078: Five Simple Ways to Boost Your Happiness–#5: You Can CHANGE the Way You FEEL!

Building Self-Esteem and Overcoming Toxic Shame–as well as feelings of depression, anxiety, inferiority, hopelessness, and anger!

Let’s face it–nearly all of us fall into the black hole of depression, anxiety, shame, and self-doubt at times. Then it’s time to ask yourself what you’re telling yourself, write down your negative thoughts, identify the distortions in them, and substitute thoughts that are more positive and realistic. Sound too easy? The results can be mind-blowing!

David and Fabrice discuss a therapy session with a woman who had been hiding something about herself for nearly ten years due to feelings of shame. When she receives a phone call from someone in her church, her feelings of anxiety and shame hit the ceiling. Learn how she overcomes her feelings of angst and self-doubt using TEAM-CBT.

David hopes to make the actual video of this dramatic therapy session available soon right here at www.feelinggood.com in his new Feeling Good Store! (still under development at the time of this write-up.)

While listening, you can download pdfs about each of seven steps to help you break out of bad moods and boost your self-esteem:

Step 1. Identify the Upsetting Event

If you click on Melanie’s Daily Mood Log you will see that the Upsetting Event was something seemingly innocuous.

Step 2. Rate Your Negative Feelings

If you click on Melanie’s Daily Mood Log again, you will see how she circled her feelings and rate each type of a feeling on a scale from 0% to 100%. You will see that her negative feelings were actually incredibly intense.

Daily Mood Log with feelings circled and rated

Step 3. Record Your Negative Thoughts

Cognitive therapists, going all the way back to the Greek Stoic philosopher, Epictetus nearly 2,000 years ago, say that we are upset, not by things, or events, but by our thoughts about them. If you click on Melanie’s Daily Mood Log with Negative Thoughts yet again, you will see what she was telling herself about the phone call from the member of her church.

Step 4. Positive Reframing

This is one of the many powerful new features of TEAM-CBT. Before trying to change the way you think and feel, focus on your negative thoughts and feelings one at a time and ask yourself two questions:

  1. What are some benefits, or advantages, of this negative thought or feelings?
  2. What does this negative thought or feeling show about me and my core values that’s positive and awesome?

Briefly stop the recording and review Melanie’s Daily Mood Log. Then see how many positives you can list. For example, what does Melanie’s shame show about her that is awesome and positive? And what are some really beautiful things about her sadness and depression? What are some potential benefits of her anxiety?

Step 5. Identify the Distortions

After the Paradoxical Agenda Setting (in this case, Positive Reframing), I asked Melanie what Negative Thought she wanted to work on first. She selected the second negative thought, “She’ll tell other people who will judge me.” See how many distortions you can find in this thought, using the list of ten distortions on her Daily Mood Log.

When you’re done, you can see how Melanie identified the distortions in this thought, using abbreviations, in the Distortion column of her Daily Mood Log. However, on the podcast, David identified one additional distortion he had overlooked during the live session with Melanie. Can you figure out which one it is?

Step 6. Challenge the Negative Thought

There are more 50 techniques that you can use to challenge a Negative Thought. After listing roughly 17 promising methods during the session, Melanie decided that she wanted to start out with a gentle method called the Paradoxical Double Standard Technique. If you click on Melanie’s Daily Mood Log  again, you can see the Positive Thoughts Melanie came up with to challenge the Negative Thought, “She’ll tell other people who will judge me.” You will also see how strongly she believed them. Remember that the Necessary Condition for Emotional Change is that the Positive Thoughts all have to be 100% true. Rationalizations and half-truths will rarely, if ever, give anyone genuine relief or mood elevation.

Now the question is this: Did the Positive Thoughts reduce Melanie’s belief in the Negative Thought? Remember the Sufficient Condition for emotional change: the Positive Thoughts must drastically reduce the belief in the Negative Thoughts. That’s the whole goal, in fact, of cognitive therapy. Remember, when you change the way you THINK you can change the way you FEEL!

If you click on Melanie’s Daily Mood Log again, you’ll see that her belief in the Negative Thought was, in fact reduced. Sometimes, you will want to reduce your belief in a Negative Thought all the way to zero. But in this case, 35% was sufficient, since some people may, in fact, judge Melanie, although most people probably will not.

Step 7. Outcome: Re-rate Your Negative Feelings

Once you’ve clobbered one negative thoughts, it’s generally much easier to knock the rest of your Negative Thoughts out of the park. This was the case with Melanie. If you review her final Daily Mood Log, you can see how she challenged the rest of her Negative Thoughts and the incredible impact this had on her feelings.

Coming Soon!

Next week we will have something very special and very precious for you–

Podcast 079: What’s the Secret of a “Meaningful” Life? Live Therapy with Daisy

This will be a dramatic and inspiring podcast that Fabrice and I feel very grateful to be able to share with you. The podcast will be based on an actual therapy session with a young woman who is struggling with depression, anxiety, and self-doubt because of fertility issues, due to strong. societal messages that women should have children and should want children. This will be a unique opportunity to go behind closed doors to see TEAM-CBT live and real with someone like yourself who is struggling with intense negative thoughts and feelings.

The live therapy sessions we have published previously–with Mark, who felt like a failure as a father, and with Marilyn, who was confronted by a sudden and totally unexpected horrific diagnosis of Stage 4 lung cancer–received tremendously positive feedback from all of you. Now we are proud to present yet another live therapy session next week! So mark your calendars!

Two Cool Upcoming Workshops for you!

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!

March 22 and 23, 2018 Rapid Recovery from Trauma, (David D. Burns, MD) J&K Seminars, Lancaster, Pa 15 CE credits, includes live evening demonstration on the evening of day 1.
You can join in person or online from wherever you live! 

Additional Resources for the General Public (all available at Amazon.com, as well as other booksellers)

  • Feeling Good: The New Mood Therapy
  • The Feeling Good Handbook
  • Feeling Good Together
  • When Panic Attacks

General public and mental health professionals might enjoy the recent article about David in Stanford Magazine authored by Robert Strauss entitled “Mind Over Misery.”

Additional Resources for Mental Health Professionals

David’s TEAM-CBT Psychotherapy ebook: Tools, Not Schools, of Therapy

David’s Tuesday evening TEAM-CBT meets at the Behavioral Sciences Building, 401 Quarry Road, Room 2209 from 5:00 to 7:30 PM, and is free. It is open to all SF Bay Area mental health professionals as well as graduate students in any mental health field, including but not limited to Stanford graduate students. There are teachers include:

  • David Burns, MD
  • Helen Yeni-Komshian, MD
  • Jill Levitt, PhD
  • Daniele Levy, PhD

For information, requirements, and consent form, contact our Greeter, Sara Swedorski, saraswedorski@gmail.com.

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.

 

 

Depression is the World’s Oldest Con!

Depression is the World’s Oldest Con!

How to Overcome Depression and FEEL GOOD!

Hi folks,

Sometimes I do podcasts for other pod casters in addition to the weekly Feeling Good Podcasts I do with our beloved Dr. Fabrice Nye. If you click the link below, you’ll discover a podcast I did with Larry Weeks that apparently received some excellent feedback from listeners.

Click here for the link on how to overcome depression and the distorted thinking that triggers it. 

Take a look and a listen. He did a really nice job, and I think you’ll enjoy it!

David

 

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!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please forward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

TEAM Training Works! (But only if you work at it!)

TEAM Training Works! (But only if you work at it!)

 

FullSizeRenderHi folks,

I just got an awesome email from a psychiatrist who attended my Philadelphia workshop. You might enjoy it!

David

Hi Dr. Burns,

How are you doing Sir. I’m doing well in Michigan.

Just like to gladly inform you that since attending your workshop in Philadelphia in April 2017, learning from your podcasts regularly, reading your work and going through your previously held workshops on DVDs few times, I have been constantly using your inventive TEAM CBT process with my veteran and non-veteran patients over a year and vigorously for the last six months. Now I can say with confidence that there are miracles happening almost every few days and weeks, as my patients are “feeling good and joyful” in their lives again. They are learning tools to heal themselves and prevent relapses.

 I also feel proud of myself again that I am doing something meaningfully therapeutic for my patients since I left my ophthalmology practice and Pakistan in 1995.

Thank you for awarding me with a new sense of purpose in my life which is to help my patients feel better about themselves and give them the tools to heal them collaboratively.

Thank you again!

I am teaching my Psychiatry Residents (who rotate with me once a week) TEAM-CBT on an ongoing basis, though most are still heavily influenced by the notion of cure via psychopharmacology–though I was of the same opinion, too, back in my residency days.

Sincerely,

Hashim Raza, MD
Diplomate American Board of Psychiatry and Neurology,
Aleda E. Lutz VA Medical Center, Saginaw, Michigan
and Assistant Clinical Prof. of Psychiatry, Central Michigan University, Michigan

Hi Hashim,

It was a real thrill to receive your gracious email. My experience is similar, and I think the more you practice TEAM-CBT the better and better you’ll get. One of the greatest joys of my life is seeing someone recover before my very eyes and get transformed from intense despair and fear to joy. It is, as you say, like a miracle.

We have just started a new Thursday evening class for psychiatric residents at the Stanford Medical School. The residents this year are incredible enthusiastic and fun to teach, and very hungry to learn some good psychotherapy. So I now have two weekly training groups at Stanford. The Tuesday night group has over 30 members, including PsyD students, PhD students, Stanford therapists, and community therapists who can receive unlimited free training and personal work at our Tuesday group.

I also offer Sunday morning hikes for several hours for people in the training groups, followed by a dim sum feast at a local Chinese restaurant. We have great fun on the hikes and do personal work and difficult case consultation. All three events are highlights of my week and my life!

If you come to the bay area, I’d love to have you visit us!

David

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!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please forward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

The Animated David!

The Animated David!

 

One of my students, Kyle Jones, sent me this cute link to an animated version of my work, which is actually pretty good, I think! Let me know if you like it. And thanks a bunch to the creative and brilliant man who created it. I don’t actually know who he is, and would like to find out so I can say thanks!

David

 

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!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please forward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

Feeling Good “Bibliotherapy”–Does it REALLY work? Or is it just hype?

Feeling Good “Bibliotherapy”–Does it REALLY work? Or is it just hype?

“Bibliotherapy” means “reading therapy.” Is there any valid research suggesting that simply reading a self-help book can really help someone with moderate to severe depression? Or is it all just a lot of hype and marketing?

There are actually many published research indicating that my book, Feeling Good: The New Mood Therapy, has fairly potent antidepressant effects, even without treatment with medications or psychotherapy. That sounds encouraging, but is the research valid? Can reading a book actually cure depression? This may not seem possible, given the sad fact that antidepressant medications as well as psychotherapy are often not effective.

So how could someone recover just by reading a book? No way!

Here’s an email I received a few days ago, and I am sharing it with you with the permission of the author. I have withheld his / her name to protect this person’s identity, but want to thank him/her in advance for kindly writing me and allowing me to share this with all of you!

Hello Dr. David,

I just finished your book Feeling Good. My depression score on the first day was 51, and today after I just finished it, I scored 0.

I just wanted to thank you endlessly!

Best Regards, (name withheld)

In case you aren’t familiar with the scoring of my depression test, the one this reader used ranges from 0 (joyous, with no depression at all) to 100 (extremely severe depression.) His / her initial score of 51 indicate moderate to severe depression.

I am always overjoyed to receive emails like this. Since Feeling Good was published, I have received more than 30,000 emails or letters (in the old days) similar to this one.

If you, or a friend or loved one, or even a patient of yours, is struggling with depression or anxiety, you might suggest they give Feeling Good “bibliotherapy” a try. Many outcome studies indicate that my book is effective for two-thirds of patients with moderate to severe depression within four weeks. A three-year follow-up study of patients given copies of Feeling Good are also extremely encouraging, so give it a try. You or someone you care about might also benefit!

All the best,

David Burns, MD

Here are a few references for those of you who are more scientifically oriented:

References

Ackerson, J., Scogin, F., Lyman, R.D., & Smith, N. (1998). Cognitive bibliotherapy for mild and moderate adolescent depressive symptomatology. Journal of Consulting and Clinical Psychology, 66, 685-690.

Floyd M, Rohen N, Shackelford JA, Hubbard KL, Parnell MB, et al. (2006) Two-year follow-up of bibliotherapy and individual cognitive therapy for depressed older adults. Behavior Modification, 30: 281-294.

Floyd M, Scogin F, McKendree-Smith NL, Floyd DL, Rokke PD (2004) Cognitive therapy for depression: a comparison of individual psychotherapy and bibliotherapy for depressed older adults. Behavior Modification,28: 297-318.

Jamison, C., and Scogin, F. (1995). Outcome of cognitive bibliotherapy with depressed adults. Journal of Consulting and Clinical Psychology, 63, 644 – 650.

Mains JA, Scogin FR (2003) The effectiveness of self-administered treatments: a practice-friendly review of the research. Journal of Clinical Psychology, 59: 237-246.

McKendree-Smith NL, Floyd M, Scogin FR (2003) Self-administered treatments for depression: a review. Journal of Clinical Psychology, 59: 275-288.

Norcross, J. C., Santrock, J. W., Campbell, L. F., Smith, T. P., Sommer, R., & Zuckerman, E. L. (2003). Authoritative Guide to Self-Help Resources in Mental Health, Revised Edition. New York: Guilford Press.

Santrock, J. W., Minnett, A. M., & Campbell, B. D. (1994). The Authoritative Guide to Self – Help Books. New York: Guilford Press.

Scogin F, Floyd M, Jamison C, Ackerson J, Landreville P, et al. (1996) Negative outcomes: what is the evidence on self-administered treatments? Journal of Consulting and Clinical Psychology, 64: 1086-1089.

Scogin, F., Hamblin, D., and Beutler, L. (1987). Bibliotherapy for depressed older adults: A self-help alternative. The Gerontologist, 27, 383 – 387.

Scogin, F., Jamison, C., and Davis, N. (1990). A two-year follow-up of the effects of bibliotherapy for depressed older adults. Journal of Consulting and Clinical Psychology, 58, 665 – 667.

Scogin, F., Jamison, C., Floyd, M., & Chaplin, W. (1998). Measuring learning in depression treatment: A cognitive bibliotherapy test. Cognitive Therapy and Research, 22, 475-482.

Scogin, F., Jamison, C., and Gochneaut, K. (1989). The comparative efficacy of cognitive and behavioral bibliotherapy for mildly and moderately depressed older adults. Journal of Consulting and Clinical Psychology, 57, 403 – 407.

Smith, N. M., Floyd, M. R., Jamison, C., and Scogin, F. (1997). Three-year follow-up of bibliotherapy for depression. Journal of Consulting and Clinical Psychology, 65(2), 324 – 327.

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!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please forward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

Priceless and Beyond Valuable

Priceless and Beyond Valuable

Hi, Dr. Burns.

This is Mona, I’m writing to you the second time.

Not sure if you can remember my case with hypochondriasis. I was reading the What-If Technique in your book, When Panic Attacks, and did the exercise, starting with my Negative Thought, “I think I have Hepatitis C or HIV.” As you suggested, I asked myself, “If that were true, what’s the worst that could happen? What am I the most afraid of?” You said you could ask this question over and over, and it was a good way to get at the deepest core fears that fuel our anxiety.

It worked really well, and the end result was, “I’m gonna end up being alone and lonely,” which send tears streaming down my face. As a result, I had a conversation about my fear of rejection with my husband sitting next to me that made me feel very relieved.

Now the second very emotional moment came when I was listening to your podcast describing the case of Ralph which was EXACTLY identical to my case. I couldn’t hold back my tears listening to his struggle and couldn’t stop laughing with my tears coming down when you said the good news is that you’re going to experience the same whenever you have a Hidden Emotion.

I just wanted to let you know that these podcasts are all very constructive and I’d recommend them to anyone who is reading either Feeling Good: The New Mood Therapy, or When Panic Attacks. The podcasts really showcase each technique and make the points made in the books crystal clear.

Dr. Burns, I don’t know how to thank you for all these insights and I would like you to know that your contributions are priceless and beyond valuable.

I don’t really believe in God but if you do, God bless you!

Mona

Thank you, Mona! Your email means a great deal to Fabrice and me. We are so happy that people like the Feeling Good Podcasts and find them beneficial! They are fun to do because I really enjoy working with Fabrice, but I hear from many therapists and non-therapists alike who say they really help, and that is what we hoped might happen.

On one of the Sunday hikes, a young therapist who works with children and teenagers told me that he listed to one Podcast per day for 30 days, and this really boosted his understanding of TEAM-CBT. I could see that this was absolutely true, because he has only recently joined my free weekly training group at Stanford, but his psychotherapy skills are simply zooming forward.

Mona, all the very best to you!

David

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!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please forward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

 

An Anxiety Question and a Blessing from Turkey for “David Uncle!”

An Anxiety Question and a Blessing from Turkey for “David Uncle!”

Hi Dr. Burns,

whenpanicattacks-sm  Thank you for your life-saving books and blogs. They really help. I have given your book, When Panic Attacks, to others. It is so good! What I admire the most is your empathy and your desire to seek the truth.

I have a simple request. Can you clarify the use of cognitive flooding and thought-disputing? I find these two methods to be quite useful but confusing at times. For example, it doesn’t seem logical to flood my mind with panic thoughts and then turn around and dispute them. Perhaps morning flooding and evening disputing?

I don’t know that a general answer is possible but any thoughts you have are sincerely appreciated. I understand you do not give personal advice and that if you do answer, it will be for the help of many others who follow your blogs and appreciate your insights.

Bill

Hi Bill, Thanks for your kind comments and question. I am embarrassed that I can’t give you a good clear answer. But I’ll try to babble briefly. Remember that there are four treatment models for anxiety, and I use all four with every anxious patient I treat.

  • The Motivational Model—where you bring the anxious patient’s Outcome and Process Resistance to conscious awareness and melt them away.
  • The Cognitive Model—where you challenge the distorted negative thoughts that trigger the anxiety, using a wide variety of techniques such as Identify the Distortions, Externalization of Voices, the Experimental Technique, and so forth. You call this “thought disputing,” but there are more than 50 ways of disputing and crushing negative thoughts.
  • The Hidden Emotion Model—often the overly “nice” anxious individual is sweeping some feeling, conflict, or problem under the rug and not dealing with it. When the patient brings the problem to conscious awareness and deals with it, the anxiety often disappears completely.
  • The Exposure Model—where you flood yourself with anxiety by facing your fears. If you stick with it, in most case the anxiety will diminish over time and then disappear. You call this “cognitive flooding,” although that’s just one of many exposure techniques.

I describe these four models and methods in my recent series of Feeling Good Podcasts on the treatment of anxiety (Podcasts 22 to 28). You might enjoy listening to them, and can link to the first one if you CLICK HERE. All four treatment methods are helpful, but they work in different ways. You never know which method or methods will be the most helpful to any individual.

But I have to confess I don’t “schedule” them as you have suggested. However, that’s not a bad idea! In my experience, depressed and anxious individuals who work with these techniques, and actually try them, including the written exercises, as opposed to just reading about them, nearly always have the best outcomes. So stick with it!

And of course, if you need help or guidance, it never hurts to check with a mental health professional. However, I would personally tend to avoid a psychiatrist as my first choice, as you are likely to get drugs, drugs, drugs. Although I am a psychiatrist, and have prescribed medications on occasion, I find that most depressed and anxious individuals can now be treated quickly and effectively without medications. In addition, research studies indicate that many people recover from depression anxiety on their own after reading one of my books, but if you need a little guidance from an expert, there’s no shame in that at all! Sometimes, we all need a little help from our friends!

Sincerely,

David

 

Hi Dear David Burns,

feelinggood  Firstly, I want to say thanks a lot for you book, “Feeling Good: the New Mood Therapy”! This book has changed my life! Now I love life and enjoy everything in life.

My story started after reading your book second time! Thanks very much! God bless you David uncle!

Sedef (from Turkey)

Hi Sedef,

Thank you so much for your kind and incredible comments, and for your blessing! I am thrilled that you are now loving life and enjoying life! That is like a miracle and the greatest gift a human being can receive.

It is many years since I wrote Feeling Good as a young man, editing it while we were on summer vacation in California, at Lake Tahoe. You might not have even been alive at that time! It seems like a miracle that my words have now touched you, so many miles away. God bless you, too, Sedef!

All the best,

David Uncle

Some Nice Endorsements

Some Nice Endorsements

Hi web visitors,

I have received some very kind comments recently, and wanted to share a couple of them them with you! I hope it won’t sound like excessive self-promotion. Be assured I occasionally get some harsh and disturbing emails as well from individuals who don’t take kindly to some of the views I post. I do encourage criticism, since I am often off base, but sometimes the tone of the criticism can be painful and somewhat shocking. So I guess I am trying, perhaps, to balance that with samples of large numbers of heartwarming emails I receive from so many of you!

As an aside, I also just received a phone call from a patient I had not spoken to in 40 years. In my book, Feeling Good, I described him, and the very intense challenges he presented to me as a young and enthusiastic cognitive therapist, just feeling my way along. I often presented him in the weekly Aaron Beck seminar I attended, where I’d get guidance on especially difficult and disturbing therapeutic dilemmas. But we persisted, and he recovered, and became a leader in the Recovery Incorporated movement, which I have always supported.

Recovery Incorporated is a free of charge self-help group started by Abraham Lowe in the 1930s, and it still serves many individuals throughout the United States. Much like AA, but for depression, in many cities you can attend daily meetings.

Well, it was wonderful touching base again, and he was in tears with gratitude. What a gift that phone call was! He said I changed his life, and I pointed out it was mutual, and that I had gained an enormous amount from the work we did together!

David

Hi Dr. David

Just a quick email to say I am reading your book, When Panic Attacks, again. Just like your first book, Feeling Good, this book on anxiety is a very interesting read and makes a ton of sense! Absolutely fantastic! You are a gifted doctor and author.

Thank you very much,

Kind regards

Shane

Hi Shane,

Thank you! I appreciate your kind note, and I’m sure my daughter will as well. She was my editor, and really helped a lot on the writing.

David

Hello Dr. Burns,

I wanted to send you a quick email to let you know that I truly appreciate your book Feeling Good. I have read several chapters several times and will for years to come! I’m sure I didn’t understand depression before reading Feeling Good, and now I realize that I had been suffering from depression and anxiety pretty much since puberty.

I initially bought the book to help my wife. She has also gone through years of emotional, psychological, spiritual and physical abuse and it has brought her from feeling hopeless every day to feeling good most days. Upon reading it with her, I realized that I also had irrational thoughts which were causing me to miss out on happiness in my life.

I’ve always been very interested in psychology. I’ve listened to a lot of lectures which are available online and I’ve gone through researching the history of psychotherapy, most of which horrifies me because of the unbelievable amount of harm caused. Your methods are by far the most effective I’ve found.

It’s refreshing to see effective talk therapy succeeding in a system which seems to think that pumping people full of anti-depressants (without talk therapy) will correct years of abuse and neglect.

I appreciate your work and your value as a person. Your work has helped at least 10 people I personally know who were suffering. I’ve bought your book for a few of my friends, and all of them said it’s helped their marriages and happiness.

I saw you were in Calgary in November and I really wish I could have come to see your workshop, but hopefully you will be in the area again and I can shake your hand and thank you in person.

Much love from Canada,

Harold

Hi Harold,

Thank you for your kind comments. It is deeply meaningful to hear from someone who has been helped by one of my books. That’s terrific!

You mentioned that you missed me in Calgary. Actually, I will be in Calgary on November 27th of this year (2017) for the large trauma conference sponsored by Jack Hirose and Associates. I will be giving a morning keynote address, followed by a four-hour afternoon workshop, and will illustrate the new, high-speed TEAM-CBT treatment methods for trauma patients who are struggling with depression and anxiety disorders. I will also deliver a two hour evening presentation for the general public (as well as mental health professionals) on Skills, Not Pills for Depression and Anxiety. You can get more details on my workshop page if you CLICK HERE.

If you plan to attend any of my presentations, make sure you come up and say hello so we CAN shake hands!

David

Hi Dr. David,

I’m not expecting a response, nor do I necessarily expect that you read all the messages that come your way, but I feel like I owe you a lot at this point. My dissertation was on reciprocity, and while I do not suffer from too many “should” thoughts directed at others, I do like to practice what I’ve studied.

I consider myself fairly intelligent, generally logical, and have an undergraduate degree in Psychology. All of which made me even more surprised with how much the first couple of chapters of “Feeling Good” resonated with me after suffering pretty badly for a year and a half following a very painful breakup. I feel silly for convincing myself I could never be happy again because I would never find someone to be with. Unproductive at research, a series of non-starting romantic endeavors, “wishing” I didn’t have kids so suicide was an option, not wanting to leave my house, dwelling on what I could have done differently so that I wouldn’t be alone the rest of my life.

I just finished the book after finally picking it up last week (my therapist recommended it a year ago). I realized that these cognitive distortions have been with me throughout my life – not that I’ve been depressed my whole life (although I probably would have claimed that 2 weeks ago). My cause is clearly a love addiction, but I’m not contacting you for therapy!

I’m contacting you because I wanted to say thank you. I feel like I have a strong understanding of the cognitive distortions that have plagued me any time I’ve faced real sad events in my life and I now have tools to combat this now and in the future. I purchased copies of your book for my ex-wife, a recent failed romantic interest, my father, my brother, and I am going to have my 17 year old daughter read through the first three chapters to see if it resonates with her as well.

I never wanted to admit that I might suffer from depression. I kept putting off facing it, even though my mother suffered from depression her whole life. My father is a retired Marine and I was raised to believe that you should be strong enough to overcome challenges “on your own”. That put me at a disadvantage in some ways, but I’m optimistic that my copious notes and highlighting in your book will be with me the rest of my life – or that I’ll never need them after I practice some of the techniques.

Anyways, this is way longer than I intended! Thank you for showing me that the dark mood spirals I’ve experienced throughout my life are treatable and not uncommon. I wish I would have realized this long ago… but I’m trying to avoid “should” thinking, so I don’t let that thought persist!

Don

Hi Don.

Thank you so much for contacting me. Greatly appreciated. And thanks, too, for permission to post your wonderful note!

All the best,

Treatment of Hypochondriasis / Health Anxiety

Treatment of Hypochondriasis / Health Anxiety

Hi Dr. Burns,

I have read feeling good and listened to all your podcasts as of today. I have a history of hypochondria and depression and your book helped me tremendously in overcoming my anxiety. I am beyond happy that I can finally have control over my emotions.

I used to go to psychotherapy sessions with multiple different psychotherapists and more often than not the solutions they offered were along the line of “keep as busy as possible not to give in to the thoughts” or “imagine the obsessive thoughts as a spoiled brat that you should not give into” which all failed dramatically. And believe me when I say they even made it worse than before!

Recently I was listening to some your anxiety podcasts in which you introduced the exposure technique. You described how it worked in the case of Pedro, the young man with OCD who was having intrusive thoughts of Jesus having sex with Mary in all the positions of the Kama Sutra. And the harder he tried to control these forbidden thoughts, the more intense they became!

You also described the Experimental Technique you used in your panic attack patients. I was wondering if these techniques can be helpful in the case of patients dealing with health anxiety.

I read a research paper of a psychiatrist treating her hypochondriac patients with exposure techniques. For example, in my case, if I’m always scared of contracting HIV, I might volunteer to work with HIV positive patients so I could confront my fear. I was wondering if that could help with the urge to get tested very often and if there are any other techniques you specifically find useful in this case.

I used the exposure technique successfully to eliminate my frightening thoughts of slitting my wrists or throat with a razor. These thoughts used to give me a tremendous amount of anxiety and I would always try to eliminate them from my mind as soon as they appeared, almost automatically thinking that’s the way to protect myself. That didn’t work! But now they are completely gone as I spent a full half-day just repeating those images in my mind, over and over again. I tried to imagine all the graphic details until I was completely bored with them! I would like to thank you for reaching out and sharing your knowledge and expertise with people despite the fact that you don’t practice anymore.

And by the way that jumping jacks story with your patient who thought she was about to die during a panic attack has become an inside joke between me and my husband!

Sincerely,

Mona

Hi Mona,

Thank you for your kind comments about the Feeling Good podcasts! I know that my host, Fabrice, will be thrilled to hear that you like them and find them helpful!

There are so many things I appreciate about your wonderful email that I’m not sure where to begin. I do want to emphasize that I cannot treat anyone or give medical advice in this medium, so my answer, as always, will consist of general teaching.

First, I resonated when you described previous therapists who gave you advice, thinking that would help. To my way of thinking, an awful lot of “psychotherapy” consists of schmoozing behind closed doors with the occasional piece of advice thrown in, and in most cases, that just doesn’t get the job done. In fact it can make people feel worse, because it is often sounds patronizing.

Second, I have a current series of several Feeling Good podcast on the treatment of anxiety using four models that are all described in my book, When Panic Attacks. They are the Motivational Model, the Cognitive Model, the Exposure Model, and the Hidden Emotion Model. All four models have tremendous healing power, and I integrate all four into my treatment of each individual with anxiety, because you never know which one, or which combination, will give you the “ah-ha” moment when the anxiety suddenly disappears completely. You can listen to those podcasts right now if you like, either on iTunes or right here on my website, feelinggood.com.

In the treatment of OCD, the Exposure Model usually has two components: Exposure and Response Prevention. So if a person has an irrational fear of HIV, as you described in your email, they could use Cognitive Exposure or Classical Exposure. Cognitive Exposure might involve fantasizing dying of HIV until the fantasy becomes totally boring. Classical Exposure might involve volunteer work with HIV patients, as you mentioned.

In therapy, I work with the patient to figure out what type of Exposure will be the most effective. The Exposure has to be anxiety-provoking, or it won’t be helpful. And, as you say, the goal of exposure is not to control the anxiety—which makes it worse—but simply to flood yourself with the anxiety until it finally loses its power over you.

Response Prevention would mean, in this case, refusing to give in to the urge to get repeated blood tests, if that’s what you are doing to deal with your fear of HIV. But the Response Prevention has to be tailored to your compulsion. Let’s assume that you had OCD with a handwashing compulsion, so you are washing your hands repeatedly all day long to get rid of the imagined “contamination.” Response Prevention would mean refusing to give in to the urge to wash your hands repeatedly. The anxiety will increase for several days, but if you refuse to give in, the compulsion will generally diminish and disappear. This is a bit like drug withdrawal, actually.

But Exposure is just one of four effective treatment models. I treated a medical student with severe OCD who also had the fear of HIV, and Exposure and Response Prevention were only somewhat helpful, and definitely not curative. In his case, the Hidden Emotion Technique ruled the day. If you are interested, you can read about that fantastic technique in my book, When Panic Attacks, and of course, one of the Feeling Good podcasts on anxiety will focus on this technique.

I have treated many patients with health anxiety / hypochondriasis and the Hidden Emotion Technique almost always contributed greatly to their (frequently rapid and complete) recovery. But in therapy, I use more than 75 techniques to help folks—it just isn’t the case that you can have one “formula” that works for everyone, since we are all individuals and our negative thoughts and feelings will be unique—so that requires an individualized approach to treatment, namely TEAM-CBT. (That’s my commercial message!)

All the best,

David

How Can I Find a Good Therapist?

How Can I Find a Good Therapist?

Dear Dr. Burns —

You seem to be a very involved, structured and positive therapist. It has been difficult to find a therapist that fits this description. I’ve seen a couple of “cognitive therapists” but it only ended up being traditional talk therapy. No one has been able to be consistent with the three-column technique or other strategies.

I am very knowledgeable about your strategies but I easily lose focus and get confused. I need guidance and consistency. What do you recommend therapy wise? How or where do I find a competent therapist?

Dear friend,

This is one of the most common questions I get at this site. Many people want to know how and where to find a good cognitive therapist, or a good therapist in general.

First, you can look on my website referral page. This will show you how to find cognitive therapists in various regions. This is a good place to start. You can also search for “cognitive therapy referral” on Google.

My colleagues and I in California have developed a new form of therapy, called T.E.A.M. Therapy, that can be surprisingly effective and fast-acting for many individuals who are struggling with depression and anxiety. T.E.A.M. addresses some of the limitations of cognitive therapy, especially in the areas of therapeutic resistance and motivation.

You can go to the website, FeelingGoodInstitute.com, to find therapists trained in the latest T.E.A.M. therapy techniques. We hope to be able to list more therapists trained in the new techniques in more locations in the United States, Canada and Europe over the next year or two. Unfortunately, at the moment most of our therapists are here in the San Francisco Bay Area. To overcome this problem, in the past some people have arranged to come here for several days of intensive, back-to-back sessions. The goal is to make a therapeutic breakthrough, and then follow up on that with a local therapist if needed after returning home. This option can be somewhat costly, and is not a good choice for everyone, but for some people it could be very helpful, or even life-changing.

What are your other options? You can call the local psychological, psychiatric or clinical social work associations in your region to ask for help. You can also call the corresponding departments at any local universities to ask. Finally, you will find several centers for cognitive therapy listed on my referral page. You can email or phone them and ask for help. They may know of someone in your region they can recommend.

My books can help you learn these methods as well, although they are not intended as a substitute for therapy with a mental health professional. There have been many published outcome studies on my book Feeling Good: The New Mood Therapy. Researchers have reported that two-thirds of the depressed people who were given the book improved or recovered within four weeks with no other treatment. That’s very exciting, but of course, the book is not a panacea, and many people will also need the help of a compassionate therapist.

Here’s a reference to one of their many research studies supporting the use of my books.

Smith, N. M., Floyd, M. R., Jamison, C., and Scogin, F. (1997). Three-year follow-up of bibliotherapy for depression. Journal of Consulting and Clinical Psychology, 65(2), 324-327.

Of course, you can view a list of all my books, with brief descriptions, on the Books page.

The Ten Days to Self-Esteem is a systematic, ten-step program for learning cognitive therapy individually or in groups. This book presents a brief and a somewhat simplified version of cognitive therapy. A group leader’s manual is also available as an eBook.

I wish I could do more. I have been frustrated by how hard it can be to find a therapist who adheres to these methods in the way they are intended to be administered.

Finally, if you are struggling with depression or anxiety, I would like to emphasize the importance of the written Daily Mood Log, which is a five-step process you do on paper, not in your head. When you write down your negative thoughts you can more easily attack them, one by one. You can learn about the Daily Mood Log in any of my books, such as The Feeling Good Handbook. And if you are struggling with a relationship problem, such as a conflict with a family member, friend, or colleague, I w3ould encourage you to try the written exercises, such as the  Relationship Journal, which are described in a step-by-step manner in my latest book, Feeling Good Together.

All the best,
David Burns, MD