David’s Upcoming Trauma Workshop

David’s Upcoming Trauma Workshop

Exciting news! I will make a three-city east coast swing in April presenting my two-day workshop on trauma treatment. This workshop features a live demonstration with an audience volunteer who has been struggling with depression and anxiety as the result of trauma. It is inspiring, and a highlight of the workshop. On day 2, I will be doing some personal healing for the entire audience as well!

Rapid Recovery from Trauma: New High-Speed TEAM-CBT Treatment Techniques

  • April 24 – 25, McLean, VA 22102, Crowne Plaza Tysons Corner (link to brochure TBA)
  • April 26 – 27, Newark, NJ, Hilton Newark Penn Station (link to brochure TBA)
  • April 28 – 29, Philadelphia, Wyndham Philadelphia Historic District (link to brochure TBA)

For more information, contact IAHB phone: 800-258-8411

You can find the details and registration information if you click on this link  which connects you to my workshop page)

You can find the workshop description plus registration information at this link.

I hope you like the photo which was from one of our recent Sunday hikes!

Is Happiness a Distortion?

Is Happiness a Distortion?

Hi Dr. David Burns,

I am confused about the idea that depression and anxiety result from distorted thoughts. For example, you say that anxiety always results from the distortion called Fortune Telling—making unrealistic negative predictions that something terrible is about to happen.

If anxiety is results from telling yourself that something bad is about to happen, feeling alive and euphoric must result from predicting that you’ll have a good future—is that right? But isn’t that also a distortion?

Why should I believe that everything is going to be fine? Isn’t that equally ridiculous as believing something bad is going to happen?

Have a Nice Day!

Jason

Hi Jason,

Thank you for the thought-provoking question. I have edited your question to make it a bit more focused and understandable, and I hope that is okay. And here is the short answer if you don’t like to read too much of my babbling—it probably isn’t a good idea to tell yourself everything is going to fine, because it isn’t!

Bad things happen to all of us. For example, you’ll make mistakes, you’ll fail at some things, you’ll lose people and things you love, and you’ll experience illness and eventually, death. Good things will probably happen to us, too! For example, you seem to be interested in my work, and you ask good questions. That’s cool! I am honored by that, and consider myself fortunate.

But these events do not cause you to feel the way you do. Your thoughts create all of your feelings, positive and negative. That’s been known for at least 2,000 years, since the time of the Greek philosophers, like Epictetus, who said that humans are not disturbed by events, but rather by our views of them. In my opinion, the most important issue is whether your thoughts about these events are realistic or distorted.

In my two podcasts on my list of ten cognitive distortions, first published in Feeling Good: The New Mood Therapy, I emphasized that negative and positive distortions can both cause problems. Let’s focus on negative distortions first. The negative thoughts that trigger depression and anxiety will practically always have many of the distortions I’ve described, such as Jumping to Conclusions, All-or-Nothing Thinking, Overgeneralization, Should Statements, Self-Blame, Magnification and Minimization, Labeling, and more.

That’s why I’ve said that depression and anxiety are the world’s oldest cons—because you’re telling yourself things that simply aren’t true, but you don’t realize it. For example, depressed patients often feel worthless because they tell themselves that they are “losers” (All-or-Nothing Thinking). They may also feel hopeless because they tell themselves that they’ll be depressed forever and their problems will never be solved (Fortune-Telling).

As you so wisely pointed out, you see the exact same distortions in anxiety. For example, a woman with an intense fear of flying told herself, “Oh, I just know that the plane is going to run into turbulence and crash!” This is an example of Fortune-Telling–making an unrealistic prediction. It’s also an example of Magnification–blowing any real danger way out of proportion. And it’s an example of Emotional Reasoning as well–she’s reasoning from her feelings, telling herself that she feels frightened, so she must be in danger.

Cognitive therapists use many powerful techniques to help individuals struggling with depression and anxiety put the lie to the distorted thoughts that trigger their distress. In fact, I use more than 75 different techniques. And the very moment you stop believing the negative thoughts that trigger your depression and anxiety, you will immediately experience a profound improvement in your mood. However, this type of therapy is extremely sophisticated and requires a high degree of therapeutic skill and training. You can’t just tell someone to cheer, or feed them a line of positive baloney! People are not that stupid!

It would be wrong to conclude that all negative thoughts are distorted. In fact, many negative thoughts are valid, and not distorted. Realistic negative thoughts trigger healthy negative emotions, such as healthy sadness or healthy fear. For example, if you are walking in a dangerous part of town at night, you may be feeling frightened because you are telling yourself that you are in danger of being mugged or murdered. You don’t need to treat your fear with a pill or psychotherapy. You WANT the fear because it may keep you alive!

The same is true for the thoughts that trigger healthy sadness. For example, I recently lost my beloved cat, Obie, who was likely eaten by a predator in the middle of the night a couple months ago. I loved him tremendously, and he was the joy of my life. We were very close. In fact, I often described him as my best friend in the whole world, and one of my best teachers, too. Now I am grieving his loss, and will miss him for a long time! My grief is an expression of the intense love I felt for him, and does not need treatment. Nor do I need or want anyone to try to cheer me up. I’m fine with my sadness.

There are also ten positive distortions that are the mirror images of the ten negative distortions. For example, depressed patients are into the “nothing” of All-or-Nothing Thinking, but patients with mania are often into the “all” of All-or-Nothing Thinking when they tell themselves, “I am a winner! I’m the greatest!”

Politicians sometimes try to control people by combining negative and positive distortions. Hitler told the German people they were the superior race (the positive distortion) and that the Jews were inferior and to blame for Germany’s economic problems (the negative distortions). These positive distortions led, as we all know, to murder, sadism, and war. Some politicians today appear to be using similar strategies, and gaining a frightening amount of power.It is shocking and disturbing to me that so many people are gullible and cannot see through them!

Positive distortions not only trigger mania—which you can see in the crowds who were listening to Hitler’s speeches in a frenzy of manic excitement—but play a central role in narcissism, relationship conflicts, violence and addictions as well. Much of the world’s suffering results from negative distortions, but a great deal results from positive distortions as well.

Positive distortions are never the antidote to depression, in my opinion, and telling yourself nonsensical positive things that are not realistic will rarely or never be helpful to anyone, in my experience. But if you believe positive distortions, you will likely feel temporarily high, overly confident, and even euphoric.

Healthy joy results from positive thoughts that are realistic, just as healthy sadness results from negative thoughts that are realistic. I hope this helps to clarifies the difference between distorted and realistic thoughts.

For more information on how to overcome the thinking patterns that trigger depression and negative, I would guide you to any of my books, like The Feeling Good Handbook.

Thanks!

David

028: Scared Stiff — The Motivational Model (Part 6)

028: Scared Stiff — The Motivational Model (Part 6)

In this Podcast, David and Fabrice discuss the fourth powerful model in the treatment of anxiety—the Motivational Model. The key here is bringing the patient’s subconscious resistance to conscious awareness, and melting it away with paradoxical techniques. This is absolutely critical if you are hoping to see a complete elimination of symptoms in any type of anxiety.

You may recall that the Outcome Resistance for anxiety disorders usually results Magical Thinking—the anxious patient may be suffering intensely and asking for help, but secretly believes that something terrible will happen if the treatment is successful and the anxiety disappears. In other words, most anxious individuals are convinced that the anxiety is protecting him or her from some catastrophic event.

David brings this concept to life with a dramatic description of his treatment of a young man named Sam who’d been struggling with intense PTSD—Post-Traumatic Stress Disorder— for six months following a traumatic interaction with two sadistic gunmen.

David and Fabrice also discuss metaphors for understanding how healing actually occurs. Most therapists think of depression and anxiety as mountains that have evolved slowly, over years or decades. They sometimes also believe that treatment and recovery will also requires years and years of treatment, with very slow progress. Of course, if the therapist and patient believe this it will function as a self-fulfilling prophecy.

In sharp contrast, David describes a new way to think about recovery, as something extremely rapid, a personal transformation that happens suddenly, within a very brief time period within a therapy session. But this remarkable phenomenon is only possible when the patient’s resistance to change has been skillfully and compassionately addressed by the therapist. At that point, the patient and therapist are on the same TEAM, working together collaboratively. Then, amazing changes can often unfold quickly.

Plans for future Feeling Good Podcasts will include a series of fascinating podcasts that will feature an actual live therapy session, with David and his colleague, Dr. Jill Levitt, acting as co-therapists, including commentaries on how each step of T.E.A.M. is being implemented. This will give you the unique opportunity to look behind closed doors so you can observe actual healing taking place.

In addition, a future “Ask David” podcast is planned, as well as a podcast on “The Truth about Benzodiazepines,” plus podcasts featuring more treatment methods for anxiety such as Interpersonal Exposure Techniques and Cognitive Flooding. Dr. Burns also promises a fascinating Feeling Good Podcast on the use of the Five Secrets of Effective Communication with violent individuals who are threatening, hostile, and dangerous.

How to Find Your “True Calling” in Life!

How to Find Your “True Calling” in Life!

Dear David,

First of all, I would like to tell you that using the methods in your many wonderful books has changed my life!!

I have a question and it would be great to get your input. I work as a team leader/software engineer in a software company. I like my profession (I enjoy programming and managing) but I also care deeply about the environment and animals. (I also volunteer in an environmental non-profit organization). This situation leads to a recurring thought that causes me a lot of suffering: “I’m wasting my life when I’m working in this job (software).”

I feel that my life calling is working with animals/helping the environment and as long as I’m not working at that I’m wasting my life. Is this true? Am I wasting my life?

Is this the hidden emotion (elephant in the room) that causes this thought?

I really need your help!

Thanks, Sharon (name disguised)

 

Hi Sharon,

Thanks for your questions! It is spirit-uplifting that you have idealistic goals. My wife and I are also concerned about the environment and the welfare of animals.

I cannot give medical advice, or do therapy in this medium. I can only give some general ideas, but perhaps you will find them useful or interesting.

First, this might be the Hidden Emotion phenomenon, and it might not be. For example, let’s say there’s something else that’s bothering you that you are kind of pushing out of your mind. Perhaps there’s a conflict of some kind with a boyfriend, or a girlfriend, or a family member. Or perhaps someone is pushing you to loan them money, and you are tempted to give in because you’re so “nice,” but you don’t really want to. Or maybe there is a problem of some kind at work that you’re avoiding. It could be anything.

These are just examples of the kinds of conflicts that overly “nice” individuals sometimes tend to avoid.

If this is going on, then the obsessing about your career could, in fact, be a way of not dealing with the real issue. If this turns out to be the case, then you are a darn good detective! But you’re the only one who will be able to say one way or the other. If you open your mind to this possibility, some problem you’ve been avoiding might suddenly pop into your mind. Then if you deal with it more directly, the obsessions about your career might diminish or suddenly disappear. But this is just a possibility.

On the other hand, it might not be the Hidden Emotion phenomenon, but simply genuine ambivalence about your career. You do enjoy your career, which is great, but you are telling yourself that you “should” be doing something more meaningful with your career and with your life. Should Statements are one of the ten cognitive distortions, as you may know if you’ve read any of my books or listened to my two podcasts on negative and positive distortions.

We could view your career concerns as a genuine decision-making issue, but there are really two different decisions involved. The first decision is whether or not you want to change careers. The second decision is whether or not you want to beat yourself up by telling yourself, “I’m wasting my life because I’m working in software development.”

It might be useful for you to do a Cost-Benefit Analysis. Draw a line down the middle of a piece of paper and label the left-hand column Advantages and the right-hand column Disadvantages. You can put the negative thought that is bothering you at the top of the page. This is the thought: “I’m wasting my life working in software.”

Then list the Advantages and Disadvantages of believing that thought and beating up on yourself about your career, and balance them against each other on a 100-point scale. Is it 50-50? 60-40>? 35-65?

To make this easier for you, I’ve attached a CBA for that you can download if you CLICK HERE. You will see that your negative thought is already at the top of the page for you.

Notice that this is NOT a decision about your career. It is a decision about obsessing and making yourself unhappy about your career.

One advantage of telling yourself that you are wasting your life is that it might motivate you to change professions, so you will be more likely to pursue your goal. Another advantage might be that your self-criticism shows that you are a very caring and idealistic person, and not someone who ignores real problems in our society. A third advantage might be that your negative thought could be a kind of “moral punishment” for doing what you enjoy—software development! After all, many cultures and religions throughout history have felt that it is a sin to be happy and to enjoy yourself!

Another advantage of criticizing yourself is that it shows how humble you are, and how willing you are to examine your life in a serious and accountable way. And humility is a spiritual quality.

Yet another advantage is that your self-criticisms show that you have high standards, and those high standards have likely motivating you to accomplish a great deal in your career! And that’s definitely a good thing.

You can likely think of more advantages, and I’m just giving examples.

And you may conclude, after making this list, that you want to keep criticizing yourself. There is nothing wrong with that!

Then you could list any possible disadvantages of your negative thought in the right-hand column. For example, if you are not actually planning to change professions any time soon, then one disadvantage would be that you’re making yourself unhappy, and perhaps unnecessarily. And you might be able to list some more disadvantages as well.

After you complete you lists, put two numbers that add up to 100 in the circles at the bottom. The critical issue is not how many things you list in each column, but how they weigh out in your mind. What feels greater? The Advantages? Or the Disadvantages?

If the Advantages of the negative thought are greater, and you decide that that DO you want to continue criticizing yourself in this way, you could be to ask yourself how many minutes per day you want to devote to beating yourself up. Would five minutes be enough? Thirty minutes? Then you could schedule time each day to sit and make yourself miserable with a barrage of self-critical thoughts. At the end of your scheduled “Worry Break,” you could go back to joyous, happy living.

In addition, you could do two additional Cost-Benefit Analyses (CBAs). First, you could list the advantages and disadvantages of sticking with your current career. Then you could do a second CBA, listing the advantages and disadvantages of switching to some type of career involving your love of animals or your commitment to saving the environment.

Here’s something else to think about that might also be interesting to you. There is no rule that says that you have to have one supreme “calling” in life that you totally devote yourself to. It can be more than enough just to have a job to support yourself. And if you enjoy your work, so much the better! And that might be enough to ask from your work as a software engineer.

You can still do things in your spare time, if you want, to pursue more idealistic causes, or other interests, and it sounds like you are already doing this. On my Sunday hikes with individuals from my free weekly TEAM-CBT training groups at Stanford, we see volunteers in the Palo Alto Foothill Park removing invasive plants and weeds that do not belong in this area. They are doing something for the environment.

In my case, I devote a lot of volunteer time each year teaching and training therapists, and even helping them with personal issues in my training groups for community therapists at Stanford, and during our Sunday hikes as well. It is all totally free,, and it gives me a lot of pleasure!

My wife and I also devote enormous time to abandoned cats that we take in, and we absolutely love them! We have a small orchard and grow tons of apples that we feed to the many grateful deer in this area in the fall. The deer sometimes make a home in our front yard and sleep under our old plum tree! We love them! When they are hungry, the mother deer comes close to our house and stares into one of the windows. When I notice that, I go out and toss out about 75 or 100 apples for them, which they quickly devour!

You can also support political candidates who support your goals and causes.

In short, life does not have to have one calling, one purpose, or one meaning. You can have as many goals, purposes, and meanings as you want! The idea that your MUST have a career that involves some lofty goal is often just a trap, just another “should.”

Do you know that in the middle of my psychotherapy career, I suddenly got the urge to pursue a career in table tennis? That might sound goofy, but it’s true!

I had been really good in table tennis as a kid, and in college, too, but had never had any formal training. So I completely gave up my clinical practice and purchased a ball machine and video camera in the garage, and hired a professional table tennis coach who called himself Ernie the Black Pearl of the Caribbean. He had just moved to Philadelphia and was looking for people to coach, so I paid him to coach me 20 hours a week for about six months. He was the Caribbean champion and was phenomenally skillful. It was strenuous Olympic type training for four hours each morning, Monday through Friday.

I also purchased an Olympic table tennis table from Sweden, as well as costly Swedish rackets with special rubber on both sides that created increased spin and speed when you hit the ball.

Oh boy! I worked and worked on my table tennis. The game had changed completely from when I was a kid, so the training involved a lot of re-learning.

Then I saw a notice that there was going to be a four-day training camp at the Eastern Regional Table Tennis Training Center in Bethesda, Maryland. It appeared to be a training program for the US Olympic Team, and I called to ask if my son and I could attend. The woman who answered inquired about my national rank, and I explained that I did not yet have a rank, but that we were pretty good, etc etc. So agreed to register my son—who was about 15—and me in the program.

This was the chance of a lifetime! We were so excited that we got up at about 4 AM and drove from Philadelphia to Bethesda at 80 miles an hour the first morning of the program. We were the first to arrive, and the woman who greeted us at the door was the former US women’s table tennis champion. It was an amazing huge facility with Olympic tables and runways surrounded by fences so you’d have a large protected area to play at each table. She said my son and I could warm up while the other candidates were arriving.

We set each other up for slamming the ball, and I was thinking she’d be pretty impressed!

Then the other candidates starting arriving. They were these super athletic looking young men, and they brought their children with them. I thought, “Wow, that is so neat that these Olympic table tennis players are bring their children to watch!

About 25 people arrived, and then she announced, “Those who are registered for the four day training program please sit on this long bench.” My son and I jumped up eagerly and sat of the bench.

But to my dismay, as the other candidates arrived, we discovered it was a training program for children! This was NOT the Olympic team! My son and I were the oldest people there, except for one teenager who was 16!

Then she said she would match us up with other players to play a five game match, to see what our skill levels were. She matched me against an 11 year old named Jimmy who looked pretty nerdy. He had horn rimmed glasses and was barely tall enough for his head to be above the level of the table.

I thought, “Oh no, this is going to be pathetic. I’m going to crush this poor little boy, and it might demoralize him.

Before we started I asked him if he played a lot of table tennis, and if this was his main interest. He said, “I do play a little table tennis, doctor, but my main thing is squirrel hunting.”

To determine who serves first,  you hide the ball under the table in your right or left hand, and your opponent has to guess what hand it is in. If your opponent guesses correctly, he or she gets to serve first. But Jimmy generously said that wasn’t necessary and I could choose whether I wanted to serve or receive first.

I told him I wanted to serve, because I had learned these incredible, high-speed spinny serves that are virtually impossible to return in Sweden during a visit I made when I was in medical school. So I gave him a mind-boggling serve, just to let him know who was boss right away.

He was left-handed, so I served it in the direction of his forehand. The serve actually appears to go off the table, and then it curves back and hits the edge of table.

I served and it was a great one. But I suddenly heard a bang, like a firecracker, and the ball game back at over 100 miles an hour on the far edge of the table and bounced against the wall 35 feet behind the table. I did not miss it, because it came so fast I did not have time to swing at it! I could not believe what had just happened, and meekly announced the score, Love – 1! I tried another fantastic serve with the same result. And after three more “fantastic” serves, all returned by massive slams, it was Love – 5.

Then Jimmy said, “Doctor, maybe you should not use that type of serve. They were popular in Sweden about 20 years ago, but now everyone can smash them back. I asked what kinds of serves people were using now, and he said he’d show me.

Then he served an idiotic, slow serve that barely made it over the net, and I thought I could smash it back. But when I attempted to hit it, it went off at right angles, and I could not get it over the net! He had thrown it high in the air at the start of his serve, and then put some kind of fantastic spin on the ball, but blocked my site with his other arm, so I could not actually see what happened at the moment the ball hit his racked.

Then he did four more similar serves, all with the same result .Now it was my turn to serve again, and the score was Love – 10.

I lost five straight games to Jimmy, all by score of 21 to 0. Wow! It was stunning!

Then I asked Jimmy, “Do you have a rank or anything like?” He said, “Oh, I am second in the United States right now in my age division, but my main thing is shooting squirrels!” He winked as he said that, and then I saw what he meant!

Well, my excursion into the world of professional table tennis was quite the adventure, but I had to accept that I just could not get my body doing what my head wanted it to!

So I went back to something I was a little better at—psychotherapy and statistics (for research articles I was writing) and teaching. And I’ve enjoyed myself tremendously since then.

Still, I’ll never regret the time I decided to pursue my “true calling in life!”

Well, I’ll stop babbling now, but hope to hear from you!

David

027: Scared Stiff — The Hidden Emotion Model (Part 5)

027: Scared Stiff — The Hidden Emotion Model (Part 5)

Fabrice launches this Podcast by asking David to remind us about the differences between healthy fear and unhealthy, neurotic anxiety, or an anxiety “disorder” like a phobia, or OCD, and so forth. David explains that negative thoughts, and not events, trigger all our emotions, healthy or unhealthy. However, healthy fear results from negative thoughts that are valid and undistorted, and does not need treatment. For example, if you are walking around Chicago in an area dominated by gangs, you may have the thought, “I could get shot. I better be careful because it’s dangerous here!” Your fear is healthy and can keep you vigilant and alive in a genuinely dangerous situation.

In contrast, neurotic, unhealthy anxiety results from thoughts that contain the same ten cognitive distortions that cause depression, such as All-or-Nothing Thinking, Jumping to Conclusions (e.g. Mind-Reading and Fortune-Telling), Emotional Reasoning, Magnification, Should Statements, and more.

David explains that the Hidden Emotion Model is radically different from CBT, exposure therapy, and most other current treatments for anxiety. The theory behind Hidden Emotion Technique is that “niceness” is the cause of (almost) all anxiety in the United States at this time. In other words, people who are prone to anxiety typically think they have to be nice all the time, and please other people, and not have certain kinds of forbidden feelings, such as anger, or loneliness, or even wanting something you are not supposed to want.

David brings this powerful treatment technique to life with a vignette involving Terry, the woman with ten years of terrifying panic attacks described in previous podcast. When David asked about her very first panic attack, ten years earlier some amazing and illuminating information emerged.

David gives tips on how therapists can use the Hidden Emotion Model,

  1. The hidden emotion or conflict is buried in the present, and not in the past.
  2. It is something very ordinary, such as not liking your job, or your major in college, or a conflict with a friend, family member or colleague.
  3. The anxiety is nearly always a symbolic expression of the feeling or problem the patient is not bringing to conscious awareness. David gives listeners an exercise to see if they can pinpoint the symbolic meaning of Terry’s panic attacks.

Fabrice asks the important question—what do you do when the anxious patient insists that there aren’t any hidden feelings? David explains that most anxious individuals will say that, and describes how to bring the hidden feeling or problem to conscious awareness.

He emphasizes the three things he really likes about the Hidden Emotion Model:

  1. It explains the timing of anxiety attacks, so it has tremendous explanatory power. Freud said that anxiety is the mysterious emotion, that comes out of the blue, and strikes like lightning, without rhyme or reason. David disagrees, and emphasizes that anxiety rarely or never comes from out of the blue.
  2. The Hidden Emotion Model can have powerful and rapid healing effects for patients with every type of anxiety, as well as individuals struggling with hypochondriasis and those who go to medical doctors with complaints of pain, fatigue, or dizziness that does not appear to have a valid medical cause.
  3. The Hidden Emotion Model teaches us that the ultimate cause of most anxiety is the fear of the self, of our emotions and how we genuinely feel as human beings.
  4. The Hidden Emotion Model teaches us that recovery from anxiety does not involve recovery from some “defect” or “mental disorder,” but rather the discovery of what it is like to be human being, with all of our feelings, and that it is okay to have an express those feelings.

Finally, David explains that while this technique traces to the teachings of Freud, Freud might turn over in his grave and find it superficial or silly, since David simply tells anxious patients that they are suppressing or repressing something that’s bothering them, and insists they bring it to conscious awareness right away. David accepts this criticism, but also adds that the Hidden Emotion Technique works and frequently triggers complete recovery with patients who are only partially helped by the skillful use of cognitive techniques and exposure techniques.

However, the “niceness” phenomenon only seems to affect about 75% of anxious patients; sometimes, a phobia is just a phobia, with no hidden feeling or conflict. Those individuals will not be helped by this technique. Fortunately, we have dozens of other powerful techniques that will be curative!

What if the People Around Me are Not Real?

What if the People Around Me are Not Real?

Hi Dr. Burns,

I have read your book, Feeling Good, and now I’m reading your more recent book, When Panic Attacks. I done a Cost-Benefit analysis for one of my negative thoughts and that helped me greatly. I also found some cognitive distortions in my negative thoughts as well.

I have a question. Sometimes I think that the people around me might not be real or are all doing stuff just to keep me happy, almost as if my life is a some kind of a simulation. Iif you watched the movie, ‘Truman Show,’ you will know what I mean!

I especially feel this way when some coincidence in my daily life occurs, like running into a friend who I hadn’t seen for a long time, at some random place, or when I learn that someone else had thoughts that were similar to my thoughts at the same time.

If you have some tips or could share some of your experiences with patients who had similar problems, I would appreciate it!

Sal

Hi Sal,

Thanks for your question! I enjoy answering questions, and hopefully others will be interested as well. However, I cannot safely or ethically give medical advice or treatment in this medium, so my comments will be quite general, and might not apply to you. Remember to consult with a licensed mental health professional or physician in person for any questions concerning your health.

Now that my disclaimer is out of the way, I will try to answer your excellent question. During my psychiatric residency, I learned about two of the more unusual symptoms of anxiety called depersonalization and derealization. Depersonalization is when you get the feeling that you are unreal, and derealization is when you get the feeling that the world is unreal. So it sounds like the feelings you described could just be symptoms of anxiety. And if so, you’re on the right track reading my book, When Panic Attacks, which, as you know, is all about anxiety.

Sometimes anxiety results from the hidden emotion phenomenon I talk about in the book. I don’t know if you’ve read that section yet. That’s when you’re upset about something or someone in your life, but you’re not aware of this due to excessive “niceness,” so you sweep your feelings under the rug, so to speak, and you kind of “forget” about the problem that’s bugging you. Then the feelings come out indirectly, as anxiety. Then you use all your energy ruminating about the anxiety, and don’t take the time to figure out what’s really bothering you.

So I always include the Hidden Emotion Technique in my arsenal when treating someone with anxiety, because it can sometimes be tremendously helpful to pinpoint what the problem is, and then do something about it. Essentially, you think about your life, and the people you know, and the things you’re doing, and ask yourself questions like this:

  • Is there something bothering me that I pushing out of my mind?
  • Am I mad at someone?
  • Do I have some feelings or emotions that I feel like I’m not “supposed” to have?
  • Do I feel tense or uncomfortable about something, or someone, in my life?

Any questions along these lines can help. Usually, the hidden problem or feeling is something recent, not something buried in the past. I have no idea if this is the cause of your symptoms, but it is often a useful tool in understanding and treating anxiety.

I’ve had a Feeling Good Podcast on the Hidden Emotion topic, and you can probably find it easily if you review the podcasts on my website. I’ve got them all organized together there now. I think it was an Ask David podcast on how to deal with an “identity crisis.” In fact, I found it for you, so CLICK HERE if interested.

To listen to a podcast gives an overview of the four models I use in treating anxiety, CLICK HERE.

Also, the most recent Feeling Good Podcasts cover the topic of anxiety, and there is an entire podcast devoted to the Hidden Emotion Technique as well. It is scheduled for Monday, March 13, 2017. I think all the podcasts on the treatment of anxiety might be of interest to you.

Thanks again!

David