Anxiety Workshop This Month! Online Slots Still Available!

Anxiety Workshop This Month! Online Slots Still Available!

Don’t miss out on learning from the “dynamic duo”–

David Burns, MD and Jill Levitt, PhD


TEAM-CBT Methods for Anxiety Disorders:

Step-by-Step Training for Therapists

Coming up SOON!

Sunday May 19th, 2019

8:30 am-4:30 pm PST (11:30 am-7:30 pm EST)

Live Online One Day Workshop

$135, 7 CE hours available

Therapists at all levels are welcome.

Learn new skills to reduce resistance and boost patient’s motivation to change. Practice powerful, practical TEAM-CBT techniques to help your patients overcome every form of anxiety rapidly.

  • Lively, amusing, and immensely useful day of online training
  • Online support and dynamic small group training
  • David and Jill will use a combination of didactic teaching, live demonstrations, and breakout group practice with emphasis on skill building.
  • Workshop will stream live and is easily accessible from anywhere on any device with WiFi. To join, just click on the link provided before the workshop.
  • Completion of this workshop counts towards TEAM-CBT Level 1, 2 or 3 Certification
  • Awesome brief videos
  • Learn how to treat GAD, OCD, Panic Attacks, Social Anxiety, Phobias, PTSD, and more

We Are Sold Out in Person–

But Online Slots are Still Available

REGISTER / LEARN MORE

Jill and I hope to see you at the workshop! We promise it will be fun, helpful, and exciting for you! 

David Burns, MD

132: Ask David: Do we REALLY create our own interpersonal reality? What if you’re being raped?

132: Ask David: Do we REALLY create our own interpersonal reality? What if you’re being raped?

Hi Folks!

Here’s the short version of today’s Ask David questions.

  1. Do depression and anxiety result from medical illnesses, like thyroid problems?
  2. Do we REALLY create our own interpersonal reality? What if you’re being raped? Are you saying that’s your fault? How can that be?
  3. I struggle with anxiety. Why is it a mistake to try to “calm down?”
  4. How do you deal with entitlement? I think my patients should do what I tell them to do! After all, I’m a highly trained professional!
  5. How do you deal with racism, sexism, and other societal barriers? What if the injustice is real and it isn’t “all in your head?”

And here are the longer versions. Fabrice and I hope you enjoy these thoughtful questions submitted by listeners like you!

1. Barbara asks: 1) How are hypothyroidism, depression, anxiety, and bipolar disorder related, and (2) how are heart disease, depression, and anxiety related?

2. Mark asks: I’m one of your most avid listeners to your podcasts. I’ve listened to most of Feeling Good Podcasts as well as the recordings of your Facebook live broadcasts with Jill. I absolutely love your content and extremely grateful for your insights and the material you put out for free. I’ve heard you say numerous times how in interpersonal relationship problems we create the poor behavior we see in the other.

At what point though, is a threshold crossed and you acknowledge the other in the relationship is creating problems? For example, if your client is being raped by their partner and is being threatened with violence if they dare leave, you wouldn’t say to your client you’re creating that kind of treatment from your partner.

Obviously the above is a very extreme example, but what if its scaled back in terms of severity of abuse, stopping short of physical attacks and threats? Where does a line in the sand get drawn where you acknowledge the client is not creating the problems themselves? I’d deeply appreciate your reply!

3. Angela asks: I was intrigued by your comment in your podcast #88 on Role-Playing Techniques that “trying to calm down is a big mistake. . . then your emotions become your enemies,” but then you said, “that’s a good topic for another podcast.” I hope you do a podcast on that topic!!! I’m eagerly waiting to hear more about that!

4. Julio asks: I’d like to share my experience. I am a therapist and I suffered from, and am still working on, feeling inadequate. I frequently questioned “am I good enough to be a therapist?” “How can I help others if I have issues of my own?”

After reading Feeling Good I realized I frequently jump to conclusions, engage in mind reading, and labeling whenever there is some uncertainty with my clients. At times I might even have blamed them when things didn’t go the way I thought they should go.

I believe I do that to protect my ego, and I might have developed some cognitive distortions related to entitlement such as

  • “I’m a therapist, people are supposed to do what I say”
  • “I worked too hard and too long and potential employers better give me what I deserve”
  • “Because I practice evidence-based therapy, I’m better than 99% of all therapists.”

These entitled thoughts led me to become irate whenever someone didn’t act according to my expectations. I would vacillate between feeling angry and feeling depressed.

I guess when I initially emailed Fabrice I was confused as to how my entitlement develops, but now I’m realizing that it comes from the same distortions that can cause depression. I didn’t know that distortions could produce depression and entitlement.

I’m curious what you and Fabrice think about this. I thoroughly what you and Fabrice think about this. I thoroughly enjoy your podcast and often find myself re-listening to earlier episodes.

5. Holly asks: “ Burns: I have found tremendous value in your books and podcast. I have noticed that you discuss some emails/letters/etc. on your podcast and I have one I’d like to hear you discuss. What are your thoughts on dealing with racism, sexism, and other societal barriers?

For example, it is not uncommon for people with dominant identities (white, male, physically able) to tell women, people of color, or those with physical challenges that their issues are all in their minds and that if they thought differently, then they would have different outcomes.

I am an African-American woman and I don’t believe this (the statistics on access to education, employment, and justice all suggest otherwise). What are you saying (if anything) in your writing, practice about thoughts related to injustice?

Best, Holly

So there you have it! Great questions, and keep them coming!

By the way, one of our podcast fans has written an outstanding and thoughtful article asking if there is a causal link between Donald Trump’s Twitter tweets and anti-Muslim hate crimes for the prestigious journal, Scientific American. Here’s the link

Thanks, David and Fabrice

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Dr. Fabrice Nye currently practices in Redwood City, California and treats individuals throughout the world (but not across U.S. state lines) via teletherapy. You can reach him at fabrice@life.net. You can reach Dr. Burns at david@feelinggood.com. If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.

* * *

THREE COOL UPCOMING WORKSHOPS FOR YOU

TEAM-CBT Methods for Anxiety Disorders–

Step-by-Step Training for Therapists

by David D. Burns, MD and Jill Levitt, PhD

jill-david

Dr. Jill Levitt and I are offering what I think will be an outstanding workshop on the treatment of anxiety disorders on Sunday, May 19, 2019. Our Sunday workshops are tremendously fun, so consider attending if you are interested. 

The last Sunday workshop in February sold out quickly so register soon if you are interested. You can join in Palo Alto in person or online from anywhere in the world.

THERE WILL BE MANY EXPERT TRAINERS TO GUIDE THE ONLINE PARTICIPANTS DURING THE SMALL GROUP EXERCISES

WHEN: May 19, 2019, 8:30 am – 4:30 pm PST
(11:30 am-7:30 pm EST)

WHERE: Join us live online or in person at the Creekside Inn, Palo Alto, CA.

HOW MUCH DOES IT COST? $135,

WILL I GET CE CREDITS? YES! 7 CE hours available

WILL I GET CREDIT IN THE TEAM LICENSURE PROGRAM? YES!
Completion of this workshop also counts towards TEAM-CBT Level 1, 2 or 3 Certification

WHO CAN ATTEND? Therapists of all levels are welcome

CAN I REGISTER IF I’M NOT A THERAPIST? Although the workshop is geared for therapists, it will be taught in a clear and basic way that anyone can benefit from.

WILL I HAVE FUN? Yes!

WILL I HAVE GET TO HANG OUT WITH SOME COOL COLLEAGUES? Yes!

WILL I GET AN AWESOME FREE BREAKFAST AND LUNCH? Yes!

You will love this lively, amusing, and immensely useful day of training with Drs. Burns, Levitt and the Feeling Good Institute Staff. The trainers will use a combination of didactic teaching, live demonstrations, video, and breakout group practice to enhance skill-building.

REGISTER / LEARN MORE

Act fast if you want to attend!

* * *

And there will be two awesome summer intensives for you this year!

July 15 – 18, 2019
Calgary four-day intensive
Sponsored by Jack Hirose & Assoc.

 

July 29 – August 1, 2019
South San Francisco four-day intensive
Sponsored by Praxis

 

The Dark Side of Clinical Practice–Protect Yourself and Your Clients

The Dark Side of Clinical Practice–Protect Yourself and Your Clients

Do you know how to predict and prevent suicide?

Treating people with depression and anxiety is, for me, and hopefully for you, an incredible privilege, and a source of tremendous personal satisfaction. I feel lucky to have  career that is so amazingly rewarding–but there’s a dark side to our work.

Experts tell us that 10% to 15% of chronically depressed patients will eventually commit suicide, even if they receive the best available treatment. Suicide is a horrible tragedy for patients, their families, and their therapists as well.

The impact can be devastating. Therapists typically struggle with feelings of intense loss, anxiety, failure and shame, and may also face the horrors of a humiliating and enraging malpractice suit which can drag on for years. Family members, friends, and therapists may struggle with this tragedy for years, or even decades, without resolution or relief.

Most therapists avoid talking about patient suicides due to feelings of anxiety, guilt and shame, and the fear of being judged. In case you missed it, you can still listen to David’s August 18, 2018 Feeling Good Podcast on suicide prevention and learn how to protect yourself, your patients, and their families from this horrific outcome.

You will learn what works–and what doesn’t–and you may save patient lives. You may also save yourself from a great deal of grief as well, so you can truly enjoy your clinical work without the fear of losing a patient in this terrible way.

If you want to take a deep dive into this subject, check out this May 15, 2017 blog on Suicide prevention as well. This may be anxiety provoking in the here-and-now, but may save you from far greater pain somewhere down the road!

This blog is part of a new approach I am using to send out blogs on topics of importance, with links to learn more, based on my previous podcasts and blogs. I hope you like it! let me know what you think. In addition, I have to thank a TEAM therapist and podcast fan, Angela Poch, for helping to make this a possibility!

David

* * *

Coming in May!

TEAM-CBT Methods for Anxiety Disorders–

Step-by-Step Training for Therapists

by David D. Burns, MD and Jill Levitt, PhD

WHEN: Sunday May 19th, 2019, 8:30 am – 4:30 pm PST
(11:30 am-7:30 pm EST)

WHERE: Join us live online or in person
at the Creekside Inn, Palo Alto, CA

HOW MUCH DOES IT COST? $135,

WILL I GET CE CREDITS? YES!
7 CE hours available

WILL I GET CREDIT IN THE TEAM-CBT CERTIFICATION PROGRAM? YES!

This workshop counts towards Levels 1, 2 or 3 TEAM-CBT Certification.

WHO CAN ATTEND? Therapists of all levels are welcome

CAN I REGISTER IF I’M NOT A THERAPIST? Sadly, this workshop is geared for therapists. You might want to attend one of my two summer intensives, also listed below. They are geared for therapists, but anyone can benefit from them.

CAN I WORK ON MY OWN FEELINGS OF ANXIETY AND INSECURITY?
Absolutely! Heal yourself, heal your clients!

WILL I HAVE FUN? Yes!

WILL I HAVE SOME GREAT FREE BREAKFAST AND LUNCH? Yes!

WILL I HANG OUT WITH SOME COOL PEOPLE? Yes!

You will also:

  • Learn new skills to reduce resistance and boost the motivation to change. This is THE key to the treatment.
  • Learn how to treat all of the anxiety disorders quickly.
  • See actual live videos of the Six-Minute Cure for Severe and Incapacitating Panic Disorder and the Fifteen-Minute Cure for Severe OCD.
  • Practice and master the Externalization of Voices and Acceptance Paradox to overcome your own feelings of inadequacy and self-doubt.
  • Master Relapse Prevention Training for lasting results.

You will love this lively, amusing, and immensely useful day of training with Drs. Burns, Levitt and the Feeling Good Institute Staff. The trainers will use a combination of didactic teaching, live demonstrations, videos, and breakout group practice to enhance skill-building.

This wonderful workshop will stream live and is easily accessible from anywhere in the world on any device with WiFi. To join, just click on the link provided before the workshop.

More than twelve expert trainers will be available to assist
the online participants in the small group exercises!

You can attend in person or from home via Live Streaming

Act fast if you want to attend!

Don’t miss out learning from David Burns, MD,
one of the pioneers of Cognitive Therapy,

and Jill Levitt, PhD, Director of Training
at the Feeling Good Institute in Mt. View, CA!

* * *
Coming this Summer

There will be two awesome summer intensives for you this year!

July 15 – 18, 2019
Calgary four-day intensive
Sponsored by Jack Hirose & Assoc.

July 29 – August 1, 2019
South San Francisco four-day intensive
Sponsored by Praxis

THE INTENSIVES ARE THE BEST WORKSHOPS OF THE YEAR!

If you can join us, they will be even better!

099: Nicole Bell’s Incredible Interview with Dr. David Burns

099: Nicole Bell’s Incredible Interview with Dr. David Burns

Behind His Brilliance: Critical Thinking

Lisa Nicole Bell is the host of the highly regarded podcast, Behind the Brilliance. In this lively interview, Nicole and David talk about

  • David’s path into the mental health field
  • the difficulties and rejections David faced getting his first book, Feeling Good, published
  • David’s advice to listeners interested in therapy
  • how he approaches perfectionism, depression, and anxiety with patients
  • the joys of a life free from the need to be special—
  • and much more!

Click here if you’d like to learn more about Nicole and hear more of her fantastic interviews! Lisa’s show delivers a smart and funny take on pursuing ambitions, designing a life, and living joyfully. Lisa’s most recent media work includes producing an Australian documentary on identity and gender politics within sports and a digital docu-series produced by Academy Award-winning actress Viola Davis.

088: Role-Play Techniques —Feared Fantasy Revisited

088: Role-Play Techniques —Feared Fantasy Revisited

088: Feared Fantasy, Part 2, and the Anti-Brushfire Technique*

Hi everybody!

Fabrice and I are thrilled to share this podcast with you, which I think you will really enjoy! We decided to include a second podcast on the Feared Fantasy Technique since it is so dynamic and powerful. We will also demonstrate the “Anti-Brushfire Technique,” which is another useful role-playing technique for individuals who fear disapproval.

We are joined tonight by two members of my weekly Stanford training group for Bay Area mental health professionals, Alisha Beal and Werner Spitzbaden. Both have brought along lists of some of their negative thoughts, which are based on real concerns.

Alisha has just completed our 12-week introductory “newbies” training group in TEAM-CBT. That group will merge with our “advanced” group next week, and she is feeling anxious and insecure for two reasons:

  1. She is concerned that people in the advanced group will think she’s not up to speed, and she’s worried that she will make a fool or herself when she has to practice techniques and get feedback from her colleague or answers questions in the class.
  2. Alisha blushes easily and is concerned that people will think she isn’t very bright and doesn’t know any anything when they see her blushing.

These concerns feel very real, and trigger fairly strong feelings of anxiety! Her negative thoughts included these:

  1. I’ll mess up.
  2. They’ll think I didn’t learn anything.
  3. I’ll blush and they’ll know I don’t know what I’m doing.
  4. I’ll make a fool of myself.
  5. David will realize that he wasted time and people when he created the introductory training group.

Werner’s concerns are similar. He has been in the advanced group for many months and has been doing a tremendous job of learning TEAM-CBT. However, he hasn’t work as a therapist for several years, but has been doing administrative work for a prominent California health delivery system. Werner is excited about the new TEAM-CBT skills he’s been developing, and wants to get back into clinical work. He has just accepted a part time position at the Feeling Good Institute in Mt. View, California.

This is great, but Werner is worried that his therapy skills won’t be good enough, and he’s afraid that the other staff members may judge him. He’s telling himself:

  1. I won’t succeed.
  2. I should know so much more than I do!
  3. I won’t do a good job!!
  4. I’ll develop a bad reputation, and no one will want to work with me.
  5. They’ll judge me and think that I’m not competent.

As you can see, although the details of his situation are quite different from Alisha’s, the underlying fears are similar.

And perhaps you’ve had similar fears and insecurities at times as well! Have you? I know that I’ve often felt that way! And that’s one of the reasons I find the techniques in this podcast so incredibly helpful and fascinating!

As you listen to the podcast, you will see what happens when Alicia and Werner both enter into an Alice and Wonderland Nightmare World where they will confront the monster they fear the most. I think you will find the results interesting, powerful, and entertaining, as they both suddenly achieve what the Buddhists have called “laughing enlightenment” for 2500 years!

* Copyright © 2018 by David D. Burns, MD

 

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.

Some Cool Upcoming Workshops

 

Coming in June! One of my best two-day workshops ever!

“Scared Stiff: Fast, Effective Treatment for Anxiety Disorders”
a two-day workshop Sponsored by Jack Hirose & Associates
June 4 -5, 2018 Calgary, Canada
June 6 – 7, 2018 Winnipeg, Canada
Mike Christensen and several others will be joining me at both locations to help out with supervision of the small group exercises. You’ll LOVE this workshop and you’ll learn TONS of powerful techniques to treat every type of anxiety. You’ll learn how to heal your clients and your own feelings of insecurity and self-doubt as well!

I greatly appreciate your support, and hope you will continue to spread the word about TEAM-CBT and www.feelinggood.com. i am trying hard to reach as many people as possible with my free programming and blogs designed to help individuals struggling with depression, anxiety, relationship conflicts, and habits and addictions, as well as the therapists who treat them!

David

 

 

Enjoy David’s Fabulous Canadian Summer Intensive!*

Enjoy David’s Fabulous Canadian Summer Intensive!*

Coming in July! My annual Canadian summer intensive!

“Advanced Cognitive Therapy for
Depression and Anxiety Disorders”

Whistler, BC, Canada
July 3 – 6, 2018

This brief video will explain why you should attend!

For workshop description / registration details, click–Jack Hirose & Associates Inc.
Phone: 604.924.0296, Toll-free: 1.800.456.5424

You’ll LOVE this workshop and you’ll learn TONS of helpful techniques to treat depression, anxiety disorders, and habits and addictions.

You’ll have your evenings free to enjoy the beautiful Whistler countryside, and I will likely offer optional evening hikes as well, with opportunities for personal work and consultation.

You’ll learn how to heal your clients and your own feelings of insecurity and self-doubt as well!

Mike Christensen and several others will be joining me at Whistler to help out with supervision of the small group exercises. Mike and I will also be doing a live therapy demonstration with an audience volunteer on the morning of day 2. Mike is a tremendous teacher and therapist, and a highly esteemed friend and colleague.

I hope you can join us in Whistler!

Attend David’s Scared Stiff Workshop!*

Attend David’s Scared Stiff Workshop!*

 

Coming in June! One of my best two-day workshops ever!

“Scared Stiff: Fast, Effective Treatment for Anxiety Disorders”

Two locations–
June 4 -5, 2018 Calgary, Canada  and  June 6 – 7, 2018 Winnipeg, Canada

Watch this brief video and I’ll tell you why you should attend!

Click this link for registration information: Jack Hirose & Associates

You’ll LOVE this workshop and you’ll learn TONS of powerful techniques to treat every type of anxiety:

  • Generalized Anxiety
  • OCD
  • PTSD
  • Phobias
  • Social Anxiety
  • Agoraphobia
  • Panic Disorder
  • and more

You’ll learn how to heal your clients and your own feelings of insecurity and self-doubt as well!

Mike Christensen and several others will be joining me at both locations to help out with supervision of the small group exercises. Mike and I will also be doing a live therapy demonstration with an audience volunteer on the evening of day 1. This promises to be a highlight of the workshop!

 

Solution to David’s Tuesday Tip #3*

Solution to David’s Tuesday Tip #3*

Here’s yesterday’s paradoxical tip #3

Therapists’ perceptions of how patients feel–the severity of symptoms–tend to be extremely inaccurate, at best, but most therapists are not aware of this.

What does this mean? Is it true? And if so, what are the consequences?

Is there a solution to this problem? And what, if anything, does the solution have to do with the first of four “Great Deaths” of the therapists ego?

Here’s Dr. David’s solution

My research and clinical experience have indicated that therapists’ perceptions of how their patients feel, and their patients feel about them, can be (and usually are) extremely inaccurate. What this means, in practical terms, is that a patient may be feeling intensely depressed and even suicidal, and yet the therapist thinks the patient is doing well. Or, the patient may be doing reasonably well, but the therapist thinks he or she is still severely depressed.

This inaccuracy involves all the negative emotions–such as depression, anxiety, and anger–and all the positive emotions as well. But since most therapists do not routinely assess patients’ feelings with brief accurate tests at every session, therapist do no know how “off” their perceptions can sometimes be. And while I do not mean to be alarmist, this can sometimes result in a failure of the therapy, or even the death of a suicidal patient.

In addition, although most therapists feel they are experts at communication, my research and clinical experience have indicated that therapists perceptions of the therapeutic alliance are also typically way off. In addition, many therapists grossly overestimate their clinical and communication skills, but they do not realize this!

To solve this problem, I have developed the Brief Mood Survey (BMS), and require all my patients to complete it in the waiting room before each session begins, and once again after the session is over. The BMS asks patients how depressed, suicidal, anxious, and angry they are feeling “right now,” at the start and end of the session. The comparison of the scores gives therapists an extremely accurate assessment of how effective, or ineffective, the session was.

It is, in a sense, like having an emotional X-ray machine available for the first time. The data are extremely valuable, regardless of whether you are doing psychotherapy, psychopharmacology, or a combination of the two.

At the end of the session, patients also complete the Evaluation of Therapy Session in the waiting, and rate the therapist on empathy, helpfulness, and other important dimensions. This only takes about one or two minutes of the patient’s time and provides the therapist with more invaluable, but potentially shocking, information.

So what does all of this have to do with the first of the four “deaths” of the therapist’s ego? Therapists who use these scales will probably make a number of uncomfortable discoveries, including, but not limited, to these:

  1. Therapists will discover that their perceptions of how their patients feel, and how their patients feel about them, will often be wildly and alarmingly inaccurate.
  2. They will often discover that the session was not at all helpful to the patient–in other words, there was little or no improvement in how the patient felt during the session.
  3. The therapist will likely receive failing grades on the Empathy and Helpfulness Scales most patients at every single session, especially if they are using these scales for the first time.

And that’s what I mean by the “death” of the therapist’s ego. You may discover, to put it in street language, that you suck! It’s happened to me often, and I usually find it painful to discover that my perceptions were off and my efforts were not effective.

But here’s the cool thing. This information can empower you to grow and change your therapeutic approach, so you can begin to deliver true healing. If you review the information with your patients in a warm and open way, it can transform the quality of the therapeutic relationship and vastly boost your effectiveness. And that’s pretty darn cool! I’ve been doing this for forty years, and my patients have proven to be my best teachers–by far!

Well, that’s it for today. Thanks so much for reading this, and if you like my blogs and Feeling Good Podcasts and FB Broadcasts, and the many other free features on my website, www.feelinggood.com, please use your sharing buttons to tell your friends. I am trying to build up my numbers as much as possible, and don’t know a great deal about social media, so anything you can do to spread the word will help.

AND you HAVE BEEN helping a lot already! Last month, (April 2018) my Feeling Good Podcasts with my esteemed host, Dr. Fabrice Nye, had more than 52,000 downloads. That’s a new record for us, so THANK YOU! I’d love to see those numbers soar even higher!

David

* Copyright © 2018 by David D. Burns, MD.

Coming in less than three weeks!

High-Speed TEAM-CBT for Depression and Anxiety Disorders 

I 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 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 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!

You will also leave this workshop with renewed confidence as well as specific, powerful tools that you can use right away to improve your clinical outcomes!

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. Online slots are also limited.

Jill and I hope you can join us!

 

 

086: Role-Play Techniques (Part 4) — Feared Fantasy

086: Role-Play Techniques (Part 4) — Feared Fantasy

This is the fourth in a series of podcasts on several powerful role-playing techniques we use in TEAM-CBT. Today, we’re going to highlight the Feared Fantasy Technique.

Here, in a nutshell, is why I created this technique. In order to get over any form of anxiety, exposure is absolutely necessary. Exposure is not a complete treatment for anxiety, and is only one of 40 methods I use to treat anxiety, but it always MUST be included in the treatment package.

However, sometimes, people have fears that you cannot easily confront in reality. For example, you may have the hidden fear that others would judge you if they knew how insecure you felt inside, or if you failed at something, or if they were way more successful than you. You can’t just say to someone, “Do you think less of me because I’m actually quite insecure?” They’ll just deny it, and you’ll feel like a nut!

So I created the Feared Fantasy Technique. Essentially, you invite the patient to enter an Alice-in-Wonderland Nightmare World where their worst fear comes true, and where people not only think of you what you most dread, but they also mercilessly tell it to your face. This gives patients the chance to face the monster. In most, if not all cases, they suddenly discover, at the gut level, that the monster has no teeth.

Like the Externalization of Voices, this is a two-person technique, although I’ve sometimes done it with many people in groups. In this case, there can be numerous feared “monsters.”

In the two-person version, you and another person, who could be your therapist, go into the Alice and Wonderland Nightmare World and act out one of your worst fears, such as being rejected by an exceptionally hostile critic because you aren’t smart enough or good enough. When you face your worst fear, you often gain liberation from it because you discover that the monster has no teeth. Your worst fears don’t usually turn out to be real monsters, but figments of your imagination that you can defeat with a little logic, compassion, and common sense. You use frequent role-reversals until the monster has been totally crushed.

I am joined in this podcast by our own beloved Dr. Fabrice Nye, and two members of my Tuesday training group at Stanford, Liz Richard, a Licensed Marriage and Family Therapist, and Dr. Rhonda Barovsky, a Forensic / Clinical Psychologist, along with Stephanie James, an LCSW psychotherapist and radio talk show host from Fort Collins, Colorado, who is visiting the group. Liz is a member of the “newbie” TEAM training group at Stanford and agreed to bring a list of her own negative thoughts that trigger her feelings of insecurity in the group. I am grateful to all of them for helping out with this podcast!

Sometimes, when I am helping a patient challenge a Negative Thought, like “I’m a bad mother” or “I’m a failure as a father,” or “my colleagues would look down on me if they knew how screwed up I actually am,” I start with a gentle technique like the Paradoxical Double Standard that we illustrated in the first podcast on role-playing techniques. It’s a gentle technique that would almost never threaten or upset a patient.

Once the patient has totally crushed the thought, I typically move up to the Externalization of Voices. This is a more challenging and powerful technique that provides a deeper level of recovery / enlightenment and allows me to model the differences between the Self-Defense Paradigm vs. the Acceptance Paradox.

Once the patient has knocked the ball out of the park with the Externalization of Voices, I often move up to the Feared Fantasy. This is the most extreme and powerful technique of all. And the moment the patient again defeats his or her most terrifying fear, the impact can be positive and extreme, and often ends in a kind of uncontrollable laughter The Buddhists call this “laughing enlightenment. It often happens the moment you suddenly realize that your worst fear was nothing more than a gigantic cosmic hoax!

You may want to read a brief description of how to use the Feared Fantasy Technique that I created several years ago for my training groups and workshops. At the end, you’ll find a comparison of the Externalization of Voices, Paradoxical Double Standard, and Feared Fantasy, along with a table contrasting the Self-Defense Paradigm with the Acceptance Paradox.

The example I am using in the write-up below is not the example in the podcast, but one I sometimes use in teaching. Often, participants are afraid to do role-playing in front of the group because of thoughts like these:

  1. I’ll probably look foolish and make a fool of myself.
  2. I’ll screw up and fail.
  3. People will judge me and think less of me.
  4. They’ll laugh at me and tell other people about what a loser I am!

It is difficult to confront these fears in reality since people generally don’t have these kinds of negative judgements toward colleagues in the group who are feeling insecure. In addition, if someone did have these kinds of thoughts they would deny having them. But in the Alice-in-Wonderland Nightmare World, people DO have these kinds of thoughts about you, and they DON’T deny them! So, it can be challenging at first to have to confront these kinds of mean-spirited perceptions, and incredibly freeing once you defeat them!

Feared Fantasy*

This is a form of Cognitive Exposure

  • Some fears are not easily confronted in reality

General instructions

Work in dyads. Decide who will play the role of therapist and who will play the role of patient

  • Use the workshop / seminar performance anxiety example

Therapist Instructions

  1. Explain that you’re going to enter an Alice-in-Wonderland Imaginary world where there are two strange rules:
  • If you think people are looking down on you, they really are.
  • Furthermore, they get right up in your face and verbalize all their negative thoughts about you. They aren’t at all nice. They try to humiliate.
  1. Ask the patient which role she or he wants to play first. Explain that you’ll do role-reversals, so the choice is not terribly important.

We’ll assume that you’ve chosen the performance anxiety example, and that you, the therapist, will start out in the role of a rejecting, judgmental audience member or friend. Your patient will play the role of himself or herself.

Now criticize your patient, saying the things that he or she would be afraid to hear, such as:

  • “Hey, I was in the audience when you did that role-play with Dr. Burns. You really looked foolish and I’ve been laughing at you ever since.”
  1. After your patient responds to each attack, ask who won the exchange. If the patient did not “win big,” do a role-reversal and see if you can come up with a more powerful response.

Tips on Defeating the Imaginary Critic

When you’re under attack, try to defeat the imaginary critic

  • You can use Self-Defense, the Acceptance Paradox, or a combination of the two

If the Self-Defense Paradigm was ineffective, try

  • The Acceptance Paradox
  • Or a combination of Acceptance and Self-Defense

If the Acceptance Paradox was ineffective, try

  • The Self-Defense Paradigm
  • Or a combination of Acceptance and Self-Defense

Comparing the Paradoxical Double Standard,
Externalization of Voices and Feared Fantasy*

Technique Patient’s Name Your Name Role-Reversals?
Paradoxical Double Standard His or her real name The name of an imaginary dear friend of the same gender as the patient. Preferably, it is not someone the patient actually knows. No
Externalization of Voices His or her real name Same name as the patient Yes
Feared Fantasy His or her real name You play the role of some judgmental or critical person the patient is afraid of. Yes

 

Comparing the Self-Defense Paradigm with the Acceptance Paradox*

Strategy

General Concept Negative Thought

Example of How to Defeat the NT

Self-Defense Paradigm You defeat the NT by arguing with it and insisting that it’s distorted and not true. A patient who suddenly relapses several weeks after recovery will often have this thought, “This shows that the therapy didn’t work and that I really am a hopeless case.” “That’s ridiculous. I had a fight with my wife last night, so it’s not surprising that I’d be feeling upset. The therapy was very effective, and this would be a good time to pull out the tools I learned and get to work.”
Acceptance
Paradox
You defeat the NT by buying into it and insisting that it is true, but you do this with a sense of humor or inner peace. During a moment of insecurity, a therapist may have the thought, “I’m not as good as I should be.” “As a matter of fact, I still have tons of flaws and a great deal to learn. Even when I’m 85 years old, there will still be tons of room for learning and improving, and that’s kind of exciting.”

The Self-Defense Paradigm is especially helpful for the types of NTs patients have during relapses, and it’s a good idea to prepare them to talk back to these thoughts when they first recover, and before they actually relapse, using the Externalization of Voices.

The Acceptance Paradox is especially helpful for the types of NTs that lead to feelings of worthless, inferiority, or a loss of self-esteem.

* Copyright © 2018 by David D. Burns, MD

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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Some Cool Upcoming Workshops

Coming in May!

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!

There are only a few spots left for the live workshop in Palo Alto, but we still have room for you to join us for the online version. We will have helpers to guide the small group exercises for those online, as well as those who attend in person.

Coming in June! One of my best two day workshops ever!

“Scared Stiff: Fast, Effective Treatment for Anxiety Disorders”
a two-day workshop Sponsored by Jack Hirose & Associates
June 4 -5, 2018 Calgary, Canada
June 6 – 7, 2018 Winnipeg, Canada
Mike Christensen and several others will be joining me at both locations to help out with supervision of the small group exercises. You’ll LOVE this workshop and you’ll learn TONS of powerful techniques to treat every type of anxiety. You’ll learn how to heal your clients and your own feelings of insecurity and self-doubt as well!

I greatly appreciate your support, and hope you will continue to spread the word about TEAM-CBT and www.feelinggood.com. i am trying hard to reach as many people as possible with my free programming and blogs designed to help individuals struggling with depression, anxiety, relationship conflicts, and habits and addictions, as well as the therapists who treat them!

David

 

 

Antidepressant Discontinuation Syndrome

Antidepressant Discontinuation Syndrome

Hi all!

Check out this link  that indicates some sobering findings about the long-term effects of antidepressants and the difficulties many individuals are having when they try to get off of them.

As you know, I’ve never been opposed to psychiatric medications, which can sometimes be helpful, even life-saving, but I’m far more excited about the many new developments in psychotherapy for depression and all of the anxiety disorders. And I’m really glad that so many individuals struggling with depression can now be helped fairly quickly without medications.

Research studies indicate that up to 65% of individuals struggling with moderate to severe depression will improve substantially or recover completely within four weeks– without any other treatment–if they are simply given a copy of my first book, Feeling Good: The New Mood Therapy. It is not costly and there are no side effects, and no “discontinuation” effects, either!

Many therapists and general medical physicians throughout the world “prescribe” this book for individuals suffering from depression because it can accelerate recovery. Some experts have even suggested it should be considered as the first line of treatment for depression. I am hoping that my new book, Feeling Great, now in partial draft form, will be even more helpful, since I am including all the amazing new TEAM-CBT techniques that did not exist at the time I wrote Feeling Good.

If you know someone who’s struggling with depression and anxiety, Feeling Good might made a good gift for that person. And if you’re a therapist treating individuals who are depressed and anxious, “prescribing” Feeling Good for homework will boost your success!

Some Cool Upcoming Workshops

Coming on May 20th! Act fast if you want to join us! Partially sold out but a few slots are still available for online participants.

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! Click here for registration information.

There are no spots left for the live workshop in Palo Alto, but we still have room for you to join us online. Mike Christensen and others will be available to help those who join online with the small group exercises in “virtual” rooms. In this workshop, you’ll have the chance to personal work, so you can boost your own feelings of confidence and self-esteem while at the same time learning tons of new tools that will greatly boost your clinical effectiveness!

Coming in June! One of my best two-day workshops ever!

“Scared Stiff: Fast, Effective Treatment for Anxiety Disorders”
a two-day workshop Sponsored by Jack Hirose & Associates
June 4 -5, 2018 Calgary, Canada
June 6 – 7, 2018 Winnipeg, Canada

Mike Christensen and several others will be joining me at both locations to help out with supervision of the small group exercises. You’ll LOVE this workshop and you’ll learn TONS of powerful techniques to treat every type of anxiety. You’ll learn how to heal your clients and your own feelings of insecurity and self-doubt as well! And I’ll do a live demonstration at each location, to add some drama, illumination, and inspiration. Should be exciting! Hope you can join us!

I greatly appreciate your support, and hope you will continue to spread the word about TEAM-CBT and www.feelinggood.com. i am trying hard to reach as many people as possible with my free programming and blogs designed to help individuals struggling with depression, anxiety, relationship conflicts, and habits and addictions, as well as the therapists who treat them!

I think there are ways you can “share” these blogs, Feeling Good Podcasts, and Sunday FB Broadcasts with friends and colleagues. Please do that! This month, my Feeling Good Podcasts with beloved host, Dr. Fabrice Nye, will likely exceed 50,000 downloads for the first time. So you ARE helping! Thanks so much!

David