038: Ask David — Negative Messages from Society

038: Ask David — Negative Messages from Society

Negative Messages from Society

A listener named Daisy describes her despair at being unable to have a baby, despite intensive efforts at a fertility clinic. She gets well-meaning messages from friends, family and support groups that she really needs a baby in order to feel truly happy and fulfilled, and these messages make her feel anxious and depressed. But she wonders whether this is really true. Does she really need a baby to feel happy?

In fact, we we get all kinds of messages from society that we need certain things in order to feel worthwhile, including:

  • Achievement / Success / Wealth
  • Intelligence
  • Perfection
  • Love
  • Approval
  • Popularity
  • Good looks

Are these things really needs? Listen to today’s podcast and you may be surprised by the answer!

In the next three podcasts, David and Fabrice will discuss three powerful uncovering techniques that can help you pinpoint the Self-Defeating Beliefs that may be at the root of your own unhappiness and anxiety. These include the Individual Downward Arrow Technique, the Interpersonal Downward Arrow Technique, and the What-If Technique. After that, David and Fabrice will also describe some powerful techniques to help you change the way you think and feel!

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Role Model? Or Possibility Model?

Role Model? Or Possibility Model?

In my Tuesday evening psychotherapy training seminar at Stanford, we train therapists in TEAM-CBT, and one of the teaching methods involves personal work for the therapists, kind of on the idea of “Physician, heal thyself.” (Luke 4:23) We work on mood problems, like depression and anxiety, relationship problems, and habits and addictions. One of our favorite members, Paulita, just made a brief video describing the work she did recently on her addiction to a certain kind of candy, and graciously allowed me to publish it here! I think you’ll enjoy it!

In her email giving me permission, Paulita wrote,

I would like to be a “Possibility” Model (not Role Model) – because I am an example of the possibility that even old dogs can learn new tricks!

Here’s the way I would put it–are you old enough yet to learn some new tricks? Paulita just turned 80 and is one of our liveliest and most beloved members. She is a local marriage and family therapist, and was originally from the Philippines.

Paulita made the video to help promote a workshop at the Feeling Good Insititute tomorrow (May 21st, 2017) on overcoming habits and addictions using TEAM-CBT. They may have a few spots left, so feel free to check them out if you’d like to attend!

By the way, my Tuesday psychotherapy training group is free of charge to northern California metal health professionals, so contact me if you’d like to visit or learn more about the work we do!

The goofy picture of me at the top (at least for some of you who read this on social media) was taken after our hike on sunday, in a place where you can order exotic Chinese drinks like Mango Lychee Green Tea Teazer (which I had). More on that later! It was a fantastic hike with a special guest.

David

 

If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and tons of resources for mental health professionals as well as patients!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

 

 

50 Years of Psychotherapy! And it Finally Worked!

50 Years of Psychotherapy! And it Finally Worked!

Topics in this blog:

  • Can we be happy ALL the time? 
  • What causes depression and anxiety?
  • Can patients really recover from depression and anxiety in just a few sessions, or in a single, extended therapy session? 

Hi Dr. Burns,

Here’s a hypothesis that I’ve been working on. Both the Freudians and the Transactional Analysis (TA) schools divide the psyche into three parts. In the case of the Freudians the three parts are Id Ego and Superego. In the case of the TA school the three parts are PARENT, ADULT, CHILD. My hypothesis is this: “Under development of any one of the three parts is the cause of many types of mental disorders.”

In my particular case, an under development of the Parent part, caused by very inadequate parents for the most part caused me to never develop the Parent part. After nearly 50 years of psychotherapy, (I started in 1968), I finally realized what was wrong, that I hated all authority. Now, I have somehow magically transformed my psyche to have a parental part. I’ve been pretty “cool” ever since.

That was about three months ago. I wanted to share this with you as my current and best therapist is “sold on your book, Feeling Good,” and I even have a hardbound 1st edition.

What do you think?

Sincerely,

Gary

Hi Gary,

Thanks for your note, and congratulations on finally achieving your goal after 50 years of hard work. Sometimes the sweetest victories come from the hardest fought battles! Your patience and persistence are amazing. Way to go!

Please thank your most recent, and best therapist, for supporting my work! I greatly appreciate that. And hey, the hardbound first editions of Feeling Good are pretty rare now! I hope I can sign it for you one day. The publisher predicted that the book would not be popular, so the initial hardbound printing was small.

You might be interested that with TEAM-CBT, we are trying to bring about the “magical” changes you described much more rapidly, sometime even in a single extended therapy session, although this is clearly not always possible. But most of the time, I pretty quickly see the sudden emergence of a compassionate, realistic, and wise voice from within an individual who has been struggling with issues involving low self-esteem, depression, and inferiority for a long time, often decades. The wise voice finds the power to crush the distorted negative thoughts that have been triggering the painful feelings and robbing the patient of joy, self-esteem, and intimacy.

I’m not sure how that would fit into your hypothesis, but I suspect there might be some overlap! Perhaps this “wise voice” that emerges so quickly in TEAM-CBT would be similar to the “adult” voice, or healthy self? Maybe that is the “adult” voice? You’ll have to teach me about this! I am thinking there might be a healthy and unhealthy version of the three voices?

Here are some links if you would like to read about the new developments in TEAM-CBT, and how and why they emerged. If you get the chance, let me know what you think! The first link is to my recent article in Psychotherapy Networker entitled, When Helping Doesn’t Help. The second is my recent blog asking whether some people can really be treated for depression and anxiety in a single, extended therapy session.

Incidentally, lots of people attribute their difficulties to their parents or childhood, and certainly most parents are flawed, and most of us have had painful experiences growing up. However, I am not convinced we yet know the causes of emotional problems. Most experts think depression and anxiety result from some combination of genetic and environmental causes, but beyond that, the specifics are still unclear. Sadly, the lack of scientific knowledge does not prevent many people from promoting this or that theory! I guess, some people believe that a wrong theory is better than none at all! I put my efforts more into developing fast, effective tools to help people change, regardless of the cause of our insecurities.

And if therapists begin to measure symptom severity at the start and end of every therapy session, as we do in TEAM, then we’ll know when we’re being effective, and when we’re not. I believe that data-driven, outcome-accountable psychotherapy will be the wave of the future. And I also believe that the future is NOW. We already have these tools, if therapists are brave enough to use them!

How important are childhood experiences in shaping how we think and feel as adults? About thirty years ago I read about an interesting research study from Sweden. They compared something like 500 children from the worst homes, in terms of stability, warmth, and so forth, with a similar number of children raised in the most loving homes, and studied them for twenty years in terms of emotional development, academic performance, and antisocial / criminal activities. Which group do you think did better? Think about it for a moment before you continue reading. You will find the answer at the bottom of this blog. Here are your choices:

a. the children from the worst homes did better.

b. the children from the most loving homes did better.

c. both groups of children did about the same.

Once I was on a morning television talk show in Philadelphia discussing my book, Feeling Good: The New Mood Therapy. A viewed called in when the show was live and asked if it was possible to be happy all the time. I said I didn’t know, but didn’t think so, but if anyone knew of anyone who’d been happy all the time, to have that person contact me because I’d love to talk to them and find out the secret of their success.

As I was leaving the show to go back to my office, the producer said there was a call for me from a man who claimed he’d been happy every minute of his life! I invited him to my office to tell me about it, and was curious to find out more about him.

The next day he arrived and explained that he’d been happy every minute of every day, in spite of numerous catastrophic events. I think he’d gone bankrupt once, had been betrayed by a loyal friend, and had successfully battle two forms of cancer. But no matter what happened, nothing got him down.

I asked him if he had any idea why? Had he had a particularly loving childhood, for example?

He said when he was about five or six years old both of his parents suddenly died, so he was adopted by his grandparents, who lived on a farm. The day he arrived, his grandfather told him that there was a tremendous amount of work to do to survive on a farm, and everyone had to pitch in and help. So he shouldn’t expect to get a lot of love because there wasn’t enough time for that type of thing. But his grandfather told him this: “Don’t ever let anyone put you down, and you’ll be fine.”

Apparently, that advice was all he needed!

Didn’t make a whole lot of sense to me, but his story was interesting, to say the least. Personally, I don’t aim for being happy all the time, for lots of reasons. First, I think the contrasts of emotions make for much of the joy in being human, including the many moments of self-doubt, anxiety, and despair, that most of us experience. Second, I think the down times provide us with enormous opportunities in terms of personal and spiritual growth. And third, I am convinced that negative emotions, such as sadness and grief, without distorted thoughts, can actually be a form of celebration, and one of the highest experiences a human being can have.

Answer to the question in the blog, Surprisingly, the correct answer is c. There were no statistically significant differences in the two groups of children! The children from the worst homes did just as well as the children from the best homes in all of the outcome variables. I wish I still had the reference to that article! if I can find it, or if a reader can find it, I will pass it on to all of you. I am recalling this from memory, and memory can be flawed, so take it with a grain of salt until we can get more confirmation. But I found the article to be mind-boggling, and it reminded me once again of how little we know about the causes of emotional distress!

David

If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and tons of resources for mental health professionals as well as patients!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

It’s Like Finding Gold

It’s Like Finding Gold

Hi visitors and colleagues,

I just got this cool reply from Michael (see previous blog of a few minutes ago).

Dear Dr. Burns,

I read it. Perfect.

This is really quite an empowering training you are giving through the podcast and e-mails. It’s like finding gold when all around you people are walking by!

Be well,

Mike

(Michael Mikulski, LMFT)

Hi Mike,

Great image! Thanks!

I’m trying to get a few folks to notice, but not too many seem to want to look! And others tell themselves it is just fool’s gold!

But I keep chipping away and emails from colleagues like you make it all very worthwhile indeed!

david

If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and tons of resources for mental health professionals as well as patients!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

 

Learning TEAM-CBT Requires Hard Work — But the Results Can Be Amazing!

Learning TEAM-CBT Requires Hard Work — But the Results Can Be Amazing!

This is a terrific email I received this morning.

Hi Dr. Burns,

I first attended your 2-hour workshop at the Evolution of Psychotherapy Conference in Anaheim in 2013. That got me started!

Then I took your 2-day training on High Speed Trauma Treatment in Pasadena 2015. That got me hooked!

Since January 2017, I’ve listened to your podcasts, each about 4 or 5 times.

I’ve read your Feeling Good Handbook – did all the exercises.

I’ve read your Feeling Good Together – did all the exercises – and my wife is practicing these.

Working through your book, When Panic Attacks, now.

Changed my life! My marriage went from pretty good to perfect! I mean perfect! All the complaints I had about my wife disappeared. She didn’t change anything!!!

What changed?

In my marriage I realized I was creating the problem I was fighting against. Yes, that’s the truth. The Five Secrets showed me my mistakes: 1. Defensiveness 2. Truth 3. Solving the Problem, and others. As a result of the Five Secrets my wife has now become my best friend. I use the Five Secrets at work too and have never felt more confident and relaxed.

My therapy practice continues to change dramatically. Finally, I’ve begun to use the Paradoxical Agenda Setting effectively. This was tough for me to learn. After a few failures, and soul searching, I’m beginning now to truly see and feel the strength and beauty of my clients’ resistance. The energy of our alliance is amazing, and you’re right, when you have that power, it’s a short jump to the elimination of symptoms.

One quick example: An African American woman in 40s had suffered from feelings of inadequacy 100% of the time since she was little. After listing the beauty of her inadequacy, she decided that she was ready to get rid of it. Why? She said it was “a thorn in my flesh.” We used the list of Cognitive Distortions, with positive thought replacement, and the Acceptance Paradox to defeat her feeling of inadequacy.

She realized that she had a choice: Live with trying NOT to be inadequate (“a thorn in my flesh”) or accept feeling inadequate in some things. Upon realizing this, she laughed and said, “I’m not feeling inadequate anymore. Feeling inadequate is normal.” She couldn’t believe it. Her scores on the depression and anxiety tests went to 0, and she left session elated. I also received perfect empathy scores. All of this transformation happened in one (2 hour) session.

I already have 4 or 5 other examples recently.

I am just so grateful to you. You’ve been generous in correspondences as well. You are truly a treasure.

All the best,

Mike

(Case study disguised to protect identity.)

Michael Mikulski, LMFT
Director of MFT Training, Pacific Clinics
Pasadena, CA 91107
mmikulski@pacificclinics.org

Thanks, Mike! You’ve “got it,” so to speak, thanks to your hard work and commitment. That’s what it takes to learn TEAM-CBT! Keep up the fantastic work you are doing! I am so glad that at least some therapists are learning these new methods and bring rapid relief to so many people who are suffering!

Your fantastic email also illustrates the importance of Healing Yourself. If we, the presumed experts, can use our techniques to bring more joy and intimacy into our own lives, then we have credibility, and our status changes from technician to healer. That is one reason why I emphasize the importance of doing personal work in my Tuesday psychotherapy training seminar at Stanford, on my Sunday hikes, and at my workshops. It is, to my way of thinking, an essential ingredient of psychotherapy training.

I also want to thank my esteem podcast host, Dr. Fabrice Nye, for making the Feeling Good Podcasts a reality! We just finished another recording session at noon today and really enjoy bring this information to all of you!

All the best,

David

 

It’s Magical!

It’s Magical!

Hi visitors and friends,

The following is a fascinating email I just received from a therapist in the TEAM-CBT certification program. I hope you enjoy it! And thanks, Thai-An, for your kind words, and for the permission to share it with visitors and subscribers to my site!

David

Omg y’all. If you haven’t listened to Dr. Burns’ feeling good podcast, specifically the last six on his and Jill Levitt’s demonstration of TEAM therapy with Mark, it’s magical! No spoilers, but the very last podcast moved me so much I was inspired to encourage everyone to listen to it. It’s so great for the learning process to listen to the masters at work.

Happy listening and learning!

Thai-An Truong, LPC, LADC
Lasting Change Therapy LLC
Postpartum Depression Counseling
Certified TEAM-CBT Therapist, Level 1
Oklahoma City, OK

If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and resources for mental health professionals as well as patients!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

Can We Prevent Suicide Attempts?

Can We Prevent Suicide Attempts?

tHi http://www.FeelingGood.com friends and colleagues,

I just received the following email from a therapist who was shocked to discover that her patient was suicidal after reviewing his scores on the Brief Mood Survey. Her intervention likely saved his life.

Patient suicides are not uncommon, sadly, and represent the dark side of our profession. The death of any patient is an enormous tragedy for the patient, obviously, and is devastating for the family and friends as well. Patient suicides can be incredibly demoralizing and anxiety-provoking for the therapist, too. It is imperative, in my opinion, that therapists have the best, state-of-the-art tools for detecting the emergence of suicidal urges so that we can intervene and have the greatest chance of preventing these horrible events.

In two upcoming Feeling Good Podcasts, Fabrice and I will discuss what happened to a psychologist named Harold who thought he did not need to use the Brief Mood Survey to track his patients’ symptoms at the start and end of every therapy session. Like so many therapists, Harold  was convinced that he was sensitive and empathic and really understood how his patients felt with reasonable accuracy. When his favorite patient unexpectedly committed suicide following a particularly “good” therapy session, Harold was understandable devastated. He felt intensely depressed, anxious, ashamed, inadequate, alone, hopeless, and angry. You may find these two podcasts interesting and sobering.

My research and training experience indicate that therapists’ perceptions of how their patients feel (in terms of suicidal urges as well as severity of depression , anxiety and anger) are often way off-base, but therapists don’t realize this because most of them are not assessing assessment scales to track progress at every session. In addition, therapists’ perceptions of how empathic and helpful they are also way off-base much of the time for the same reason. They don’t measure empathy, and most don’t even ask patients to rate how warm and understanding they are.

That’s why I developed tools like the Brief Mood Survey, so therapists can track patient progress in multiple dimensions before and after every therapy session. I believe it’s use represents a major breakthrough in psychotherapy, because it’s like having an emotional X-ray machine to inform the therapist about what’s really going on, and to guide the treatment. Of course, I’m more than a little biased on this point! And the use of the BMS requires lots of courage, because the vast majority of patients are shockingly honest in the way they rate their therapists on these scales, and while the information can be invaluable, and even life-saving, it can also be quite disturbing and threatening to the therapist’s ego.

David

Hi David,

I just wanted to let you know that I recently started using the THERAPIST’S TOOLKIT and found myself in a similar situation you described. I recently had a patient whose scores were virtually ZERO on the Brief Mood Survey one week (meaning no symptoms at all), so I was convinced he was doing well. However, the following week I was alerted to high scores on your two-question “suicidal impulses” scale, which, to my chagrin, I nearly missed. That’s because I am in a new office with low lighting and I am visually impaired. But when I looked more closely, I discovered there my patient not only had suicidal thoughts and urges, but an actual plan for suicide!!!

Boy was I grateful having on hand the full blown Suicidal Urges Survey and Suicide Assessment Interview, which I proceeded to do in a two-hour session the following day. Just as surprising, his scores following THAT session were all ZERO again (except for Empathy and Self Help:-)

(David’s explanation. Scores of zero on the Depression, Suicide, Anxiety and Anger Scales are the best possible scores, indicating no symptoms at all. In contrast, scores of 20 out of 20 on the end-of-session Empathy and Helpfulness Scales are the best possible scores, indicating that the therapist was tremendous empathic and helpful during the session.)

Although I was/am at least temporarily relieved by the rapid reversal, I can’t say I know how to account for it, since most of the interview was assessment based, unless I just ooze TEAM-CBT without realizing it!

All that came to mind was “Hawthorne Effect.” As an aside, I know the “Suicidal Urges” survey is one of the “experimental” ones, but I saw no scoring sheet; I imagine they generally correspond with the BMS, the higher the worse.

Also, in answer to your query, I for one would LOVE to learn more about the Self-Defeating Beliefs survey and/or any info you impart in this regard. I was focused on that with the patient when I almost missed his staggering scores on the two questions on suicidal impulses. But I would like to return to it, and I will plan to give it for homework on a weekly basis to check his “emotional temperature” which is vitally important for this patient as you can imagine, I will consult some colleagues as well who have expertise in ethics and legal issues.

My TEAM CBT group (with Lynne Spevack) meets tomorrow, and we will focus on Testing, yay! And on Monday I will be starting Taylor Chesney’s TEAM CBT group! Both groups meet 2x/month. If only there were a group that met every day:-)

Meanwhile, I hope you’ve received my check by now for the EASY Diagnostic System which I cannot wait to get my hands on and need it desperately!!! When might I expect to receive the email with this valuable info?

I am enjoying your Feeling Good Podcasts, as well as your Feeling Good Blog and newsletter. I am more than fairly certain, were it not for your inventory (the Brief Mood Survey), I would have missed this potentially life-saving intervention. I’d even done a brand new Intake the week before. Although we do not have the power 100% to prevent a person from committing suicide, if we do not detect it we don’t have a fighting chance. I at least have the peace of mind now that with this knowledge, I can do everything in my power to insure this patient gets all the help he needs and hopefully the right help.

Thank you for being you and your contributions for making such a meaningful difference in the world for our patients and us therapists!

Kathy

PS I also really appreciated your podcast on anti-depressants, which I LOVED and wasn’t surprised. I’m sure that took tremendous courage, along with your well-intact integrity to speak your truth. I wish more Psychiatrists were like minded. Until there is such a paradigm shift, which I think is coming, such decisions will have to be decided between the patient and their doc largely comprised of big Pharma mentality. who’ve drunk the cool aid, sadly.

Hi Kathy,

Thank you for your enlightening email. I greatly enjoyed reading it, and kudos to you for saving your patient’s life.

You asked about the scoring of the two-item Suicidal Urges scale. I intentionally don’t have a strict numerical scoring key, as I want the therapist to attend to it thoughtfully. There are some guidelines in the massive update to the Therapist’s Toolkit. You probably have it already, but email me if you need it.

The first of the two screening items asks about suicidal thoughts and fantasies. Most depressed individuals will have these thoughts, such as the idea that they might be better off dead, but this is not generally alarming if there are no suicidal urges. Of course, you will always want to back up the survey with some questions to make sure.

The second of the two screening items asks about suicidal urges or plans. Any endorsement of this item is more worrisome, and usually merits a suicide assessment interview, just as you did. In general, you will only have to do this once with any particular patient, and it should ideally be done at the beginning of therapy, at the initial evaluation.

A third thing is to note changes in how the patient answers these two items, since any increase in the scores can indicate the development of increased suicidal urges. And as you say, we cannot 100% prevent suicide attempts in our patients, but the Brief Mood Survey will give you vastly improved information, since you will have the patient’s scores at the start and end of every therapy session.

One additional point, most versions of the Brief Mood Survey ask how the patient is feeling right now, just prior to the start of the session, and once again right after the end of the session. This is so the therapist can find out how effective, or ineffective, the session was. Such information is incredibly valuable! However, you can also ask if the scores reflect how the patient was feeling during the week, between the sessions. This is important, because the patient may have had times when he or she was feeling more suicidal, and this might merit a more intensive interview to assess the risk.

When you receive you EASY Diagnostic System from me (I assume you’ve already don this), you’ll find a structured screening interview for suicidal patients at the end of the diagnostic manual. This can be very helpful. There’s also a chapter in my psychotherapy eBook (Tools, Not Schools, of Therapy) on “The Prediction and Prevention of Suicide and Violence” that can be helpful as well. I have also included that chapter in the upgrade to the Therapist’s Toolkit.

Finally, please give Lynne Spevack my regards. She is a terrific teacher and therapist! I enjoyed catching up with her at the Newark workshop and encouraged her to meet more frequently with her training group. I agree that twice a month is not really enough. Keep in mind we now have three TEAM-CBT training centers in New York (for links, check out my referral page), plus numerous weekly online training groups that therapists around the world can join.

All the best,

David

 

If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and resources for mental health professionals as well as patients!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David