David and Rhonda are joined in today’s podcast by Dr. Taylor Chesney, a former student of David’s who is now the head of the Feeling Good Institute of New York City. She is a prominent TEAM-CBT therapist and trainer, and specializes in the treatment of children and teenagers. Taylor kindly agreed to do some live work today on her panic and despair because of the impact of the pandemic on her family. Her situation is especially challenging and poignant because her husband, Gregg, is a highly esteemed Emergency Room / Intensive Care physician in New York, and he is constantly working to save the lives of Covid-19 victims. Ten days ago he moved to a separate apartment several blocks away so he will not put his wife and children in harm’s way in case he contracts the Covid-19 virus. But will he, himself, be struck down by this vicious virus? He told Taylor that he recently had to intubate several of his colleagues, which is horrifying. Taylor fears that  she may lose her beloved husband, and that her three children may have to grow up without a father. She also feels overwhelmed because she’s supporting many people now. David begins with a brief overview of the cognitive model, including several key points:

1. All negative feelings result from thoughts, and not from what’s actually happening. So even in a crisis that is as real and devastating as the Covid-19 pandemic, all of our emotions will still result from the way we think about it. Remember the teachings of Epictetus 2,000 years ago, when he wrote: “People are disturbed, not by things, but by the views we take of them.”

This is potentially empowering, because we usually cannot change the fact—the pandemic is real and we are powerless to make it disappear—but we may be able to change our perceptions (eg thoughts, or “cognitions”) about what’s happening. There’s a healthy and an unhealthy version of every kind of negative feeling. For example, healthy fear is not the same as unhealthy anxiety; healthy sadness and grief are not the same as clinical depression; healthy remorse is not the same as neurotic guilt. And so forth. Our goal is not teaching you how to be happy all the time no matter what—that would be absurd—but simply to reduce or eliminate unhealthy negative feelings.

2. Healthy negative feelings result from valid negative thoughts, and do not have to be “treated.” Unhealthy negative feelings, in contrast, result from negative thoughts that are distorted and illogical. David reminds us that even in a crisis, depression and anxiety are still the world’s oldest cons, and that you CAN change the way you feel.

But is this possible? It just doesn’t sound right! Can Taylor really change the way she thinks and feels when the crisis is so overwhelming and so real? And can you? As the session unfolds, Taylor tearfully describes her intense fears for her husband, who she loves so greatly, as well as their three young children. She says that 75% of the time, she’s “okay,” when she’s awake and involved with caring for her kids, but 25% of the time—especially late at night when she’s alone with the kids—things get pretty desperate, and sobs for 30 minutes or more while experiencing “sheer terror.” What’s making the situation more painful is that Gregg is temporarily living six blocks away in order to protect his family in the event he does contract the potentially deadly virus. Taylor says that “it feels like we’re kicking him out. He’s at war. He’s fighting, struggling, suffering.” She says he’s passionate about his work, but she wishes he’d quit! Take a look at Taylor’s  Daily Mood Log at the start of the session. As you can see, she is focusing on how she is feeling every night before going to sleep. She circled seven different categories of negative feelings, and all are intense, including the depression, anxiety and frustration clusters (all are 100%), the lonely and hopeless categories (both 90%), as well as feeling “bad” (50%.) You can also see the negative thoughts she recorded. She is telling herself that:

Negative Thoughts	% Now
1.      I shouldn’t have to do this alone.	90
2.      I can’t handle parenting alone.	70
3.      I shouldn’t burden Gregg with my feelings.	70
4.      I shouldn’t share my feelings.	50
5.      I should be strong and tough.	80
6.      I’ll let my patients down if I don’t have enough time for them.	50
7.      I’ll lose Gregg.	50 – 100
8.      I shouldn’t have to do this.	100
9.      I should be able to work and support my family while Gregg stays at home safely.	50

You can also see that her belief in these thoughts varied from 50% to 100%. After empathizing for 30 minutes, Rhonda and David asked about her goals for the session, which would be to turn down the intensity of her negative feelings. Together, Rhonda, Taylor and David do Positive Reframing, asking two questions about each negative thought and feeling:

1. What does this negative thought or feeling show about Taylor that’s positive and awesome?
2. What are some benefits, or advantages, of this negative thought or feeling?

Together, they generate an impressive list of Positives. Then Taylor decides she can use the Magic Dial and reduce her negative feelings, while not eliminating them completely, as you can see at this link. Then they use a variety of techniques to challenge each negative thought, staring with #4, “I shouldn’t share my feelings.” Taylor identifies many distortions in this thought, including Should Statement, Emotional Reasoning, Mind-Reading, Self-Blame, and Mental Filter. Taylor decides to think about it like this instead:

“It’s okay to share my feelings. It could bring us closer together. It’s human to be struggling, given the circumstances. My feelings matter to Gregg.”

She believes this Positive Thought 100%, and her belief in the Negative Thought fell to 5%, which was enough, since there was a little truth in the thought. You might have to be thoughtful about the timing of self-disclosure. Rhonda and David continue to challenge the rest of Taylor’s Negative Thoughts, using a variety of techniques such as the Externalization of Voices, Acceptance Paradox, Paradoxical Double Standard Technique, and more. The most challenging Negative Thought was #7—her fear that Gregg might die. At the end of the session Taylor recorded a substantial reduction in her negative feelings. Thanks for tuning in, and please let us know what you thought about today’s program! Rhonda, Taylor, and David https://traffic.libsyn.com/feelinggood/Corona_Cast_4.mp3?_=1 Taylor Chesney, PsyD is Director of Treatment and Training,  Feeling Good Institute-NYC, 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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IMPORTANT ANNOUNCEMENT

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 Bay Area, California counties. For more information, please go to the website:  Feelinggood.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!

Learn More & Register

* * *

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

June 4 – 5, 2020, Seattle, Washington

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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.

Learn More and Register

* * *

Watch for the Awesome

December Evolution of Psychotherapy Conference Anaheim, December 9 – 13, 2020

Sponsored by the Erikson Institute

It is always spectacular and I’ll be presenting, too!

Details TBA