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!

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 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

David and Mike Christensen Will Discuss “The Four Great Deaths”!

David and Mike Christensen Will Discuss “The Four Great Deaths”!

Watch David and Mike on FB Live tomorrow,
April 22, 2018, at 3 PM (Pacific Time) as they discuss–
the “Self” and the Death of the Self

Hi all!

As early as 2500 years ago Buddhists began talking about the “Great Death” as the path to enlightenment. Many other religions and spiritual paths also talk about death and rebirth.  But what do these concepts actually mean, and do they have anything to do with psychotherapy, or are they strictly spiritual concepts?

In his FB Live broadcast tomorrow, David and Mike Christensen will explore these concepts and focus on a number of specific questions.

  1. David claims there is not one, but four “Great Deaths” of the self, and they are involved in recovery from depression, anxiety disorders, relationship conflicts, and habits and addictions, respectively. What are these  four Great Deaths?
  2. Many individuals struggling with depression or anxiety fear the judgement of others. Have you ever felt like others might judge you because your “self” is defective, inferior, or simply “not good enough.”  How does one escape from this dilemma? Is it even possible? What if your “self” really isn’t good enough?
  3. Can the “self” be judged? Can you judge the worthwhileness of a human being, as opposed to the specific things we think, do or say? Does the “self” even exist?

David and Mike will discuss these questions from a practical, psychological, and spiritual perspective, and will include vignettes and examples to breathe life into the discussion, and to keep it practical.

You will also get an update and sneak preview of David’s new book, Feeling Great, currently in progress!

 

Some Cool Upcoming Workshops

Coming in May! Act fast if you want to join us!

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!

David

Register for the May 20, 2018 Workshop with David and Jill!

Register for the May 20, 2018 Workshop with David and Jill!

 

David Burns FB Ad-01

Coming Soon!

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!

 

 

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.

 

 

Does Tapping Work?

Dear Doctor David,

I am interested in your Scared Stiff anxiety workshop, as 95% of my primary care patients deal with this in some way, and I would argue that it is more common and in some ways more harmful than depression. I am a fan of CBT.

Question: is TFT (“tapping”) a lot of hooey or is there something to it? I have had some good personal experience, and would like to use it with primary care patients because I like simplicity and something that I can teach the patient to use at home (like deep breathing technique or affirmations). I like tools that the stressed patient can do RIGHT NOW, without an appointment or prescription, without spending money, without regard to insurance status, without needing more than 2 or 3 minutes, and without depending on an external source like the bottle of Jack, the pill (legal or otherwise), the partner, the “provider”, etc.

I respect your work, and you are an MD.  I would appreciate your thoughts on the TFT technique.

Kindest regards,

Lisa

Dr. David’s Answer

Hi Lisa,

Thank you for your question. TFT and EMDR combine something new (like tapping on your eye brow or jiggling your eyes back and forth) with exposure techniques that have been around for decades. I am skeptical that these types of distraction add much, if anything, to good, old-fashioned exposure. You can read about “Tapping” TFT if you click this link and you can read about EMDR at if you click this link

When I treat anxiety disorders, I combine a wide variety of exposure techniques with cognitive techniques, motivational techniques, and the Hidden Emotion Technique. You can read about these four treatment models in my book, When Panic Attacks, or in my psychotherapy eBook. I do not use eye jiggling or tapping on body parts during exposure, and have not found them to be necessary for outstanding or even dazzling results.

In my psychotherapy eBook I have a chapter entitled “The Clinician’s Illusion.” This refers to various ways that therapists and researchers fool themselves into believing things that may not be true. One problem I describe is called “coupling.” That’s where you combine an old, established technique, such as exposure, with some new technique, like eye jiggling or tapping on the eyebrow or whatever. Of course, exposure can be remarkably helpful, but you may mistakenly attribute the clinical improvement to the new technique that you are “coupling” with the older and more established technique.

In some cases, therapeutic enthusiasm may be due to the illusion of “seeing is believing.” If you use one of these newer techniques and your patient improves, it is natural to conclude that the treatment worked and that they theory is valid. But the special component you are using (such as eye jiggling, rhythmic knee tapping, or eyebrow or clavicle tapping) may, in fact, just be hooey, to use your language. The patient probably improved because of the exposure, and not because of the new component. Unfortunately, it is really easy for us to become “true believers,” especially if some new treatment is skillfully and aggressively marketed. Then we get invested and don’t like to be challenged, but challenging our thinking is the basis of science.

Another potential problem that confuses therapists and researchers alike is the placebo effect, which can be powerful. What’s the placebo effect? If people strongly believe something will help, it has a good chance of helping, even if it is nonsensical. When patients take an antidepressant and recover, or try some new treatment and recover, we think the pill or the therapy was the effective ingredient—but in most cases, the improvement is just due to the placebo effect.

I used to joke in workshops that we could create a new “ear tugging” school or psychotherapy, based on tugging on the ear lobes to let the evil spirits and pressures out of the brain, so the brain can get back into a proper balance again. I used to say that if you could get your depressed patients to believe in this notion, 35% to 50% would recover in three weeks as a “result” of their ear-tugging, especially if they work hard and do their five minutes of “ear tugging” homework every night. But in reality, it would just be the placebo effect.

Therapists in my workshops seemed to get a kick out of this example and laughed when I illustrated “ear tugging.” However, several years later a physician approached me during one of the breaks at my workshop, and asked if I’d heard about a fantastic new treatment for depression and anxiety. He had literature promoting the new treatment and wanted permission to distribute it. He swore that the new treatment had a 90% success rate and worked almost immediately.

I was intrigued and asked what the treatment was. He said it was called “Ear Tugging.” This is the honest truth. And he had paid quite a lot of money to attend a training program in this new “treatment!”

We all want to believe in something. People who challenge our beliefs are sometimes punished. In part, that’s probably why Socrates was put to death and forced to drink the poison hemlock–the people of ancient Greece did not want their cherished beliefs challenged.

Well, I’m no Socrates, and my thinking about TFT and EMDR may not be fair or accurate. It’s just my take on things, and I want to apologize ahead of time if I am way off-base. I’m just sharing my own thinking, for what it’s worth, but remember that I don’t know all the answers, and often my point of view is wrong.

Please let me know if I can post your interesting question, and my reply, on my website.

All the best,

David D. Burns, M.D.

Lisa’s Reply

Dr. Burns —

I’m happy to be part of your online discussion, and thank you for this thoughtful perspective – I appreciate it very much!

Didn’t Galileo face a similar problem as Socrates when he proposed that the Sun and not the Earth was the center of the world?  There is so much we don’t fully perceive and thus can’t understand, and so much associated fear.

I think it is important and interesting to collaborate broad-mindedly in figuring out what works, and in differentiating the genuinely effective intervention from its lucky-underwear surroundings.

These effectiveness questions are interesting and important, because isn’t the use of science-based exploration how CBT evolved into TEAM and how things improve generally?  I think so, and I am glad I asked you.

I come from a long line of people with depression and some bipolar as well, as well as apparently menopause-induced psychosis. That’s why I have always been interested in exploring what helps and what doesn’t and why.

Revolutionary to me was the idea that you are more than your thoughts, and that it is possible to change your frame of mind by working with the content of your thoughts. The shift from a negative to a positive orientation through thoughts and behaviors over which one has some control has been enormously helpful to me and makes so much sense.

So thank you!

And thank you for this response, and I will hope to attend one of your workshops in the future.

Kindest regards,

Lisa

Dr. David’s Second Response

You are so right. There were decades of suffering due to the Copernican revolution. And you are right that therapy methods can evolve rapidly, just as computer chips keep getting faster and better. Every week we develop new treatment and training techniques at my weekly training groups at Stanford and other locations around the SF Bay region.

Getting quantitative feedback from every patient at every session is tremendously helpful, both from a clinical and from a research perspective, because you can see what really works, and what does not.

I hope to meet you at an upcoming workshop!

All the best,

David Burns, MD