Ask David: Featuring Matt May, MD
1. Roy asks: How can I challenge my core belief that there is something wrong with me?
2. Lynn asks: Do you have any recommendations for someone with health anxiety?
Note: The answers below were generated prior to the podcast, and the information provided on the live podcast may be richer and different in a number of ways.
1. Roy asks: How can I challenge my core belief
that there is something wrong with me?
Hello Dr .Burns,
Regarding podcast 294, I had a few quick questions/suggestions on acceptance. Is it possible to do a podcast with you and Matt and Rhonda on one specific core belief?
The belief: There is Something Wrong With Me
Let me explain. I have dated and had relationships with some very physically attractive women in the past. In the last year I have not been able to duplicate these past successes and I suspect it’s because I am at least 10 years or more older than these women ( 23-28). Let’s say I NEVER EVER date or have a relationship with my specific type EVER again? This has caused a ton of frustration and some depression ( low) but has been a bit to my self image and self esteem
Thoughts? Thanks Dr. Burns
David: At my request, Roy provides more information on his Core Belief: There is something wrong with me.
Why believe it?
1. My parent said “What’s wrong with you?” whenever I got in trouble in school ( infers there IS something wrong with me)
2. It feels like there is something wrong with me
3. I make mistakes and am not perfect so there MUST be something wrong with me
I believe this Core Belief to be 100 % True
David: I asked Roy to provide a Daily Mood Log.
Activating Event: 3 specific events
A) My ex girlfriend dumped me and ended our relationship
B) A woman I suspect is a super model said No to my request to go out on a date
C) I have recently struck out with the last 5 women I REALLY want to date. They ALL rejected me
1.There is something wrong with me (100%)
2. I must get this specific woman’s love and approval to feel good about myself (80%)
3. If I am a sexy charming guy then this woman would find me attractive. I must not be very attractive (100%)
4. If I played in the NBA or NFL then this woman would be attracted to me (100%)
5. The sex would be amazing if I were to be intimate with this woman (100%)
6. I would be so much happier if I was to have a relationship with this woman (100%)
7. Women like her with incredibly sexy attractive bodies only go for high status millionaires. I am not a millionaire. It’s awful I am not a millionaire (100%)
8. I am 10 years older than these women and therefore my age turns them off (100%)
David wrote back, suggesting that Roy list the benefits of his belief that “there’s something wrong with me.”
Positives of believing There is Something Wrong With Me
Very easy explanation why these specific types of women reject me
I don’t have to make any changes about myself ( clothes) or behaviors ( more charming)
Familiar feeling and comfort in familiarity
I can feel sorry for myself and have a pity party
Gives me something to complain about with my friends lol
My fantasy ( sexual and relationship) of these specific women remains unchallenged and is a great distraction when bored
Shows I accept I am not perfect and defective
I accept responsibility for my failings
Don’t have to get angry or upset about my mother’s poor parenting skills
Incredibly easy cop out whenever I fail to achieve any type of goal
Can quit working towards a goal when face adversity
Next, Roy identified some distortions in this belief.
Distortions in believing There is Something Wrong with Me
Why? Feels like there is something wrong with me. I am assuming 100% blame. I am not focused on any positive things done in my life
I am stuck because my mother said what’s wrong with you when I was a kid. I concluded there must be something wrong with me. Whenever I get rejected this core belief surfaces.
Is this what you had in mind?
All the Best and THANKS
Thanks for the email.
Everything about you and me could be improved. Is that all you mean when you say “there’s something wrong with me?”
Or are you saying you have a “self” that is somehow damaged.? If so, was your “self” always damaged, from the time of birth? Or did it “become damaged” at some point?
If the answer is yes, at what point did your “self” become “damaged?”
To me, conversations about “selves” have no meaning. Conversations about specific flaws or problems do have meaning.
You are kind of kicking your dating problem up into the clouds of abstraction, to my way of thinking, when you obsess about a “damaged self.”
Lots of colleagues who used to come to my Sunday hikes had dating problems, in your age range, and most eventually solved them. But talk about “damaged selves” was never part of the dialogue that I can recall.
I wrote a book on dating, Intimate Connections.
Just my thinking!
More from David after an email exchange
I don’t think you answered, or attempted to answer, my question. One problem is that you would like to date and have sex with more younger women who are in great shape. That is something specific and clear. I understand it, anybody can make sense of what you are saying.
When you say, “In addition, I believe I have a ‘self’ that is defective (or whatever), I don’t “get” what you are talking about. Can you explain this at the fourth-grade level?
Do you mean that you get upset when you get rejected? Is that all you mean?
Or do you mean that you get frustrated and disappointed when you cannot get a date with X, Y, or Z woman?
Nearly all men have these reactions at times. Does this mean there is “something wrong” with their “selves?” There are lots of reasons why woman A might not be attracted to man B. Do you agree?
Which reason makes the man’s “self” not good enough.
She may not be attracted to him because he is chasing her, for example. This means that his dating style needs some fine tuning, and perhaps that he needs to learn to be happy when he is alone, and that he does not “need” love or her love, etc. Those are specific things, easily changed.
But I don’t get the “self” bit!
We all having varying qualities and ratings. Take math. Everyone has a certain skill in math. 50% of people are above average, and 50% are below average, in math.
Do you agree? Is there some skill level that means that there is something “wrong” with your “self?”
On today’s podcast, Rhonda, Matt and David discuss effective and ineffective approaches to dating, including a mind-set that may be a huge turn-off to women. They also illustrate how to challenge some of Roy’s distorted thoughts using three strategies:
The Acceptance Paradox
The CAT, or Counter-Attack Technique
Matt and Rhonda speculate that Roy may be harboring some anger toward his mother, and toward women in general. David is less convinced, but more focused on change in the here-and-now, regardless of causes, which can sometimes be difficult to prove. At any rate, if Roy’s goal is to develop more loving and rewarding relationships., there are many available tools.
2. Lynn asks: Do you have any recommendations for someone with health anxiety?
I am a long time fan of your work, and I have a long history of health anxiety. My therapist tells me that this is really death anxiety. I’m not sure I agree…but do you have any recommendations for someone with health anxiety? ( imaginal exposure therapy has not been helpful) I’d be eternally grateful for any insight.
Thanks for the kind words, Paul. I will try to include this in an upcoming Ask David segment!
Using uncovering techniques, like the ‘What if’ technique, Hidden Emotion, Downward Arrow and Interpersonal Downward Arrow could help answer this question. If you had a problem with your health, what would you worry about, most? If you were having a problem with your health, what would you worry about, in terms of how other people would treat you? What would it mean, about you, if you had a problem with your health. Identify the specific negative thoughts behind your suffering will help your therapist identify methods that could help you. As far as Death Anxiety, you could consider a chapter in Feeling Good, where David breaks this fear down into more specific parts. Are you afraid of the process of dying? The moment of Death? What comes after? If so, what are you afraid of, specifically? Most people don’t fear Death, it doesn’t really exist, like a shadow, just the contrast to something real, Life.
In the podcast, Matt, Rhonda, and David emphasize the role of the Hidden Emotional Model in the treatment of Health Anxiety, and describe two dramatic cases involving rapid recovery, one of them personal—David’s belief he had a lymphoma in his armpit shortly after completing his psychiatric training. The other involved a college student with a long history of health anxiety who David and Matt hypnotized. While in the trance, she suddenly “remembered” what she was actually upset about, and burst into tears.
This was a life-changing moment!
Thanks for listening today!
Matt, Rhonda, and David
Rhonda and I are convinced that Dr. May is one of the greatest therapists on the planet earth. If you have a question or would like to contact Dr. May, please check out his website at: www.matthewmaymd.com
Dr. Rhonda Barovsky is a Level 5 Certified TEAM-CBT therapist and trainer and specializes in the treatment of trauma, anxiety, depression, and relationship problems. Check out her website: www.feelinggreattherapycenter.com.
You can reach Dr. Burns at email@example.com.
This is the cover of my new book, Feeling Great.
It’s on sale right now on Amazon, and it’s ridiculously cheap!
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Excellent podcast, i have fear of symptoms, can you tell me i can do to kill the fear thanks
Thanks! Glad you liked it. Answer: you can read my books or utilize any of the free resources on my website! or listen to more podcasts, you’ll find the list on website, plus search function. Best, david
Hi Dr. Burns, you’re books have been really helpful to me. How do I submit a question to the ‘Ask David’ podcast segment?
You just did ask a question, and I just now answered it! Ask away! Now you know how! best, d
Cool! I wasn’t sure if my comment went through and ended up sending you guys an email as well… sorry.
My question is in regards to your views on physical exercise. You have so many great points and techniques in your books (I’m using EAR ‘affirmation’ here to lead into some criticism) and you’ve become my trusted source of information on depression and anxiety… That said, I was surprised and confused about your views on physical exercise as not being significantly helpful for depression:
given the amount of anecdotal and scientific evidence of benefit from reputable sources:
It looks like there are complex, systemic effects in the brain and body that result from exercise – and likewise depression is a complex illness (I know your view on the ‘endorphins’ theory from your blog post 248 – I’d liken it to the ‘neurotransmitter imbalance’ theory of depression).
And from personal experience, I am someone for whom vigorous exercise seems like the magic key.
I was formally diagnosed with MDD 6 months ago, but the label doesn’t mean much to me. My episodes of mood disturbance over the years have been correlated with periods of time in which I couldn’t or didn’t exercise. A decrease in exercise over the past year, resulting from several injuries, has seen more ‘sticky’ negative moods and thoughts return. This is actually what prompted me to buy your book a few months ago – I needed another tool in my arsenal to help me when I couldn’t exercise.
My mind/brain feels ‘whole’ again after exercise, in a way not much else can accomplish. It’s like it becomes ‘unlocked’ (in terms of CBT, I would say that in the aftermath of exercise, my cognitive distortions are either eliminated, forgotten, or have had their salience drastically reduced), and frees up my thoughts, emotions, and attention. Reality seems more interesting and I want to interact with people. I always feel some degree better – there has never been a session of exercise where I’ve felt worse afterward.
As soon as I figured this out (as a somewhat anxious and depressed high school kid 16 years ago), exercise became essential to my life and my emotional and mental wellbeing. Exercise helps me make decisions and sort through difficult emotions and circumstances. It has allowed me to weather terrible storms and stressful periods in my life that might have crushed me otherwise. It gives me more confidence in myself and results in positive feedback loops.
The effect of exercise is undeniable in my life. Case-in-point: lifting weights a few hours ago has made writing this post much easier. I’m feeling clear-headed, focused and relaxed – a contrast to how I felt this morning. I’m not claiming exercise is sufficient on it’s own to manage depression, but to me evidence points to exercise being like a facilitator of depression treatment, like SSRIs
(https://bjsm.bmj.com/content/early/2022/09/23/bjsports-2022-105964). At least for some people.
In summary: what do you make of my personal experience, the studies I referenced above, and other people for whom exercise seems to clearly help lift out of the depths of negative thinking and moods?
And sorry for the long reply, I felt it was important.
Thanks for your long and thoughtful note. I apologize that my message may appear to be in conflict with yours, and regret that I don’t have the time to read all of these references, but others may find them very helpful, so this is a great resource. I believe it is impossible to change the way you feel without changing the way you think. Obviously, many people do get a mood lift from exercise, which can be fun, as well as athletic activities. I used to love table tennis, for example, and found a long point to be even more rewarding than winning. You can get into a kind of trance state, and enjoy the rhythm. Aside from that, I’ve never found running to be mood elevating. I believe that people who do enjoy exercise as a “treatment” for their moods experience a change in thinking, more positive thoughts, during exercise, and this is the mechanism that leads to a change in feelings. My opinion only!
One last thing, and it might sound cynical. I used to review research articles for some scientific journals. When someone tells me to read this or that research article that supports some position they take, I nearly always find that the research was of poor quality and did not really prove what they thought. However, I have never once seen that this influences the thinking of someone who is committed to some notion or idea. So I stopped spending the censurable time necessary to review articles. Often, people who are committed to something just don’t want to be contradicted, and we see this all the time in politics, for example. That might sound unfair, and if so, I apologize!
Best regards, david
David, I just stopped blaming myself and what a change I made. All the madness and resistance broke and the weird proocess of reliving and remembering the past left. I dont have a pathological need to look up yet more psychology or remember the bad stuff in the past. Blame can really cause a lot of problems.
You’re right, and blame is addictive, too! d