With the “Shelter in Place” orders in California, we are recording these podcasts from our homes instead of from the Murietta Studios. The sound quality may not be as high as usual while we are learning to use the new technology. Let us know what you think! Thank you, David & Rhonda
David and Rhonda are joined again in today’s podcast by Jeremy Karmel, who is working with David on the new Feeling Great app. In our first Corona Cast, we promised to present an example of how TEAM-CBT can be helpful for individuals who feel depressed and anxious about the personal impact of the pandemic.
Rhonda kick starts today’s session by describing her treatment with a patient we’re calling Alice just a few days ago. Alice woke up feeling stressed and having trouble settling in and getting to work. If you click here, you can see how she filled out the first few steps of the Daily Mood Log just before the start of her session with Rhonda.
The Upsetting Event was simply waking up and feeling out of sorts. She circled and rated her negative emotions, which were fairly intense, especially the feelings of depression, anxiety, inadequacy, despair, frustration. Her anxiety was only minimal, but she was also feeling tremendously “jittery.”
Why was Alice feeling so upset? Her feelings didn’t result from the corona virus epidemic, but from her thoughts about it. As you can see, she was telling herself:
|1. This could be the new normal.|
|2. My life is going to waste.|
|3. I should be handling this better.|
|4. I could catch the virus and die.|
|5. No one is in charge.|
She strongly believed all of these thoughts except #4, which she only believed 40%. You may recall that in order to feel upset, two things must be true:
- You must have one or more negative thoughts on your mind.
- You must strongly believe these thoughts.
How are we going to help Alice? In the old days, I would have jumped right in to help Alice challenge her Negative Thoughts, but now we have a far more powerful and systematic approach called TEAM-CBT, as most podcast fans probably already know!
These are the four steps of TEAM-CBT:
T = Testing. Rhonda tested how Alice was feeling at the start and end of the session.
E = Empathy. Rhonda provided warmth and support without trying to “help” or “cheer-lead.”
A = Assessment of Resistance. This is one of the unique aspects of TEAM-CBT, and it’s the secret of ultra-rapid recovery. Rhonda used the Miracle Cure Question, Magic Button, Positive Reframing, and Magic Dial to bring Alice’s “resistance” to change to conscious awareness, then quickly reduced it before trying to “help.”
M = Methods. Rhonda helped Alice identify the many cognitive distortions in her thoughts. For example, her first Negative Thought, “This could be the new normal,” was an example of All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Fortune Telling, and Emotional Reasoning.
The goal of the M = Methods phase is to crush the Negative Thoughts that are upsetting you. Do you know how to do this? You have to come up with a Positive Thought that has two characteristics:
- It must be 100% true. Positive affirmations and rationalizations and half truths are worthless. Cognitive therapy is based on the Biblical idea the “The truth shall set you free.”
- The Positive Thought must drastically reduce your belief in the Negative Thought you’ve recorded on your Daily Mood Log, and ideally your belief in it will go all the way to zero.
In fact, the very instant you stop believing the Negative Thought, your feelings will change, and often quite dramatically.
Rhonda helped Alice challenge her Negative thoughts with a powerful technique called the Externalization of Voices. For example, Alice was telling herself that “I should be handling this better” because she’d been having trouble adjusting to the home isolation and had been procrastinating instead of focusing on her writing, and she was also telling herself that “My life is going to waste,” thinking she’d be procrastinating and feeling miserable forever: “The new normal.”
The Positive Thought that crushed it was, “I have a lot of experience as a self-starter, and I’ve got eight weeks of free time now to write, which is pretty awesome. In addition, I can give myself a break, instead of putting myself down, and give myself a little to regroup!”
After all, there are hundreds of millions of people around the world who are feeling isolated and in distress, and probably most of them aren’t being nearly as productive as they usually are, but clearly, that isn’t going to go on forever! Instead of putting yourself down, you can give yourself some support and encouragement, in exactly the same way you might talk to a dear friend.
Once Alice crushed her Negative Thoughts with strong Positive Thoughts, her feelings suddenly changed. Although the session was only one hour long, Alice experienced incredible improvements in how she felt, thanks to Rhonda’s compassion and skillful guidance. Alice’s depression went from 95 to 5, and her anxiety dropped from 95 all the way to zero. The rest of her negative feelings dropped to very low levels or zero as well.
Did it last? Long-term follow-up isn’t possible for such a recent session, but she did call Rhonda the next morning to say that she woke up Feeling Great . . . which is the name of my new book, due for release in September. You can see the cover below! If you want, pre-ordering on Amazon may be available by the time you hear this podcast.
In next week’s Corona Cast 3, we will switch our focus to the impact of the pandemic on personal relationships, using a real example of a young woman named Zeina who felt her mother, aged 72, was not being sufficiently careful about social distancing. Zeina felt panicky because she feared her mother would get the virus and die.
They ended up arguing and feeling frustrated with each other. We will illustrate a sophisticated TEAM-CBT technique called “Forced Empathy” that brought tears to Zeina’s eyes, and we’ll also talk to you about how you can improve your relationships with friends and loved ones as well during these challenging times.
Thanks for tuning in, and let us know what you thought about today’s program!
Until next time,
Rhonda, Jeremy, and David
You can reach Dr. Burns at email@example.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and specializes in TEAM-CBT for depression, anxiety, and relationship problems. She can be reached at firstname.lastname@example.org.
Today’s featured photo is courtesy of Nancy Mueller photograpy in Los Altos California.
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
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FREE TEAM THERAPY FOR HEALTHCARE WORKERS
Health care workers face incredibly challenging times, having to fight a potentially fatal epidemic without adequate supplies or protection. The TEAM therapy community is now offering free TEAM-CBT treatment for 100 health care workers in San Mateo and Santa Clara counties. For more information, please contact the Feeling Good Foundation.
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This is the cover of my new book, Feeling Great. It will be released in September of 2020, but you will soon be able to pre-order it on Amazon, possibly by the time you read this!
Need Training or CE Credits?
Check Out these Awesome Upcoming Workshops!
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
With Drs. David Burns and Jill Levitt
May 17, 2020 | 7 CE hours. $135 (online only)
TEAM-CBT includes more than 100 powerful techniques to change the distorted thoughts that trigger negative emotions. But what techniques should I select for my patient who feels depressed, anxious, or angry?
As you know, in my book, Feeling Good, I listed the ten most common cognitive distortions, like All-or-Nothing Thinking, Should Statements, Emotional Reasoning, and more, and you probably use that list all the time in your clinical work. But do you know which techniques work the best for each distortion?
Come to this workshop and find out! You’ll learn with tons of cool techniques you can use every day to boost your clinical effectiveness.
This workshop will be live-streamed (and in person in Palo Alto, CA) so you can join from anywhere in the world! There will be many expert online helpers to assist you with the small-group exercises.
Move rapidly if you want to come. We are already SOLD OUT in person, but there are still slots available online.
There will be many helpers from the Feeling Good Institute to assist and guide you in the small group exercises in person and online as well. Our last workshop on resistance in February was our most highly rated ever! We hope to make this a terrific and fun learning experience for you, too!
* * *
2-Day Clinical Master Class
Rapid Recovery from Anxiety Disorders–
GAD, Phobias, Panic Attacks, Social Anxiety,
OCD, PTSD and Health Anxiety
by David D. Burns, MD
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The All-New Annual South San Francisco Intensive!
Enhanced Empathy Training
August 10 – 13, 2020
It’s Going to Be Awesome!
Videos, Live Demonstrations
Small Group Practice with
Personal Feedback and Mentoring,
and Chances for Personal Work and Healing
During this four-day intensive workshop you will learn:
- How to develop deeper and more meaningful relationships with challenging, difficult clients.
- How to deal skillfully with people who refuse to open up and talk to you; won’t listen; are relentlessly critical, narcissistic or controlling; always have to be right; use, abuse, or exploit you; complain endlessly; are hostile, threatening or violent; as well as clients who are overwhelmed, hopeless and suicidal.
- How to develop more loving relationships with the people you care about—as well as the ones you don’t.
- Powerful new techniques to help clients who are struggling with conflicts with loved ones, friends, or colleagues.
- How to deal with the inner chatter and powerful feelings that make it so difficult to deal with conflict when you feel angry or hurt.
- How to identify and modify the self-defeating beliefs that make us vulnerable to conflicts with others.
- How to identify and melt away the intense outcome and process resistance that make the treatment of relationship problems so challenging.