September 18, 2017 by Dr. Burns

053: Ask David — “I don’t feel like doing it!” Quick Cure for Procrastinators

Quick Cure for Procrastinators

In this podcast, David and Fabrice answer a question from a listener named Benjamin on the topic of procrastination. He wrote:

“The live therapy with Marilyn was very interesting – like other listeners, I was impressed by her character and strength.

“Towards the end of this most recent podcast, you were musing on what topics to cover in future podcasts. I would love to hear about how you treat people suffering from chronic laziness (“Do Nothingism”). In particular, there seems to be a strong potential of a Catch-22 with Process Resistance: The patient cannot find the motivation to do anything, yet they have to carry out the process (do the homework) to improve.

“Even worse, in “Feeling Good”, you categorize “Do Nothingism” into around 10 different categories, and suggest a different approach for each one. What should a lazy person do, who identifies with multiple categories, but is already starting to feel overwhelmed at the prospect of doing one of those activities, let alone five of them?

“I would love to hear David’s thoughts on this!”

David and Fabrice begin by thanking Benjamin, and David emphasizes how helpful and inspiring it is to receive specific questions like this, which makes it easy to create a (hopefully) informative and interesting podcast.

David says that his thinking about the treatment of procrastination has changed greatly since he wrote Feeling Good. One big change is that he no longer tries to “help” individuals who procrastinate, since this will cause them to continue to procrastinate, and the failure will now be the failure of the therapist, who’s “helping” wasn’t good enough.

Instead, David outlines a multi-step approach, based on someone who has ten years of unfiled papers that have piled up in his office, so that by now 15 feet of desk space is completely covered by piles of papers roughly one foot high. Fabrice plays the role of the resistant patient, and David plays the role of the therapist.

The steps include:

Paradoxical Agenda Setting: David asks, “The procrastination seems to be working for you. Why would you want to change? Let’s make a list of all the benefits of procrastination, and all the reasons NOT to change.” David emphasizes that the patient has to convince the therapist that this is something he really does want to change. It’s NOT the therapist’s role to help or to convince the patient to change!

Miracle Cure Question: What kind of help would you like in today’s session? Most patients say they need help with motivation. David declines to offer this, explaining that it isn’t on the therapeutic menu today—only the “Blue Plate Special!” The patient must agree to begin working on the filing in spite of having no motivation.

David also explains the underlying concept behind this strategy: most procrastinators are waiting for motivation, but that never works. You’ll be waiting forever, because you’re NEVER going to feel like doing all that filing! You aren’t entitled to motivation!

Productive individuals know that action comes first, and motivation comes second.

Specificity: What time would you like my help in overcoming your procrastination? The patient’s requests for help yesterday or tomorrow are declined by the therapist, so they settle on 6 PM today.

Little Steps for Big Feats: Let’s list the first five things you would need to do tonight at 6 PM, making sure that every step can be completed in 15 to 30 seconds. They list these steps:

Walk into my office
Choose one pile to start working on
Pick up the top piece of paper on the pile
Put it into a blank manila file folder
Label the file folder

Let’s Be Specific: David asks if Fabrice needs help with Step 1? Step 2? Etc. Fabrice finally admits he can do these five steps.

Five Minute Rule: David asks if Fabrice will agree to do these five steps between 6 PM and 6:05 PM, and if he will agree to work on his filing for ONLY those five minutes. At the end of the five minutes he has completed 100% of the assignment. The rationale is that if Fabrice tries to do it all, he’ll get so overwhelmed that he won’t do anything. But if he agrees to ONLY five minutes, that will be do-able. And if he surprises himself, and gets motivated to do more, he can, be he only gets credit for the first five minutes.

Problem – Solution List: David asks Fabrice to put a line down the middle of a piece of paper, from top to bottom, and list all the problems that will get in the way at 6 PM, and then to list convincing solutions to each problem in the right-hand column. Fabrice lists two problems: 1. I won’t feel like it. And 2. Traffic might be heavy, so I might not get home by 6 PM.

“I Stubbornly Refused” Technique: David asks Fabrice to agree to an unusual phone call at 6:05 PM!

TIC – TOC Technique: David plays the role of Fabrice’s “Task-Interfering Cognitions” (TICS) that will tempt him to procrastinate, and asks Fabrice to play the role of the “Task-Oriented Cognitions” (TOCS) he can use to combat the TOCs. The TICS include the familiar ones such as:

Five minutes won’t help, the job is overwhelming.
Even if I get started, I’ll just relapse, so there will never be a permanent solution.
It’s not such a big problem, I don’t need to do my filing now.
I can watch Game of Thrones on TV instead. That will be more fun.
It will be too anxiety provoking to get started.
It’s too late to get started anyway.
Tomorrow will be a better day.

David confesses the problem is one that he actually had, and describes how he solved it, using this exact approach!

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 forward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

September 11, 2017 by Dr. Burns

052: Your Responses to the Live Work with Marilyn — Are People Honest in Their Ratings, and Do the Improvements Stick?

The responses to the Marilyn session were extremely positive. At the start of the podcast, Fabrice reads a response from a listener who was moved and inspired by the work Marilyn did.

David and Fabrice discuss two questions commonly raised by people who have seen David’s live demonstrations with individuals experiencing severe depression and anxiety. Since the change in Marilyn’s scores were so fantastic, some skeptical listeners have asked, “Was this real, or was it staged?” Others have asked if patients are simply giving favorable answers on the Brief Mood Survey and Evaluation of Therapy Session forms as a way of being “nice” to the therapist.

David points out that the opposite is true. If patients are in treatment voluntarily, without some kind of hidden agenda such as applying for disability, they tend to be exceptionally honest in the way they fill out the forms. In fact, most therapists find that they get failing grades from nearly every patient on every scale at every session at first. This can be very upsetting, especially to therapists who are narcissistic and defensive about criticism. But if the therapist is humble and open to the feedback, the patient’s feedback on the Brief Mood Survey as well as the Evaluation of Therapy Session forms can provide a fabulous opportunity for growth and learning.

So in short, it is not true that patients fill out the forms just to be “nice” and to please the therapists. The scores are brutally real! If you are a therapist and a doubters, you can give the assessment instruments a try, and I think you’ll be surprised, and perhaps even shocked when you review the data!

Still, David acknowledges that the rapid and phenomenal changes he now sees most of the time when using TEAM-CBT are hard to believe, especially when you’ve been trained to think that recovery is a long, slow process. David discusses a model of brain function proposed by a molecular biologist / geneticist, Dr. Mark Noble, that allows for extremely rapid change.

David and Fabrice also address the question—can these kinds of miraculous results last, or are they only a flash in the pan? David emphasizes the importance of ongoing practice whenever the negative thoughts return. The “one and done” philosophy is not realistic. Part of being human is getting upset during moments of vulnerability, and that’s when you have to pick up the tools and use them again!

David describes experiencing three hours of panic just a few days ago, and Fabrice asks what techniques he used to deal with his own negative feelings, including Identify the Distortions, Examine the Evidence, Reattribution, and the Acceptance Paradox.

David agrees with the Dalai Lama that happiness is one of the goals of life, but emphasizes that it is not realistic to think one can be happy all the time. Fortunately, you can be happy most of the time–but you have to be willing to pick up the tools and use them from time to time when you fall into a black hole!

David and Fabrice

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 Podcast 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!

Thanks! David

September 9, 2017 by Dr. Burns

Exciting Upcoming Events!

Dear Web visitors,

I would like to invite you to some exciting events coming up in the near future. The Feeling Good talk will be sponsored by Stanford and is free to Stanford-affilated health professionals. Three is a $40 fee for the general public. I’ll be discussing CBT as well as the new developments in TEAM-CBT, with a dramatic video clip and some inspiring vignettes. I’m very honored to have this opportunity to present at Stanford!

The Fault workshops will take place in three east coast cities at the end of October, and the first will be live-streamed, so you can “attend” from anywhere in the world.

I hope you can join me for one of these exciting events!

All the best,

David

Feeling Good

October 27, 2017, 8 to 10 AM
Stanford University Li Ka Shen Center, Room 130
For health professionals as well as the general public

Sponsored by the Stanford Health Promotion Network, this presentation by David D. Burns, M.D., will focus on fast, effective, drug-free treatments for depression and anxiety disorders. This event is free for Stanford-affiliated individuals and $40 for others who wish to attend. I hope you can join us!

Click here for registration and more information

“And It’s All Your Fault!” Transforming Troubled Relationships Into Loving Ones

October 30 – 31, 2017–Raleigh, NC: Double Tree Raleigh Brownstone-University
November 1 – 2, 2017–Atlanta, GA: Atlanta Marriott Century Center
November 3 – 4, 2017–Denver, CO: Double Tree by Hilton Denver-Westminster
For more information, click here, or contact IAHB, phone: 800-258-8411

The Raleigh workshop on Oct 30 – 31 INCLUDES A LIVE WEBCAST– Click here for more information

Thanks! David

September 7, 2017 by Dr. Burns

Cool Introductory Online TEAM-CBT Course!

Hi everybody,

Here’s a fabulous online introductory course on TEAM-CBT by Mike Christensen, an outstanding teacher. Check it out!

I apologize this is last minute, but I just learned about it, and you still have time to register before the free introductory session on Monday!

All the best,

David

Thanks! David

August 28, 2017 by Dr. Burns

Temporary Podcast Hiatus

Hi friends and colleagues,

Fabrice is taking a much deserved summer vacation break, so we will not be broadcasting any Feeling Good Podcasts this week or next week. We both apologize for the break, but want to thank you for your terrific support of our efforts!

By the way, both summer intensives were fabulous! I want to thank all those who attended in Canada (Banff) and in the United States (Burlingame, CA). I did live demonstrations at both, and they were tremendously rewarding and informative, except for a few participants who did not believe people could recover from depression and anxiety so rapidly and completely, and claimed that the live demonstrations with audience volunteers were staged! Some people have been taught that the treatment of depression is a long, slow process, and they have a hard time re-adjusting their expectations and beliefs, which is totally understandable.

With TEAM-CBT, the recovery is usually sudden. The very moment the patient stops believing the distorted negative thoughts, the mood almost instantly changes. This is more like the model of pain reduction when you take your hand off of a hot stove!

I have been posting much less recently to all my blogs because I am using my time and energy on my new book, which will be for all of you!

All the best,

David

Thanks! David

August 22, 2017 by Dr. Burns

051: Live Session (Marilyn) — Methods, Relapse Prevention (Part 3)

Live Session (Marilyn) — Crushing Negative Thoughts (Part 3)

In this third and final podcast featuring live therapy with Marilyn, David and Matt move on to the M = Methods phase of the session along, and encourage Marilyn to challenge the Automatic Negative thoughts on her Daily Mood Log using techniques such as Identify the Distortions, the Paradoxical Double Standard Technique, the Externalization of Voices, and Acceptance Paradox. Marilyn emerges as a powerful partner and begins to crush the negative thoughts that had seemed so real and overwhelming at the start of the session.

David emphasizes that the perceptions of therapists can often be way off base, so even though Marilyn appeared to change—fairly dramatically—during the session, David, Fabrice, and Matt will not know for sure until they review Marilyn’s end of session ratings on the Daily Mood Log, Brief Mood Survey, and Evaluation of Therapy Session.

David defines a relapse as one minute or more of feeling lousy. Given this definition, all human beings will “relapse” frequently, including Marilyn. But relapses following recovery do not have to be a problem if the patient is prepared for them ahead of time. You will hear David and Matt doing relapse prevention using a number of techniques, including the Externalization of Voices.

Fabrice, Marilyn, Matt and David discuss the session, and what it meant to Marilyn from a personal and spiritual perspective. You can view this session as a powerful psychological experience—a “mind-blowing” single session “cure,” if you will—or as a profoundly healing spiritual experience: the emergence, resurrection, or rebirth from the “Dark Night of the Soul.” And you can ask yourself—did a genuine miracle happen here today?

Marilyn DML, end of session, mood only
Marilyn BMS before and after, v 1

I, David, am very indebted to Marilyn for making this phenomenal and intensely personal experience available to all of us. What a gift! Thank you, Marilyn. We love you!

I also want to thank my co-host, Fabrice, for making these podcasts happen! What a joy it is to work with you every week, Fabrice.

And I want to thank my fantastic co-therapist, former student, and colleague, Matthew May, MD, for support and friendship over these many years! Matt, as you know, I often sing your praises in my workshops around the country, telling people how amazing you are. Now they will see what I mean first-hand!

I hope that through these three podcasts, Marilyn will touch large numbers of people for years, even decades, to come. If you were touched by these recordings, please let your friends and colleagues know, so that they might have the chance to “tune in” as well.

In the first session with Marilyn, I mentioned the highly controversial theory that our pain usually results from our thoughts, and not from the circumstances of our lives. What do you think now?

Note: We’ll publish the raw, uncut version of the complete session separately (iTunes does not seem to distinguish it from the regular podcast episode).

August 15, 2017 by Dr. Burns

Fabulous Feedback for Marilyn!

Hi Web visitor,

I just received this wonderful email after the second of the three Marilyn live therapy podcasts, and reproduce it here with permission from the author, and want to thank Jennifer for writing it! I also want to thank Marilyn for her incredible contribution to so many of us, and also my wonderful co-therapist, Dr. Matt May, and fabulous host, Dr. Fabrice Nye!

David

Subject: Marilyn Podcast

THANK YOU to you and Marilyn and Matt. And Fabrice!

The podcasts with Marilyn were powerful! Just finished the second part and had to write. I live in New Orleans and so am unable to attend all your wonderful Tuesday night Stanford training groups we hear about, so to have this podcast is pretty significant and wonderful 🙂

I immediately felt connected to Marilyn during the first episode, feeling her emotions right long with her, like I was able to experience what it may be like to have this diagnosis. And felt sad when it was over and could hardly wait to hear the next week. So I had to be with that discomfort . . .

Among other profound ways she helped through sharing her experience, she is teaching us the great lesson of impermanence, as the Buddha taught. Such a valuable teaching she gives by sharing her experience!

And this week was amazing, I was trying to pay close attention to the brilliant work of you and Matt. He is just SO GOOD! It was such a great learning experience!! I felt like I was realizing and discovering right along with Marilyn.

My heart is filled with love and pure compassion and deep appreciation for the three of you for sharing this with us. I want each of you to know what a tremendously beneficial learning experience this was for listeners and that I will undoubtedly use this in my work (mainly with folks from LGBTQ / POC and other marginalized communities, often dealing with addiction). I am hopeful it will directly impact my ability and skills in helping others. Ripples . . .

I have been training in TEAM since 2013 but I’m a slow learner and have mastered nothing about it (yet). However, the timing of this podcast was perfect so that I have learned enough that I was with y’all every step of the way, listening, experiencing, and perhaps absorbing it in a new way. It brought some clarity to the process and flow.

Pardon my rambling praise but I am filled with gratitude and awe and looking forward to the next one!

If you can pass on my thanks to Marilyn and Matt and Fabrice (if you’re still reading this!) – thanks.

Jennifer Myhre

PS what’s great about not being able to sleep?

Time for great learning from David’s podcasts!

😁