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139: Can a Self-Help Book REALLY Help? Or Is It Just Hype?

139: Can a Self-Help Book REALLY Help? Or Is It Just Hype?

What’s Bibliotherapy?

Hi podcast fans,David and Rhonda discuss and old controversy: Can a self-help book can really help? Or will you need psychotherapy and / or an antidepressant if you are seriously depressed?


I (DB) wrote up the following overview of bibliotherapy research prior to today’s recording with Rhonda. I hope you find it interesting!

I have to admit that I’ve never had much respect for self-help books. Many of them seem to be written by narcissistic individuals with pretty superficial ideas who mainly want to promote themselves, and this has been my strong bias as well. When I pick one up in a bookstore, I nearly always get immediately turned off. And I get a flood of them in the mail as well, from authors asking for an endorsement. I have a policy of not doing book or product endorsements—it’s the easiest way to say no.

And I never thought of my book, Feeling Good: The new Mood Therapy, as a self-help book. My idea was that people receiving cognitive therapy could read it between sessions as a way of speeding up their recovery, so that the therapist could do the individual work and not have to do so much teaching about the basic concepts, like my list of ten cognitive distortions.

But at the same time, shortly after the book was released, I began getting letters, and later on emails, from individuals who said they book had actually caused them to recover from pretty severe depression. In fact, over the years, I would guess I’ve received more than ten thousand letters or emails like that, and probably way more than that, maybe even fifty thousand.

Still, it had not occurred to me that it might actually be a self-help book, in spite of the fact that lots of the people who wrote me said the book had helped them much more than the treatments they’d received over the years.

One day a colleague asked if I’d seen the article about my book in the New York Times. Apparently, Dr. Forrest Scogin, a research psychologist from the University of Alabama Medical Center, had studied the effects of reading a self-help book on patients seeking treatment for moderate to severe depression. In a nutshell, their studies indicated that simply reading Feeling Good may help some patients overcome depression and may help to prevent future relapses as well. This finding was a shock, but was not entirely unexpected due to all the testimonials I’d been received from people who’d read the book.

In their first study, Dr. Forest Scogin and his colleagues told patients seeking treatment for depression that they’d be placed on a four-week waiting list before beginning treatment. Half of the patients were given a copy of either my Feeling Good or a self-help book on depression by Dr. Peter Lewinsohn called Up from Depression. The researchers suggested that the patients could read their book while they were waiting for their first appointment with the psychiatrist.

The other half of the patients who were placed on the four-week waiting list did not receive a copy a self-help book. Both groups of patients were contacted each week by a research assistant who administered a test to assess the severity of depression. The goal of course was to find out if there were any changes in depression in any of the patients.

The results of the study were interesting. Approximately two-thirds of the patients who received one of the self-help books improved or recovered from depression during the four weeks, even though they received no other treatment with drugs or psychotherapy. In fact, they improved to such an extent that most of them did not even need any further treatment. In contrast, the patients who did not receive one of the books failed to improve during the four-week waiting period. As far as I know, this was the first time that the anti-depressant effects of a self-help book had ever been documented in carefully controlled research study published in a scientific journal.

Then the researchers did a number of additional experiments. First, they gave a copy of one of the two self-help books to the patients in the second group who had not improved. They asked them to wait four more weeks before beginning treatment, but suggested they read the book during their wait. Two-thirds of them also improved and did not need further treatment. This study was published in the medical journal, Gerontologist.

Some critics challenged the study, arguing that the improvement in the patients who received the self-help book might have simply been a placebo effect. In other words, maybe it was just the reading, and the expectation of recovery, that helped, as opposed to the ideas and techniques described in the books.

To test this, the investigators studied a new group of patients who were asked to read a “placebo” book while waiting for treatment. The researchers chose a classic book by Victor Frankl called Man’s Search for Meaning. If these patients also improved, it would confirm that the effect of reading on mood was simply a non-specific “placebo” effect. This is incredibly important, because almost any type of intervention can have a placebo effect, so that as many as 35% of patients will improve just because they think they’ll improve.

Surprisingly, the patients who read the Victor Frankl book did not improve. This exciting finding indicated that a self-help book can have a specific and fairly strong antidepressant effect, but that the book had to contain sound information that was actually helpful to individuals with depression.

Finally, the investigators also did several careful follow-up studies on these patients to find out if the antidepressant effects of Feeling Good and Up from Depression would last. In several additional publications, they reported that these patients did not relapse but maintained their improved moods for periods up to three years, and that they actually continued to improve following their initial Feeling Good “bibliotherapy.

However, they did not report that they were happy all the time. But when they hit bumps in the road, most of them picked up the book again, and re-read the sections that had been the most helpful, and then quickly recovered again.

It’s great that two thirds of the patients improved so rapidly. This result is at least as good as the effects of antidepressants or treatment with psychotherapy—and it’s far cheaper, and with no side effects either! But at the same time, one third of the patients did NOT improve. And of course, you see the same thing with treatment of depression by a psychiatrist or psychologist. In fact, recent research indicates that only 50% of patients, AT MOST, improve with professional treatment.

In my research, I’ve attempted to figure out what’s different about the patients who do not rapidly recover when treated with psychotherapy or Feeling Good bibliotherapy. And I believe I did find out why. To learn about that, you’ll have to listen to the Feeling Good Podcasts or read my new book, Feeling Great, when it comes out. Hopefully fairly soon!

I was pretty inspired by the terrific and important research by Forrest Scogin, and want to thank him!

If you or your patients would like to read one of my “self-help” books, the following table will show you which books are best for which kinds of problems. The reading list at the end is for individuals who might like to check out the original studies by Dr. Scogin and his colleagues.


David and Rhonda


Topic / Problem

Feeling Good: The New Mood Therapy

Mild to severe depression

The Feeling Good Handbook

Depression and anxiety

When Panic Attacks

All anxiety disorders

Feeling Good Together

Relationship Problems

Intimate Connections

Dating Problems

Ten Days to Self-Esteem

This is a simplified ten-step program to overcome depression and boost self-esteem. it is effective individually or in support groups.

Bibliotherapy Research

  1. Ackerson J, Scogin F, McKendree-Smith N, Lyman RD (1998) Cognitive bibliotherapy for mild and moderate adolescent depressive symptomatology. J Consult Clin Psychol 66: 685-690.
  2. 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. Behav Modif 30: 281-294.
  3. Floyd M, Scogin F, McKendree-Smith N, Floyd DL, Rokke PD (2004) Cognitive therapy for depression: a comparison of individual psychotherapy and bibliotherapy for depressed older adults. Behav Modif 28: 297-318.
  4. Jamison C, Scogin F (1995) The outcome of cognitive bibliotherapy with depressed adults. J Consult Clin Psychol 63: 644-650.
  5. Mains JA, Scogin FR (2003) The effectiveness of self-administered treatments: a practice-friendly review of the research. J Clin Psychol 59: 237-246.
  6. McKendree-Smith NL, Floyd M, Scogin FR (2003) Self-administered treatments for depression: a review. J Clin Psychol 59: 275-288.
  7. Scogin F, Floyd M, Jamison C, Ackerson J, Landreville P, et al. (1996) Negative outcomes: what is the evidence on self-administered treatments? J Consult Clin Psychol 64: 1086-1089.
  8. Scogin F, Hamblin D, Beutler L (1987) Bibliotherapy for depressed older adults: a self-help alternative. Gerontologist 27: 383-387.
  9. Scogin F, Jamison C, Davis N (1990) Two-year follow-up of bibliotherapy for depression in older adults. J Consult Clin Psychol 58: 665-667.
  10. Scogin F, Jamison C, Gochneaur K (1989) Comparative efficacy of cognitive and behavioral bibliotherapy for mildly and moderately depressed older adults. J Consult Clin Psychol 57: 403-407.
  11. Smith NM, Floyd MR, Jamison CS, and Scogin F (1997) Three-year follow-up of bibliotherapy for depression. J Consult Clin Psychol 65: 324-327.



You can reach Dr. Burns at david@feelinggood.com. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at rbarovsky@aol.com.

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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


Dr. Jill Levitt and I are offering what I think will be an outstanding workshop on the treatment of anxiety disorders on Sunday, May 19, 2019. Our Sunday workshops can be tremendously rewarding, so consider attending if you are interested. 

The last Sunday workshop in February was really fun! We have been SOLD OUT for the in person slots in Palo Alto for two months, but still have spots online, and you can join us from anywhere in the world. Register soon if you are interested, as the online slots are also limited.


WHEN: May 19, 2019, 8:30 am – 4:30 pm PST
(11:30 am-7:30 pm EST)

WHERE: Join us live online or in person at the Creekside Inn, Palo Alto, CA.


WILL I GET CE CREDITS? YES! 7 CE hours available

Completion of this workshop also counts towards TEAM-CBT Level 1, 2 or 3 Certification

WHO CAN ATTEND? Therapists of all levels are welcome

CAN I REGISTER IF I’M NOT A THERAPIST? Although the workshop is geared for therapists, it will be taught in a clear and basic way that anyone can benefit from.




You will love this lively, amusing, and immensely useful day of training with Drs. Burns, Levitt and the Feeling Good Institute Staff. The trainers will use a combination of didactic teaching, live demonstrations, video, and breakout group practice to enhance skill-building.


Act fast if you want to attend!

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And there will be two awesome summer intensives for you this year!

July 15 – 18, 2019
Calgary four-day intensive
Sponsored by Jack Hirose & Assoc.


July 29 – August 1, 2019
South San Francisco four-day intensive
Sponsored by Praxis


Solution to David’s Tuesday Tips (#14)*

Solution to David’s Tuesday Tips (#14)*

Hi folks,

This was yesterday’s paradoxical tip of the day!

Sometimes, psychotherapy dovetails with religious teachings. What does this passage, from Romans 2:1 mean?

For whenever you blame another you condemn yourself.

Everyone who responded came up with great ideas and comments. Thanks!

Here’s my solution. Most of the time, when we have relationship conflicts, we tend to blame the other person and see ourselves as the victim of his or her bad behavior. My research, as well as my clinical and personal experience, has taught me that blame is the actual cause of the conflict.

The problem is NOT that the other person is to blame—the real problem is the fact that we are blaming them. And when you blame the other person, you really do condemn yourself because you will probably end up in hostility, resentment, and chronic conflict. And you are also fooling yourself because you do not “see” your own role in the conflict.

In the Interpersonal TEAM treatment model, I ask the person seeking help with a troubled relationship to identify one specific interaction in that did not go well. Then I ask my patient to write down one thing the other person said, and exactly what he or she said next. That’s all you need to understand the entire conflict, and all you really need to turn transform the hostility into warmth and trust—IF that’s what you want to do!

When we analyze the interaction, I can always show the person seeking help how he or she is triggering and reinforcing the very pattern he or she is complaining about. This is usually pretty painful and shocking for the patient, but it also empowers you to change the way you react to the other person so you can enjoy greater trust and intimacy.

If you’d like to observe this in an actual therapy session, I am currently publishing three podcasts with a live therapy session with a man who complained that his wife was overly critical and controlling. He was pretty convinced that she was like this because she had an overly controlling mother.

During the session, he was shocked to discover that he, and not his mother-in-law, was the cause of his wife’s frequent criticisms and efforts to control him. This was a very painful discovery, but it was also quite liberating.

Here is the link to the first of the three podcasts, in case you’d like to listen to them. My wonderful colleague, Dr. Jill Levitt, was my co-therapist. The session was quite rich and powerful and be worth an investment of your time.

I have to confess I am not a very religious individual, but I do believe that when we are doing our deepest and best work as psychotherapists, we are working not simply at a psychological level, but at a spiritual level as well.

Many of the most amazing insights about human nature and how to escape from suffering have been around for hundreds, if not thousands of years. But it seems like all of us have to learn these deep insights on a personal, experiential level before we can suddenly “grasp” them and experience our own enlightenment.

If you’d like to learn more about how to develop more satisfying and loving relationships, I would strongly recommend my book, Feeling Good Together. It’s for the general public, but it will also be helpful to therapists, since we all have relationship problems from time to time. At least, I know that I do! And I’m pretty sure that you do, too!

Hey, the San Francisco intensive is almost upon us. Have you considered attending? It’s usually pretty awesome. See the details below.

Use the Reply / Comment feature below to let us to know how you understand today’s tip.



* Copyright © 2018 by David D. Burns, MD.

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Hey, folks, my San Francisco summer intensive will start in a few weeks. it is always one of my BEST training programs of the year. The group will be quite small, giving you lots of chances for Q and A and personal connection with me, plus networking with your colleagues. In addition, many individuals from my Tuesday group at Stanford will join me to provide feedback for you 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/
phone: 800-258-8411

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!

Hope to see you in San Francisco in August! David

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Also coming up soon on David’s Sunday FB Live Broadcasts

Sunday, July 22nd, 2018, at 3 PM: The Shouldy Approach to Life–How to Crush Should Statements, with special guest, Jill Levitt, PhD

If you attend live, you can ask questions and be a part of the show. However, they are all recorded so you can tune in anytime on my Public FB page!

073: David Answers Your Five Secrets Questions

073: David Answers Your Five Secrets Questions

Relationship Problems–We’ve all got ’em!

In today’s podcast, David and Fabrice address five questions submitted by listeners who listened to the recent series of podcasts on the Five Secrets of Effective Communication:

  • Elie: I kept disarming my wife who was criticizing me, and it didn’t work. She just got angry! What am I doing wrong?
  • Joli: Dr. Burns, all of your examples of relationship problems in involve errors the women are making. This is chauvinistic! Why are you always blaming women? I think you must have had problems with women in the past!
  • Tamara: The five podcasts on the Five Secrets were at a very introductory level. Can you do some more teaching at a more advanced level?
  • Rajesh: I was in a conflict with a very demanding friend and I said, “I understand how you feel.” My friend just got more annoyed. Why? What am I doing wrong? Also, what should you do if the person who’s criticizing you is just saying a lot of things that are distorted, things that aren’t really true?
  • Jonathan: A friend said, “You’re so damn cheap!” This was my response: “Yeah I mean sometimes I do get a little upset and annoyed when I’m judged by you like that. To be quite honest, I don’t like it when you say stuff like that.” How did I do? Does my response need to be improved?

David and Fabrice love your questions so keep them coming! At the next session, we are going to begin a new episode series on Five Secrets of Happiness.

Fabrice and I hope you enjoy our Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing!


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.


070: Five Secrets Training — Stroking

070: Five Secrets Training — Stroking

David and Fabrice discuss Stroking, the fifth of the Five Secrets of Effective Communication. The definition of Stroking is to express some warmth or admiration for the person you’re in conflict with, as well as people you’re NOT in conflict with! Essentially, you say something positive or complimentary about the other person, even in the heat of battle. It can make a huge difference in how the other person feels, and how the situation gets resolved.

In the last four podcasts we went over the  E = Empathy and the A = Assertiveness of the EAR acronym. In this podcast, we will concentrate on R = Respect. Stroking is the technique for the R = Respect. The term is crude, but I’ve never found an alternative that worked better.

Philosophically, Stroking goes back to the work of Martin Buber, the 20th century philosopher / theologian who talked about the difference between an “I – It” relationship and an “I – thou” relationship. In an “I – It” relationship, you think of the other person as an object to be manipulated, and not as a human being. You may compete with the other person, and try to beat or defeat them, or you may try to punish, exploit, or hurt them. For many examples, you only have to turn on the evening news and see how some of our politicians talk about their “enemies.” In contrast, in an “I – thou” relationship, you treat the other person with respect and dignity, even if you’re at odds, even if you’re feeling angry.

In the last podcast, we discussed “I Feel” Statements–sharing your own feelings openly. If you have negative feelings you need to express, you can include Stroking at the same time. Sometimes, that’s the sugar that makes the medicine go down.

Here’s an example. Let’s imagine you’re ticked off at a friend named Jim, and you’ve been arguing with each other and getting frustrated. I’ll give you example of how you might use Stroking, and i’ll put the name of the technique I used in parentheses after each sentence so you’ll know exactly what I’m doing.

“Jim, I’m feeling really ticked off at you right now, and I’m having fantasies of strangling you! (“I Feel” Statement) At the same time, it bothers me when we argue like this because I’ve always admired you tremendously and felt you were one of my best friends. (Stroking)  I know there’s a lot of truth in what you’re saying. and I’m sure when work this out, we’ll be even closer. (Disarming Technique) With that in mind, you can tell me more about how you’re thinking and feeling? (Inquiry) “

Hopefully, you can see that this type of statement conveys warmth, respect and openness, while at the same time clearly expressing your anger. Of course, this is just an example, and the way you express yourself will be very different.

Expressing your negative feelings with warmth requires discipline, because most of the time we get defensive and want to lash out at the person we’re mad at. And you can do that if you want–I give in to that urge every now and then, too! But if you express yourself with warmth and caring, and if you share your feelings instead of arguing or attacking the other person, or putting him or her down, you’ll usually get a far more positive response.

David describes how he used Stroking (along with the Disarming Technique) to good effect when he was ruthlessly put down by a hostile examiner during his oral medical board examination when he returned home to California with his family in 1995.

David and Fabrice describe errors people make when trying to use Stroking, such as saying something “canned” or formulaic that does not sound genuine or specific. All of the Five Secrets have to come from the heart or they’ll backfire.

David and Fabrice also describe the intense resistance that people often put up when trying to learn the Five Secrets. For example, you may tell yourself that you “shouldn’t have to” say something nice to the other person because you’re so mad, or because you’re labeling the other person as “a loser” or “a jerk” and you see that person in an entirely (and distorted) negative light, thinking (wrongly) that there ISN’T anything good or positive about him or her.

Your homework for this week will be to practice Stroking. Say five positive things to people every day, and you can do this easily in your day-to-day interactions with anyone, even strangers. You can find something you like or admire about the other person, and say that to them. People, for the most part, will like that and respond positively! We understand that this is a simple and superficial assignment. Once you’ve practiced it over and over, it will be far easier to use it effectively in the heat of battle!

Fabrice and I hope you enjoy our Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing!


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.


069: Five Secrets Training — “I Feel” Statements

069: Five Secrets Training — “I Feel” Statements

David, Helen and Fabrice discuss “I Feel” Statements, the fourth of the Five Secrets of Effective Communication. The essence of this technique is to share your thoughts and feelings openly and with respect, rather than hiding your feelings or acting them out aggressively.

The Five Secrets are organized around the acronym, EAR. E = Empathy, A = Assertiveness, and R = Respect. The last three podcasts were on the E = Empathy techniques. This podcast will be on A = Assertiveness.

David, Helen and Fabrice discuss how the Five Secrets differs from assertiveness training, which has been incredibly popular for the past 50 years, with many best-selling books. Assertiveness is all about expressing your own needs and feelings. Although this is incredibly important, David argues that assertiveness alone can come off as somewhat “self”-centered, since your talking about how YOU feel and what YOU need. In contrast, that the most skillful and effective communication involves a more balanced focus on your own and the other person’s feelings, in a spirit of mutual respect and “oneness.”

David tells a funny story of what happened after he read a book on assertiveness training when he was a psychiatric resident. He dutifully and enthusiastically tried to apply the techniques he was reading about in the assertiveness book during a dispute with a gas station attendant in Philadelphia, and the gas station attendant threatened to break his kneecaps!

Although David does not like formulas, they can sometimes help you when you are learning a technique for the first time. The formula for an “I Feel” Statement would be a statement along these lines: “I feel X, Y, and Z,” where X, Y, and Z are words from the Feeling Words list.

David, Helen and Fabrice discuss the importance of this technique, and how to use it in different settings. Although sharing your feelings can be vitally important in conversations with loved ones, as well as interactions and negotiations with colleagues at work, you would use different kinds of feeling words in different settings. For example, you might say, “I feel kind of hurt and put down right now” during an interaction with your spouse or partner, but you probably wouldn’t say that when talking to your boss, because it would sound goofy!

They also discuss common errors people make when trying to use “I Feel” Statements. A common error I saying “I feel that . . . ” followed by something about the other person, such as “I feel that you’re wrong.” This is not the expression of your feelings, but a criticism of the other person.

They also discuss common sources of resistance to using this technique. For example, you may be afraid that if you share your feelings openly, and allow yourself to be vulnerable, something bad will happen, or that people will take advantage of you or use the information to hurt you.

In addition, many human beings, and perhaps most of us, tend to repress our feelings and hide them from others, thinking we “shouldn’t” feel the way we do. For example, if you feel ashamed, you may feel the urge to hide your feelings from others. David describes how he often feels this way if he makes errors during his teaching–he thinks he has to hide his shame from his students, thinking a Stanford professor should not have such feelings!

David emphasizes that even include famous people who claim to be experts in communication have the urge to hide their feelings. David describes an awkward but funny interaction he had recently with a famous communication expert at the recent Evolution of Psychotherapy Conference.

Your homework for the week is to use five “I Feel” Statements every day. They can be positive as well as negative, and it can something as simple as “I feel great because the sun is shining today,” or “I feel sad and disappointed because my talk wasn’t as successful as I’d hoped, and someone in the audience was critical of me.”

David, Helen, and Fabrice emphasize once again that using the Five Secrets one at a time is artificial, like the practice exercises on musical instrument. So the homework exercises are like that. Once you’ve master each of the Five Secrets, and you have a feel for how they work, you can integrate and weave them together masterfully in challenging real life situations that are sensitive and important to you.

And Helen emphasizes the crucial idea that the Five Secrets will only help you if you have a sincere desire to resolve conflicts and to develop more loving and successfully relationships with others.

Fabrice and I hope you enjoy our Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing!


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.