Rhonda and David discuss two challenging questions submitted by listeners like you.
Question #1: Cindy asks: My suicidal daughter refuses to talk to me! What can I do?
Comment: Dear David,
I stumbled upon you teaching in another podcast a few months ago. Immediately I was stunned by how much your words echoed in my mind. I have listened to your book three times in Audible and many of your podcasts. You Changed my life!!!
I am much more relaxed now and I can sleep!!! I talked about you with my massage therapist and she bought your book for her daughter (who has anxiety attacks) and her niece. Her daughter is an aspiring artist who said that she would buy your book and give them away to teens when she becomes famous.
I now ask you to change another life, that of my daughter’s. She has been depressed for more than 20 years, suicidal (bought a noose, watches suicide movies, talked about ways to kill herself) and no therapists could help. We went to therapy together this past summer and it only ended that she abruptly canceled and is no longer responding to me by any means: phone, text, card, or email. The last time I saw her was late August and she was very down and had very poor personal hygiene. I have since sent her a loving text at least every other day, I offer to drive to her city (an hour away) to have dinner with her, I sincerely apologized for everything I could think of that I have done wrong since she was a child, I sent gifts to her by mail, I invite her to come for holidays, I ask her cousins to call (she did respond to them). No response to me at all. I am wondering how to communicate with a loved one who just totally shut you off.
Always your fan,
Cindy
Thank you, Cindy. Sorry to hear about your daughter, very concerning. My heart goes out to you. Our own daughter had a rough time as a teenager, too, but now is doing great. I hope things evolve with your daughter, too.
The first podcast highlights common errors in trying to “help” someone who is hurting, and emphasizes how to respond more effectively, using the Five Secrets of Effective Communication.
The second podcast illustrates how to get people to open up using one of the advanced secrets called “Multiple Choice Empathy / Multiple Choice Disarming.
My book, Feeling Good Together, explains these techniques in detail, with practice exercises, and includes an entire chapter on how to talk to someone who refuses to talk to you. You can learn more on my book page. (https://feelinggood.com/books/). Some support from a mental health professional might also be helpful to you, as these techniques sound simple, but are actually challenging to master.
Your daughter might also benefit from my book, Feeling Good: The New Mood Therapy (https://feelinggood.com/books/). It is not a substitute for treatment from a mental health professional, but research studies indicate that more than 60% of the people who read it improve significantly in just four weeks. It is inexpensive, and I’ve linked to it if you want to take a look.
All the best,
David
Question #2: Lorna asks: How can I deal with my jealousy?
Comment: Hi David,
I’ve recently discovered your books and your podcast and CBT has really been helping me in my personal life. I really want to thank you for all the amazing work you do!!
The issue I’m having however seems to still really get my moods down and I was wondering if perhaps you could offer some general advice via the podcast.
I’m in a great relationship but the ex-girlfriend of my partner has recently moved back to the city where we live and now we are in similar social circles. They were together for a very long time and now I’m really struggling with the prospect of spending time with her.
When we all spend time together, it’s actually fine, but afterwards I really struggle with thinking about them together, getting to know her and thinking about her personality and how we compare.
I think most people would find this uncomfortable, but it really has triggered a downward spiral for me. My partner and I argued about it and I struggle to let things go that were said in arguments.
Do you have any advice on dealing with a situation of an ex-partner being on the scene and perhaps how to not dwell on things that were said during arguments?
Thanks,
Lorna
Hi Lorna,
Thanks, might work. What does this mean: “Do you have any advice on dealing with a situation of an ex-partner being on the scene and perhaps how to not dwell on things that were said during arguments?”
The rest of the email seems to suggest feelings of jealousy, insecurity, and so forth, as if she is a threat to your current relationship. is this correct?
david
Hi David,
Thanks so much for getting back to me!
I don’t actually think she is a threat to our relationship, and don’t feel that they have feelings anymore for each other, but it just makes me super uncomfortable to think about how long they spent together.
I’m always comparing our relationship to what I think their relationship was like in the past. I know I should stop thinking about those things but I really struggle to stop!
I know my partner and I are very much in love but I keep having thoughts like
“It’s not fair that I have to spend time with her,” or
“I feel really guilty because he wants to be friends with her but can’t due to how I feel about the situation.”
I also feel like he blames me.
I was hoping you could shed some light on what you think in general is a good strategy for dealing with situations where an ex-girlfriend/boyfriend of your partner is on the scene and you all have to spend time together.
I do have feelings of jealousy and insecurity but I struggle to understand why as I don’t believe they want to be together anymore at all.
We had a few arguments about it initially where he said things like “you are just angry that I have an ex-girlfriend” or “what’s the big deal about it all?”
I was so hurt by the way he made my feelings seem petty and trivial. We have both apologized but I keep remembering what he said and how hurt it made me feel.
Do you have any advice on letting go of past arguments when the ‘problematic situation’ (ex-girlfriend being around) is still on-going?
Thank you so much!
Lorna
David and Rhonda discuss this question, and include David’s story in Intimate Connections as a medical student when David had a broken jaw and the ex-boyfriend of Judy, the girl he was living with in Palo Alto, charged into his house with a tough-looking friend and demanded to see Judy. David called the police, and the two fellows left and set, “we’re going to get you!” David was terrified, since his jaw was still broken, and got some jaw-dropping advice the advice from his buddy, Sergio. You will be surprised to hear about what happened next!
In addition to learning to “let go” of jealousy, Rhonda and David discuss many additional strategies for dealing with jealousy, including:
Use of Self-Disclosure
Positive Reframing: do you really want to give up your jealousy and vigilance?
Cost-Benefit Analysis: Is it worth the hassle of constantly being suspicious, as opposed to simply deciding to trust and let the chips fall here they may?
Downward Arrow: What are you the most afraid of?
Love Addiction
Fear of Rejection
Fear of Being Alone
Overcoming the fear of being alone and the “need” for this man’s love, or any man’s love, is discussed in the first section of Intimate Connections.
Exposure: You could fantasize the two of them together, making yourself as anxious and jealous as possible, until the feelings diminish and disappear.
Self-Monitoring: Counting your thoughts about them on a wrist counter or cell phone for four weeks. David describes his work with an intensely jealous law student after his girlfriend broke up with him so she could date another fellow in his class.
Understand the frequent ineffectiveness of apologizing, and why it doesn’t work! This is really important. David describes a powerful vignette about a troubled couple, where “I’m sorry” was CLEARLY a way of saying “shut up, I don’t want to feel about how hurt and angry you feel.” The Five Secrets of Effective Communication are a vastly more effective way of dealing with negative feelings. David and Rhonda contrast effective vs. dysfunctional “apologizing.”
While it can be important to say “I’m sorry,” this formulaic response is usually insufficient because it often ends the conversation but the difficult or hurtful feelings remain. What’s important to add is talking about the other person’s feelings, thoughts and experiences of the conflict and sharing your own thoughts and feelings.
When you say, “I’m sorry,” it’s sometimes insufficient because it often ends the conversation, but the difficult or hurtful feelings remain.
What’s important to add is talking about the other person’s feelings, thoughts and experiences of the conflict and sharing yours.
After David emailed Lorna with the outline for the podcast, Lorna replied:
Hi David,
Thank you sounds great! Can’t wait to listen to the episode. I think I will definitely order your book – I think it’s the only one missing for me to have the complete collection. Thanks again!
Lorna
Thanks for listening today! By the way, if you are looking for CE credits or training in TEAM-CBT, my upcoming workshop on therapeutic resistance on February 9, 2020 will be a good one. You’ll learn how to use the techniques described in today’s podcast.
See below for details and links!
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.
A practical 4-week online course for therapists with
Jill Levitt, Ph.D.
Highly Interactive
Live Online Training
Fridays 11 am – 12:45 pm PST (2 – 3:45 pm EST)
4 weeks starting 2/7/20
You’ve got powerful tools to help your patients change, and you see great progress with lots of your patients, but what about the times when you find yourself working harder than your patients? Do you like pushing your patients to change and watching them dig in their heels or subtly resist your help?
If you would like to try a different approach, join us and learn how to boost motivation and get unstuck with your most challenging patients using tools from TEAM-CBT developed by Dr. David Burns.
When: Four Fridays in a row starting 2/7/20 (11 am-12:45 pm PST / 2-3:45 pm EST)
Who: Mental health professionals and graduate students
Instruction level: beginner to advanced.
Instructor: Jill Levitt, Ph.D
Price: $240, Offers 7 CE Hours*
We will use a combination of live group didactic sessions together with practice and role play, with an emphasis on skill-building of powerful tools and techniques in a warm and supportive environment.
I’ll be doing two cool one-day workshops on topics of enormous importance:
How to overcome therapeutic resistance and boost patient motivation on February 9, 2020. This is the most important topic in all of psychotherapy, and the methods you will learn are innovative, surprising, and powerful. The focus will be on melting away therapeutic resistance in patients with depression (morning session) and anxiety disorders (afternoon).
On May 17, 2020 we’ll show you the best techniques to smash each of the ten cognitive distortions first described in my book, Feeling Good: The New Mood Therapy.
I’m thrilled to be joined at both workshops by my esteemed colleague, Dr. Jill Levitt. We love to teach together because it makes for a dynamic and fun dance of learning. If you’ve heard us before, you know that Jill is warm, brilliant, and incredibly clear, so you can really LEARN and master techniques that can transform your practice.
You can join both online from anywhere in the world, or join us in person in Palo Alto for free breakfast, lunch, and schmoozing! You’ll find the details below.
David
Coming Soon
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 also spotted an error in the blog I just sent out. The error was an error in the audio file for the Monday, January 13, 2020 (not January 6) podcast on “What if I really am a useless human being?”
I have also discovered that on the list of Feeling Good Podcasts, all the podcasts from #17 to the present time are off by 1. I am checking with a colleague to see the best way to fix this, as the list is an extremely valuable resource.
I apologize for some glitches we are fixing since the launch of the newly remodeled website, and hope you will like the new version!
Hungry for Some Awesome Training?
BI’ll be doing two cool one day workshops on topics of enormous importance:
How to overcome therapeutic resistance and boost patient motivation on February 9, 2019. This is the most important topic in all of psychotherapy, and the methods you will learn are innovative, surprising, and powerful. The focus will be on melting away therapeutic resistance in patients with depression (morning session) and anxiety disorders (afternoon).
I’m thrilled to be joined at both workshops by my esteemed colleague, Dr. Jill Levitt. We love to teach together! When we teach together, it makes for a dynamic and fun dance of learning. If you’ve heard us before, you know that Jill is warm, brilliant, and incredibly clear, so you can really LEARN and master concepts and practice techniques that can transform your practice.
You can join both online from anywhere in the world, or join us in person in Palo Alto for free breakfast, lunch, and schmoozing! You’ll find the details below.
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!
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.
For many of you, there was an error in the audio file for the Monday, January 6, 2020 podcast on “What if I really am a useless human being?” I have corrected this problem, and you can find the show notes with the fully functioning audio file at this link. Rhonda and I apologize for this error, and greatly appreciate your interest and support!
You can also play the audio right here, but the show notes may also be of interest to you and you’ll find those at the link above.
Hungry for Some Awesome Training?
BI’ll be doing two cool one day workshops on topics of enormous importance:
How to overcome therapeutic resistance and boost patient motivation on February 9, 2019. This is the most important topic in all of psychotherapy, and the methods you will learn are innovative, surprising, and powerful. The focus will be on melting away therapeutic resistance in patients with depression (morning session) and anxiety disorders (afternoon).
I’m thrilled to be joined at both workshops by my esteemed colleague, Dr. Jill Levitt. We love to teach together! When we teach together, it makes for a dynamic and fun dance of learning. If you’ve heard us before, you know that Jill is warm, brilliant, and incredibly clear, so you can really LEARN and master concepts and practice techniques that can transform your practice.
You can join both online from anywhere in the world, or join us in person in Palo Alto for free breakfast, lunch, and schmoozing! You’ll find the details below.
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 Level 4 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!
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.
Rhonda and David address a question from Karolina, a therapist in Poland who was failing with a depressed patient who felt totally convinced he was a “useless” human being. I think you will find their discussion of this case fascinating, as it deals with the cause of practically ALL therapeutic failure, and illustrates the solution al well, using TEAM-CBT methods and concepts.
Today’s podcast is intended for therapists and patients alike!
For the show notes, we are including the email David received from Karolina, as well as his initial response.
Dear Dr. Burns,
I’ve been listening to your podcast for 6 months now and it’s been so helpful with my work as a therapist as well as in my personal life. I’m starting to develop a habit of considering every unwanted state with a “what does it say that’s awesome about me?” and I’m much happier now :).
I’m wondering if you’d consider helping me some more. I have a client who’s been struggling with depression for many years. At the moment he’s doing ok and his mood is up. Lately the topic of his uselessness came up again and he’s willing to work on that. He said he’ll consider the possibility that he’s not a useless human being and asked me to not to dismiss the possibility that he is – that’s how he’ll know that I’m not just trying to cheer him up.
It’s been bugging me ever since. Although I’ve agreed, I really can’t find in me any part that is ready to think that. I strongly believe he’s not a useless person. I can’t imagine labeling anyone in that way and in his case it feels so personal as I like him very much and I care about him.
I’m starting to have dreams about our next session when I fail him by trying to convince him to think as I do. How can I be open about our conclusion when my mind is already fixed? Any thoughts on this would be deeply appreciated.
Best wishes from Poland
Karolina
Hi Karolina,
Thanks! The term has no meaning. It is just a vague put down, like what a bully might say.
I might ask him what time of day he was feeling useless, and then have him fill out a Daily Mood Log for that moment, step by step. We can only help him at one specific moment.
You can use a large number of techniques but must first get an A on Empathy, and then do effective paradoxical agenda setting, starting with the Paradoxical Invitation Step and then asking “what type of help would you be looking for?” then you can do the Magic Button and Positive Reframing.
All of the negative thoughts and feelings on the Daily Mood Log will be advantageous and will show something about him that is awesome and positive. You should be able to generate a list of at least 25 overwhelming positives. Then you can use the Magic Dial.
When you get to M = Methods, you can put the thought, “I am a useless human being” in the middle of a recovery circle, and then select a minimum of 16 methods to challenge it.
You can start with Identify the Distortions. There are likely at least 9 distortions in the thought, including AON, OG, MF, DP, MAG / MIN; ER; LAB; SH; SB.
You can try, “let’s define terms,” and ask what’s the definition of a “useless human being”? You’ll find that no matter how you try to define it,
The definition will apply to all human beings.
The definition will apply to no human beings.
The definition does not apply to him.
The definition does not make sense.
The definition is based on some kind of arbitrary cut-off points.
You can do this as a role-play, being a close friend trying to find out if you’re useless, and asking him for guidance on how to find out.
You can do the Paradoxical Double Standard Techniques, Downward Arrow, Hidden Emotion, Externalization of Voices, Acceptance Paradox / Self-Defense Paradigm, Examine the Evidence, Semantic Method, and on and on.
The problem is NOT that he’s a “useless human being” but rather that he’s obsessing and wasting time on a meaningless construct, and beating up on himself.
The whole key to success will be agenda setting. You can take the position that maybe this is not something that he really wants to challenge, since it may be working for him, and also reflects all those 25 wonderful things about him.
The whole key to success will be agenda setting. You can take the position that maybe this is not something that he really wants to challenge, since it may be working for him, and also reflects all those 25 wonderful things about him. Remember that just about 99.9% of therapeutic failure results from Agenda Setting errors. Is this something you want to help him with, or something he is desperately asking you for help with? I am almost 100% positive that this is your agenda, not his. In fact, your need to “help” him with this may actually keep him stuck.
In fact, here is the proof. You write: “I’m starting to have dreams about our next session when I fail him by trying to convince him to think as I do. How can I be open about our conclusion when my mind is already fixed?”
If you don’t understand this, I recommend some supervision from a TEAM therapists or join one of the online classes, or attend my workshop on resistance, coming up in a month or so, check out my website workshop page for details. You can join online.
David D. Burns, M.D.
Hi Dr. Burns,
Thank you so much for your quick and thorough response!
I kinda felt that my “helping” is the issue here as I’ve felt my own frustration rising…
Thanks for reminding me that uselessness is just a meaningless concept, I needed that. And I love the idea of role-playing as a friend asking for help with defining his uselessness. I’ll pace myself, though, and give us time to walk through all the steps, especially Empathy and Agenda Setting and check how it goes and what my clients wants, not I.
I appreciate information on the resources and supervision I can access online, so good to know there are options!
You can use my real name, can’t wait to hear the podcast :).
Karolina
Thanks for listening today! By the way, if you are looking for CE credits or training in TEAM-CBT, my upcoming workshop on therapeutic resistance on February 9, 2020 will be a good one. You’ll learn how to use the techniques described in today’s podcast.
See below for details and links!
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.
People in the featured photo for today’s podcast. Back row: Amir, David, Rhonda, and Dave. Front row: Steve and Barb
This will be our first podcast of 2020, so we wanted to make it a really good one!
Rhonda, Dave and I are very proud to welcome Steve Reinhard and his wonderful wife, Barb, on today’s podcast. Steve and Barbara flew in from Colorado to join the Sunday hike and do this podcast in the “Murietta Studios” following the hike. Steve is a former electrical contractor and lay minister, and is the first certified life coach to be admitted into the TEAM-CBT certification program at the Feeling Good Institute in Mt. View, Ca, (link).
The following is a heart-warming email I received from Steve prior to the show.
Subject: Re: looking forward
Hi David,
Woohoo! We are partners in crime! I’m feeling super comfortable now.
Thanks David for your generous invitation! I’m happy to jump on any of the 3 options you suggested for the show. I’d love to hear your stories, especially those of undistorted sadness where you celebrated with tears, aware of the suffering we folks tend to keep hidden.
I cry a lot these days, laugh a lot too. In that regard I’d love to have my own personal Ask David session. David, I love the old, demented, weak human guy, while admiring the pioneering, genius who teaches so clearly & humanly. My questions wouldn’t be so much for me to learn or be taught but to connect with you. I’m crying as I write. As a listener I want to connect with the human, David. May or may not be something you want to do. We have loads to interact with.
Yep, I take a “spiritual ” approach & would love to interact with you being anti-religious. Listeners might find this helpful & it sounds fun to me. A great opportunity for me to experience a death of the ego & the acceptance paradox which I have found liberating before I knew what it was called.
I’d love to talk about what it’s like to be diagnosed with blood cancer and holey bones & some of the nutty things we say to each other when we don’t know what to say. Empathy in the Five Secrets way is extremely rare from my distorted perspective. Aging & being willing to challenge the many shoulds & shouldn’ts that accompany things being different than they were last year would be fun to talk about.
I can’t keep track of the # of times folks repeat “getting old is hell”, same with cancer, vision problems, walking problems, drug side effects. I would love to hear your stories & experience as an old demented guy who can’t walk as fast as he did a couple years ago.
Thanks for your generous invitation. I still find it surprising that I get to have this experience with you all. I’m really looking forward to today’s show.
Steve
We began the podcast with a discussion of the role of lay therapists in the field of mental health. Coaching is newly emerging field of counseling that does not require graduate work in psychiatry, psychology, social work, or counseling. In the past, coaches have not been permitted to enter the TEAM-CBT certification program. However, Dr. Angela Krumm, who is the head of the FGI certification program changed that policy specifically so that Steve—and now, other certified coaches as well–can be certified in TEAM-CBT, and I applaud this change.
The role of lay therapists has always been highly controversial. I can recall that when I was in college in the 1960s, there was a lively debate about so-called “lay psychoanalysts.” Previously, you had to be an MD to be a psychoanalyst, but over time, non-MDs were permitted to become psychoanalysts. To my way of thinking, this debate has always been more about power and the protection of territory than about skill or the capacity to heal.
Now we are seeing the same questions being raised about certified life coaches. In my experience, graduate training doesn’t always guarantee that someone will be a skillful therapist, and sometimes the opposite is true. In fact, in my experience, the LESS previous training therapists have, the easier they are to train in TEAM-CBT, because they don’t have so much training they have to “unlearn.” The Buddhists say that an empty cup is better than a full cup, because the full cup spills over when you try to pour the wine.
Of course, there’s a downside, too, since therapists can also be sometimes exploitative and can be hurtful to patients. This includes coaches as well as mental health professionals with graduate training.
Next, we asked Steve about the role of spirituality in his TEAM-CBT counseling, since he is a also a lay minister. I am convinced that the spiritual dimension can be important and powerful in therapy, and that at the moment of our deepest change, the change is not only psychological, emotional, and behavioral, but also spiritual, because we may suddenly “see” things from a much deeper perspective. Much in TEAM-CBT is easily integrated with spirituality. For example, the Acceptance Paradox is an inherently spiritual technique that can play an important role in recovery from depression and anxiety.
One of Steve’s motives I doing this podcast was to have his own Ask David session, and one of his questions was, “What is it like to be regarded by many people as a guru?” I described the blessings as well as the occasional curses and problems that come with this moniker!
Then the conversation turns to Steve’s devastating diagnosis of blood cancer—multiple myeloma—just over a year ago, and how hard and frustrating it has been for Steve to get people just to listen and provide support, including his doctors, and how incredibly meaningful it is when people express simple compassion and love.
Steve also talks about how he has decided to accept his cancer, and not to “fight it” or to go to war with his body. And acceptance does not mean refusing treatment—Steve is receiving chemotherapy for his multiple myeloma. The acceptance we are describing is more of a mind-set of peacefulness. We also talked about the fact that the problems of aging are not unique, but are simply the problems of living, problems we can encounter at any age. The whole basis of cognitive therapy is that our feelings result from our thoughts, and not the circumstances of our lives. This is a very optimistic message because we often cannot change the facts of our lives, but we can do a great deal to change the way we think and feel.
I ended the podcast by raising the question of “Sadness as Celebration.” I asked whether tears and feelings of sadness in response to the suffering of others might actually be one of the highest experiences a human being can have, and is perhaps the deepest meaning of spirituality. I described a somewhat bizarre experience I had on the Nevada desert when I was a Stanford medical student in the 1960s—it was an experience I have kept secret for nearly 50 years, and talk about for the first time on this podcast.
After the podcast, I emailed Rhonda to get her “take” on the show. Usually, we focus on specific techniques our podcast fans might want to learn. But this time, we just kind of were “hanging out” together, so I was concerned and feeling a bit self-critical. I was also concerned that I may have sounded like a loony at times on the show, since my personal story was perhaps over the top.
Here’s how Rhonda replied:
Hi David,
As I was listening to the Steve podcast, it struck me that it was really friends talking, getting to know each other, sharing stories and joking around and being serious sometimes. That’s why I thought it was really lovely.
I listened to Steve’s podcast after dinner. I loved it!
You are so charming, and tell sweet stories that open up your life to the listener. I think everyone will love how endearing you are.
Steve was articulate, vulnerable and open. While it’s not an episode where you are teaching anything specific, it is a lovely podcast and I think regular listeners will love the opportunity to get to know you.
Rhonda
So, let us know what you think!
Thank you, Steve and Barbara, for your generous appearance on today’s show.
And we also thank YOU for tuning in today!
Rhonda and David
PS After the show, Rhonda and I got this great email from Steve:
Hi David and Rhonda,
Just getting back to communicating after a full & thrilling trip to California! Arrived home Monday evening, then off to Chemo center most of Tuesday & now regaining energy.
I like your show notes David—mucho.
Really enjoyed the hike, lunch, getting to sit in on Amir’s podcast, then to interact with David, Barb, & Rhonda. Loved your stories, David, and the whole experience of tears and celebrating sadness. Oh yea, and the big kiss on the lips!
A lot of other ideas & questions have popped into my thinking since the podcast. One being that us Christians are pretty judgmental. This is supremely true, and is probably one of the best-selling points of religion that’s kept hidden behind the smoke and mirrors.
It’s so much fun to judge folks, look down on everyone else and have that feeling of moral superiority! Probably better than LSD I’m guessing.
What bugs me about “religion” most is how many folks suffer under the whip of having to improve and become better and jump over impossible standards. Of course, they could move on to the Acceptance Paradox and right into celebrating sadness in a split second if they wish.
What wonderful time it was with you all.
Feeling grateful to share life with each of you.
Love you,
Steve
Second PS: If you are looking for CE credits or training in TEAM-CBT, my upcoming workshop on therapeutic resistance on February 9, 2020 will be a good one. See below for details and links!
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.
This will be our last podcast of 2019, so we wanted to make it something special. We also want to thank all of you for your support over the past year, and wish you all the very best in 2020!
Thanks to all of you, we surpassed 1.5 million downloads this year, and will likely hit 2 million in the spring of 2020. If you like the Feeling Good Podcasts, please tell your friends and family members, as word of mouth is our best marketing by far. In addition, if you are a member of any mailing lists, send them this link to the list of all the Feeling Good Podcasts. On any given day, 30% of human beings are feeling depressed and / or anxious, so you’ll be doing lots of people a favor, since the podcasts, as you know, are entirely free.
We are joined today by Amir Sabouri, PhD, MD, a highly esteemed neurologist from Iran with extensive medical training in the United States in addition to his PhD research in molecular immunology in Japan. Amir specializes in the treatment of horrific neuromuscular disorders such as ALS (the dreaded Lou Gehrig’s Disease) at one of our local Kaiser Hospitals here in the San Francisco Bay Area. In today’s riveting and inspiring interview, Amir describes how he discovered that, in spite of his extensive technical training, his strongest and most effective medicine by far is sometimes a healing dose of humility and compassion, delivered with the Five Secrets of Effective Communication.
We are also joined by our wonderful host, Dr. Rhonda Barovsky, as well as my friend and neighbor, Dave Fribush, who has joined many of our podcasts recently, as well as Steve Reinhard, a certified coach and TEAM-CBT therapist who flew in from Colorado for the Sunday hike and podcasts. Steve will be the featured guest on next week podcast, along with his wife, Barbara, on the topic of “Sadness as Celebration.”
Back row: Amir, David, Rhonda, and Dave Fribush. Front row: Steve and Barb
Amir and I have had a friendship and professional collaboration that goes back several years, when Amir first joined one my Sunday hikes, along with his wife, Dr. Sepideh Bajestan, PhD, MD, who was one of my students during her psychiatric residency at Stanford. In the past couple years, Amir has attended the Sunday hikes regularly and has worked hard to learn and master TEAM-CBT, especially the Five Secrets of Effective Communication, which have begun to play a huge role in his clinical and professional work.
Amir begins with a description of the first time he did personal work on one of the Sunday hikes. At the time, Amir was struggling with feelings of sadness, guilt and inadequacy about his role as a physician and neurologist. That’s because, in spite of his incredible background training and research in molecular immunology and neuromuscular pathology, the bottom line was that he had no cure to offer his many patients he had to diagnose with incurable diseases, such as ALS, and he confessed that he often felt like a failure in his attempts to help these unfortunate patients and their families.
However, by looking at his own negative thoughts, and pinpointing the distortions in them, he was able to challenge and crush those thoughts, and accept the incredible value of the immense caring and compassion he brought to his work with his patients. The change he experienced on that hike was quite pronounced, and was arguably his first “enlightenment.” It was a very moving experience for me, too.
Next, Amir tackled the Five Secrets of Effective Communication, and worked extremely hard to practice and master these techniques, which have also been invaluable in his medical work. He describes two recent patient encounters where these skills were invaluable. One involved an angry new patient who aggressively criticized Amir from the very moment he walked in the door. The many also criticized bitterly all the other doctors he’d seen. He complained that he didn’t want to be there, that nobody could help, and that nobody cared about him.
Amir responded using the Five Secrets of Communication, empathizing and disarming hat the man was saying, and using “I Feel” Statements, Feeling Empathy, Stroking, and Inquiry as well. The man suddenly began to sob and share his deepest feelings throughout his entire encounter with Amir. At the end, Amir was concerned that he’d given him “nothing” other than his efforts at skillful listening using the Five Secrets, and was afraid the man might issue yet another complaint.
One hour later, Amir received a touching email from the patient, filled with praise and gratitude, and he said he felt hope for the first time! We talked about the paradox of “giving nothing,” just listening with compassion, without trying to help or fix. and how this is often the greatest gift of all.
Amir and David on the Sunday hike, 10/28/19, practicing the Five Secrets while hiking. The Five Secrets can be incredibly helpful in professional and personal relationships, but requires lots of commitment, humility and practice.
Amir also talked about his interaction with a young woman who suffered horrific complications from a powerful medication that Amir had prescribed for her neurologic problem, and Amir was flooded with guilt and fear, thinking that he had failed her and that he might get sued. But once again, his use of the Five Secrets transformed their interaction into a deeply meaningful connection.
We discussed how training in the Five Secrets should perhaps be mandatory for medical students, and residents as well, since rigorous training in communication with patients is not really a part of medical training, although the doctor patient relationship is, of course, given lip-service. Of course, we also strongly feel that Five Secrets training should be mandatory for all human beings!
I mentioned an experience I had as a medical student working in the medical outpatient clinic at Stanford under the direction of Dr. Allen Barbour, who wrote a beautiful book on the human side of medicine, Caring for Patients. I was assigned to a mailman who had been struggling with intractable angina, which is relentless chest pain due to problems with the blood supply to the heart. He was scheduled for one of the first open heart surgeries at Stanford. The idea was to improve the blood circulation to the heart, and the surgery was brand new and still somewhat experimental, and potentially quite risky.
While I was examining the patient, I had a hunch that something was “off,” and asked the man if there were any problems in his life that were bothering him. This led to an unusual and unexpected set of events you can hear about on the podcast. Telling the story so many years later brought tears to my eyes.
After the podcast, Steve Reinhard, who had been in our “live audience” at the “Murietta Studios” today, began to cry and mentioned his own struggles with cancer. He told us how hard it has been for him to find compassionate doctors who seem to care, and how wonderful it would be if he could find a gentle, humble and loving doctor like Amir! We decided to edit Steve’s comments into today’s podcast as well.
High tech medicine is wonderful, and evolving rapidly, with new healing miracles every day. But the doctor’s most powerful medicine, by far, is still the bedside manner, just as it has been for the last two thousand years.
The Five Secrets of Effective Communication can enrich your life, too, and can vastly improve your interactions with loved ones, friends, and colleagues. These tools can also make you more effective in the business world, or in any human interaction. Our world seems very troubled these days, to say the least, and we can all start some healing by changing the way we relate to others and learning to speak with our third “EAR,” which stands for Empathy, Assertiveness, and Respect.
I hope that doesn’t sound hopelessly corny, elderly, or demented, but if so, I will have to plead guilty as accused.
Thanks so much for tuning in today, and if you like these shows, please tell your friends!
If you would like to learn more about the Five Secrets, a great first step would be to read my book, Feeling Good Together. Make sure you do the written exercises while you read, and make sure you practice as well!
On the right hand panel of every page on my website, http://www.feelinggood.com, you’ll find a Search function. If you type in “Five Secrets” or “Relationships,” you’ll find many helpful podcasts on this topic as well.
Learning the Five Secrets takes lots of commitment and practice. It’s like learning to play the piano or learning to play tennis. You’ll have to work at it. Amir is incredibly brilliant, and he had to work at, too. If you’re willing to do the same thing, the results can change your life, too!
All the best,
Amir, Rhonda, Dave, Steve, and David
Note: As an Amazon Associate I earn from qualifying book purchases. My books are available from virtually any online or in-person book seller.
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 Holidays to everyone! Today’s podcast is nestled between Hanukkah (on the 22nd) and Christmas eve (on the 24th.) We send our warmest greetings to all of our listeners of all religious faiths.
Today, Rhonda, Dave and David discuss three questions you have submitted:
Does emotional trauma cause brain damage?
Do you have to have a good cry when something traumatic happens?
Why does avoidance make anxiety worse?
1. Is it true that emotional trauma affects the brain?
Hi again Dr Burns,
I love the 5 secrets, and have had great success in my new job by implementing them! I keep listening to all the 5 secrets podcasts over and over to keep it fresh for me and really loved the podcast on advanced techniques.
My question today is about how trauma affects the brain. ‘Trauma’ is the new buzz word in education, and psychologists are creating presentations geared for teachers and other school professionals that claim the “trauma-affected brain” is altered and cannot learn as easily. They allege imaging technology can prove this.
Do you know if PTSD/trauma actually impacts a person’s ability to learn? I thought that it was the negative thoughts that interfere with attitudes toward learning, not an actual brain impairment.
Another term that is used frequently is “intergenerational trauma”, meaning if my parent experienced trauma, it could be passed down to me and therefore impact my ability to cope with life stressors. Any thoughts? Any credible research you are aware of?
In the Ask David, could you also include your opinion on how Adverse Childhood Experiences impact people’s mental health and ability to cope? There are a range of experiences cited in studies from moving around a lot in childhood to witnessing a murder to molestation. After listening to your podcast episode 147 (Garry with PTSD) I was satisfied with the effectiveness of TEAM to treat trauma rapidly. But then I remembered a documentary I had seen about ‘feral children’ who were extremely neglected as children, and I wondered if there are some cases where the psychology or potential of a person is forever impacted by an adverse childhood experience. Your take?
All the best,
Jackie
Educational Consultant
Mountaintop School Division
Answer
David finds these buzzwords and buzz-theories somewhat misleading, and sometimes even pseudo-scientific. He has treated large numbers of patients struggling with the effects of severe trauma, and has found that trauma patients are usually the easiest to treat and the quickest to learn. David like to focus on rapid healing, using TEAM-CBT, rather than sending people the message that they are impaired, damaged or defective because of some emotionally traumatic experience.
In fact, nearly all humans have experienced quite a lot of traumatic events, which can range from mild to extreme. And lots of us have some degree of brain damage. My brain (David Burns) was squashed at birth, for example, and there are certain cognitive functions that I’m not very good at. For example, for some reason, I can’t often find something that’s right in front of me, and I have lots of trouble remembering names and faces.
I just try to accept my many shortcoming and work around them. The problem is rarely our flaws or imperfections, but rather the distorted negative messages we give ourselves; messages that generate anxiety, fear, inadequacy, shame, and so forth.
Of course, animals and humans with traumatic experiences at a young age, or any age, may struggle with fear and may seem, as you say, “feral.” My wife and I (David) have adopted many feral cats, and have found that consistent warmth and love can lead to dramatic changes and the development of trust. We all have a history, and every person’s story and suffering deserve respect and profound compassion.
2. What’s displacement? Is it true that you have to have a good cry when something traumatic happens?
Hi there again,
I’ve been practicing TEAM-CBT for a year while at the same time studying Dr. Gordon Neufeld’s theories on the need for “tears of futility” for true healing (including adaptation, maturation and development of resilience). He states that if we only work on the cognitive level, we risk to just displace the symptoms in our clients and they would miss out on maturation and adaptation. I’m wondering if you have ever seen a displacement of the symptom in treating your patients with TEAM-CBT?
In most live sessions I’ve seen with you you seem to have this gift / skill to make it safe for the client to let the tears flow and that this often seem to be the moment when a breakthrough is about to happen. So I wonder if you think the client needs to shed tears or at least feel the feelings of futility or “true sadness” before we should move forward to methods (in addition to getting perfect empathy scores)? And what role you think tears play in the healing process?
Would love to hear your thoughts on this! (See my last e-mail if you want more details to why I’m asking.)
Thanks,
Warmly, Malena
Answer
I am really pleased to see that you, Malena, are a certified TEAM-CBT therapist in Sweden! I always love to hear from a fellow Swede!
You are right, Malena, that emotion is very important in therapy, since it shows that the patient trusts the therapist and is willing to be vulnerable. This is a critical part of the E = Empathy in TEAM-CBT. Therapy without emotion, without tears, may be overly technical, dry and almost “empty.”
In addition, some patients do intellectualize as a way of avoiding emotions. I call this fear of negative emotions “Emotophobia.” I try to confront patients who do this in a gentle way. I might say, “Gee, Jim, I just asked you how you were feeling, and I notice that you didn’t really answer my question. Did you notice this as well?”
This technique is called Changing the Focus, and it has to be done in a kindly, non-threatening way. We discussed it on a recent podcast that was one of our most popular.
I’ve seen a patient recently who had incredible problems sharing his own feelings in interactions with his wife, and equally intense problems acknowledging her feelings. If a patient is determined to overcome this fear of his or her feelings, using the Five Secrets of Effective Communication, tremendous progress can be made, but the patient’s resistance has to be dealt with first.
Early in my career, I was aware of the idea that if you don’t cry when a traumatic event, like the loss of a loved one happens, that you are setting yourself up for emotional difficulties, so I often pushed my patients to cry. And occasionally this was very helpful.
But in general, I have not found it necessary to think that every patient has to cry, and it is definitely not true that crying during sessions is a panacea. During my residency training, I had many patients who cried constantly during therapy sessions without any improvement at all. They just kept crying and crying every session! You could even argue that this makes patients worse, because you continually activate and strengthen the same negative circuits in your brain.
When I learned cognitive therapy, I had many tools to help patients change their lives, and that’s when I became to see far more improvement and recovery. The tears were helpful, but rarely or never curative.
If you are getting perfect empathy scores from your patients on the scales on the Evaluation of Therapy Session, Malena, you are doing great! Way to go!
David (a fellow Swede)
3. Why does avoidance make anxiety worse?
Hi Dr. Burns,
I love your show and work so much. I can’t wait to buy “Feeling Great.”
There’s a question I’ve had for about three years that I’ve badly wanted to get my head wrapped around. It’s in regard to something I’ve heard you say on a Feeling Good Podcast: “Most experts in exposure therapy or behavior therapy say that attempts to control your symptoms (of anxiety) is the cause of all anxiety.” I have heard others say that too/
Why is this?
I understand if you push-through an anxiety you can learn whether it’s warranted or not.
But how is trying to avoid an anxiety actually the cause of all anxiety?
I want to be able to understand it for when I feel myself trying to move away from social anxiety I can understand at a moment’s notice why doing so actually is the cause of all my anxiety. To be able to skewer the rationalizations in my mind of why I shouldn’t push-through.
Thank you David.
Best Regards,
Mark
Answer
Rhonda, David and Dave discuss why avoidance makes anxiety worse, and why exposure often leads to improvement or even complete recovery. David describes the incredible resurgence of his own fear of heights when he took his children on a camping adventure in Havasupai Canyon in Arizona one spring when he and his wife were living in Philadelphia, and he avoided climbing down a cliff he had climbed down many times when he was younger.
Anxiety is not caused by the thing you fear, but by your distorted thoughts and fantasies. When you pull back instead of confronting the monster, you do not get the chance to discover that the monster has no teeth, so your negative thoughts and fantasies can quickly spiral out of control.
We will see you again next week for our final podcast of 2019. Thanks for so many wonderful questions, and for your support during the past year. We have had more than 1.5 million downloads, thanks to you! We look forward to serving you again in 2020!
If you like the podcasts, please tell your family, friends, and neighbors. You are our marketing team! And if you are a mental health professional, you might be interested in my February workshop on therapeutic resistance with Dr. Jill Levitt. It’s going to be a good one, and you can find the details below.
Rhonda, David, and Dave
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.
Course uses a combination of live group didactic sessions together with practice and role play, with emphasis on skill building of CBT therapy tools and techniques
Completion of this course meets criteria for TEAM-CBT Therapist Level 1 Certification, or partial criteria for Level 2 or 3 Certification
Affordable online training, less than $35/hr for live, interactive, professional training
“Mike Christensen is one of the rising stars in TEAM-CBT. He is a terrific teacher and therapist, and a very compassionate individual! Highly recommended!”
David D. Burns, MD, Author of “Feeling Good: The New Mood Therapy”
* * *
I also have two tremendous one-day workshop scheduled with my colleague, Dr. Jill Levitt–
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.
Today, Rhonda rejoins us as host after a three week hiatus! My neighbor, Dave Fribush, joins us as well, as we answer two thought-provoking questions!
Is it possible to treat “burnout?”
Can negative feelings can make physical pain worse?
1. Does “burnout” exist? How do you treat it?
Comment: Hi!
I have been listening to your podcast for a while now and it has helped, and has encouraged me and made me feel less alone. Thank for your work and sharing your podcast with us!
My situation now is very much defined by my burnout syndrome (a medical diagnosis in Sweden, not sure about the US) and/or depression. From what I’ve learnt there is no evidence of CBT as a treatment for burnout – really nothing other than adaptations at your workplace. What triggered me to ”hit the wall” was studying too hard and not giving my body and mind time to recover.
Do you have any thoughts on burnout and effective treatment of it? I feel I have made huge progress in the underlying reasons to my burnout like perfectionism, performance-based self-esteem, figuring out how I want my life to be, who I am etc (although the last one is a big one!). All this with the help of CBT and other sorts of therapy. What remains is mental fatigue, on and off anxiety, not being able to focus and hardly any mental or emotional resilience.
Through healthcare, you are basically treated for depression, the treatment being anti-depressants. I’ve been on sick leave full time for over four years now, am in my late twenties and am constantly frustrated, sad and feeling stuck. I want to get going towards this life I now know that I want but I don’t seem to get any better. I eat and sleep well and exercise. I realize this could be a complete medical question but nobody REALLY seems to know anything about burnout. A long question but hey ho 🙂 Would be grateful for any thoughts you might have, thanks again!
Sincerely,
Elisabeth
Hi Elisabeth,
I’m sorry to hear that you’ve been struggling for some time, but I’m glad you’ve been making progress, and I’m so glad you wrote to me.
To my way of thinking, there is really no such “thing” as burnout. Depression, anxiety, anger, and other negative feelings do exist. Burnout is just a vague buzzword for feeling upset when something upsetting has happened.
When I was in clinical practice, I saw as many as 17 depressed and anxious patients in one day, and as the day went on, I just got higher and higher and more energetic. That’s because I loved what I was doing and felt I had something to offer, a lot, actually. I only got “burned out,” or unhappy, if I felt I had said something that hurt someone’s feelings, or if I had not done a good job for someone. Then I got really upset, but it was my thoughts, and not what I was doing, that caused my feelings. That, of course, is the cognitive model.
I found it helpful to zero in on one moment when I was feeling depressed, anxious, or “burned out,” and to do a Daily Mood Log focusing on that moment. I’ll attach one to this email in case you are interested. I’ve also included a completed one so you can see how it works. This is not a similar case, just something I grabbed by way of illustration.
Thanks,
David (a fellow Swede)
On the show, I describe one of the most stressful experiences of my career, when I appeared on a Philadelphia TV show with Maury Povich, and a patient of mine threatened to commit suicide. Fortunately, the story had a surprise ending that was very positive.
So my message is one of hope. The idea is to focus on some specific thing you are upset about, as opposed to getting overly focused on a concept like “burnout.”
I think we all feel pretty exhausted at times, and if you’ve been studying or working too hard, it definitely makes sense to take a break to take care of yourself. When I transferred from my residency training program at Highland Hospital in Oakland, California, to the residency program at the University of Pennsylvania, in Philadelphia, one of my supervisors gave me this advice–he told me to make sure I set aside at least one half a day a week to stare at walls.
What he meant was that I was working intensely, 24/7, during the first two years of my residency, and he wanted to make sure I gave myself a break to rest from time to time. So every Sunday afternoon I just watched football games on TV, often with a cat on my lap. This was refreshing and helpful, and my supervisor’s advice helped me avoid feeling guilty for not working 24/7!
2. More on physical pain. Is it really true that negative feelings can make physical pain worse?
We recently did a podcast with Dr. David Hanscom, a back surgeon who emphasized non-surgical treatments for back pain that can be surprisingly helpful. In that podcast, I described my research indicating that 50% of the pain we experience can the result of negative feelings, such as depression, anxiety, and anger. And if you can reduce or eliminate those negative feelings, your physical pain will often diminish substantially, and may even disappear entirely.
I first discovered this amazing phenomenon when I had a dramatic and traumatic personal experience as a medical student. One night I was drinking beer at a bar in Palo Alto, and hurt a commotion, and turned to look. A fight had broken out, and although I was not involved in the fight, I saw a beer mug flying in slow motion toward my face. It hit my jaw, and glass exploded everywhere, and blood came gushing out of my mouth. I realized that my jaw was broken, and my front teeth were loose as well, so I ran outside to my old VW Beetle and drove at high speed to the emergency room of the Stanford Hospital. I ran inside and announced that I was a medical student and my jaw was broken.
They put me on a gurney, and ordered an x-ray. I was in intense pain, and I was scared and angry, and still intoxicated, and probably wasn’t the most cooperative patient.
Eventually, a plastic surgeon was consulted and he talked to me after reviewing the X-ray. He explained that I had a broken jaw, and that he was going to hospital me and do surgery in the morning. He said my jaw would be wired shut for six weeks.
I asked if I was going to lose my front teeth that were loose. He said he didn’t think so, but that I would have a dental consult to check things out after they removed the wires on my jaw in six weeks. Then he said that he knew I was in severe pain, and that he’d ordered pain shots for me during the night. He said he wanted me to be comfortable, and explained that he wanted me to request a pain shot any time I was in pain during the night. Then he put his hand on my shoulder and said, “This is very routine, and you’re going to be fine.”
At that very moment, my pain instantly went from severe to zero, and I did not need a single pain shot all night long.
Dave Fribush emphasizes that while the surgeon’s warmth and compassion were helpful, the thing that made my pain suddenly disappear was the sudden disappearance of my negative feelings–intense anxiety about losing my teeth, as well as anger at feeling that I was being neglected. And the very moment my negative feelings changed, my anger disappeared as well.
My later research confirmed that negative emotions can, in fact, magnify the experience of physical pain, and that, on average, 50% of the pain we experience results from our negative emotions. This finding should provide hope for individuals struggling with physical pain, especially since this is a drug-free treatment not involving opiates.
if you want to reduce your negative feelings, one approach would be to read one of my books, like Feeling Good or When Panic Attacks.
They are, of course, not guaranteed to cure you, but research confirms that many people who read them do develop a more positive outlook on life and experience significant reductions in depression and anxiety. And the can be obtain inexpensively at Amazon or other book sellers.
Next week, David, Rhonda and Dave will discuss three more questions you have submitted:
Does emotional trauma cause brain damage?
Do you have to have a good cry when something traumatic happens?
Why does avoidance make anxiety worse?
David & Rhonda
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.
3. The Annual South San Francisco Intensive
August 10 – 13, 2020
Small Group Practice with Personal Feedback and Mentoring, and Chances for Personal Work and Healing
