In today’s podcast, Rhonda and I interview the incredibly brilliant, funny, and creative Amy Spector. Amy is a licensed marriage and family therapist and credentialed school counselor with over a decade of experience working with adolescents and their families. She is passionate about providing school-based mental health services and advocates for legislation to mandate universal mental health care for youth.
Amy works with “at risk” teenagers at Vicente High School in Martinez, California. This is a continuation high school, as well as teens at Briones School, an independent study school. Her students are credit deficient and at risk of not graduating from high school. Nearly all have experienced significant trauma and most are severely depressed, anxious and angry when first referred to Amy, and some have suicidal thoughts or urges as well.
Although you might think that this would be an exceptionally challenging, oppositional, and frustrating group to work with, Amy has had tremendous success treating these teenagers with TEAM-CBT. She measures symptom severity at the start and end of every session, just as we do with adults, and often reports a phenomenal reduction of 60% in depression and anxiety in a single, 30-minute therapy session. Although this may be hard, or even impossible, to believe, it is real, and you’ll see why when you listen to this amazing interview. Amy’s secret involves a combination of superb E = Empathy skills to form a meaningful relationship, along with A = Paradoxical Agenda Setting to reduce resistance, followed by truly creative applications of M = Methods. And, of course, she does T = Testing with every student at every session, and plots her effectiveness over time.
Amy describes her work with a severely anxious young man with artistic skills, who drew an “Anxiety Hero” figure who saves the world by worrying constantly about every little thing, plus a “Chilled Out” figure who never worries and ends up getting hit by a bus. In other words, Amy skillfully emphasized the many BENEFITS of the young’s man’s constant anxiety, as well as the downside of getting cured. This paradoxically boosted his motivation, and he improved rapidly.
This is prototypical TEAM, which is difficult for many therapists to learn, because therapists are so used to, and addicted to, “helping.” Amy has developed expertise in aligning with the resistance of her students. paradoxically, she ends up on the same page, and this allows some awesome TEAMwork to emerge.
Amy, Rhonda and David talk about the idea of teaching TEAM through creative innovations, with many examples of games Amy has created. For example, she created a game with another one of our fabulous TEAM-CBT therapists, Brandon Vance, MD, which can be played with teens and adults, called “Tune In / Tune Up.” This game provides a really fun way to learn the 5-Secrets of Effective Communication. If you’re interested, you can check it out at www.gamefulmind.com.
Although I (David) have been primarily an adult shrink, I have really enjoyed working with teenagers as well. A few years back, I tested hundreds of juveniles who had been arrested in California, many for violent crimes, including murder, at the request of the probation department, using my Brief Mood Survey to find out how depressed, anxious, suicidal, and angry the kids were.
Toward the end of the podcast, I describe what happened when I was invited to visit two groups of incarcerated gang members at the Juvenile Hall in San Mateo, California to find out how they felt about the tests I administered, and to get their take on the causes of so much teen violence.
I think you’ll find this episode to be fun, funny, and inspiring! Amy is a strong advocate for including mental health training in high schools, and her experience illustrates the enormous potential for rapid and profound mental health growth and learning in teens.
If you would like to contact Amy, she can be reached at babyfreud@gmail.com.
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com.
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
* * *
You may have missed the Calgary and South San Francisco intensives, but there will be two more awesome workshops
for you this fall.
High-Speed Treatment of Depression
and Anxiety Disorders
A Four-Day TEAM-CBT Advanced Intensive
November 4 – 7, 2019
The Atlanta, Georgia Intensive
I also have a tremendous one-day workshops scheduled with my colleague, Dr. Jill Levitt, that will be potentially life- and career-changing experiences (really!) You will learn powerful skills that will boost your clinical effectiveness and improve your relationships with your patients as well as the people you care about.
Advanced Empathy Tools for Connecting
with Challenging Patients,
Colleagues, Friends, and Loved Ones
With Drs. David Burns and Jill Levitt
Oct 6, 2019 | 7 CE hours, $135
Do you have a patient, colleague, friend or loved one who:
Complains endlessly but does listen to any of your good advice?
Appears irate, but insists s/he isn’t upset?
Refuses to express his / her feelings?
Never listens?
Argues, and always has to be right?
Always has to be in control?
Is relentlessly critical?
Insists you don’t really care—or understand—when you think you do?
Then you’re going to LOVE this workshop with David and Jill. You’ll learn about–
The Powerful “Law of Opposites”
How to find out how your patients really feel about you–if you dare!
How to transform therapeutic failure into success
How to talk to people who refuse to talk to you
Why your worst therapeutic failure is actually your greatest success in disguise
The fine points of the Five Secrets of Effective Communication
Three Advanced Empathy Techniques: Multiple Choice Empathy / Disarming, Changing the Focus, and Positive Reframing
And more, including lots of small group practice with expert feedback and mentoring to refine your skills!
Attend in person or from your home via Live Streaming
Sign up early because we nearly always sell-out for the in-person seats. Of course, there will be lots of skilled trainers to help the online participants with the small group exercises, so you will win either way.
My one-day workshops with Dr. Levitt are usually pretty awesome! It is always an honor to teach with Jill!
Learn More & Register
* * *
Coming up in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
David and Rhonda goofed! We posted the wrong audio for today’s wonderful podcast on social anxiety and vulnerability featuring Michael Simpson. Rhonda has just returned from a month of teaching in India, and can hopefully get the error corrected soon so you can hear the proper audio.
David
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com. She is a Certified TEAM-CBT therapist and specializes in the treatment of trauma, anxiety, depression, and relationship problems. She also does forensic work in family court, but finds TEAM-CBT to be way more rewarding!
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
Coming up in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
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.
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
Incredible training. The best workshop I have ever attended. David is a compassionate, extremely knowledgeable teacher and psychiatrist. I guarantee you will not be disappointed! Marilyn Coffy, PhD
The following are unsolicited anonymous comments from participants on the workshop evaluation forms–
The live demonstration in the evening was freaking incredible!!!
The live demonstration was dynamite! . . . It was beautiful!!
The entire process was fantastic!
I liked all of it! I appreciated Dr. Burns willingness to be vulnerable with his own flaws and fears.
Today’s podcast features Michael Simpson, a friend and colleague of Dr Burns, who describes his personal battle with social anxiety. Dave Fribush will again be our host, since Rhonda is celebrating the important religious holiday of Yom Kippur with her family.
Michael first became acquainted with David when he read David’s book, When Panic Attacks, which he says was SO GOOD! But when he went to David’s website, www.feelinggood.com, he was shocked to see so much terrific free content for people, but the website was not well-presented. In fact, it was pretty sucky!
So, Michael sent David a brief video, pointing out all the problems, and offered to redo the website in exchange for some help with his social anxiety—and the relationship took off from there!
Michael describes his own experiences with social anxiety, which amounts to slight to moderate nervousness, tension and dis-ease during interactions with people. There is no apparent pattern to his triggers: he can become anxious (or not) around friends, strangers, men, women he is attracted to, and women he is not attracted to. He experiences the anxiety physically: butterflies in his stomach, tension around his face and a general tightness in his body. He is usually unaware of his negative thoughts, which involve fears of looking weak, being judged by others because of his anxiety, and being unable to connect with others while he is feeling anxious. He usually tries to hide all of these fears.
In addition, his social anxiety does not appear to inhibit him — he is a tall, handsome, articulate man, and when he confides his social anxiety to others, they are usually extremely surprised that someone who outwardly appears so confident could possibly be struggling with social anxiety.
Michael describes one of his first “homework assignments” from Dr. Burns, who suggested that instead of hiding his anxiety, he should approach attractive women he encounters on the street and simply tell them that sometimes he becomes anxious when speaking to attractive women. The purpose of the exercise was to confront his fear (Exposure) and do a real-world experiment to find out if his fears of being judged are realistic.
Opening up about his anxiety was very challenging for Michael, to say the least, given that he had spent most of his life trying to hide it. He describes walking around Times Square in New York City, procrastinating, and trying to muster up the courage to follow through on his assignment.
So, he finally approached a woman from Brazil whom he found exceptionally attractive. He kind of had to chase after her to stop her to tell her. We can call her Adrianna. Adrianna did not judge or reject Michael, and the two of them seemed hit it off tremendously. And they talked and hung out together every day.
Michael described their relationship as one of the deepest and most fulfilling relationships he’d ever experienced. He was amazed by Adrianna’s warmth, compassion, and openness, and appreciated the respect and love she conveyed to everyone she met. Michael also describes visiting her and spending a week together in Brazil after she returned home.
One of the take-home messages for Michael was that vulnerability, rather than trying to be cool, or trying to impress people that you have it all together, is the real key to intimacy and joy in our relationships with others.
Dave Fribush and David Burns feel very indebted to Michael for his awesome work on today’s podcast. Michael hopes his experiences will be helpful to any of you who have also struggled at times with social anxiety.
My new website makeover will probably be launched by the time you read this, so let us know what you think! It’s will be at the same address: www.feelinggood.com.
If you are struggling with social anxiety, you might also enjoy my book, Intimate Connections. It’s now a bit dated, but the ideas can still be tremendously helpful. Here’s an unsolicited endorsement I recently received from a young professional woman:
“I’d like to share a story about a book I started reading on my trip to Asheville this past weekend. On the plane, both tears and uncontrollable laughter simultaneously streamed from my face while reading the Intimate Connections book. No more peanut butter and jelly sandwiches telling myself what a loser I am!” ZR
David
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com. She is a Certified TEAM-CBT therapist and specializes in the treatment of trauma, anxiety, depression, and relationship problems. She also does forensic work in family court, but finds TEAM-CBT to be way more rewarding!
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
Coming up in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
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.
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
Happy Thanksgiving if you live in the United States! This is my favorite holiday, because it means just hanging out with the people you love, eating some wonderful food together, and doing simple things like a family hike, without the commercialism and “push” of some of the other holidays. I wish the very best to you and yours, too!
Today, Rhonda could not join us due to Yom Kippur, the highest Jewish holy day. So we will record three podcasts with my wonderful neighbor, Dave Fribush, as host. In addition, we are joined by Michael Simpson, who flew out from New York to attend my Empathy workshop two days ago. He will also join the Tuesday group at Stanford tonight. Michael is doing a massive upgrade / fast lift of my website, www.feelinggood.com, which will likely be published by the time you read this. Let us know what you think about the new “look.”
Dave Fribush, Michael and I answer many thought-provoking questions submitted by listeners like you!
1. How can I overcome my fear of blushing?
Hi David,
Hopefully this reaches you well. I am dealing with Erythrophobia (the fear of blushing) and have been having issues with going out with friends, being in public, in work meetings, etc. The weird part is that I don’t even get red, but the visualization in my head is so vivid sometimes (Kool-Aid man) that I believe it.
Sometimes, if I think about it long enough (like an internal panic attack for 20+min), I get kind of red. . . . Currently, I am trying to just break this habit and I have been reading your book When Panic Attacks and it has been pretty good at helping me.
I have been facing my fears and going out into public and hanging out with friends; I’m kind of anxious on the inside of getting red all of sudden, which puts me on edge. I look in the mirror and see that I am not red, but it’s been hard to train my brain to believe it. I started reading your book five days ago and it has helped a lot already. Since then, I have been able to accept
I don’t mind being occasionally red or nervous and I’m fairly confident, but I struggle to accept the idea of being perpetually red? Part of me wants to accept the idea that “Eff-it! If I’m red, I’m red! That’s who I am,” but another part of me knows that it’s not true; occasionally I might blush but it’s not the norm.
Please let me know if you have any advice. I think this might be a great podcast topic because I know a lot of people with Rosacea deal with anxiety and I’m sure that would help a lot of others.
I cannot do therapy through this medium, so this is just general teaching, but exposure / self-disclosure in one method you could use. You could tell 5 to 10 strangers every day something like this:
“Could I speak to you for a moment? I’ve had the fear of blushing almost all of my life, and I’ve been hiding it from everybody out of shame. But today, I’ve decided to stop hiding and being ashamed, so I’ve decided to tell people, and that’s why I’m telling you.”
Actually, blushing is NEVER a problem. The only problem is the shame. Without the shame, the blushing, like shyness, can be an asset, making you more human and more appealing.
Also, on my Sunday hike yesterday, we were joined by a young Stanford dermatologist who showed us some photos and videos of a new laser treatment for rosacea, which is similar to blushing. Apparently, the treatment is quite effective.
Thanks, David
2. How can you get over a broken heart?
Hi David,
First of all, I would like to thank you from my bottom of my heart for the wonderful jobs you are doing. I have a question regarding aftermath of divorce and searched feelinggood.com for any post but I couldn’t find any. My best friend is going through divorce process and he cannot forget the good memories he had with this wife. He still loves her so much and would like to continue their relationship but she’s not interested in that. They have been separated for 4 years and he tried his best to bring her back.
How can I help him move forward? Those good memories are haunting him?
Thanks,
Didi
Hi Didi,
Thanks for your terrific question, as most of us were rejected by someone we loved at some point in our lives.
You’re in luck! We just recorded a podcast on how to help a friend or loved one who’s hurting, and by the time you read this, it will have been published. It’s Podcast #164 on “How to HELP, and how NOT to Help!” It was published on October 28, 2019. You can find the link on the list of all of the published podcasts on my website. I would definitely listen before trying to “help” your friend!
Resources for your friend might include the book I wrote on this topic, which is called Intimate Connections. One of the themes is that rejection could never upset a human being—only distorted thoughts about being rejected. This book can be helpful to the many people who have been divorced, or who have broken up with someone they loved, and are having trouble getting back into the dating game effectively, as well as the many people who are having trouble getting into the dating game for the first time.
Another great resource for him would be the chapter on the Love Addiction in Feeling Good: The New Mood Therapy. It describes a woman who had just been rejected by her husband, who was having an affair with his secretary, and she was telling herself that she couldn’t be happy without his love. The story had an amazing outcome, and might be very helpful for your friend.
Of course, motivation is incredibly important. Your friend might not want to be “cured,” so to speak, since his depression and thoughts about his Ex keep the relationship alive in his mind, and also give him an excuse to avoid dating and developing new relationships, which can be anxiety-provoking and effortful for just about anybody!
David
3. How would you treat someone with anorexia nervosa?
This question was submitted by our friend, Professor Mark Noble, on behalf of one of his colleagues at the University of Rochester.
I, David, explain what anorexia is, and describe my experience with an anorexia patient I treated in Philadelphia when she was discharged from the inpatient unit. I emphasize the need for the TEAM-CBT technique called the Gentle Ultimatum, since the patient didn’t want o maintain her weight at a safe level, and just wanted to talk talk talk during sessions without doing any psychotherapy homework.
I also describe the “Coercive Therapy” also called Family Therapy for anorexia, developed at the Maudsley in London, and we talk about how the same principle—getting the parents to work together on the same team, with firmness, intense mutual support, and compassionate insistence—works for almost any problem children are having.
However, this requires the parents to support one another, and work together as a strong and loving team, and many parents who are in conflict will find it difficult to do this, since the urge to argue and fight can be so powerful. Then the parents sacrifice the well-being and happiness of their children in the name of ongoing war (blame, fighting, sticking up for “truth,” and so forth).
Dave F. and Michael Simpson ask why this approach of getting parents to work together, can be so incredibly powerful and helpful to children.
David
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com. She is a Certified TEAM-CBT therapist and specializes in the treatment of trauma, anxiety, depression, and relationship problems. She also does forensic work in family court, but finds TEAM-CBT to be way more rewarding!
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
Coming up in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
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.
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
Professor Mark Noble was our special guest on the one hundredth Feeling Good Podcast. In that podcast, he described the effects of TEAM-CBT on the human brain. Many listeners were enthralled by Dr. Noble’s revolutionary ideas!
Today, Dr. Noble returns to discuss his illuminating ideas, and prevents an overview of his chapter entitled, “TEAM CBT and the Art of Micro-Neurosurgery: A Brain User’s Guide to Feeling Great,” which will appear in David’s new book, Feeling Great, which will be released by PESI in 2020.
Rhonda begins the podcast by asking how Dr. Noble met Dr. Burns. What brought the two of you together?
Dr. Noble explains that he read about David’s work on drug-free treatments for depression in the October, 2013 issue of Stanford Magazine entitled Mind Over Misery, This article became the most-read article in the history of the Stanford Magazine. Dr. Noble was particularly interested in drug-free treatments for depression because of some alarming research emerging in his laboratory on the central nervous system impact of some popular antidepressants on lysosomes in the brain.
So, Dr. Noble made a trip to California so he could visit David’s Tuesday training group at Stanford and participate in one of David’s famous Sunday hikes. This was so much fun, and so intellectually rewarding, that he become an irregular regular at the Tuesday groups and Sunday hikes! Since that time, there have been many Sunday hikes and many Tuesday groups in the emerging friendship and professional collaboration between David and Dr. Noble.
David describes some of the resistance he runs into from mental health professionals who cannot believe that the rapid recoveries David sees in TEAM-CBT can be real. Most therapists were trained to believe that depression develops slowly, over many years, and that effective treatment must also be very slow, often requiring many years, or even more than a decade of weekly sessions. But Dr. Noble argues that the amazingly rapid changes David routinely sees in TEAM-CBT are actually highly consistent with the latest neuroscience understanding of how the human brain works.
David and Dr. Noble on a Sunday hike
In fact, Dr. Noble presents the amazing idea that if you had to invent a form of psychotherapy that was specifically developed to capitalize on how the brain works, you would come up with something very much like TEAM-CBT.
Dr. Noble discusses neuroscience in simple, everyday terms that anyone can understand. Even me (david)! Dr. Noble teaches in a kind of clear, accessible way of communicating that I (david) admire greatly. I have seen this in all of the teachers that I’ve admired the most in college, medical school and beyond.
Dr. Noble explains that if you want to change the way you think, feel, and behave, you have to change certain specific networks in your brain. That’s because networks of nerves are the biological equivalents of thoughts.
But how do you do that? How can you change the networks in your brain that cause you to feel depressed, anxious, and inadequate? It’s through two basic concepts of neuroscience called FTWT and WTFT! In Dr. Burns’ new book, Dr. Noble writes:
“One of the most famous concepts in the science of learning is called, “What Fires Together Wires Together” (FTWT). Nerve cells that frequently interact with each other become functionally connected, and the more they fire together, the stronger the connections become. This is how new networks are formed and how existing networks become stronger.
“In addition, nerve cells that are Wired Together tend to Fire Together (WTFT). WTFT. This idea explains why once you’ve learned something it gets easier to repeat it every time you do it.”
Dr. Noble also views TEAM-CBT as a kind of micro-neurosurgery, because you replace highly selected negative brain circuits that send distorted signals, such as “I’m not good enough,” or “I’ll never recover,” with new circuits that are far more accurate and positive.
Dr. Noble also explains why Dr. Burns’ concept of “Fractal Psychotherapy” is so complimentary to our understanding of the human brain, as are the other components of TEAM-CBT, including T = Testing, E = Empathy, A = Assessment of Resistance, and M = Methods.
David and Dr. Noble following a Sunday hike, just before the dim sum feast with the hiking group at the Joy Luck Palace in Cupertino, California, Notice the slightly bulging but happy stomachs from both doctors!
Dr. Noble also explains why conventional therapy–where the patient comes in week after week to vent about his / her problems–may actually make the patient worse. This is because the neurons that Fire Together every week, actually Wire Together. So, in simple neuroscience terms, conventional therapy may actually lead patients in the wrong direction, by strengthening the negative circuits in the brain.
You will love this down-to-earth discussion of TEAM-CBT and the human brain!
David D. Burns, M.D. & Rhonda Barovsky, Psy.D.
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com. Today’s featured photo is courtesy of Nancy Mueller–www.nancymuellerphotography.com.
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
* * *
I have two tremendous one-day workshop scheduled with my esteemed colleague, Dr. Jill Levitt, next year–
Workshops in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in psychotherapy. Nearly all therapeutic failure results from the failure to address resistance effectively. Therapists do not understand what causes resistance or how treat resistant and oppositional patients who “yes-but” you or fail to follow through on homework assignments.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
You can join this workshop in person or online (live streaming) from anywhere in the world!
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
You can join this workshop in person or online (live streaming) from anywhere in the world!
In today’s podcast, David and Rhonda interview Dr. David Hanscom, a renowned and controversial spine surgeon who gave up a large and lucrative surgical practice in favor of helping and educating people struggling with back pain, directing them on the path to recovery without surgery or drugs.
Dr. Hanscom describes his personal journey and recovery from panic, pain, and other disabling somatic symptoms when he read Dr. Burns’ book, Feeling Good: The New Mood Therapy, and began doing the written triple column technique to challenge his own negative thoughts and overcome his own feelings of depression, panic, hopelessness, and anger.
He also began to study alarming research reports indicating that many of the surgical procedures were no more effective than placebos; and even worse, he could see that back surgery often had damaging and even disabling and horrific effects on patients. He also discovered that most of the patients seeking surgery for back pain could be helped simply through talk therapy and support, by focusing on the problems in their lives, rather than simply focusing on pain and pills.
Dr. Burns supports Dr. Hanscom’s premise, that even physical pain can have powerful psychological causes and cures. Dr. Burns briefly summarizes his own research on hospitalized inpatients with significant emotional problems as well as chronic pain. He wanted to answer the question of why physical pain and negative feelings so often go hand-in-hand.
To find out, he studied changes in negative feelings, like depression, anxiety and anger, as well as the intensity of pain, in more than 100 patients attending a 90 minute cognitive therapy group. He saw that there were often massive shifts in negative feelings, like depression, anxiety, and anger, as well as the severity of physical pain, during the groups.
He analyzed the data with sophisticated statistical modeling techniques to evaluate two competing theories about why pain and negative feelings go hand-in-hand.
Physical pain could cause negative feelings, like depression, anxiety and anger. This seems plausible, since physical pain is so debilitating, and just plain awful.
Negative feelings could have a causal effect on physical pain.
The analyses indicated that there were causal effects in both directions, but the most powerful effect, by far, was the effect of negative emotions on physical pain. In fact, the analyses indicated that, on average, half of the physical pain these patients were experiencing, on average, was the direct result of their negative emotions.
This means that if you’re in pain, and you’re emotionally upset, which would be totally understandable, that a great deal of the pain you are feeling is the result of a magnification of the pain by your negative emotions.
There is a positive implication of this finding that supports what Dr. Hansom is saying–namely, that if you are in pain, including chronic pain, and you are willing to overcome your negative feelings and deal with the problems in your life, there is a good chance that your pain will improve substantially. Some people, as David saw in the groups, will experience a total elimination of pain–something he often observed within the group.
It is also possible that you will experience a reduction of your pain, but not a complete elimination. And it is possible that your pain will not improve when your negative feelings disappear–but at least you won’t have to struggle with pain and depression!
So he has now devoted his life to making people, as well as his surgical colleagues, aware of the realities vs. the myths of back surgery. To learn more, visit his website, or pick up a copy of his terrific book, Back in Control. The book includes a section on your personal roadmap out of pain.
Rhonda and I are incredibly grateful to Dr. Hanscom for this illuminating, challenging, and profoundly personal interview. We hope you enjoy it! And if you’ve been struggling with any kind of chronic or debilitating pain, we hope you will find some hope, as well as a drug-free path to recovery!
David D. Burns, M.D. & Rhonda Barovsky, Psy.D.
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com. Today’s featured photo is courtesy of Nancy Mueller–www.nancymuellerphotography.com.
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
* * *
I have two tremendous one-day workshop scheduled with my esteemed colleague, Dr. Jill Levitt, next year–
Workshops in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in psychotherapy. Nearly all therapeutic failure results from the failure to address resistance effectively. Therapists do not understand what causes resistance or how treat resistant and oppositional patients who “yes-but” you or fail to follow through on homework assignments.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
You can join this workshop in person or online (live streaming) from anywhere in the world!
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
You can join this workshop in person or online (live streaming) from anywhere in the world!
In today’s podcast, David and Rhonda answer two questions about suicide submitted by podcast fans.
Question 1. Why do shrinks kill themselves?
Dear Dr Burns,
Before I get to my question (which I hope you will consider addressing in your ‘Ask David’ segment of the podcast), I would like to extend my gratitude to you. Your book, Feeling Good, came to me at a time when I was struggling to make sense of my depression and anxiety, and it has been a vital part of my recovery journey. The exercises and the podcast have been such lifelines, and I am grateful to you for the incredible and life-changing work that you do.
I know you have addressed the topic of suicide in a previous episode, but I recently was struck by a piece of news from my alma mater, the University of Pennsylvania, where a senior member of the college’s counselling services (CAPS) died by suicide. Here was someone who had spent his life’s work on promoting suicide prevention, and had a great deal of knowledge on resilience. How can we process/understand the decisions that someone like this might make to take his life. How can I arrive at the understanding that his decision doesn’t necessarily spell doom for the rest of us? What TEAM-CBT exercises can we do to make sense of the world when it might not make much sense at first glance, during situations like these?
Thank you very, very much,
Sindhu
Dr. David’s Answer
Thanks, Sindhu, this is a really great question.
I’ll put this in the Ask David folder. Should I use your name?
Here’s the short answer. It’s a lot like saying that an infectious disease expert shouldn’t get pneumonia, or that an orthopedic surgeon shouldn’t have back pain, or a broken leg. I know of at least three mental health professionals who have committed suicide, but my knowledge based is tiny. I’m sure there are thousands of mental health professionals who have committed suicide.
People can commit suicide for many reasons, and I can only mention a few here, as my knowledge, like yours, is limited.
Hopelessness is one of the most common causes of suicide in depressed individuals. Hopelessness always results from cognitive distortions, and never from a valid appraisal of one’s circumstances. Depressed people often turn to suicide, thinking (wrongly) that it is the only escape from their suffering.
You may have done something that you are profoundly ashamed of, and fear it is about to be made public. Like the fellow in New York arrested for child abuse who hung himself just a few weeks ago.
I am convinced that sometimes people commit suicide to get back at someone they are angry with, someone perhaps who rejected them.
Physician-assisted suicide. I believe that physician assisted suicide is absolutely indicated and compassionate if someone is in excruciating pain from an irreversible terminal illness.
The Achievement Addiction. Feelings of failure and worthlessness. In our culture, we sometimes (wrongly) base our feelings of self-esteem on our success in life, our income, or our achievements. And so, if your achievements are only “ordinary,” you may feel worthless, like “a failure,” and kill yourself.
The Love Addiction: Many people (wrongly) tell themselves they must be loved to feel happy and worthwhile, and then kill themselves when they are rejected by someone they thought they loved and “needed.”
Drug and alcohol abuse: These habit, when severe, can greatly disrupt a person’s life. They can also make someone more impulsive, and more likely to jump or pull the trigger when intoxicated.
There are likely way more causes than just these common ones. For example, a psychotic process like schizophrenia might sometimes play a role as well.
I suspect you may have a hidden “Should Statement,” telling yourself that a mental health professional “should not” get depressed or have the urge to commit suicide. But to me, that would be a nonsensical claim, and it isn’t even clear to me why you might think that way. In fact, most people are drawn to this profession because of their own unresolved suffering. There is, I suspect, MORE depression and anxiety in mental health professionals, but I have not seen data, so I’m not certain of this. But I’ve trained tens of thousands of mental health professionals, and pretty much ALL of the ones I’ve known personally have struggled at times, and sometimes intensely.
People also ask, “Why did so and so commit suicide? S/he was so famous and loved and wealthy!” Well, famous and loved and wealthy people often suffer and commit suicide, too.
Finally, I would say that suicide is both tragic and devastating—for the patient for sure, for the family and friends who typically suffer for years, and for the therapist as well. Fortunately, the family and friends can be helped, if they ask, but it is too late for the person who was depressed. And the tragedy is needless in most cases, since the patient’s intense negative feelings can be treated effectively in nearly all cases.
David
Question 2. How can you find out if a friend or loved one is suicidal?
Many people are afraid to ask a depressed friend or family member if they are feeling suicidal, fearing this will create conflict or may even cause the person to become suicidal. For the most part, these fears are unfounded, and the biggest mistake could be avoiding the topic.
Most people who are feeling suicidal are willing to discuss their feelings fairly openly. Several types of questions can be useful.
Suicidal thoughts or fantasies. Most people with depression due have suicidal thoughts or fantasies from time to time, and these are not necessarily dangerous.
First, you can ask, “do you sometimes feel hopeless, or have thoughts of death, or wishing you were dead?” If s/he says yes, you can ask him / her to tell you about these thoughts and feelings. You can also ask if s/he thinks of suicide as the only way out of his / her suffering.
Second, you can ask if s/he simply has passive suicidal thoughts, like “Sometimes I feel like I’d be better off if I were dead,” or active suicidal thoughts, like, “Sometimes I have fantasies of killing myself.”
Suicidal urges. You can ask if s/he sometimes has urges to kill himself / herself. Suicidal thoughts or fantasies without suicidal urges are usually not especially dangerous.
Suicidal plans. You can ask if s/he has made any plans to actually commit suicide. If so, what method would s/he use? Jumping? Shooting? Hanging? Cutting?
You can also ask if s/he has been acting on these plans. For example, if shooting is the choice, you can ask if s/he has access to a gun and bullets. If jumping is the choice, you can ask where s/he plans to jump from.
Deterrents. When evaluating suicide, you can also ask if there are any strong deterrents, such as religious beliefs, impact on family and friends, and so forth. If there are no strong deterrents, the situation is more dangerous.
Desire to live, desire to die. You can also ask the person how strong their desire to live is, and how strong is their desire to die?
Past suicide attempts. If the person has made suicide attempts in the past, the risk of a future suicide attempt is greater.
Drugs and alcohol. You can ask if the person drinks or uses drugs, and has ever has a stronger urge to commit suicide when intoxicated. This is a danger sign.
Impulsiveness. Some people make suicide attempts when they’re feeling impulsive, kind of on the spur of the moment. You can ask if they every have these kids of sudden impulses.
Willingness to reach out. You can ask if they’d be willing to reach out and ask for help if they ever have a suicidal urge.
Honesty. You can ask if they were felt reasonably open and honest in asking your questions, or if it was difficult to answer some of the questions.
Once you have explored these types of questions, you can decide whether action is necessary. If the person seems in danger of making a suicide attempt, you can bring him / her to an emergency room for an evaluation.
If s/he refuses, you can dial 911 and ask for help. Generally, the police will come immediately and do a safety check, and bring the person to an emergency room involuntarily if necessary. You can also call his or her therapist and alert that person to the situation.
This may all sound grim and very unpleasant, but these kinds of conversations can sometimes be lifesaving, and can protect you from much greater pain later on.
In a future podcast, we will focus on this question: How do you treat someone who is suicidal using TEAM-CBT?
David D. Burns, M.D. & Rhonda Barovsky, Psy.D.
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com. Today’s featured photo is courtesy of Nancy Mueller–www.nancymuellerphotography.com.
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
* * *
I have two tremendous one-day workshop scheduled with my esteemed colleague, Dr. Jill Levitt, next year–
Workshops in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in psychotherapy. Nearly all therapeutic failure results from the failure to address resistance effectively. Therapists do not understand what causes resistance or how treat resistant and oppositional patients who “yes-but” you or fail to follow through on homework assignments.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
You can join this workshop in person or online (live streaming) from anywhere in the world!
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
You can join this workshop in person or online (live streaming) from anywhere in the world!
How does someone deal with burnout if they don’t have the means to quit their job and don’t think they have time for therapy?
How can you say “No” and set boundaries at work?
Won’t people be disappointed in you if you say no?
What should I do if I hate my therapist?
What qualities should people look for in a therapist?
If someone is struggling with anxiety, they don’t want to just go to any therapist, they want to find someone who can really help them. How can find a therapist who has the specific skills that will help you?
If you disclose a problem such as substance abuse, is my therapist required to report it?
Why do I only get angry/upset with my inner circle including my family and partner?
I feel so insecure, small and insignificant in the real world. How can I help this feeling of overwhelming fear and anxiety?
Can you describe how you’ve seen the evolution of your patients change over the past few years? Because mental health is a bigger topic in the media, more people are talking about it, and more people are open to seeking help. It’s slowly becoming less stigmatized. So have you seen the attitudes of your patients change? And have you seen the levels of resistance that they come in with change over the past few years?
What makes TEAM-CBT different from other forms of therapy practices?
And more!
I hope you enjoy Jill’s interview!
David
* * *
You may have missed the Calgary and South San Francisco intensives, but there will be one more awesome intensive this fall, and it’s right around the corner!
High-Speed Treatment of Depression
and Anxiety Disorders
A Four-Day TEAM-CBT Advanced Intensive
November 4 – 7, 2019
The Atlanta, Georgia Intensive
I also have two tremendous one-day workshop scheduled with my colleague, Dr. Jill Levitt, next year–
Coming up in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
I just wanted to tell you I LOVED the latest podcast on when not to help. I know you mentioned you’ve covered many of these ideas before, but this podcast really helped it all sink in for me, especially as a non-therapist. Also, I can’t seem to find Dave’s email, but I wanted to say I thought he added some especially valuable perspectives as a non-therapist.
Rhonda, I absolutely loved the story you shared about your son. And I’m so grateful for the therapist that allowed her 5 secrets response to be played. Listening to that was incredibly eye-opening – I’ve made the same mistake countless times but didn’t really get it until now.
Thank you both for all your amazing work on these podcasts!
best,
Daisy
David’s Reply
Thanks Daisy for your kind and thoughtful comment! I’m so glad this message is “getting through” at last! Some ideas are so hard to convey, because they seem to go against our natural human impulses, like the urge to jump in and “help” or “rescue” a friend or loved one who is in distress.
David
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com.
If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.
* * *
You may have missed the Calgary and South San Francisco intensives, but there will be one more awesome intensive this fall.
High-Speed Treatment of Depression
and Anxiety Disorders
A Four-Day TEAM-CBT Advanced Intensive
November 4 – 7, 2019
The Atlanta, Georgia Intensive
I also have two tremendous one-day workshop scheduled with my colleague, Dr. Jill Levitt, next year–
Coming up in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
The Incredible Atlanta Intensive Is Just Around the Corner—November 4 – 7, 2019!
With David D. Burns, MD
The Atlanta intensive is just days away, and there are still a few slots open! If you need 32 CE credits, or want to learn state of the art therapy techniques for depression and all of the anxiety disorders, you might want to consider this amazing workshop.
You’ll work incredibly hard for long hours, but this training will change your life. You’ll discover that incredibly rapid recovery from depression and anxiety is now possible, and I’ll show you how to use these techniques this with your most difficult and challenging patients.
This will be my first east coast intensive in more than 25 years. I’m older now, and less excited by airports! But it’s always fun teach in Atlanta.
The intensives are usually mind-blowing. You’ll probably experience personal enlightenment, with freedom from feelings of self-doubt and insecurity. You’ll also learn many incredible therapy techniques that can transform the way you do therapy. This workshop will provide you with greater feelings of satisfaction in your clinical work and in your personal life as well.
The registration website has been impaired, and is now being fixed. Please persist if you’re having trouble with registration. Or, call Courtney Kendler right away. She can register you personally if needed: 1-248-978-7787.
I hope to see you in Atlanta!
Warmly,
David D. Burns, MD
This will be my first east coast intensive in more than 20 years! If YOU can join me, it will be over the top!
This workshop has been approved for Levels 1 through 3 TEAM-CBT Certification and is suitable for novice as well as highly experienced therapists and coaches. Graduate students are also welcome.
The intervention on anxiety was so inspiring. Very powerful . . . a healing and amazing experience!
I loved the Stage Fright demonstration. The stage was full of such beautiful people. I love your spontaneity, David, normalizing it with your nightmarish experience. Yeah! Celebrate!
Such a safe environment. Vicarious healing. Awesome!
Superb at all levels. Dr. Burns’ brilliance shines through even in the difficult moments.
The unplanned and spontaneous anxiety (fear of public speaking) group was a real WOW!
It was beautiful!
It was Fantastic to see all the people with public speaking anxiety get up on stage. Fantastic! They looked at the fear monster in the face and realized it has no teeth!!
The Externalization of Voices role-play was awesome.
Love the sensibility of joyous failure!
Fantastic training!
Amazing!
David’s integration of philosophy and spirituality into the TEAM-CBT model—absolutely brilliant! An amazing experience!
Today was very emotional for me. I didn’t have the courage to get up on stage and speak about my public speaking anxiety, but it was a wonder to watch the other participants share their own struggles. It brought tears to my eyes. Wonderful!
During the practice with the Externalization of Voices, I experienced a shift that I did not think would be possible.
Demos, role-plays. Helpers were fantastic, supportive. I learned a lot. Lots of tears. Facing my demons. Thank you, Dr. Burns!
I think these ideas are light years better than most things that typically happen in therapy! Very motivating!
We saw healing happen before our very eyes!
Wow, fabulous! To go through the whole exercise was rewarding. The helpers were awesome. Thank you, Dr. Burns, for your awesomeness and helpful, brilliant mind.
WOW WOW WOW! No words needed. AMAZING! Thank you for this experience!
Thrilling!
Superb!! Thank you, Dr. Burns!
Our helper was awesome. Loved the night session! A+!
Lately, I’ve received numerous emails asking, in essence, “how can I help my loved one who has this or that problem?” I would say that I get several emails like that every week.
For example, here’s one from a man we’ll call “Karl.”
Love you podcasts. Listen as often as I can. keep reading your books.
Our son is in an unhappy marriage. Last night we talked and he mentioned that there is no love in their marriage. Just coldness. The children “feel” the chasm. There is a lack of trust in the home.
Our son feels he did not protect the children in defense of their mom, even though he disagreed with her. Now the children feel their father does not have their best interests. Our daughter-in-law feels that everything is fine. She uses the passive-aggressive “silent treatment” to punish others.
Our son says she is controlling and manipulative, and that the children have become that way also. There’s no truth in the home. Years ago, she wanted them to go to counseling, but our son refused; now the tables are turned.
Sad. We want to help but don’t know how to approach it.
What podcasts would be helpful to us? And to our son and daughter-in-law? We visit our grandchildren often, sometimes one-on-one. Communications are open with them and with our son.
Daughter-in-law feels, and tells others, we are conspiring against her
Karl
Thank you Karl, for that moving email. It can be really sad and frustrating to see a couple in conflict who are at odds with each, especially when your son and grandchildren are involved. And I can imagine you might also be feeling anxious and a bit helpless, and deeply concerned!
When I wrote Feeling Good forty years ago, I tried to make it clear that the cognitive therapy tools I described in that book are for people to use to help themselves. It is okay to correct your own distorted negative thoughts in order to break out of a bad mood. But it is generally NOT a good idea to try to correct someone else’s distorted thoughts, because they’ll just get ticked off at you!
This is a very understandable error, because you may get really excited by the things I’m teaching, and how helpful they can be when you’re feeling depressed, anxious, or insecure. So it just makes sense that you would want to share these tools with others.
But those are generally NOT the tools to use when you’re talking to your son, daughter, spouse, or friend who’s feeling down in the dumps. There is a way to help someone you love who’s hurting—but you’ll have to use an entirely different set of tools and skills—the Five Secrets of Effective Communication—WITHOUT trying to “help.”
So, the short answer to your question is—skillful listening is all that’s called for. Anything more runs the risk of getting you into trouble. But this may require a radical change in the way you communicate, as well as your personal philosophy.
Let’s talk about what TO do, and what NOT to do when patients, friends or people you care about express angst, or seem troubled, or describe problems in their lives, and they seem to be hurting a lot.
DO NOT
Give advice
Try to help
Try to cheer the person up
Try to solve the problem s/he is struggling with
Try to get the other person to think or act more positively
Try to minimize the problem by saying it’s not that bad, or things will get better.
Point out ways the other person may be thinking or acting in a self-defeating manner.
Before we tell you what does work, let me focus on just one of these errors, to bring it to life for you. Recently, Rhonda and I recorded a live therapy session with a man named who was upset because his mother had lost the use of her legs to due a rare neurological disorder, and needed much greater care in an assisted living facility. This required selling the house his mother was living so they could afford the assisted living facility, and it was a great loss for everyone, since Kevin was raised in that house, and his parents and grandparents had lived there, too.
After Rhonda and I empathized with him for about thirty minutes, we asked the other therapists to offer empathy as well, as part of their practice and training that evening. We stressed the importance of simply summarizing what Kevin had told us (Thought Empathy) and how he was feeling (Feeling Empathy), without trying to “help.” One of the therapists, who was new to the group, kind of missed the mark, She did what we call “cheerleading,” telling Kevin what a wonderful and heroic person he was without acknowledging what he’d be saying and how painful it was for him.
You’ll hear this brief excerpt from the session in the podcast. When we asked Kevin how he felt about her comment, he had to tell her that he was embarrassed, and not helped, by what she’d said.
Here’s why. When you don’t acknowledge someone’s profound negative feelings of loss, anxiety, sadness, anger, and more, you might unintentionally convey the message that you don’t want to hear about how they really feel inside. And when you cheerlead, it also conveys the message that the person is not very intelligent, and simply has to be cheered up, and then everything will be okay!
We cannot be too hard on this therapist, because her efforts came from the heart, and I’m sure she felt sad for this man. And most of us have made the same mistake at times, or even often. I frequently hear parents trying to cheer their children up, or trying to tell their children what to do, or how to change, without really listening.
But, most of the time, it just doesn’t work like that!
Now that you know what NOT to do, what can you do that WILL help?
DO
Use the Five Secrets of Effective Communication, with an emphasis on the listening skills. One of the most important skills is called Feeling Empathy—simply acknowledging how the other person is feeling, and asking them to tell you more, and if you got it right.
For example, let’s say a friend or family member is procrastinating on something important, like a research report or college application, and is feeling pretty upset and self-critical. You could say something like this: “It sounds like you’re beating up on yourself for procrastinating, I’m wondering if you’re feeling
down, sad or depressed?
anxious, worried, pressured, or nervous?
guilty or ashamed?
inadequate, worthless, defective, or inferior?
alone or lonely?
humiliated or self-conscious?
discouraged or hopeless?
stuck or defeated?
angry, annoyed, hurt, or upset?”
I find that people really like it when I ask these questions, and I let them answer each one. Then I ask them about their negative thoughts. What are they telling themselves? What are the upsetting messages?
When you use this approach, you are literally doing nothing to “help” the other person, but if you listen skillfully, she or he will probably really appreciate your listening, and you may end up feeling really close. In fact, I (David), had this exact experience just a couple days ago with a student who was struggling and feeling down.
Often, the person who’s depressed will be someone you love, like a family member, so your concerns for him or her, and your desire to “help,” are an expression of your love. But listening skillfully will likely be a whole lot more effective. And you can express your own feelings, too, with “I Feel” Statements, like “I feel sad to hear how down you’ve been feeling, because I love you a lot.”
Example
A woman named Clarissa was concerned because her son, Billy, who is in his early 20s, had been severely depressed for several years, and had not responded to treatment with antidepressants and even lithium. Clarissa had read my book, Feeling Good, and listened to almost all of the Feeling Good Podcasts. She described herself as a true “TEAM-CBT convert because she’d worked with a therapist trained in TEAM-CBT and no longer suffered from the depression and anxiety she’d struggled with most of her adult life. She agreed with a lot of what I’d said on the podcasts about the chemical imbalance theory (there’s no convincing evidence for it) and antidepressants (recent research suggests they do not outperform placebos to a clinically significant degree).
But Billy was saying things like this:
“Mom, I KNOW I have a chemical imbalance because this cloud will suddenly come over me, and I feel TERRIBLE. It’s not about negative thoughts—I don’t have any negative thoughts. My depression is clearly the result of a chemical imbalance, and I feel doomed by my genes.”
Then Clarissa would try to cheer him up, which always failed, or would try to convince him that it’s not about a chemical imbalance and that if he really tried TEAM-CBT, he could overcome his depression, just as she had done. These are such common errors!
How could Clarissa respond more effectively? If she focuses on good listening skills, instead of trying to win an argument, she might say something like this:
“Billy, I really love you, and feel so sad to hear about your depression. You’re absolutely right, too. Sometimes a bad mood seems to come from out of the blue, with no rhyme or reason. And genes can be important. I’ve struggled with depression in the past, and maybe you’ve inherited some of my genes. Tell me more about how you’ve been feeling. Have you been feeling down, anxious, ashamed, hopeless, or angry? What you’re saying is so important, and I really want to her what’s it’s been like for you.”
Can you see that Billy would be more likely to open up and might even share some things that he’s been hiding, out of a sense of frustration, anger, or shame? And can you also see that providing some love and support—pure listening, with compassion—might be a lot more helpful than getting into an argument about the causes of depression? He might open up about all sorts of things that have been eating away at him—problems with girls, sex, sports, or his studies, or concerns about his looks, or even feelings of shame about his depression.
The next question is—when DO you help someone? And HOW do you help them.
The approach I use as a therapist might be the same approach you’d want to use. At the beginning of every therapy session, I empathize without trying to help, exactly as I’ve been teaching you in this podcast, and in this document, and I give the other person some time—typically about 30 minutes or so—just to vent while I use the Five Secrets of Effective Communication—listening skillfully—without trying to “help.”
Then I ask the patient to grade me on empathy. I say, “How am I doing so far in terms of understanding how you’re thinking and feeling? Would you give me an A, a B, a C, or perhaps even a D?”
Most of the time, the other person WILL give you a grade. If they give you an A, you’re in good shape. But if they give you an A-, or a B+, or worse, ask them to explain the part you’re missing, or not getting right.
When they tell you, you can use the Five Secrets again, summarizing the part you missed, and then ask what your grade is, to see if you’ve improved. Usually, your grade will improve a lot.
Do NOT try to “help” until you received an A!
So, let’s assume you’ve gotten an A. What then?
Then I do what’s called the Invitation Step in TEAM therapy—I ask if the other person wants help with any of the problems s/he has been discussing. You can ask the same question.
If the other person does NOT want help, but just wanted to talk and get support, your job is done. You can also ask if they want to talk some more. Most of the time, all people want is a little listening and support, and they’re not looking for help or advice.
But if the other person DOES want help, you can ask what kind of help they’re looking for. Then you can decide if you’re in a position to provide that type of help. Sometimes, the help they’re looking for might not be something you can provide. For example, they may be angry at someone they’re not getting along with, and may want you to tell the other person to change. I explain that this is not something I would know how to do, but I could possibly help them change the way they interact with that person.
This may sound really simple, but it takes a lot of practice and determination! It can be a lot harder than it looks.
Many people will NOT want to go down this road, and will insist on jumping in to help or cheerlead. You can do that if you want, but in my experience, pushing help on people who are hurting is rarely helpful. The “need” to help or rescue can result from your love and compassion, but it can also result from narcissism, codependency, or the desire to control or dominate another person. I see it as a kind of an addiction, too.
If you want to learn more about this, here are some things you can do:
You can read my book, Feeling GoodTogether, and do the written exercises while reading, so you can master the Five Secrets of Effective Communication. This is a BIG assignment, but the reward, in terms of more loving and satisfying relationships with the people you love, will be equally great.
You can try using “I Feel” Statements and Feeling Empathy with at least one person every day this week.
David D. Burns, M.D. & Rhonda Barovsky, Psy.D.
You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com. Today’s featured photo is courtesy of Nancy Mueller–www.nancymuellerphotography.com.
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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You may have missed the Calgary and South San Francisco intensives, but there will be one more awesome intensive this fall.
High-Speed Treatment of Depression
and Anxiety Disorders
A Four-Day TEAM-CBT Advanced Intensive
November 4 – 7, 2019
The Atlanta, Georgia Intensive
I also have two tremendous one-day workshop scheduled with my colleague, Dr. Jill Levitt, next year–
Coming up in 2020
High Speed Methods to Reduce Resistance and Boost Motivation
This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.
Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!
The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts
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.
