Yikes! The Feeling Good Podcast Cured 40 Years of Depression! What Happened?

Yikes! The Feeling Good Podcast Cured 40 Years of Depression! What Happened?

Comment: Dear David and Fabrice,

hke photo 3Thank you for the Feeling Good podcasts!

I am 63 years old and have had mild to moderate depression since my 20s. The lowest score I ever got on the BDI in your book, Feeling Good, was 12, when I was seeing a therapist. (David comment. The BDI is the old Beck Depression Inventory, and it goes from 0 to 63. A score of 12 indicates mild depression.) Usually, my depression score was in the 21-22 range. (David comment: moderate depression.)

Four weeks ago, I was having a very bad day, and thought I’d try one of your Feeling Good podcasts. I started listening to one that was a few episodes into the series about cognitive distortions, and it was information I knew, but I thought, “this is good, I’m starting from Episode 1, called “You Feel the Way You Think.” I was in a parking lot and I started to drive and listen to Episode 1. Halfway through the episode I thought, “I don’t think I’m depressed….at all.” It was such a different feeling, like David talks about, but I never believed him.

It’s four weeks later, and I’m still not depressed. I took the BDI and scored a 1. You tell *me* what happened. I don’t know!

I am a little concerned that I don’t really know what “relapse prevention” steps I should take, but I’m taking exercise classes (a miracle in itself), working every week on my novel, and other amazing things. Whatever happened, thank you, thank you, thank you!.
Deepest respect and regards,

Arlene
Hi Arlene,

Thank you for your fantastic email. I really appreciate it. That is SO COOL!

I am about to fly to the east coast for three workshops, so can only give you a brief response now, but will write a more detailed blog for you on Relapse Prevention Training when I return home. Here are the high points of it, with more details later, I promise!

  1. You must know that we will all relapse forever. I define a relapse as one minute or more of feeling crappy. Give that definition, we all relapse all the time. No one is entitled to be happy all the time, and your negative thoughts will try to return over and over. But it does not have to be a problem if you are prepared and know what to do. In fact, bad moods are part of what makes us human, and they give us the potential for emotional (and, arguably, spiritual) growth.
  2. The technique that worked for you the first time will likely always work for you. Initially, when I work with some, I may have to try several techniques before I find the one that works. But after that, it is much easier, as you just use that same method or technique. For example, it might just be writing down one of your negative thoughts, pinpointing the distortions in it from my list of ten cognitive distortions, and then substituting a more positive and realistic thought, perhaps the way you might talk to a friend who was depressed and anxious.
  3. You need to write down the negative thoughts NOW that will almost definitely cross your mind, and every person’s mind during a relapse. they include thoughts like these:
  • a. This relapse proves I’m hopeless.
  • b. This relapse proves the therapy didn’t work. It was just a fluke that I got better.
  • c. I didn’t even really get better, I was just fooling myself.

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

 

Should Therapists Apologize? A Raging Debate!

Should Therapists Apologize? A Raging Debate!

Hi web visitors and friends on social media. Yesterday I got a really interesting email from my esteemed colleague, Angela Krumm, PhD, who created the certification program for TEAM-CBT. Angela’s clinical practice is located at the Feeling Good Institute in Mt. View, California. and they also offer training for therapists. I thought you might enjoy the question, as well as my answer. You will see that the information is relevant to everybody, and not just therapists.

If this topic of developing more loving and satisfying relationships interests you, you can read more about these techniques in my book, Feeling Good Together, available at Amazon and other book sellers.

IMG_1761Hi David,

The TEAM Certified list serve is having a colorful discussion about the use of apologies (specifically, saying “I’m sorry”) within the Five Secrets of Effective Communication. People are pretty engaged and arguing both for and against “I’m sorry.” Would you like me to share the comments with you?

If you’re interested, I’d love to post a response from you about whether you teach people to say “I’m sorry.” I think your general mode (if I remember from past training) is to avoid “I’m sorry” since it’s so generic and less specific than the Five Secrets.

Let me know if you want to see the comments and have a chance to respond.  I can send them to you!

Angela Krumm, PhD

Hi Angela,

To my way of thinking, “I’m sorry” can be effective or dysfunctional, depending on how it is used. In my experience observing clinicians in training, as well as troubled couples in treatment, it is nearly always dysfunctional, but it doesn’t have to be. Let me explain.

I recently treated a troubled couple from Los Angeles who had treated each other shabbily out of anger for many years. Without going into all the details, the husband had an affair with a woman they both knew from their church, and slept with her every night for six months. The affair appeared to be his way of getting back at her for something she had done that hurt him.

His affair was devastating to the wife, and she kept making up excuses for the children why Daddy can’t come home tonight. Every time she tried to express her feelings of being hurt, angry, anxious, humiliated, and betrayed, her husband would say, in a defensive tone of voice, “I’ve said I’m sorry! You have to put that behind you so we can move on! We’ve already talked about this!”

As you can see, he used “I’m sorry” as a way of avoiding listening and hearing how his wife felt. And although they’d bickered about their problems endlessly, he’d never really listened or giving her the chance to be heard.

I don’t want to scapegoat him—she gave the same dismissive and defensive answers when it was her turn to listen to his complaints and feelings. But it seems pretty clear to me that his use of “I’m sorry” was defensive and aggressive. It was his way of saying, “shut up, I don’t want to hear what you have to say.”

Therapists frequently do much the same thing in response to criticisms from patients. For example, a patient might say, “Last session you interrupted our session to take an emergency call, but I’m paying for the time!”

The well-meaning therapist might apologize and say, “I’m really sorry. I’ll remind my secretary to hold calls during our sessions unless it’s something super severe like an actively suicidal patient.”

It should be easy (I hope!) to see that this therapist is also using “I’m sorry” as a way of brushing the patient off, so the therapist doesn’t have to deal with the patient’s anger and hurt feelings. But those kinds of feelings may be a central problem in the patient’s life, and the therapist has missed a golden opportunity to deepen the relationship through the skillful use of the Five Secrets.

I have often said that no therapist in the United States or Canada is able to deal with or acknowledge a patient’s anger. Of course, this is an exaggeration to make a point, but it is SO TRUE most of the time! In my experience, it is very difficult for therapists to master the Five Secrets, for use in therapy, as well as in their personal lives, which can be even harder.

Of course, you can apologize skillfully. Apologies aren’t inherently dysfunctional. For example, you could respond to your patient’s criticism like my example below, which is based on the Five Secrets of Effective Communication. The abbreviations in parentheses at the end of each section indicate the communication technique(s) used in that sentence.

“I felt badly about interrupting the session, too. (IF) This is your time, and any interruption is unfair, and I want to apologize. (DT) The call was from an actively suicidal patient, but still my focus should be on you. (DT) I wouldn’t be surprised if you’re feeling hurt and ignored, and maybe even a bit angry with me, for good reason. (FE; DT) This is especially painful for me, because one of the themes you have described is that ever since you were a kid, the people you care about seem to ignore you, and don’t take you seriously. You said they gave your older brother all the attention, because he was a straight A student, so you end up feeling lonely and rejected most of the time. (IF; FE; DT) Now I’m in the role of ignoring you, and it’s especially painful for me because I respect you tremendously (IF; DT; ST) At the same time, I’m excited, because this is really important and can give us the chance to slay that dragon and deepen our relationship. (ST; Positive Reframing) Can you tell me more what that was like for you, as well as other times I’ve said or done things that hurt your feelings? (IN)”

I’m sure that can be improved upon, and is perhaps too long. But the important thing is that you are honoring your patient’s feelings, and encouraging him or her to open up. In this context, the apology is okay. However, notice that the phrase, “and I want to apologize” probably isn’t even needed.

I would also say that therapists, as well as patients, sometimes polarize things as “this way” vs. “that way,” so they can argue and feel like experts. Sorry if I sound a bit cynical here! Skillful and effective therapy is rarely “this way” vs “that way,” but exists on a higher plane. TEAM-CBT does not consist of simple formulas you can apply. It is an art form that is difficult to master, and simplistic approaches usually won’t be effective.

The bigger issue is that every one of the Five Secrets can be used in a skillful, compassionate, helpful way, or in a dysfunctional way. In fact, this is true of every method and technique in TEAM-CBT. For my two cents, I’d rather hear that people are asking for help in learning, rather than arguing about who is right and who is wrong, but I’m old and probably sound pompous or annoyed, so I will stop babbling!

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 relationshp conflicts.

Thanks! David

 

Self-Acceptance–Are We All Defective?

hike photo 9Hi everybody,

I’ve been getting lots of great emails with questions recently, and will try to get to as many as possible. Here is one from this morning.

Hi Dr. Burns,

I really hope you get to see this! I just wanted to say how I love your book and it has been helping me a lot I bought and read Feeling Good: The New Mood Therapy, and I’m currently reading your book on anxiety, When Panic Attacks.

But I did want to say one thing. On page 216, near the bottom, it says, ” … in fact, we’re all defective and you can view your ‘defectiveness’ as a reason for suicide or a cause for a celebration….”

I didn’t understand that. That we should view us being defective as a reason to kill ourselves?? It threw me off and I asked my friend to read it over. I just want to know what you meant!

It’s near the bottom second to last paragraph on page 216

Nicole

Hi Nicole,

Sometimes I write things that may be hard to “get” at first, so I appreciate your question. First, let me emphasize that suicide is never appropriate or needed for someone who is feeling depressed and hopeless. However, was writing about something I call the Acceptance Paradox, where you achieve enlightenment by accepting your many shortcomings with a sense of inner peace, or even with a sense of humor. I call that “healthy acceptance.”

And when you “grasp” this notion that it is okay to be flawed and defective, or even wonderful, you can achieve liberation from feelings of depression, anxiety, shame and self-doubt. And it brings you a lot closer to other people, too, because, believe me, there are TONS of other defective people out there, so we can have a party and lots of folks will join us, and we can just hang out and not worry about having to impress each other.

But people who are depressed usually have what I call unhealthy acceptance. They wrongly believe that because they are defective, they should kill themselves.

If you CLICK HERE, you will find a chart that distinguishes healthy from unhealthy acceptance.  As you can see, healthy acceptance is characterized by joy, intimacy, laughter, and creativity. In contrast, unhealthy acceptance is characterized by cynicism, depression, hopelessness, and loneliness.

This is sometimes hard to “see” at first on an emotional level, especially if you are depressed, or prone to depression. But when you suddenly “get it,” it’s like seeing the grand canyon for the first time. It simply takes your breath away, and you discover that it’s only okay to be defective, it’s actually great–in fact, the very BEST way to be!

I am writing something more ambitious on this topic, and I’ll publish it here soon. This is just a beginning note intended to whet your appetite, hopefully at least! What I am writing about now are some of the more philosophical underpinnings of TEAM-CBT, although the notions are actually ancient, and go back at least 2500 years. I will try to address two questions:

  1. Is it possible to be worthwhile or to be worthless?
  2. Do we have a “self”?

Although these themes may seem abstract, they have powerful, practical, emotional consequences. Just one small example, let’s say you struggle with anxiety and shyness. You may have the fear that others will judge you because you are inferior, or not “good enough,” and this thought can cause tremendous suffering. But this thought is based on the notion that you have a “self” that can be evaluated or judged. When you see through this notion, you can experience liberation from your fears.

The Buddhists called this “The Great Death.” Of course, we all fear death, and struggle to keep our egos alive. But once you’ve “died,” so to speak, you can join the Grateful Dead, and then life suddenly opens up in unexpected ways. And for those who may misread me, or interpret my words literally, I am not referring to physical death, but death of the “self.”

So, stay tuned if this type of dialogue interests you! And thanks for reading this!

Doctor David

If you are reading this blog from Facebook or Twitter, I appreciate it! I would like to invite you to visit my websitehttp://www.feelinggood.com, and register there as well. You will find a wealth of free goodies, including my Feeling Good blogs, plus all my Feeling Good Podcasts to date, and the Ask Dr. David blogs as well, along tons of resources, including videos for mental health professionals as well as patients and the general public!

An Anxiety Question and a Blessing from Turkey for “David Uncle!”

An Anxiety Question and a Blessing from Turkey for “David Uncle!”

Hi Dr. Burns,

whenpanicattacks-sm  Thank you for your life-saving books and blogs. They really help. I have given your book, When Panic Attacks, to others. It is so good! What I admire the most is your empathy and your desire to seek the truth.

I have a simple request. Can you clarify the use of cognitive flooding and thought-disputing? I find these two methods to be quite useful but confusing at times. For example, it doesn’t seem logical to flood my mind with panic thoughts and then turn around and dispute them. Perhaps morning flooding and evening disputing?

I don’t know that a general answer is possible but any thoughts you have are sincerely appreciated. I understand you do not give personal advice and that if you do answer, it will be for the help of many others who follow your blogs and appreciate your insights.

Bill

Hi Bill, Thanks for your kind comments and question. I am embarrassed that I can’t give you a good clear answer. But I’ll try to babble briefly. Remember that there are four treatment models for anxiety, and I use all four with every anxious patient I treat.

  • The Motivational Model—where you bring the anxious patient’s Outcome and Process Resistance to conscious awareness and melt them away.
  • The Cognitive Model—where you challenge the distorted negative thoughts that trigger the anxiety, using a wide variety of techniques such as Identify the Distortions, Externalization of Voices, the Experimental Technique, and so forth. You call this “thought disputing,” but there are more than 50 ways of disputing and crushing negative thoughts.
  • The Hidden Emotion Model—often the overly “nice” anxious individual is sweeping some feeling, conflict, or problem under the rug and not dealing with it. When the patient brings the problem to conscious awareness and deals with it, the anxiety often disappears completely.
  • The Exposure Model—where you flood yourself with anxiety by facing your fears. If you stick with it, in most case the anxiety will diminish over time and then disappear. You call this “cognitive flooding,” although that’s just one of many exposure techniques.

I describe these four models and methods in my recent series of Feeling Good Podcasts on the treatment of anxiety (Podcasts 22 to 28). You might enjoy listening to them, and can link to the first one if you CLICK HERE. All four treatment methods are helpful, but they work in different ways. You never know which method or methods will be the most helpful to any individual.

But I have to confess I don’t “schedule” them as you have suggested. However, that’s not a bad idea! In my experience, depressed and anxious individuals who work with these techniques, and actually try them, including the written exercises, as opposed to just reading about them, nearly always have the best outcomes. So stick with it!

And of course, if you need help or guidance, it never hurts to check with a mental health professional. However, I would personally tend to avoid a psychiatrist as my first choice, as you are likely to get drugs, drugs, drugs. Although I am a psychiatrist, and have prescribed medications on occasion, I find that most depressed and anxious individuals can now be treated quickly and effectively without medications. In addition, research studies indicate that many people recover from depression anxiety on their own after reading one of my books, but if you need a little guidance from an expert, there’s no shame in that at all! Sometimes, we all need a little help from our friends!

Sincerely,

David

 

Hi Dear David Burns,

feelinggood  Firstly, I want to say thanks a lot for you book, “Feeling Good: the New Mood Therapy”! This book has changed my life! Now I love life and enjoy everything in life.

My story started after reading your book second time! Thanks very much! God bless you David uncle!

Sedef (from Turkey)

Hi Sedef,

Thank you so much for your kind and incredible comments, and for your blessing! I am thrilled that you are now loving life and enjoying life! That is like a miracle and the greatest gift a human being can receive.

It is many years since I wrote Feeling Good as a young man, editing it while we were on summer vacation in California, at Lake Tahoe. You might not have even been alive at that time! It seems like a miracle that my words have now touched you, so many miles away. God bless you, too, Sedef!

All the best,

David Uncle

Do We Have a “Self?” / Truth vs. Happiness

Do We Have a “Self?” / Truth vs. Happiness

IMG_1226Hi Dr. Burns,

Being as you love my questions here is another. It is a heavy philosophical one but don’t feel the need to give a long answer. The question is: Should we believe what is true or what makes us happy?

Albert Ellis, in his book “the Myth of Self Esteem,” actually mentions you. I know you’d want to kill the guy if he were still alive for destroying the basis of many of your books, but don’t you feel honored that grumpy old Al mentioned you? He writes a few hundred pages but all he seems to be saying is that you can’t prove whether you are worthwhile or not so you’d might as well believe that you are.

My new coach seems to think that truth is relative and all that kind of stuff. She thinks that you should believe what is best for you and don’t worry about whether it’s true. Even Dr. Ali Binazir says something like the usefulness of a belief is more important that its truth (can’t find exact quote).

What do you think? Should I believe what makes me happy and forget about logic or keep on thinking (and maybe be not as happy)?

Richard

Hi Richard,

Great questions, thanks!

First, with regard to Dr. Ellis, I was a huge fan of his, and we saw eye to eye on a great many topics. I admired his ruthless integrity and regard for the truth. He did not steal ideas from others, as so many in our field do, and call them his own, but always gave credit where credit was due. So I was a huge fan and always honored when he mentioned me!

of course, he was a wild man, no doubt about it, and all those who saw him in person during his workshops will know what I mean. Every third word that came out of his mouth was the F-word. But he had tremendous numbers of fans and followers. In fact, i think many people liked him because he was so delightfully outrageous and honest!

As you know, Dr. Ellis created Rational Emotion Therapy (RET), which later morphed into Cognitive Behavioral Therapy (CBT). He is considered the “grandfather of CBT.” Beck is often thought of as the “father of CBT.” I might be the son of CBT! Who knows? So many talented therapists and researchers have contributed to the new approaches in psychotherapy that began about four or five decades ago.

I agree with Ellis that you cannot measure your worthwhileness as a human being, so you might as well give up this fruitless and often painful endeavor. but I don’t even need to assume that I am worthwhile. I am too busy enjoying life to waste time on that idea!

I have a beautiful new kitty, Miss Misty. she doesn’t care whether or not I am worthwhile, either! But she loves to play and cuddle. That’s enough for me.

You can measure the worthwhileness of specific things, like this post. For example, you might give it an A, a B, a C, or below, depending on how much you like it and learn from it. But you cannot measure the “worthwhileness” of your “self.” In fact, there is no “self.” We can focus on improving in specific areas, however. For example, if you exercise regularly your conditioning will improve. But your “self” won’t improve!

One of the best students I ever had was Matt May, MD, who now teaches with me at Stanford and has a booming clinical practice. He is a totally fabulous clinician, dear friend and esteemed colleague. When he was a resident, I would supervise him three hours a week, going over clinical cases and personal issues as well, which is typical of what happens in psychiatric training.

One day we were driving back to my house from a pizza place where we’d been eating and discussing his cases, and going over some personal stuff. We stopped at a stop sign, and he looked at me in very meaningful way and said, “Dr. Burns, I want you to know that I’m working so hard every day to become a better person!”

I said, “Matt, I hope you get over that pretty soon!”

He immediately broke into laughter and “got it.” That was the moment of his enlightenment. Enlightenment often comes with laughter, as you realize your suffering has been the result of a kind of cosmic joke. This is a Buddhist notion going back 2500 years, but it is also embedded in most religions.

Thie idea that we have no “self” is mystical but practical and potentially liberating. Buddha got the ball rolling when he talked about the “Great Death,” or the death of the ego. I lost my “self,” along with my “self-esteem” years ago, when I was jogging home from the train station in Bryn Mawr Pennsylvania after work. And what a relief to get rid of them. They kind of fell off, and then I started jogging faster without having to carry them any longer.

Sadly, my “self” (and my pride) have a way of coming back to life from time to time, so then I have to get rid of them again! That sucks!

If you understand this, it is likely crystal clear and super obvious, perhaps. But if you don’t understand it, it is likely sounding like so much mumbo-jumbo!

You asked if we should believe what is true, or what makes us happy? This is a vague question, so I don’t know what you are referring to. Usually I try to avoid general questions without specific examples. Perhaps you could make your question a bit more specific? For example, what belief in particular are you referring to?

If you go to Las Vegas you may want to believe that if you put your life savings on a number on the roulette wheel, you will earn a tremendous amount of money. But the likelihood is small, so even though the notion is enticing, you probably won’t want to do that.

In therapy, I use both truth and motivation in working with someone who is depressed, anxious or angry. Both are powerful and potentially healing technologies for folks. Obviously, we tend to believe things that appear to be true. But we also tend to believe what we WANT to believe. Motivation also plays a basic and powerful role in how we think and what we do.

Cult leaders motivate followers by telling them absurd things that could not possibly be true. For example, the Heaven’s Gate San Diego cult leader told his followers that if they committed suicide they would be reincarnated on the Hale–Bopp comet that was passing close to the earth. So they all killed themselves! The cult followers WANT to believe what they are being told, so they buy into it. Hitler used the same method to motivate people, telling them they were the superior race. People want to feel superior, and want to scapegoat and blame others for their problems.

From a philosophy of science perspective, some statements or theories can be proven to be false. For example, you can easily test the claim that if you drop your pen, it will float up to the ceiling. Drop it and you will see that this theory is false.

But sometimes we make value judgments, or stipulations, that cannot be proven one way or the others. For example, take the statement, “All men (or all humans) are created equal.” This is a value system we endorse, but it cannot be proven one way or the other. Our moral and legal laws are like this.

Take the belief, “I should always try to be perfect.” This cannot be proven to be true or false, it is just a value you might, or might not, endorse. There are many advantages to this belief, as well as many disadvantages. I deal with this belief all the time in therapy, as it seems to trigger feelings of depression, inferiority, anxiety, and defectiveness, to name just a few. But at the same time, the belief may motivate and make you feel like something wonderful is going to happen when you achieve your goal.

So, sometimes considerations about truth will dominate our thinking and our decisions, and sometimes considerations about advantages and disadvantages (motivational issues) will tend to dominate our thinking, and sometimes considerations of truth as well as motivation both play a role in how we think, feel, and behave.

This is all a bit too theoretical for me, although still interesting. I am a psychiatrist, but my main treatment tool is psychotherapy. The type of psychotherapy I do always focuses on something specific and real, for example, a specific moment when someone is upset and wants to feel better or behave more effectively. General discussions have been much less effective as treatment tools in my experience.

But still fun to talk about! So thanks, Richard!

David

Is Happiness a Distortion?

Is Happiness a Distortion?

Hi Dr. David Burns,

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

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

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

Have a Nice Day!

Jason

Hi Jason,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Thanks!

David

How to Find Your “True Calling” in Life!

How to Find Your “True Calling” in Life!

Dear David,

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

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

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

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

I really need your help!

Thanks, Sharon (name disguised)

 

Hi Sharon,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

David