037: Ask David — “My negative thoughts aren’t distorted!”

037: Ask David — “My negative thoughts aren’t distorted!”

Podcast 37: Ask David

“My problems are real! The world really IS screwed up! And that’s not a distortion. So what can I do about my severe depression and anxiety?”

IMG_1764David and Fabrice discuss two questions submitted by Feeling Good Podcast listeners.

#1. Shari writes:

“I read your book Feeling Good and now I am reading your book When Panic Attacks–thanks to April’s podcast with you. I still struggle but recently our current political situation and environmental research about our negative impact on earth—has triggered severe anxiety and depression again. The problem is that I don’t think my thoughts are distorted—it certainly seems logical to assume that life on earth is threatened. So I am not sure how to do this. How can I make progress with my mental and emotional health while being aware of situations around the world? Any advice or thoughts would be deeply appreciated.”

This is a wonderful note, and I’m sure that huge numbers of people feel the same way, in varying degrees. So how can we attend to our own emotional well-being in the face of genuine adversity?

Dr. Burns discusses this from the perspective of Paradoxical Agenda Setting, which is the key component of TEAM-CBT, and emphasizes the most common therapeutic error of all—jumping in to try to help, without seeing all the really GOOD reasons for the patient NOT to change. From this perspective, Shari’s question becomes the most important question in all of psychiatry and psychotherapy—how do we help patients who may not want to change?

#2. After listening to the A = Agenda Setting portion of the live therapy with Mark, Paul submitted this question:

“Hi David,

Thanks to you, Fabrice and Jill for this episode – as with the previous episodes with Mark, this has really helped in bringing the TEAM approach to life. As I have been using your books in the past few years to self-treat feelings of anxiety and depression, I was very keen to hear how the new agenda setting step works.

I am wondering what your thoughts are on how effectively the “A” step can be carried out by a patient on his/her own (i.e. without someone else verbalizing the reasons not to change / playing the part of the patient’s sub-conscious)? Do you have any tips? I think I heard Mark say something to the effect that, on his own, he wouldn’t have thought of all the positives that you came up with in the session.

Thanks again for sharing these great tools and techniques – looking forward to the “M” step soon.

Paul”

This was another terrific question on a topic of great importance. David explains that it is actually easier for patients to learn to use Positive Reframing and the other Paradoxical Agenda Setting techniques than for therapists to learn them. Because of his excitement over this prospect, David has just begun a new book which will show depressed and anxious individuals exactly how to do this on their own in a step-by-step manner. He is optimistic that the new TEAM-CBT techniques, in book form, may be even more helpful to patients than his first book, Feeling Good: The New Mood Therapy. Research studies indicate that 65% of patients with moderate to severe depression improve substantially within four weeks of receiving a copy of Feeling Good, even without any other treatment. Dr. Burns is hopeful that his new book will provide the answers for the 35% who were not helped by Feeling Good.

So the answer is yes, I think many individuals WILL be able to do the “A” step on their own, and I am hopeful the positive impact will be great!

If you would be interested in David’s new book, please indicate this in the Survey attached to this podcast.

David and Fabrice have exciting plans for upcoming podcasts. They will be addressing these two questions in one or two podcasts:

  1. Is it possible to measure our “worthwhileness” or “worthlessness” as human beings?
  2. Do we even have a “self”?

These two questions have been discussed by experts for thousands of years, going all the way back to the Buddha, and most recently by the incredible Austrian philosopher, Ludwig Wittgenstein. And although the answers are tremendously simple, people can’t seem to “get it.” The issues are not simply philosophical, but eminently practical, since most depression and anxiety result from the perception that one is “worthless,” or “inferior,” or simply “not good enough.”

In addition, David and Fabrice are hoping to create a second live therapy session broken into smaller podcast chunks, but featuring David and a totally awesome former student and now highly esteemed colleague, Matthew May, MD. For the past ten years, David has been telling workshop audiences that Matt is one of the finest therapists in the world. So this is an event you won’t want to miss!

Click here to listen to Fabrice being interviewed on Dr. Carmen Roman’s podcast.

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024: Scared Stiff — The Cognitive Model (Part 3)

In this Podcast, David and Fabrice describe cognitive model of anxiety, which is based on three powerful ideas:

  1. Anxiety always results from negative thought (NTs) that involve the prediction of danger. For example, if you have public speaking anxiety, you are probably telling yourself something like this: “I just know I’m going to blow it. My voice will tremble. People will know I’m anxious. My mind will go blank. I’ll mumble and make a total fool of myself.” Or, if you struggle with panic attacks, you probably have thoughts like this: “I think I’m about to die. I can’t breathe properly. I’m about to pass out!” Or, “I’m about to lose control and go crazy.”
  2. The NTs that trigger anxiety are always distorted and illogical. In contrast, valid NTs cause healthy fear.
  3. When you put the lie to the distorted NTs, the anxiety will disappear. This can sometimes happen in an instant.

Dr. Burns describes his treatment of a woman named Terry who had suffered from ten years of incapacitating panic attacks and severe depression prior to contacting Dr. Burns. During each panic attack, Terry would experience tightness in her chest and tingling skin and tell herself she was about to pass out, suffocate, or die of a heart attack. Multiple emergency room visits, medical tests, and reassurances from doctors did not help. In addition, years of medication and psychotherapy were not at all helpful.

After trying a number of cognitive techniques that did not help, Dr. Burns persuaded her to let him induce an actual panic attack during an office visit so he could use the Experimental Technique, which is arguably the most powerful technique ever developed for the treatment of anxiety, and he televised the session. What happened next will blow your mind!

In the next podcast, Drs. Burns and Nye will describe the Exposure Model of treatment, and Dr. Burns will describe his personal struggles with his fear of blood during medical school.

 

→ Click here to download Terri’s Recovery Circle

012: Negative and Positive Distortions (Part 3)

In this final podcast on the ten cognitive distortions, David and Fabrice discuss Should Statements, Labeling, and Blame. He brings these distortions to life with a case of a severely depressed woman who felt profoundly guilty and devastated after her brother’s tragic suicide. Dr. Burns also describes the negative thoughts of an individual who experienced horrific childhood abuse, and concludes with a surprising vignette of an elderly woman who was absolutely convinced that the problems in her marriage over the past 35 years were entirely her husband’s fault.

011: Negative and Positive Distortions (Part 2)

In this podcast, David and Fabrice discuss the three common distortions: Jumping to Conclusions (including Mind-Reading and Fortune-Telling), Magnification and Minimization (also called the Binocular Trick), and Emotional Reasoning. David explains how the negative versions of these distortions trigger feelings of depression, inferiority, anger, anxiety, shyness, and hopelessness, and how the positive versions can lead to bad habits, such as procrastination and binge-eating, and also helped to trigger the Iraq war.

010: Negative and Positive Distortions (Part 1)

Nearly 2,000 years ago, the Greek Stoic philosopher, Epictetus, emphasized that we are upset, not by what happens to us, but rather by our thoughts and interpretations of those events. A significant advance in this ancient theory occurred in the 1950s and 1960s when Dr. Albert Ellis, from New York, and Dr. Aaron Beck, from Philadelphia emphasized that the thoughts that upset us when we’re feeling depressed, anxious, or angry are nearly always distorted and illogical. As Dr. Burns emphasized in his book, Feeling Good, depression and anxiety are the world’s oldest cons, because you’re almost always telling yourself something that’s actually untrue. But you probably do not realize that you’re fooling yourself because your negative thoughts, like “I’m a loser,” or “Things are hopeless,” or “I shouldn’t have screwed up” seem as valid and real to you as the skin on your hands.

In this podcast, David and Fabrice discuss the first four of ten common thought distortions that trigger negative feelings: All-or-Nothing Thinking, Overgeneralization, Mental Filter, and Discounting the Positive. Dr. Burns explains that each negative distortion also has a mirror-image positive version as well, and these positive distortions trigger hatred, violence, narcissism, and mania, as well as habits and addictions. See if you can recognize some of your own distorted thinking patterns as you listen to this podcast!

008: M = Methods (Part 2) — You Can CHANGE the Way You FEEL

In this Podcast, Dr. Burns describes his work with a severely depressed, suicidal, hospitalized woman with rapidly cycling bipolar illness, who’d had 15 years of failed treatment with drugs and psychotherapy. She was telling herself:

  1. This f___ing disease has ruined my life.

  2. I’m a burden to my family.

  3. My family and doctors would be better off if I were dead.

She was absolutely convinced that each of these negative thoughts was 100% true. Dr. Burns used several T.E.A.M. methods to help her challenge those thoughts, including Identify the Distortions, Examine the Evidence, the Experimental Technique, the Externalization of Voices, and the Acceptance Paradox. Listen to this podcast and find out about the shocking and rather unexpected impact of those techniques.

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