083: Role-Play Techniques (Part 1) — Externalization of Voices / Acceptance Paradox

083: Role-Play Techniques (Part 1) — Externalization of Voices / Acceptance Paradox

This is the first several podcasts on the Role-Playing Techniques David has created. They include:

  • Externalization of Voices (with Acceptance Paradox and Self-Defense Paradigm)
  • Paradoxical Double Standard Technique
  • Feared Fantasy
  • Devil’s Advocate
  • Forced Empathy
  • Man from Mars
  • And more

David’s explains that he began developing role-playing techniques in the early days of cognitive therapy because many of the Beckian techniques, such as Examine the Evidence and the Socratic Technique–while sometimes very helpful, were sometimes a bit dry, and he wanted to include punchier and more powerful and dynamic techniques in his therapeutic toolkit. These role-playing techniques are just one part of what sets TEAM-CBT apart from traditional, Beckian CBT.

Today, he explains and demonstrates the Externalization of Voices, which is always combined with the Self-Defense Paradigm and the Acceptance Paradox. He is joined by Fabrice, of course, and “Sarah,” one of the members of his Tuesday training group at Stanford. Sarah has volunteered to use a personal example in the podcast to help demonstrate the Externalization of Voices.

Sarah has brought a partially complete Daily Mood Log to the session. The Upsetting Event was that Sarah has decided to move to Austin, Texas in two weeks. She has many moderately strong negative feelings about the move, including sadness (30), anxiety and nervousness (75), inadequacy (60), loneliness (75), self-consciousness, and discouragement (70). She also felt stuck and defeated (70). The numbers in parentheses indicate how strong each type of feeling was on a scale from 0 (not at all) to 100 (extremely.)

Her Negative Thoughts include:

  • “All of my friends are ahead of me in life (careers and relationships).”
  • “I should be further along in my career and I should be 100% certain this is the best career for me in the long term.
  • “For the most part, I haven’t helped most of my clients very much.”
  • “My anxiety over the past year indicates that I’m in the wrong profession.”
  • “I’ll never get back in the great shape, physically and emotionally, that I was in three years ago.”
  • “Moving to California set my life back by a year.”
  • “I won’t be able to make new friends in Austin.”
  • “I will be lonely and without friends.”
  • “I won’t be able to cope with stress.”
  • “My therapy skills aren’t good enough,”

and more.  Her belief in many of her Negative thoughts is quite high, in the range of 70% to 100%. However, her belief in one of them, “Moving to California set my life back by a year,” was only 20%.

Although David did not intend this to be a live therapy session, but rather a practice session to demonstrate how the Externalization of Voices works, David does some brief paradoxical Agenda Setting first, since Sarah’s example is real, and not made up. David uses several techniques to melt away Sarah’s Outcome Resistance, including:

  • The Invitation
  • The Miracle Cure Question
  • The Magic Button
  • Positive Reframing

During the Positive Reframing, David asks Sarah two things about her negative thoughts and feelings:

  1. What does each negative thought or feeling reveal about you and your core values that is positive and awesome?
  2. What are some advantages, or benefits, of each negative thought or feeling?

They come up with a list of ten positives, including these: “My negative thoughts and feelings show that

  1. I’m realistic and honest.
  2. I’m thoughtful.
  3. I’m committed to self-care, since I want to have good mental and physical health.
  4. I’m motivated to grow and improve my therapy skills.
  5. I have compassion for my clients and want to give them the best care that I can.
  6. I’m honest about my shortcomings.
  7. I’m humble.
  8. I have high standards.
  9. I want to connect with others.
  10. I’m committed to my career.

They conclude the Paradoxical Agenda Setting with the Magic Dial. Sarah decides to lower her negative feelings f to much lower levels, in the range of 5% to 15%.

Then, David asks Sarah which Negative Thought she wants to work on first. She chose the thought about never being able to get back into top physical and mental shape again. They identify the many cognitive distortions in the thought, such as All-or-Nothing Thinking, Overgeneralization, Mental Filter, Discounting the Positive, Fortune-Telling, Magnification and Minimization, Emotional Reasoning, Should Statements, and self-Blame.

Then David explains how the Externalization of Voices works, and they launch into the technique. David starts out as the “Negative Sarah,” and attacks her with the Negative Thought she wanted to attack first, using the second-person, “You.” Sarah responds in the role of the “Positive Sarah,” using the first-person, “I.”

Sarah fairly quickly knocks the ball out of the park, and easily crushes the Negative Thought David has attacked her with. Then David attacks Sarah with the rest of her Negative Thoughts, one at a time, doing occasional role-reversals to illustrate different ways to attack the thought. They continue doing role-reversals until Sarah described her victory over each Negative Thought as “huge.”

This only takes a few minutes. Then Sarah re-rates her negative feelings on the Daily Mood Log, and nearly all have been reduced to zero. David cross-examines Sarah to find out if this amazingly rapid and dramatic change was real, or if she was just being “nice” to try to produce a good role-play for David!

Fabrice raps up the podcast with his (as usual) great interview with David and Sarah, bringing out many of the teaching points during the session. He emphasizes that you can actually use many of David’s 50 Methods when doing Externalization of Voices, and points out the power of “Let’s Be Specific” that David demonstrated during the role-playing.

Next week: The Paradoxical Double Standard Technique!

Coming Soon! Advanced, High-Speed TEAM-CBT for the Treatment of Depression and Anxiety 

We warmly invite you to attend this fabulous, one-day workshop by Drs. David Burns and Jill Levitt on Sunday, May 20th, 2018. Click on the link above for registration and more information.

  • 6 CE Credits
  • The cost is $135
  • You can join in person or online from wherever you live!

You will enjoy learning from David and Jill, working together to bring powerful, healing techniques to life in a clear, step-by-step way. Their teaching style as a team is entertaining, funny, lucid, and inspiring. This is a day you will remember fondly!

In the afternoon, you will have the chance to do some personal healing so you can overcome your own feelings of insecurity and self-doubt. David and Jill promise to bring at least 60% of the audience into a state of spiritual and psychological enlightenment, WITHOUT years of meditation. That’s not a bad deal at all!

You will LOVE this workshop. Seating for those who attend live in Palo Alto will be strictly limited, and seats are filling up fast, so move rapidly if you are interested.

Jill and I hope you can join us!

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

Subscribe

At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

 

082: Neil Sattin Interview — Change your Thoughts, Change Your Life!

082: Neil Sattin Interview — Change your Thoughts, Change Your Life!

In this podcast, David and Fabrice feature David’s recent interview on the topic of “Change your Thoughts, Change Your Life!” The interview was first published on Neil Sattin’s highly regarded Relationship Alive Podcast. Although some of the material may be familiar, there’s much that’s new, and you will enjoy the chemistry between Neil and David as they discuss each of the ten cognitive distortions and raise many challenging questions, such as:

  • Is it really true that only our thoughts–and NOT external events–can change the way we feel?
  • If someone has the belief, “I’m unlovable,” isn’t that type of thought immutable? How could you possibly change or modify a thought that may be rooted in traumatic experiences and so deeply embedded in a patient’s psyche?
  • Should we try to change other people’s cognitive distortions, or just our own?
  • How can we challenge each of the ten cognitive distortions?

And much more!

David’s first interview with Neil received more than 25,000 downloads in the first month, and this riveting interview promises to be every bit as popular. If you want to download a transcript of this exciting interview, you can do so at www.neilsattin.com/feelinggood2.

Coming Soon!

Next week we will begin an exciting series on the powerful role-playing techniques in TEAM-CBT, including

  1. Externalization of Voices (with Acceptance Paradox and Self-Defense Paradigm)
  2. Paradoxical Double Standard Technique
  3. Devil’s Advocate
  4. Forced Empathy
  5. Man from Mars
  6. And more

These episode will feature students and teachers in David’s Tuesday training group at Stanford, so you will get a taste of what an actual Tuesday group is like and see, first hand, how these methods work. They are unique to TEAM-CBT, and most have been created by Dr. Burns. We will also devote one episode to live Shame-Attacking Exercises, featuring the master of Shame Attacking, Dr. Joseph Towery, and we will all be out on the street doing Shame Attacking ourselves.

These episodes will be designed for therapists as well as your patients, and of course also for the general public.

Also Coming Soon!

May 20th, 2018  Advanced, High-Speed CBT for the Treatment of Depression and Anxiety A one day workshop by Drs. David Burns and Jill Levitt. 6 CE Credits, $135
You can join in person or online from wherever you live!

You will LOVE this workshop because you will learn and practice techniques you can use in your clinical practice, but you will also have the chance to do your own personal work! And you will also have the unique opportunity to experience the tag-team teaching of David and Jill working together!

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

Subscribe

At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

 

081: Ask David: What’s the Best Smoking Cessation Treatment? Is there a Dark Side to Human Nature?

081: Ask David: What’s the Best Smoking Cessation Treatment? Is there a Dark Side to Human Nature?

“Do I always have to face my fears? Aren’t some fears healthy?”

In this podcast, David and Fabrice answer five challenging questions submitted by listeners:

  1. Galina asks whether we always have to face our fears? Isn’t it okay to be anxious sometimes?
  2. Courtney asks how to find the supplemental written materials, tests, and diagrams if you have purchased the eBook or audio-book copy of Feeling Good: The New Mood Therapy.
  3. Carlos asks about the best treatment for smoking cessation. During the discussion, Fabrice asks if Paradoxical Agenda Setting is important for therapists using hypnotherapy.
  4. Avi asks whether humans have a dark side, with dark negative motives that sometimes compete with positive, loving motives. And if so, how do therapists help patients deal with their own negative motives?
  5. Ben asks what to do if you’re very anxious but simply can’t pinpoint your negative thoughts.

Coming Soon!

In a couple weeks we will begin an exciting series on the powerful role-playing techniques in TEAM-CBT, including

  1. Externalization of Voices with Acceptance Paradox and Self-Defense Paradigm
  2. Paradoxical Double Standard Technique
  3. Devil’s Advocate
  4. Forced Empathy
  5. Man from Mars
  6. And more

These episode will feature students and teachers in David’s Tuesday training group at Stanford, so you will get a taste of what an actual Tuesday group is like and see, first hand, how these methods work. They are unique to TEAM-CBT, and most have been created by Dr. Burns. We will also devote one episode to live Shame-Attacking Exercises, featuring the master of Shame Attacking, Dr. Joseph Towery, and we will all be out on the street doing Shame Attacking ourselves.

These episodes will be designed for therapists as well as your patients, and of course also for the general public.

Also Coming Soon!

May 20th, 2018  Advanced, High-Speed CBT for the Treatment of Depression and Anxiety A one day workshop by Drs. David Burns and Jill Levitt. 6 CE Credits, $135
You can join in person or online from wherever you live!

You will LOVE this workshop because you will learn and practice techniques you can use in your clinical practice, but you will also have the chance to do your own personal work! And you will also have the unique opportunity to experience the tag-team teaching of David and Jill working together!

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

Subscribe

At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

 

080: Ask David: Where Do Negative Thoughts Come From?

080: Ask David: Where Do Negative Thoughts Come From?

“I’m a loser. . . I’m a failure. . . Where do my negative thoughts come from? “

In this podcast, David and Fabrice answer several fascinating questions submitted by listeners:

  1. Jackie asks where our distorted thoughts come from, since they are so often irrational and distorted, and inconsistent with the facts. Why do we sometimes beat up on ourselves relentlessly with negative thoughts?
  2. Tyler asks if it possible to do TEAM-CBT in conventional, 45 minute sessions. And if so, how? It seems my patients are just warming up by the end of the session, and then we have to start all over again the next week.
  3. Jess asks if it is possible to use the Five Secrets of Effective Communication in non-therapy settings. For example, if you are in a position of authority, like a high school teacher, will your students lose respect for you if you use the Five Secrets? Could you use the Five Secrets if you are working with violent gang members?

Two Cool Upcoming Workshops for you!

March 22 and 23, 2018 Rapid Recovery from Trauma, (David D. Burns, MD) J&K Seminars, Lancaster, Pa 15 CE credits, includes live evening demonstration on the evening of day 1.
You can join in person or online from wherever you live! 

May 20th, 2018  Advanced, High-Speed CBT for the Treatment of Depression and Anxiety A one day workshop by Drs. David Burns and Jill Levitt. 6 CE Credits, $135
You can join in person or online from wherever you live!

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

Subscribe

At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

 

079: What’s the Secret of a “Meaningful” Life? Live Therapy with Daisy

079: What’s the Secret of a “Meaningful” Life? Live Therapy with Daisy

“I’m a failure. . . I’m not good enough. . . My life will be empty and meaningless without . . . “

Sound familiar? Sometimes, the messages we get from society, and the impossible standards that we accept, can lead to enormous, intense suffering.

Several months ago I received a compelling email from a young woman named Daisy who asked about the message we get from society that lead to suffering. Fabrice and I were so inspired that we devoted an entire Feeling Good Podcast to it (Podcast 038: Negative Messages from Society) The theme of the podcast, as well as the three subsequent podcasts, was how to pinpoint and modify the Self-Defeating Beliefs (SDBs) that lead to depression, anxiety, and relationship problems.

At the time, I did not know who Daisy was, and was not aware that she was living in this area. Now, Fabrice and I are thrilled and honored to present an entire TEAM-CBT therapy session with Daisy, along with her husband Zane.

The focus of the session was a problem that many young couples face–infertility. In spite of heroic, costly, and exhausting efforts to conceive using IVF (in vitro fertilization), Daisy and Zane have still not been blessed with a pregnancy. And Daisy is finding herself between a cognitive rock and a hard place. She is suffering, on the one hand, from intense feelings of failure, shame, and inadequacy because she has not yet become pregnant. But at the same time, she has mixed feelings about having children, and feels that if she can find happiness with children, she will be ostracized by society and seen as some kind of oddball.

Daisy’s scores on the Brief Mood Survey, which she completed just before the session began, indicated mild to moderate depression, severe anxiety, mild anger, and a profound loss of pleasure and satisfaction in her life–indicating an almost complete absence of any strongly positive feelings.

Daisy brought a partially complete Daily Mood Log to the session. The upsetting event she recorded at the top was “four years of infertility; three years of failed treatment. Daisy mentioned that a fifth upcoming trial with IVF was planned in a couple weeks, and that she was feeling intense anxiety. The negative feelings she circled on the Daily Mood Log, plus her intensity estimates, included:

  1. sad, blue, depressed, down, unhappy: 90%
  2. anxious, worried: 100%
  3. ashamed: 70%
  4. inferior, worthless, defective, incompetent: 100%
  5. lonely, alone: 70%
  6. hopeless, discouraged, pessimistic, despairing: 100%
  7. thwarted, defeated: 90%

As you can see, all of these feelings intense. These feelings did not result from the real problem, the infertility, but rather from Daisy’s Negative Thoughts about the problem, including:

  1. My life will be empty and meaningless without children. 90%
  2. People with children live happier and more fulfilling lives. 100%
  3. I am defective and inferior to people who can have children. 70%
  4. I’m missing out on the most important part of life. 100%
  5. If this treatment doesn’t work, my life will be a failure. 80%
  6. I should have done more in my career, given that I don’t have kids. 100%
  7. Without children, there isn’t much to look forward to. 100%
  8. It’s unfair that this treatment doesn’t work for us. 70%
  9. I’m a disappointment to my family. 80%
  10. If I don’t want kids, that means there is something wrong with me. 100

As you listen to the session unfolding, Dr. Burns reviews the T = Testing, followed by E = Empathy. Dr. Burns uses the Five Secrets of Effective Communication to acknowledge Daisy’s tremendous pain, without trying to save, help, or rescue her. Then he uses several Paradoxical Agenda Setting techniques to melt away any potential resistance to change, including the Miracle Cure Question, the Magic Dial, Positive Reframing, and the Magic Dial. She decides she wants to dial down her negative emotions to much lower levels, without necessarily making all of them disappear completely. Then Daisy and David complete the “% Goal” column on the Daily Mood Log, indicating the ideal level for each type of feeling that she hopes to achieve by the end of the session.

  1. sad, blue, depressed, down, unhappy: 90% / 30%
  2. anxious, worried: 100% / 30%
  3. ashamed: 70% / 10%
  4. inferior, worthless, defective, incompetent: 100% / 5%
  5. lonely, alone: 70% / 20%
  6. hopeless, discouraged, pessimistic, despairing: 100% / 40%
  7. thwarted, defeated: 90% / 40%

As you can see, she wanted to reduce some of her feelings dramatically, such as shame, inferiority, and loneliness, and wanted to reduce other feelings moderately, including depression, anxiety, hopelessness, and feeling defeated.

At this point David and Daisy used the Downward Arrow Technique to pinpoint the underlying beliefs that were triggering this problem, starting with a new Negative Thought that popped into Daisy’s mind:

  • If the IVF doesn’t work, we won’t have kids, we won’t have kids coming home for holidays and milestones–it will just be the two of us.
  • Then our lives will be lacking connection.
  • Then our lives won’t be meaningful.
  • Then there would be no purpose in life.

As you can see, these chain of negative thoughts reveals at least two Self-Defeating Beliefs:

  1. A woman must have children to have a purposeful, meaningful, rewarding life.
  2. You must have a meaningful, purposeful life to feel happy and fulfilled.

Then David and Daisy use a variety of M = Methods to help Daisy challenge her negative thoughts, as well as these underlying beliefs, starting with the first negative thought, “My life will be empty and meaningless without children.” The Methods included Identify the Distortions, Examine the Evidence, the Paradoxical Double Standard Technique, the Externalization of Voices with role-reversals, and the Acceptance Paradox as well as the Self-Defense Paradigm.

Fabrice noticed that at one point David switched from the Paradoxical Double Standard to the Acceptance Paradox, and then went back to the Paradoxical Double Standard before switching to the Externalization of Voices for a second chem. David explains his strategy.

At the end of the session, which lasted less than two hours, Daisy was dramatically improved. If you review her completed Daily Mood Log here, you will see that she achieved or exceeded all of her emotion-reduction goals for the session. In addition, her end-of-session scores on the Brief Mood Survey indicated dramatic reductions in depression, anxiety and anger, an a huge boost in Positive Feelings. On the Evaluation of Therapy session, she gave David perfect scores on the Empathy and Helpfulness scales, and indicated what she liked least and most about the session.

What she liked the least: “It took me a while to reveal my ambivalence about having kids.”

Actually, David overlooked this as well until half way through the session, and this did make for a kind of turning point in the session. Things seem to get more immediate and real at that point.

What she liked the best: “I feel completely different–more hopeful, less anxious, and less despairing.”

Fabrice and I are deeply grateful to Daisy and Zane for allowing us to share their story with you. Although the facts of your life are likely to be very different, you may also sometimes feel down or inadequate because you, too, have not measured up to some “requirement” based on messages from society. And perhaps Daisy’s experience can inspire you to break out of your own inner prison as well, believing that you, too, are perhaps inferior, or “not good enough,” because of this or that flaw!

Daisy Follow-Up

The next day, I received this email from Daisy:

Hi David,

I was planning to send you a thank you email, and you beat me to it. Thank you so much for taking the time to work with me on what has been an excruciating situation for years. Both Zane and I are extremely grateful for all the opportunities we have to spend time with you and learn from you. I actually thought it was amazing how quickly you were able to zero in on my ambivalence towards having children as well as the anger I have towards my mom and her expectations. It’s really hard for me to acknowledge either of those things, even to myself, and I thought it was so brilliant how you were able to pull those out so quickly.

There were so many “aha” moments for me last night but a couple really stand out. One was about self-compassion being the most important part of life. The other was about how it makes no sense to judge ourselves as “defective” in a global way. Those insights really hit me at a gut level last night. I’m sure I’ll be drifting out of enlightenment soon and am very grateful for your very generous offer to give me a tune-up, especially as we go through all these treatments again!

I will work on my Daily Mood Log and send it to you later this evening.

Also, many thanks to Fabrice for his insights and for making the recording possible!

Best,

Daisy

Zane Follow-Up

I also received this wonderful email from Zane:

Hi David,

I also wanted to thank you for having us on the show. I really enjoyed hearing your views about what a “meaningful” life means (or doesn’t mean). It was my “aha” moment. I’ve often seen that way of thinking as a slippery slope, but only had a vague sense as to why. Hearing you describe it as a trap really made a lot of sense. Daisy and I were talking it over this morning and the thought occurred to me that meaning could often be defined as having enjoyment or interest (in one’s life or work). Therefore, looking to the world, a relationship, an experience, or a job, or [fill-in the blank] is a hidden should statement (e.g. “My life should be meaningful, and if it’s not, it’s not very good.”). Having this thought or belief kind of takes responsibility to make life fun and interesting off of oneself, and places it on external circumstances or others. Am I understanding this concept correctly?

I’m also grateful for the books and DVD you hooked me up with. And extra-large thanks to Fabrice the “Fab Man” for being the man behind the magic in orchestrating these podcasts!

Zane

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

Subscribe

At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

 

078: Five Simple Ways to Boost Your Happiness–#5: You Can CHANGE the Way You FEEL!

Building Self-Esteem and Overcoming Toxic Shame–as well as feelings of depression, anxiety, inferiority, hopelessness, and anger!

Let’s face it–nearly all of us fall into the black hole of depression, anxiety, shame, and self-doubt at times. Then it’s time to ask yourself what you’re telling yourself, write down your negative thoughts, identify the distortions in them, and substitute thoughts that are more positive and realistic. Sound too easy? The results can be mind-blowing!

David and Fabrice discuss a therapy session with a woman who had been hiding something about herself for nearly ten years due to feelings of shame. When she receives a phone call from someone in her church, her feelings of anxiety and shame hit the ceiling. Learn how she overcomes her feelings of angst and self-doubt using TEAM-CBT.

David hopes to make the actual video of this dramatic therapy session available soon right here at www.feelinggood.com in his new Feeling Good Store! (still under development at the time of this write-up.)

While listening, you can download pdfs about each of seven steps to help you break out of bad moods and boost your self-esteem:

Step 1. Identify the Upsetting Event

If you click on Melanie’s Daily Mood Log you will see that the Upsetting Event was something seemingly innocuous.

Step 2. Rate Your Negative Feelings

If you click on Melanie’s Daily Mood Log again, you will see how she circled her feelings and rate each type of a feeling on a scale from 0% to 100%. You will see that her negative feelings were actually incredibly intense.

Daily Mood Log with feelings circled and rated

Step 3. Record Your Negative Thoughts

Cognitive therapists, going all the way back to the Greek Stoic philosopher, Epictetus nearly 2,000 years ago, say that we are upset, not by things, or events, but by our thoughts about them. If you click on Melanie’s Daily Mood Log with Negative Thoughts yet again, you will see what she was telling herself about the phone call from the member of her church.

Step 4. Positive Reframing

This is one of the many powerful new features of TEAM-CBT. Before trying to change the way you think and feel, focus on your negative thoughts and feelings one at a time and ask yourself two questions:

  1. What are some benefits, or advantages, of this negative thought or feelings?
  2. What does this negative thought or feeling show about me and my core values that’s positive and awesome?

Briefly stop the recording and review Melanie’s Daily Mood Log. Then see how many positives you can list. For example, what does Melanie’s shame show about her that is awesome and positive? And what are some really beautiful things about her sadness and depression? What are some potential benefits of her anxiety?

Step 5. Identify the Distortions

After the Paradoxical Agenda Setting (in this case, Positive Reframing), I asked Melanie what Negative Thought she wanted to work on first. She selected the second negative thought, “She’ll tell other people who will judge me.” See how many distortions you can find in this thought, using the list of ten distortions on her Daily Mood Log.

When you’re done, you can see how Melanie identified the distortions in this thought, using abbreviations, in the Distortion column of her Daily Mood Log. However, on the podcast, David identified one additional distortion he had overlooked during the live session with Melanie. Can you figure out which one it is?

Step 6. Challenge the Negative Thought

There are more 50 techniques that you can use to challenge a Negative Thought. After listing roughly 17 promising methods during the session, Melanie decided that she wanted to start out with a gentle method called the Paradoxical Double Standard Technique. If you click on Melanie’s Daily Mood Log  again, you can see the Positive Thoughts Melanie came up with to challenge the Negative Thought, “She’ll tell other people who will judge me.” You will also see how strongly she believed them. Remember that the Necessary Condition for Emotional Change is that the Positive Thoughts all have to be 100% true. Rationalizations and half-truths will rarely, if ever, give anyone genuine relief or mood elevation.

Now the question is this: Did the Positive Thoughts reduce Melanie’s belief in the Negative Thought? Remember the Sufficient Condition for emotional change: the Positive Thoughts must drastically reduce the belief in the Negative Thoughts. That’s the whole goal, in fact, of cognitive therapy. Remember, when you change the way you THINK you can change the way you FEEL!

If you click on Melanie’s Daily Mood Log again, you’ll see that her belief in the Negative Thought was, in fact reduced. Sometimes, you will want to reduce your belief in a Negative Thought all the way to zero. But in this case, 35% was sufficient, since some people may, in fact, judge Melanie, although most people probably will not.

Step 7. Outcome: Re-rate Your Negative Feelings

Once you’ve clobbered one negative thoughts, it’s generally much easier to knock the rest of your Negative Thoughts out of the park. This was the case with Melanie. If you review her final Daily Mood Log, you can see how she challenged the rest of her Negative Thoughts and the incredible impact this had on her feelings.

Coming Soon!

Next week we will have something very special and very precious for you–

Podcast 079: What’s the Secret of a “Meaningful” Life? Live Therapy with Daisy

This will be a dramatic and inspiring podcast that Fabrice and I feel very grateful to be able to share with you. The podcast will be based on an actual therapy session with a young woman who is struggling with depression, anxiety, and self-doubt because of fertility issues, due to strong. societal messages that women should have children and should want children. This will be a unique opportunity to go behind closed doors to see TEAM-CBT live and real with someone like yourself who is struggling with intense negative thoughts and feelings.

The live therapy sessions we have published previously–with Mark, who felt like a failure as a father, and with Marilyn, who was confronted by a sudden and totally unexpected horrific diagnosis of Stage 4 lung cancer–received tremendously positive feedback from all of you. Now we are proud to present yet another live therapy session next week! So mark your calendars!

Two Cool Upcoming Workshops for you!

May 20th, 2018  Advanced, High-Speed CBT for the Treatment of Depression and Anxiety A one day workshop by Drs. David Burns and Jill Levitt. 6 CE Credits, $135
You can join in person or online from wherever you live!

March 22 and 23, 2018 Rapid Recovery from Trauma, (David D. Burns, MD) J&K Seminars, Lancaster, Pa 15 CE credits, includes live evening demonstration on the evening of day 1.
You can join in person or online from wherever you live! 

Additional Resources for the General Public (all available at Amazon.com, as well as other booksellers)

  • Feeling Good: The New Mood Therapy
  • The Feeling Good Handbook
  • Feeling Good Together
  • When Panic Attacks

General public and mental health professionals might enjoy the recent article about David in Stanford Magazine authored by Robert Strauss entitled “Mind Over Misery.”

Additional Resources for Mental Health Professionals

David’s TEAM-CBT Psychotherapy ebook: Tools, Not Schools, of Therapy

David’s Tuesday evening TEAM-CBT meets at the Behavioral Sciences Building, 401 Quarry Road, Room 2209 from 5:00 to 7:30 PM, and is free. It is open to all SF Bay Area mental health professionals as well as graduate students in any mental health field, including but not limited to Stanford graduate students. There are teachers include:

  • David Burns, MD
  • Helen Yeni-Komshian, MD
  • Jill Levitt, PhD
  • Daniele Levy, PhD

For information, requirements, and consent form, contact our Greeter, Sara Swedorski, saraswedorski@gmail.com.

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

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077: Five Simple Ways to Boost Your Happiness–#4: Resolve a Conflict with a Friend or Family Member

This topic may SEEM simple, and the rewards can be tremendous–but it requires courage, lots of practice, and the death of the ego!

Most of us, and perhaps all human beings, run into conflicts with family members, friends, and colleagues from time to time. And as we all know, these conflicts can weigh us down and rob us of happiness. In this podcast, you will learn how to transform anger and bickering into intimacy and joy.

I’ll bet you know someone who

  • complains endlessly, but ignores your good advice and just keeps complaining
  • argues defensively and always has to be right
  • won’t listen
  • criticizes you unfairly
  • only cares about himself or herself
  • refuses to talk or express his or her feelings

Does any of that sound familiar?

And if you’re a therapist, I wouldn’t be a bit surprised if you run into conflicts with angry, critical patients from time to time as well. Sometimes that happens to me, and it can feel intensely demoralizing.  But when I resolve the conflict, and develop a deeper and more rewarding relationship with the person I was at odds with, it is exhilarating.

Here are some fairly common complaints therapists sometimes hear from patients:

  • You don’t “get me.”
  • You don’t really care about me. . . You’re just in it for the buck.
  • You’re not listening.
  • You haven’t helped me. . . in fact, you’re making me worse!
  • Aren’t you just a student? Do you think I need a real therapist?
  • This therapy sucks!

In today’s Feeling Good Podcast, you will learn about a powerful “Intimacy Exercise” which David has developed. This exercise is designed for therapists and for the general public alike. It’s designed to help you fine-tune your communication skills, so you can develop more rewarding relationships with the people you care about. You may have listened to some of the five previous podcasts on the Five Secrets of Effective Communication, but this is the first time this training technique has been illustrated.

David and Fabrice are joined by Jacob Towery, MD, as well as Lida Sharlin, LMFT, and Eleanor Scott, a certified marriage and Family Therapist. Jacob is one of the teachers at David’s weekly Tuesday evening psychotherapy training group at Stanford, and Lida and Eleanor attend the group as students. Jacob is a psychiatrist and author of the Antidepressant Book for teenagers, recently released as an audiobook. David and Fabrice are very grateful that Jacob, Lida, and Eleanor volunteered to participate in this podcast. Hopefully, their real-life examples will make the podcast far more dynamic and interesting for you!

This is not a trivial statement, since the key to learning involves the philosophy of “joyful failure”–Lida and Eleanor will have to be willing to learn from their mistakes, which will be pointed out immediately while they are role-playing. This exercise is especially challenging, since just about everybody makes all kinds of mistakes initially. For experienced therapists, this can be a shock to the system, since they thought they’d mastered empathy skills in graduate school–but that is rarely the case. If you check your ego at the door, as Lida and Eleanor have bravely done, the learning potential can be tremendous.

As you will see, the exercise involves one person who does the criticizing, and a second person who attempts to respond effectively, using the Five Secrets of Effective Communication. Then the role-play suddenly stops, and three types of feedback are provided for the person who was trying to respond effectively:

  1. Your letter grade (A, B, C, D, or F)
  2. Here’s what worked and what didn’t work.
  3. Here’s how you might improve your response, using the Five Secrets of Effective Communication.

I think you will enjoy seeing Lida and Eleanor, struggle to respond effectively to two patient conflicts, and two personal conflicts, while Jacob and David provide feedback and tips on how to improve.

Responses to two stinging (and real) patient criticisms are illustrated first:

  1. “This session sucked! I ended up feeling worse at the end.”
  2. “You’re so invested in giving me homework assignments during our sessions that you don’t pay any attention to me, and how I’m feeling!”

After that, two angry criticisms from loved ones are illustrated:

  1. “You’re selfish and only think about yourself!” (My sibling said this.)
  2. “You’re always so self-righteous! How could I ever confide in you!” (My son said this.)

How would you have responded?

If you would like to delve deeper into this topic, pick up a copy of David’s book, Feeling Good Together, on Amazon.com. There are many exercises to help you master the Five Secrets of Effective Communication.

Coming Soon

Next week David and Fabrice will conclude the last of five podcasts on how to boost happiness. The focus will be how to change the way you think and feel when you fall into a black hole of insecurity and self-doubt and beat up on yourself with negative thoughts. Sound familiar?

And the following week we will have Podcast 079: What’s the Secret of a “Meaningful” Life? Live Therapy with Daisy.” This will be a very special podcast that Fabrice and I feel very grateful to be able to share with you. The podcast will be based on an actual therapy session with a young woman who is struggling tremendously with depression, anxiety, and self-doubt because of fertility issues, along with strong. societal messages that women should have children and should want children.

The live therapy we have published previously–with Mark, who felt like a failure as a father, and Marilyn, who was confronted by a sudden and totally unexpected horrific diagnosis of Stage 4 lung cancer–received tremendously positive feedback from our subscribers. Now we are proud to present yet another live and inspiring therapy session in just two weeks! So mark your calendars!

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

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At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

 

076: Five Simple Ways to Boost Your Happiness–#3: Face a Fear

Simple for Sure–but Facing a Fear Requires Courage!

This will be the third Feeling Good Podcasts on five specific things you can do to boost your happiness. Today, David and Fabrice will talk about confronting something you fear, something you’ve been avoiding.

Most people have some fear or other. When I (David) wrote my book, When Panic Attacks, I counted up all the fears I’ve had in my life, and I came up with a list of at least 17 things I’ve feared at one point or another. I’ve had the fear of bees, dogs, horses, blood, heights, public speaking, cameras, and more. So I know very well the joy that results from facing and defeating, one of your fears. And although it’s SIMPLE to face your fears, it does require a LOT of courage, because you’ll have to endure some fairly intense anxiety.

The value of confronting a fear has been around for at least 2500 years, going back to the earliest teachings of the Tibetan Buddhists. In the modern era, it’s called Exposure Therapy, but it really hasn’t changed a great deal since the earliest times. There are two ways to face your fears–gradual exposure, where you confront the fear little by little, and flooding, where you do it all at once. Both strategies are equally effective. Personally, I prefer exposure, because you get it over with quickly. But sometimes, gradual exposure is more appealing, and it also works very well.

Why does exposure help? Why does can it boost your happiness?

First, when you face your fears, instead of running away, you will probably discover that the monster you’ve been running from has no teeth, and was just a distortion in your mind. And this not only creates relief, because your anxiety disappears, but mood elevation, because you feel empowered. Exposure is actually one of the four forms of spiritual enlightenment that I’ll be discussing in my new book (currently in progress.)

David gives a number of personal and clinical examples of how he overcame his own fears, including his intense fear of heights when he was in high school, as well as his intense social anxiety when he was teaching at a local Kaiser mental health clinic.  David also describes how he’s helped many colleagues or patients who felt shy and insecure around others.

In the final two podcasts in this “Boosting Happiness” series David and Fabrice will talk about how to change your distorted negative thoughts and beliefs when you’re feeling inadequate, or inferior, or simply “not good enough,” as well as how you can use the Five Secrets of Effective Communication to resolve a conflict and develop a deeper and more rewarding relationship with someone you care about!

Fabrice and I hope you like our Feeling Good Podcasts, and also hope you can leave some positive comments for us and five star ratings if you like what we’re doing!

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At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

 

075: Five Simple Ways to Boost Your Happiness–#2: Do Something You’ve Been Putting Off

075: Five Simple Ways to Boost Your Happiness–#2: Do Something You’ve Been Putting Off

Note: I am republishing this because I published it in the wrong category last time. You have likely already received it, and if so, ignore this new version, as it is the same. I apologize for my error! david

Use the Anti-Procrastination Sheet!

This the second of five Feeling Good Podcasts on simple things you can do to boost your happiness. Procrastination is one of the most common causes of unhappiness, and this bad habit is almost universal. We all put off the tasks we dread because they make us anxious, and because we’re tempted to do other things that are way more rewarding. But the longer you procrastinate, the worse you feel, and this robs you of motivation. As a result, you fall into a vicious cycle where procrastination triggers negative feelings like depression, anxiety, and guilt, and your negative feelings, in turn, reduce your motivation and trigger more procrastination. A vicious cycle.

Fabrice and I are going to show you how to break the cycle and boost your happiness. To get started, please think of ONE thing you’ve been procrastinating on. It could be anything, such as working on your taxes, cleaning your garage, filing papers, working on a paper or presentation you’ve been avoiding, reading something you have to read for school or work–anything at all.

Now I want to ask you a question. Would you like to overcome the procrastination so you can get started on that task? If your answer is no, you can come back and listen later when you do want to solve this problem.

If the answer is yes, then I have a second question for you. WHEN would you like to overcome your procrastination and get started? Today? Or later on?

If your answer is today, then we’re ready to rumble. If you say, “tomorrow,” or some later time, then I’d encourage you to come back to this podcast when you are ready to solve the problem. I can ONLY help you overcome your procrastination today! NOT tomorrow.

Finally, I want to know if you’d be willing to devote a very small amount of time to getting started TODAY. I’m asking you to invest something like five minutes, and I’m also asking you to agree to limit your work this small amount of time. This is crucial, because if you tell yourself you have to do the entire job, that may take hours, and you’ll probably feel so overwhelmed that you won’t do a thing!

Finally, I want to know if you’d be willing to get started for five minutes even if you’re not “in the mood,” and even if you’re completely unmotivated, and EVEN if the very thought of the task makes you anxious and guilty. If the answer is YES, then we’ve got a deal. But if you want to wait for the motivation, I urge you to turn off the podcast and come back to it at some later time.

One philosophical principle is the approach we’re going to teach you is NOT to wait for motivation. Most procrastinators think that motivation comes first, followed by productive action, but this is an illusion, because you’ll probably NEVER feel motivated to do some awful task you’ve been putting off. If you’re waiting for motivation, you’ll be waiting forever!

As I wrote in my first book, Feeling Good: The New Mood Therapy,  highly productive people know that ACTION comes first, followed by motivation. In other words, you have to get started on some task before you’ll feel motivated. You’re not entitled to feel motivated until you’ve start accomplishing something! Waiting for motivation is the trap that keeps your procrastination alive and prospering.

I’m going to make things simple for you using a tool I created years ago called the Anti-Procrastination Sheet! To make this podcast experiential, think about the specific task you’ve been putting off, like filing papers, preparing your taxes, cleaning the garage, a paper or report you have to prepare–anything at all.

Now take a look at the Anti-Procrastination Sheet. As you can see, it has five vertical columns, but they’re different from the columns on the Pleasure Predicting Sheet that we discussed in last week’s podcast. In the first column you break the task into small, or even tiny, steps, and number them. Make sure that each step can be completed quickly and easily–for example 30 seconds, or a minute or two.

You don’t have to outline the entire task, just the first four or five steps. And make sure the steps are small enough so you can complete all or most of them in five minutes or so. The philosophy behind this is called “little steps for big feats!” If you aim to do just a little, you may end up doing a great deal. But if you aim to do it all at once, the odds are high that you’ll just end up procrastinating, because the task will seem overwhelming.

After you’ve outlined the first few steps, predict how satisfying or rewarding each step will be in the second and third columns, on a scale from 0% (not at all satisfying) to 100% (tremendously satisfying.) Make sure you complete this column before you do the activity. And make sure you do it on paper, and not just in your head!

Now complete the first step, and indicate how satisfying and rewarding it turned out to be on the same scale, from 0% to 100% in the fourth and fifth columns. That’s all there is to it! Now do the same thing for the second step of the task.

You are welcome to print the attached copy and use it personally, but distribution or reproduction electronically is not permitted. Therapists who want to use this and hundreds of other assessment and treatment tools can purchase my Therapist’s Toolkit–you’ll find the order form on my website, www.feellinggood.com.

Now I’ll show you how the Anti-Procrastination Sheet works using a personal example of a task I hate and typically put off–and since this is something that I’m procrastinating on right now, we’ll see if the method works!

The task I’ve selected is listing my business expenses for our annual meeting with the accountant who prepares our taxes. This is something I always put off because it seems hard, boring, and anxiety-provoking.

Throughout the year, I save my receipts in file folders for various types of expenses–mailing expenses, professional entertainment expenses, software expenses, and so forth. So I have to list and total up all the expenses in each category, which involves a lot of busy work. I also have to do some complicated things like downloading our yearly charge card business expenses so I can list them as well, and I also have to download my PayPal receipts for sales of Therapist’s Toolkits and other things I sell on my website. And I nearly always have to call the help lines to figure out how to do the downloading, since I find it a bit complicated and confusing.

Yuck! No fun!

Take a look at my Anti-Procrastination Sheet. As you can see, I listed the first five steps of this task, beginning with something really simple–turning on the computer.  I made sure the next four steps were reasonably quick and easy, too.

Then I predicted how difficult and satisfying the first step would be, on a scale from 0 (not at all difficult or satisfying) to 100 (extremely difficult or satisfying. As you can see,  I did not expect it to be especially difficult or satisfying, since I turn on my computer all the time. But I thought it might be slightly satisfying because I could tell myself, “hey, I just got started!”

Next, I made my difficulty and satisfying predictions for the next four steps. Again, my estimates for the difficulty of each step were fairly low, as were my expectations of satisfaction, as you can see.

Once you’ve listed the first few steps and predicted how difficult and satisfying each step will be, go ahead and complete the first step, and record how satisfying and difficult it turned out to be in the third and fourth columns, on the same scale from 0 to 100. As you can see, my predictions for the first step were fairly accurate. It wasn’t at all difficult, but it was twice as satisfying as I had anticipated.

Then, I got a little boost in my mood–since I was facing the task I’d been putting off–and completed the next four steps, which were surprisingly easy, and somewhat more satisfying than I had predicted, as you can see. I’m sure you’ve heard the old Buddhist proverb that the longest journey begins with a single step–or, if you’re using the Anti-Procrastination Sheet, three or four small steps!

That’s all there is to it! Give it a try and email us to tell us how it worked for you!

Now let’s just suppose you’re not sold on what Fabrice and I have been teaching you in this podcast, and you’re telling yourself, “Oh, this is too hard for me, I just can’t get myself to outline the task on the Anti-Procrastination Sheet.” What should you do then?

Well, I have a suggestion for you, and another cool tool you can use. My suggestion is to stop telling yourself, “I can’t,” because this is not a valid statement. It isn’t true that you CAN’T get yourself to use the Anti-Procrastination Sheet. For example, if I held a gun to your head and told you to outline a task you’ve been putting off, you’d suddenly discover that you CAN do it!

But what is at issue here is that you may not WANT to do get started–for a whole variety of reasons! If that’s where you’re at, I would suggest that you list all the really GOOD reasons NOT to use the Anti-Procrastination Sheet today.

In fact, you may not even want to do that, so Fabrice will do it for you, and you can just look at this list that he and I came up with:

Really GOOD Reasons to Keep Procrastinating

  • Tomorrow will be a better day
  • I need more sleep
  • There’s something really good on TV right now
  • I’m not in the mood
  • I’ve done enough work for the day
  • I need some time to relax
  • It’s not necessary to do it right now
  • It will take too much time
  • It will be too hard
  • It will be too upsetting
  • I have other more important things to do.

Once you’ve complete your lists, or simply reviewed the list that Fabrice and I created for you, I would like to ask you this question: “Given all those many wonderful  advantages and benefits of procrastination, and all the really good reasons NOT to get started right now, why in the world would you want to get started? Your procrastination makes all the sense in the world!”

Oh, I forgot to tell you how my own Anti-Procrastination Sheet worked out for me. Doing the first few steps got me into a flow, and over the next several days, I completed the entire task fairly easily, working a couple hours a day, even without having to outline any more steps on my Anti-Procrastination Sheet. I’m ready for the meeting with our accountant, and my wife informed me that I’m actually a month ahead of schedule. The whole secret was getting started, taking that first small step.

And DID it boost my happiness? Absolutely! I feel relieved, proud,and happy with what I’ve accomplished. That awful chore is no longer a heavy stone I have to carry around on my shoulders all day long! No guilt, either!

Next week, we’ll have another cool and simple tool you can use to boost your happiness–by confronting a fear. You may have a phobia, like the fear of cats or dogs, or heights. Or perhaps you’re shy and fear opening up in groups of people, or maybe you have public speaking anxiety. Since I’ve had and defeated tons of fears in my life, and since I’ve had thousands of therapy sessions with individuals struggling with every conceivable form of anxiety, this is one my favorite topics. I can’t wait to see you at next week’s Feeling Good Podcast!

Fabrice and I hope you enjoy our Feeling Good Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing!

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At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.

 

074: Five Simple Ways to Boost Your Happiness–#1: Do Something Rewarding

Note: I am republishing this because I published it in the wrong category last time. You have likely already received it, and if so, ignore this version, as it is the same. I apologize for my error! david

Use the Pleasure-Predicting Sheet!

This will be the first of Feeling Good Podcasts on five specific things you can do to boost your happiness. The topics will include:

  1. Use the Pleasure Predicting Sheet (today’s program)
  2. Do Something You’ve been Putting Off: the Anti-Procrastination Sheet
  3. Confront a Fear
  4. Boost Your Self-Esteem
  5. Resolve a Conflict with a Friend

David begins with a brief discussion of the philosophy of happiness, including the ancient Buddhist idea that everything in the universe is transitory and constantly changing, including our positive and negative moods, so the idea that you will be hopelessly depressed forever, or endless happy, are both illusions. Happiness, or pleasure, are transitory, and can only be achieved at specific moments. However, you can significantly increase the number and duration of the happy periods in your life.

David briefly discusses research evidence that simply doing potentially satisfying and rewarding activities, whether or not you’re “in the mood,” can reduce depression and enhance feelings of happiness and joy in daily living. This simple treatment method, called “Behavior Therapy,” was pioneered by Dr. Peter Lewinsohn, from the Oregon Research Institute, and has been shown to have significant anti-depressant effects.

One way of doing this is with David’s famous “Pleasure-Predicting Sheet.” It’s pretty simple to use. As you can see from the link, it is a sheet with four vertical columns. In the first column, you schedule activities with the potential for pleasure, learning, personal growth, or helping others. You can include activities that are not overly time consuming or burdensome. In the second column, record who you plan to do each activity with. If you do the activity alone, put “self” in the second column, since you’re never truly alone. You’re always with your “self.”

In the third column, predict how satisfying or rewarding the activity will be, on a scale from 0% (not at all satisfying) to 100% (tremendously satisfying.) Make sure you complete this column before you do the activity! And make sure you do it on paper, and not just in your head!

Once you’ve completed each activity, indicate how satisfying and rewarding it turned out to be on the same scale, from 0% to 100%. That’s all there is to it!

Then you can compare the last two columns (the predicted and actual satisfaction). Sometimes, depressed individuals think that things they used to enjoy will be boring or unrewarding, so they give up on things, fail to answer the phone, and mope around at home in a state of hopelessness and self-pity. Of course, that’s a self-fulfilling prophecy and a vicious cycle, because when you stop doing things, you will probably become more depressed, and then you’ll be even more likely to give up doing things for pleasure. In contrast, when you do things, you may discover that many activities are more rewarding than you anticipated.

You can also compare the satisfaction you experience when doing things by yourself versus the activities you do with others. Many depressed people with the Love Addiction believe they cannot be happy when they’re alone, thinking they must be loved to feel truly happy and fulfilled. David describes a woman who tested this belief, and made an unexpected discovery, after her husband rejected her for another woman. You can see her Pleasure Predicting Sheet if you click here.

Finally, David gives an example of how a depressed, perfectionistic medical professor made another unexpected discovery with a modified version of the Pleasure-Predicting Sheet.

The Pleasure-Predicting Sheet is one of only 50 to 100 methods that David has learned or created for defeating depression and anxiety. He doesn’t see it as a complete treatment for depression, but it usually has some nice mood-elevating effects. Fabrice and I encourage you to try it this week, so you can let us know how it works for you!

Next week, we’ll have another cool tool you can use to boost your happiness by overcoming procrastination!

Fabrice and I hope you enjoy our Feeling Good Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing!

Subscribe

At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.