Podcast 222 Ask David December 28, 2020
Ask David featuring five challenging questions.
- Jay asks: How do you treat individuals with personality disorders using TEAM-CBT?
- Jeff asks: Can you talk more about the “great death” of the therapist’s “helping” or “rescuing” self? This was really helpful to me!
- Darkmana asks: Hey David, are there any books about Buddhism you would recommend? I can see you’re a fan of it from Feeling Great!
- Angela asks: What’s a perfect score on your empathy test?
- Margaret asks: What can you say to a patient who doesn’t want to push the Magic Button?
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- Jay asks: How do you treat individuals with personality disorders using TEAM-CBT?
Dr. Burns
Have you considered doing a podcast on using TEAM-CBT or CBT for Borderline, Narcissistic and Histrionic Personality Disorders? The interesting thing is those with personality Disorders seem to blame everyone and everything for their problems but themselves
Also, what if anything could individuals do to not get attracted or quickly eject when they encounter these folks. One theory is that folks with abusive or neglectful parents are vulnerable. Because the chaos and drama is familiar.
I think many therapists avoid folks with pd no? Particularly patients with Borderline PD. It’s interesting in that kids have years of relating to parents with personality disorders.
So how would TEAM-CBT help?
Just curious what your experience and Rhonda too
Jay
Rhonda and David talk about how TEAM-CBT developed out of David’s treatment of large numbers of individuals with Borderline Personality Disorder, and what some of the treatment strategies are.
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- Jeff asks: Can you talk more about the “great death” of the therapist’s “helping” or “rescuing” self? This was really helpful to me!
Hi Dr. Burns,
I loved what you’ve taught on the death of the selves – and recently read the Four Great Deaths of the Therapists Ego in your new book, Feeling Great. One part that I found so helpful was the death of “The Helping, Rescuing Self.”
I think I’ve believed that’s my purpose. That’s why I’m there. I’m there to “help” the client feel better and live a full, rich, meaningful life. That’s something I’ve struggled with – because if I’m not there to help, what am I there for?
And if I don’t FEEL like I’ve helped, then I’ve failed the client. I’d love to hear this concept expanded on. I think many therapists, coaches, etc. would benefit from seeing how they can work with clients without thinking they have to help or rescue them. Thank you, Dr. Burns.
P.S. Your new book is a goldmine. Enjoying it immensely.
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- Darkmana asks: Hey David, are there any books about Buddhism you would recommend? I can see you’re a fan of it from Feeling Great?
Hi Darkmana,
Thank you for your question. I’m sure there are many great books out there, but I have never studied Buddhism or read anything about it. I just sort of make things up!
David will tell his Buddhism story when eating in a noodle house with his son Erik.
Rhonda has invited the Dalai Lama to appear on a Feeling Good Podcast. It seems like a long shot, but it would be delightful to have the chance to chat with him, as there is so much overlap between Buddhism and TEAM-CBT! I would guess that he likely has a good sense of humor, since humor and laughter can be such great ways of grasping certain ideas and achieving enlightenment.
I have heard that the Buddha talked about the “Great Death” of the self. In Feeling Great, I talk about four “great deaths” that correspond to recovery from depression, anxiety, relationship problems, and habits and addictions. I’d love to hear the Dalai Lama’s thoughts about this. There may be large numbers of “Great Deaths,” I suspect.
To me, “reincarnation” is something that happens when we are alive, and not something that happens after our bodies die! However, I think most Buddhists might fiercely oppose my thinking in this regard.
I think that “literalism” is one of the problems with most organized religions. Stories that are intended to convey wisdom and insight are taken as literally true.
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- Angela asks: What’s a perfect score on your empathy test?
Hello David,
In the weekly practice group that I host, the question came up today “what does Dr. Burns mean by no less than 20? Is it the first section titled “Therapeutic Empathy” which is 20 points total, or the entire survey which is 20 questions?
Warmest blessings,
Angela Poch, RPC-C
Hi Angela,
Thanks, yes that is correct. 20 on the empathy scale is the lowest passing grade. A score of 19 and below indicate some significant failure in the therapeutic relationship / empathy.
Since we are hoping for failure, I try to make failure as easy as possible! That’s part of my “anti-perfectionism” philosophy. I encourage the four “great deaths” of the therapist’s ego, and this is the first of the four deaths.
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- Margaret asks: What can you say to a patient who doesn’t want to push the Magic Button?
Hi Dr. Burns,
I attended your intensive in Atlanta and am working on my level 3 certification. TEAM CBT has transformed my life personally and transformed my practice professionally. I will be forever grateful to your hard work and dedication in developing this approach.
My burning question is about the magic button / magic dial. After the positive reframe, when we ask, ” With all these awesome things your negative emotions show about you and all the benefits you get from them, why would you want to press this button?” Ninety five percent of the time my clients argue for change and that is great.
My problem is when they say, “I guess I wouldn’t want to press that button.” I feel like I am cheating them by not offering the magic dial. It seems like all or nothing thinking. If you press the magic button, “all” of these positive things will go away.
They never get the chance to even learn about the magic dial and then may never get the chance to learn about cognitive distortions and all of the other cool methods you and others have created. My clients always benefit from the positive reframing. How much do they have to argue for change? How critical is this?
Maybe I am thinking about this all wrong. I can really use some guidance.
Thank You so Much,
Margaret McCall
I just realized my pun with “Burn”ing question- that was not intentional, lol
Hi Margaret,
Great question! Will add it to an Ask David.
Quick answer: you can agree that it is not a good idea to press the Magic Button, and ask them what their NTs and feelings show about them that is positive and awesome, and also ask them why they might NOT want to push the Magic Button, and then once again paradox them.
All you have to do is say “Good thinking. Let’s list all the really GOOD reasons NOT to press that button.” Then you go right into Positive Reframing, followed by the Magic Dial.
Also, if they do not want help, which is often the case with relationship problems as well as habits and addictions, you can just ask if them if there is anything they DO want help with!
It is not my job to persuade the patient to work on something. It is the patient’s job to persuade me to help him or her!
Rhonda and David
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, but due to Covid-19 restrictions is working via Zoom, and can be reached at rhonda@feelinggreattherapycenter.com. She is a Level 4 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. Check out her new website: http://www.feelinggreattherapycenter.com
This is the cover of my new book, Feeling Great. The kindle is available now, too, and the audio version may be available by the time you read this!
Thanks for the pod.
The answer to the Buddhist question was very strange.
Why brag about making things up about Buddhism in a two day workshop? (My thought as a listener is…what else is David “bullshitting” about?)
If TEAM is based off a single phrase given to you by the Buddhist on the street in Pennsylvania, why didn’t that encounter make you curious enough to spend a couple hours reading any book about Buddhism?
I’m religion-free (and adverse) myself, but the… glee? you seem to take in being ignorant and offense to the Buddhist diners at the restaurant is quite, quite odd.
I get it – you are trying to be irreverent and fun, but this was serious old-man-has-lost-the-pulse-of-what-is-socially-appropriate cringe. ( Relatedly, why is the restaurant “Buddhist”. Because it is an Asian restaurant? )
If you find yourself saying other people need to, in effect, “lighten up” – *you* are probably the one being a jerk.
Rhonda seemed legitimately nervous about your potential behavior after her using her connections and friendships to put you in touch with the Dalai Lama. I am nervous *for* her!
Luu Noodle does sound delicious though, so that was a good tip.
Feeling Unsettled,
Ike
Hi Ike, Thanks for the note. I’m sorry my Buddhist comments offended you!
I don’t actually “bullshit” except in humor, but I think your point is incredibly important. It’s really important to question what people say, especially in our field where people make all kinds of claims that aren’t really valid. Our field really consists, in a sense, of competing “cults” who all claim to have the best answers and best techniques. I am trying to move the field in the direction of science based, data driven therapy. I believe our field is in the very earliest phases of becoming more science based.
I probably should read and study Buddhism more, and could probably learn a lot! And it sounds like I offended you, and you’re perhaps annoyed with me. My apologies, again. I actually greatly enjoyed the diners and appreciated the comments and warmth of the Buddhist leader from South Korea.
You are right too, that I’m really old now. 78 years old, and it seems I have made comments that are disrespectful. Thanks for pointing that out! I have great respect for Buddhism. It is one of the paths that does not seem to aspire to orthodoxy and violence in the name of this or that religious concept.
I do think that it is good to “lighten up,” and feel badly that I cam across as “a jerk.” I will forward your message and check with her if I am making her “nervous.”
If we get over the pandemic, and you visit the Palo Alto area, let me know and we can go the noodle house on me. Although that’s not a big deal, since they are quite inexpensive. Two things they have that are out of sight include fresh squeezed orange juice (they squeeze it when you order) plus coconut juice that is also fresh and sweet and to die for. When I go there, I generally order two coconuts and one fresh OJ.
You will see that they function and operate quite unlike other restaurants, with all the staff kind of working together as one. The food, to me, is just fantastic, and quite inexpensive.
Hey, glad to hear you’re also religion-free and adverse. I can’t definitely buy into that thinking, too!
All the best,
David
Thank you for the incredibly gracious response. While I am merely a layperson, and not somebody with lifetime of professional experience like you, I couldn’t agree more that there is a need to use empiricism to pull therapy out of the dogmatic dark ages. I am glad that you are leading that movement, which is why I *do* get frustrated when I hear things occasionally on the pod that strike me as “off”. Thanks again for your generosity in time and effort making these podcast episodes available to the world. Cheers.
Hi Ike, What a lovely note, thanks! I’ve thought a bit more, and while I cannot recall the ethnicity of the folks at the noodle house, my vague memory is that some are definitely chines, and many are hispanic. The Buddhist thing is how it is organized. You don’t have your own waiter, or your own check at the end, and the seating of folks is not strictly separate either. The staff works as a whole unit, which is really cool. The experience gives off more of a feeling of “one.” But they do serve dishes that include fish and meat, so it is definitely not vegetarian. There are a number of tasty vegetarian chinese restaurants in the area, including some that are vegan.
Here is another thing. I am a very slow reader, and learn by teaching and treating folks and analyzing data. The reason I don’t read about Buddhism is that I’m just not motivated. There isn’t anything about Buddhism that I’m hungry to understand. It all just kind of makes intuitive sense to me. From time to time colleagues or friends who are Buddhist have said this or that, and at first I don’t “get it.” Then a day or so later I “get it,” at least in my own way.
I don’t grasp or endorse everything about Buddhism, and Buddhist teachings, but really do embrace the general philosophy, at least as In understand it. And I do think that learning through humor has a lot to be said for it, and in my teaching and therapy there’s a ton of laughter. But sometimes people feel hurt by my humor, and this has been very painful but “enlightening” for me to see.
I feel lucky that most people, like you, seem to be really forgiving!
Warmly, david
Hello and Happy New Year!
I am an avid listener and huge supporter..
I was wondering if you have ver encountered a patient with monophobia or autophobia better known as Adult Separation Disorder and if you have any advice with treatment?
Thank you!
Too many big words for me. I can only help people with one specific brief moment in their lives. The step by step procedures are clearly explained in my latest book, Feeling Great. All the best, david