Fabrice and David address several challenging questions submitted by individuals who listen to the Feeling Good Podcasts.
Richard: Do you have to get along with everybody? How do you deal with a sociopath?
Dave: Positive distortions can trigger mania, addictions, narcissism, and violence–but how can you get rid of them?
Julia: What can you do if you’ve been depressed all of your life and wake up every morning with your mind flooded with negative thoughts? I spend two hours trying to dispute them, but they just keep coming back the next day.
Omhur: How would you treat “Reading OCD?” I feel compelled to read every sentence and paragraph carefully and repeatedly so I won’t miss anything!
Unnamed fan (who left a negative review on iTunes): Isn’t your concept of the death of the ego potentially dangerous to people with low self-esteem who are being abused?
Thank you for your terrific questions, your frequent praise, and your occasional criticisms and challenges. They keep us on our toes, and we deeply appreciate all of you. So keep your comments coming, as well as your suggestions for shows and topics you want to hear more about!
We are receiving more than 50,000 downloads a month. Please tell your friends about us so we can continue to build our audience.
Thanks! We really enjoy doing these shows for you.
David and Fabrice
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October / November / December 2018– Cool Workshops for You!
Sunday October 28th, 2018 (8:30 am to 4:30 pm PST)
Live in Palo Alto plus online streaming
Learn how to reduce patient resistance and boost motivation to change. Master skills that will enhance communication skills and increase intimacy with loved ones. This workshop will be highly interactive with many case examples and opportunities for practice using role plays.
Join us for a day of fun and inspiring learning on site in Palo Alto
OR online from anywhere in the world.
The in person version is now sold out, but limited spaces are still available if you would like to join online. There will be experts to assist the online participants with small group exercises in break out rooms, so you will have the same experience as those who attend in person. But act fast it you want to be included!
November 29 and 30, 2018–San Francisco, CA (in person only)
December 3 and 4, Portland, Oregon (in person and live streaming)
PESI is proud to offer an exciting workshop by David Burns, M.D., a pioneer in the development of cognitive behavior therapy (CBT). Achieve rapid and lasting recovery with all your anxious clients, just as Dr. Burns has done in over 35,000 therapy sessions with severely troubled clients. Become skilled at treating every type of anxiety without drugs.
In this unique 2-day certificate course you’ll master more than 20 treatment techniques to help your clients eliminate the symptoms of anxiety quickly – even your most challenging, resistant clients.
Dr. Burns will illustrate concrete strategies that provide rapid, complete recovery and lasting change for your patients. You’ll learn…
How to integrate four powerful treatment models to eliminate symptoms.
How to enhance your client’s engagement in therapy.
How to develop a treatment plan that specifically targets each client’s unique problems and needs.
…and so much more!
David will provide you with guided instruction and share powerful video sessions that capture the actual moment of recovery. You will take away practical strategies to use immediately with any anxious client. Leave this certificate course armed with tools you can use in your very next session!
Don’t miss this opportunity to learn from one of America’s most highly acclaimed psychiatrists and teachers!
Successful treatment requires the death of the therapist’s ego;
recovery requires the death of the patient’s ego.
Sorry to be super brief again today because I am currently in Canada on the second day of the four-day intensive. If you missed it this year, you can find an announcement for the annual San Francisco intensive at the bottom of this blog! It’s coming up in August so you still have time to register.
So, what’s the solution to yesterday’s puzzle?
One of the unique features of TEAM-CBT is that patients rate therapists in the waiting room immediately after the session is over, using the Brief Mood Survey and Evaluation of Therapy Session forms. Patients leave the completed surveys before they go home. This gives the therapist the chance to review the ratings when the session is still fresh in the therapist’s mind so he or she can find out how effective, or ineffective, the session was.
The Empathy and Helpfulness scales are extremely sensitive to the smallest errors or failures of the alliance, and most therapists will get failing grades from most of their patients when they first start to use the Brief Mood Survey and Evaluation of Therapy Session. This can be painful, as it bursts the therapist’s bubble of optimism and self-confidence.
But if you, the therapist, process the information with your patient at the start of the next session in the spirit of humility, warmth, and curiosity, it can have a tremendously beneficial effect on the treatment. I’ve experienced this amazing phenomenon more times than I can remember! But it can be very painful to have to face your errors and shortcomings. That’s because the patient’s criticisms of the therapist will always contain, not just a grain of truth, but a whole lot of truth!
Yikes! That sucks!
So, the death of the therapist’s ego will often be required. This, to me, is a good thing, because it gives therapists tremendous opportunities to grow and learn at the same time that their patients are growing and learning. But the negative feedback does hurt at times. And the pain can be fairly intense.
For the patient to recover, the death of the ego may also be required. A great deal of depression and anxiety results from the idea that we aren’t good enough, so we beat up on ourselves relentlessly, thinking perhaps that if we punish ourselves enough, we will grow and eventually attain some goal of perfection or superiority.
But this mind-set is the problem; it is not the cure. Recovery more often results from what I call the Acceptance Paradox–which means the death of the patient’s ego. That means accepting that you are, and always will be, quite flawed, and accepting this with a sense of inner peace, or even humor. In fact, once your ego has died, you can join the Grateful Dead, and that’s incredibly freeing and cool!
More later, and sorry to offer you so little in the last couple weeks. I’ve been working hard on the new book, so I’m kind of short on time, but there will be a ton on this topic when the book is released, so hang in there!
Hey, folks, my San Francisco summer intensives is nearly always my BEST training program of the year because the group is quite small, giving you lots of chances for Q and A and schmoozing. In addition, many individuals from my Tuesday group at Stanford join me to provide feedback during the small group exercises. Here are the specifics:
* * *
Coming in San Francisco in August
High Speed, Drug Free Treatment of Depression and Anxiety Disorders–
A Four-Day TEAM-CBT Advanced Intensive
August 6 – 9, 2018, South San Francisco Conference Center, California
For more information, click here
or contact http://www.iahb.org/
If you can only attend one of my workshops, consider this intensive! it is simplly
Seating is limited. Register now if you want to get in on the action!
After yesterday’s live Q and A on Facebook, I received an interesting email from one of the participants whom I’ll simply refer to as JD. We kind of ramble and babble, but I enjoyed our exchanges, and you might enjoy the dialogue as well! During the FB live broadcast, I described the three “deaths” of the ego that are necessary for the patient and for the therapist as well. JD apparently resonated with that discussion, and added some of his own beautifully thoughtful comments!
Enjoy, and feel free to add your own thoughts if you are interested!
As an aside, the next live FB Q and A will be at 2:30 PM, Sunday afternoon, on November 5th. There will be no live broadcast this Sunday, October 29th, because I’m flying to the east coast for three relationship workshops in Raleigh, Atlanta, and Denver.
Hello, Dr. Burns,
Thank you so much for responding to my question about Buddhism’s similarities to C.B.T. on your Facebook live video session yesterday (Sunday, October 22nd).
Your anecdote about “bullshitting about Buddhism” was hilarious and entertaining. I also enjoyed the opportunity to meet Miss Misty (David’s new cat). I’ve been a big fan of black cats all of my life, and always seem to attract them. Catching you and Misty today during your live broadcast was a happy synchronicity that made my Sunday and stoked my desire to go back to school and become a therapist.
One of the other commenters, who posted after I did, said that your live feed was for therapists, not patients. I missed the beginning of your talk and consequently missed any opening words or disclaimers to that effect which you might have laid out. I apologize if I was trespassing on your broadcast, but I was so happy to see you reading my thanks, and I want to repeat my thanks to you and reiterate what I said in my first comment, that I credit you with saving my life.
David’s comment: My podcasts, blogs, and broadcasts are for therapists as well as the general public. To me, there is only the thinnest of lines between “therapist” and “patient,” as we all tend to hurt in the same ways! So all are more than welcome to join!
I’m currently rebuilding my life after a four-year gay relationship characterized by verbal abuse. The insanity of the relationship led us to seek therapy, and while my partner never followed through with attending therapy, he did speak to a therapist who recommended your Feeling Good series of books, and that’s how we happened upon your work.
That was about a year ago. About four months ago, I left the relationship, as my partner seemed to be stepping up his irrational attacks proportionally to my starting to feel better. I’d done everything possible to accept responsibility for my own actions and to follow the wisdom contained in Feeling Good Together, but there came a point when it became clear my partner was not doing his share of accepting responsibility for himself–for example, finding a therapist for himself.
My summer since exiting the relationship has been pretty difficult, as I’ve mourned the loss of my former life and love while seeking refuge in the home of my parents, which opens up another whole can of worms. As I felt myself slipping into depression about a month ago, I picked up your Feeling Good Handbook and rediscovered the Acceptance Paradox. Upon reading about it one Saturday, in the throes of my depression, I instantly began to experience relief, to my wonderment.
David’s comment: Break up of loving relationships is almost always pretty painful. I’m sad you’re having to go through that. But yes, the Acceptance Paradox is totally mind-blowing, and I’m so glad that you “got it.”
That same night I accompanied my parents to a concert by the local philharmonic, held at the William Saroyan Theater in the downtown district of our city. As we were leaving, I happened to look up at the wall of the theater and see a quote by the eponymous author emblazoned there: ““The greatest happiness you can have is knowing that you do not necessarily require happiness.” This seemed like a resounding affirmation of the Acceptance Paradox, and upon reading it, my mood elevated even more!
In the past few weeks I’ve begun to adopt a Buddhist practice, meditating weekly with a local sangha. This past week I learned about the Dhammapada, an ancient Pali text whose 26 chapters contain what’s purported to be the sayings of the Buddha in verse form. It begins with this:
“All that we are is the result of what we have thought: it is founded on our thoughts, it is made up of our thoughts. If a man speaks or acts with an evil thought, pain follows him, as the wheel follows the foot of the ox that draws the carriage.”
From there, the C.B.T. parallels just keep on coming. What struck me in relation to my present situation was this third and fourth verses:
“Those who entertain such thoughts as ‘He abused me, he beat me, he conquered me, he robbed me’ will not still their hatred”
And its paired verse is
“Those who do not entertain such thoughts as ‘He abused me, he beat me, he conquered me, he robbed me, will still their hatred.”
Before you think this is a Buddhist lesson and stop reading, I’ll leave off quoting this text, but I am curious about what you meant by saying you were “anti-Buddhist.” Do you think that cultivating a Buddhist practice is a waste of time and that the mind is better trained through C.B.T. principles? Or was that a bit of hyperbole?
David comment: You are right, when I say I am “anti-Buddhist” it is just hyperbole, trying to send a message, I guess, that being a joiner and follower is perhaps not the path I personally prefer. Certainly, the Buddha was not a “Buddhist” either, so I think I am in pretty good company!
I also wonder if you have any advice for me. I’m 45 years old. After earning a Bachelor’s degree in Modern Literature from the University of California at XYZ 23 years ago, I left academia in search of “real-world” experience and continued my education in the proverbial School of Hard Knocks (at its campuses in S.F., NYC, and L.A.).
Now, having returned to the place where I began, I am filled with the desire to help improve life in the Central Valley, in particular for other marginalized people (I feel as though I had to leave my home town in order to become who I was meant to be) as well as for LGBT+ folks everywhere.
In my desperate search for help over the last few years, I found very few books aimed at LGBT people. This is a pity, as the gay community that I delved into these past 20 years is shockingly unwell.
It’s as if wellness is not a concept, especially in the gay male community. An almost nihilistic hedonism seems to be the norm, and self-destructive behaviors are celebrated, propagated, and inculcated with alarming uniformity. Do you have any thoughts in relation to this observation? And would you agree that there’s a need for specialized outreach to this community?
I realize you might not have time to respond, so I won’t be offended if you don’t. Thank you so much for being there. If you’ve read this all the way through, I apologize if I’ve bored you or overshared. You’re a real hero to me, and I really wish I could be your student and go on hikes with you all. 🙂
With much gratitude and all my wishes for your happiness and health,
Doctor David‘s Response
Thank you for the excellent email! I’d love to publish it, with your permission.
I liked your quoting from the Buddhist teachings, and it does sound a lot like cognitive therapy. We actually worked on anger thoughts on yesterday’s Sunday hike, using some of the new Paradoxical Agenda Setting techniques, which seemed to help a great deal. We also used the Acceptance Paradox which proved really helpful, too.
I am a strong gay supporter, in part because my father, a Lutheran minister, was anti-gay, and I felt that was unfair and a form of hatred, and clearly not an expression of religion, love or spirituality! I have many fine young therapists in my training groups who are gay, and they are doing some great outreach work, which I applaud and support.
I feel that gays and LGBT folks suffer very unfairly by so much hatred in our society, and in our so-called “modern” civilization throughout the world. The human race has a nasty dark side, and perhaps the prognosis for our long-term survival is not that good.
My wife and I do not regret so much that the human race may drive itself to extinction via nuclear war, global warming, or whatever, but we do regret that we will take so many innocent and vulnerable animal species along with us.
We also feel disgusted by those who hide their hostility and cruel behavior behind religious concepts, claiming they are doing this or that atrocity in the name of God, or some prophet, or some “higher” principal. To me, this absurd denial of their dark motives and aggression is almost more hateful than their cruelty to those they judge as inferior, defective, bad, or whatever.
I’ve also embedded some comments in your thoughtful and excellent email above!
Thank you for your response. I am delighted to hear back from you, and I’m so happy you liked my email. Please feel free to publish it on your blog. Using my initials would be fine.
I’m grateful for the clarification of your “anti-Buddhist” statement. I’m not much of a joiner either, having grown up Catholic and endured 13 years of Catholic schooling before rebelling dramatically from it for the next few decades. I am still vehemently opposed to the Catholic Church, and my parents’ adherence to the church is one of the big sticking points in my current experiment in co-existing with them after 25 years away.
In Buddhism, I’ve found a helpful tool for calming and stilling my mind and accepting things as they are, as well as keeping a grateful focus on the present moment. I appreciate that, in contrast to Catholicism, Buddhism rejects hocus pocus, esoteric dogma, and the cruel rejection of others. It’s rooted in the real world and advocates a training of the mind as a means of alleviating suffering.
I believe you to be what’s known as a bodhisattva, if you don’t mind me saying so, a true adult who’s transcended the ego and lives in mindfulness of the world’s suffering, doing his best to free others from the cycle of their karma.
Ultimately, I agree with you and your wife that the real tragedy in our human condition is our devastation of the other species with whom we share the earth. I feel terribly for the innocent victims of our greed and heedless behavior. Becoming a vegan last year has connected me to purpose in a very fulfilling way, and since making that transition I’ve felt my capacity for empathy expand.
Thank you for your encouragement of gay therapists and their important outreach. Allies such as yourself are essential to the community’s feeling better, learning to overcome decades of social stigmatizing, and developing the skills to love and care for its own.
Please stay well and keep up the profoundly beautiful and helpful work.
With gratitude and deep respect,
Doctor David’s Final Response
Oh, thanks, thanks, thanks! We seem to be on the same wavelength!
If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and tons of resources for mental health professionals as well as patients!
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