worst, you won’t be so disappointed if you fail. Good point. Do you have any other tips/techniques for inspiring hope in clients?

    • Thanks Jessica. Definitely an important topic. Since I have written on this extensively, I’d need to know if you’ve read any of my books, like Feeling Good, or my therapy book entitled Tools, Not Schools, of Therapy? In addition, I’ve talked about this in the Feeling Good Podcasts, and will focus on it a lot in my new book that I’m currently editing. david

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