129: Flexing the Mindfulness Meditation Muscle

129: Flexing the Mindfulness Meditation Muscle

What is Mindfulness? Why Meditate?

In this role-reversal of the traditional Feeling Good Podcast, Dr. David Burns and his special guest, Dr. Rhonda Barovsky, interview Dr. Fabrice Nye, your beloved podcast host, on the topic of Mindfulness and Meditation, which are currently popular with the therapeutic community.

Fabrice answers questions like these:

  1. What’s mindfulness? How does it differ from meditation?
  2. What’s the history of mindfulness as well as meditation? Did it originate with the Buddha, or did it date back even earlier?
  3. What are some of the goals and potential benefits of mindfulness?
  4. Why specific exercises can you do to develop greater mindfulness ?
  5. Why is mindfulness helpful? How does it work?
  6. Some people meditate in silence for prolonged times, like ten days, for example. What is the goal here?
  7. Are there any dangers of meditation?
  8. How does mindfulness differ from yoga, relaxation training, and self-hypnosis?
  9. Some people seem to love and benefit from meditation, and others find it uninteresting or even annoying. Why is this? What’s the difference in these two groups of people? Is it okay not to be interested in meditation, or is something that everyone “should” do?
  10. The goal of mindfulness seems to be learning to deal more effectively with stressful thought and feelings. Does it deal with motivation and the resistance to change? TEAM-CBT makes us aware of the incredible importance of resistance, and provides many methods for reducing or eliminating resistance before you try any Method to “help” the patient. Does Mindfulness Meditation deal with resistance, or would it best be viewed as a method that can help individuals who are already strongly motivated to invest time and effort in their personal growth?



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 VanDonsel, you may download it here.

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TEAM-CBT Methods for Anxiety Disorders–

Step-by-Step Training for Therapists

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

May 19, 2019

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

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

IMG_1226Hi Dr. Burns,

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

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

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

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


Hi Richard,

Great questions, thanks!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


026: Scared Stiff — The Exposure Model (Part 4)

026: Scared Stiff — The Exposure Model (Part 4)

In this Podcast, David and Fabrice discuss the Exposure Model for treating anxiety. They begin by briefly describing the three different deaths of the ego that are required for recovery from depression, anxiety, or a relationship conflict, respectively. For depression recovery often results from the “Great Death,” A Buddhist concept that involves the discovery that there is no such thing as a “self” that could be worthless, or inferior, or judged by another person. David and Fabrice only touch on this theme and promise an entire future podcast on this fascinating and helpful spiritual notion that can lead to recovery from depression.

For anxiety, the death of the ego is quite different, and involves surrendering to the monster the patient has always feared and avoided using a wide variety of exposure techniques. David traces the origin of Exposure Therapy to teachings in the Buddhist hold scriptures, the Tibetan Book of the Dead, more than 2,000 years ago. David describes the amazing and hilarious phenomenon of “laughing enlightenment,” which often happens when anxious individuals confront their fears.

David describes how he used Flooding, an extreme form of exposure, to get over his own blood phobia, which he’d had since childhood. His fear of blood caused him to drop out of medical school at Stanford for a year on two separate occasions. He finally decided to confront his fear by working for a month in the Emergency Room of Highland Hospital, a major trauma treatment center, in Oakland, California. David explains what happened when a totally bloody man on the verge of death was rushed into the ER after a bomb he was building in his basement blew up.

In the podcast David forgot to mention something fascinating about his experience at Highland. David had had a blood phobia since he was child, and blood phobia is thought to have genetic causes, and perhaps be inherited. And yet, David was totally cured in roughly 15 minutes without any medication at all. The important point is that even if things are biologically caused, they can often be treated with psychological techniques.

Most therapists hate the word, “cure.” David explains why he sometimes uses this term when treating anxious patients, and also explains the difference between a 100% cure and a 200% cure.

David emphasizes the importance of motivation and resistance in the treatment of anxiety, since few patients, if any, will want to use exposure techniques, because it is so terrifying. David and Fabrice will describe the Motivational Model in the next podcast.

David and Fabrice raise questions about the mechanism of recovery during exposure. Why does it work? Is it due to the change in thinking, or is there some other healing mechanism at work?

Fabrice asks about patients who resist exposure and protest that it won’t work. For example, a patient with the fear of heights might say, “Oh, exposure can’t possibly help, because every time I get in a situation where I’m exposed to heights, like when I’m in looking over a railing on the third floor of a building or hiking on a mountain trail, I get terrified. This has happened hundreds of times and it never helped!”

Finally, David describes a humorous but real example of his 8-minute treatment of a therapist with 20 years of failed therapy (several times a week of psychoanalysis) for her elevator phobia.

David and Fabrice end by talking about the enormous amount of information they have to share with listeners, including large numbers of creative exposure techniques that fall into three categories:

  1. Classical Exposure
  2. Cognitive Exposure
  3. Interpersonal Exposure

They promise future podcasts describing these fascinating techniques with more amazing vignettes based on patients Dr. Burns has treated, as well as his treatment of his own many fears and phobias!