Fitness and Self-Esteem

Hi website visitors,I recently received a lovely email and some cool questions from a journalist working for the website, POPSUGAR, (, a wellness website which claims more than a billion visitors per year. Wow! That’s a lot! She asked for some help on the topic of self-esteem and body image.Here’s her note:

Hi! Dr. Burns,

Thanks so much for getting back to me; I honestly didn’t know if you’d see my message!

I have some questions for you, and would of course link my interview to Feeling Good, and mention your resources. I have to tell you — your book changed my life, and the lives of many people I’ve talked to who have also struggled with depression and anxiety. I got it for my dad last Father’s Day and he loved it, too.

My idea for our story is centered around the idea that many women deal with a lot of negative self-talk, whether it’s about their physical appearance, fitness journey, abilities, etc. I brought up your 10 categories of distorted thoughts in our staff meeting and how your book teaches someone to identify those and replace those thoughts with ones that are rooted in positivity and reality — we all thought this will be a wonderful trick to teach our readers as well.

Would love to include a quote or two from you in the intro about identifying these thoughts, and how to correct them. In fact, if you could answer these four questions it would be a great help:

  1. How do distorted thoughts affect body image?
  2. Do you think distorted thoughts can be a roadblock in someone’s wellness/fitness journey? How so?
  3. What’s a small piece of advice you could suggest to a woman struggling with poor self-esteem/body-image issues?

And less important, but if you have time:

  1. Do you believe that fitness and healthy eating plays a strong role in having a healthier mindset and more positive / realistic thoughts?

Thank you again for your help on this story, I’m so honored to work with you! Have a great night,


To read David’s response, CLICK HERE!

Or, if you prefer to read Dominique’s columns based on her email exchanges with David, here they are:

Dr. Burns,

I just realized I never sent you the finished piece! It did so well and my colleagues LOVED it! Here’s the link (CLICK HERE).

I also referenced you and that post we worked on together in my latest piece about food shaming. CLICK HERE

Let’s definitely work on something again soon — our readers love any mental health topics, and are starting to be more open about anxiety. Excited to do more together soon!

024: Scared Stiff — The Cognitive Model (Part 3)

In this Podcast, David and Fabrice describe cognitive model of anxiety, which is based on three powerful ideas:

  1. Anxiety always results from negative thought (NTs) that involve the prediction of danger. For example, if you have public speaking anxiety, you are probably telling yourself something like this: “I just know I’m going to blow it. My voice will tremble. People will know I’m anxious. My mind will go blank. I’ll mumble and make a total fool of myself.” Or, if you struggle with panic attacks, you probably have thoughts like this: “I think I’m about to die. I can’t breathe properly. I’m about to pass out!” Or, “I’m about to lose control and go crazy.”
  2. The NTs that trigger anxiety are always distorted and illogical. In contrast, valid NTs cause healthy fear.
  3. When you put the lie to the distorted NTs, the anxiety will disappear. This can sometimes happen in an instant.

Dr. Burns describes his treatment of a woman named Terry who had suffered from ten years of incapacitating panic attacks and severe depression prior to contacting Dr. Burns. During each panic attack, Terry would experience tightness in her chest and tingling skin and tell herself she was about to pass out, suffocate, or die of a heart attack. Multiple emergency room visits, medical tests, and reassurances from doctors did not help. In addition, years of medication and psychotherapy were not at all helpful.

After trying a number of cognitive techniques that did not help, Dr. Burns persuaded her to let him induce an actual panic attack during an office visit so he could use the Experimental Technique, which is arguably the most powerful technique ever developed for the treatment of anxiety, and he televised the session. What happened next will blow your mind!

In the next podcast, Drs. Burns and Nye will describe the Exposure Model of treatment, and Dr. Burns will describe his personal struggles with his fear of blood during medical school.


→ Click here to download Terri’s Recovery Circle

How Can I Buy Tools, Not Schools, Of Therapy, in Venezuela?

Greetings Dr. Burns,

I am a psychologist and I am interested in buying your psychotherapy eBook, Tools, Not Schools, of Therapy, but I cannot do it because I live in Venezuela. Would it be possible to me to buy it from Amazon in the future?

I am a great admirer of your life and work and I am deeply grateful to you,

All My Best Wishes to You!


Hi Raúl,

Thanks for your kind words. Anyone can send me the funds via PayPal, using a credit card. Have the funds sent to my email address,, and make sure you include an order form so I’ll know what you are ordering. Also, please add 4% for the PayPal charges. This has worked for quite a few individuals. You will receive the eBook as a pdf, attached to an email, with a code so you can open it.

All the best to you!


Free Resources for Aspiring Therapists Who are Poor!

Hi Dr. Burns,

I am currently a sophomore doing my BA in Psychology and wish to continue all the way thru to get my Doctorate. I saw one of your podcasts on motivational therapy during my last class at Argosy University. After seeing it I have gotten very interested in what you’re teaching and feel that it could eventually be helpful to me when I start my practice.

I would love to learn more about what you’re teaching but right now I don’t have any money to buy any books or anything—maybe eventually I can.

Thanks so much for taking the time to read this and whatever you can pass my way would be very appreciated!

Sincerely, Robin

If you would like to see Dr. Burns response to Robin, CLICK HERE.

Anxiety and Magical Thinking

Hi web visitors,

The following is a note about anxiety that I just sent to my Tuesday training group at Stanford this week, and it occurred to me that you might find it of interest. You may need the definition of Outcome Resistance and Process Resistance to grasp the note. Outcome Resistance means that although the patient is suffering, he or she will resist effective treatment for a wide variety of reasons. In anxiety, the Outcome Resistance nearly always results from Magical Thinking. In other words, the patient has the superstitious belief that the anxiety, although uncomfortable, protects him or her from some terrible catastrophe.

Process Resistance means that the patient may (or may not) want a positive treatment outcome, but does not want to engage in the therapeutic process required to cause a successful outcome. For anxious patients, the focus of the Process Resistance almost always has to do with Exposure Techniques. Nearly all anxious patients will fairly forcefully resist using Exposure because it is so frightening to them. They simply do not want to have to face their fears. If the therapist gives in, and agrees not to use Exposure, the likelihood of full recovery is poor.

And about 75% of mental health professional do give in to the patient’s resistance, because the therapist also fears Exposure therapy, thinking it is, indeed, dangerous for this or that (erroneous) reason. I call this “Reverse Hypnosis.” In other words, the patient has hypnotized the therapist into believing that Exposure is dangerous as well!

If you’d like to read about my new insight on this topic of the effect of Magical Thinking on Outcome Resistance and Process Resistance for anxiety disorders, CLICK HERE.

Does Mental Illness Exist?

Hi Dr. Burns,

I am halfway through “feeling good”, I just want to say how powerful it is. It is absolutely fantastic so far. I am applying your techniques to myself.

Do you mind me asking, and this is nothing to do with my health, is the whole idea of low serotonin levels being linked to depression a mere myth? Is there a link between depression and any brain neurotransmitters your opinion?

What about mental illness, does it exist?

Kind regards, Shane

To see Dr. Burns’ response, CLICK HERE.

Two Miscellaneous Trivial Pics You Might Like

Hi web visitors.

I just got two photos in the email. The first is a photo taken by one of our Sunday hikers at the Ranger Station half way through our hike yesterday. I like to think of this as my new therapy office! And you can’t beat the fees, either!

Of course, I’m no longer in clinical practice, and I’m not doing real treatment, but it is fun to think about, since I have always really loved doing therapy. The joy of seeing someone suddenly recover is one of the greatest highlights of my life.

Hikers, like members of my Stanford training group, get unlimited free training–both in the Tuesday group and on the Sunday hikes if they are interested–and they can also do some personal work in both settings, since the concept of “healing yourself” is absolutely essential to TEAM-CBT, even for therapists. If a therapist has used his or her own tools for personal healing, he or she will have far greater effectiveness and credibility with patients.

Personal healing and training have often been linked in the history of psychotherapy. The personal healing makes for the crucial difference between a technician–who has learned the methods–and a healer, who arguably comprehends suffering, and recovery, at a somewhat deeper level.

CLICK HERE FOR THE GOOFY PHOTO of David in his new “office.”

The second photo was sent my a website visitor who found a free copy of Feeling Good at a local, outdoor “lending library.” CLICK HERE FOR PHOTO. She also included this lovely note:

Hi Dr. Burns,

Just wanted to say I am really loving ‘feeling good’ a copy of which I randomly found in a free mini community library box in a hedge near my house (!) one day when I didn’t have anything to read while my baby was napping. I think your strategies will permanently help me overcome my self critical thoughts. God bless you for your work to help people. Inspirational! Can’t wait to check out the podcast.


Just a little trivia for today!