Fantastic Email–“I was planning to commit suicide the day you left a copy of Feeling Good at my front door!”

Fantastic Email–“I was planning to commit suicide the day you left a copy of Feeling Good at my front door!”

Dear friends and colleagues,

I thought you might enjoy this wonderful email I received several days ago, and publish here with the permission of Dr. Robert Schachter, from New York city.

David

Dear David,

I want to share an experience that almost made me cry.  A woman from Nebraska had tracked me down on the internet to treat her mid-20’s daughter who was living in New York.  She said that she had been profoundly affected by Feeling Good: The New Mood Therapy.

She went on to say that when her daughter was in preschool, the nursery school teacher was fired and had been very distraught. She had liked this woman and felt very bad for her. So, she went to her house but the woman would not come to the door. She then went home and took her copy of Feeling Good and left it on the woman’s doorstep.

Their paths diverged, but some time later she bumped into her.  The woman came up to her and said, “I just want to thank you.  I want you to know that you saved my life!  My father had committed suicide and the day that you came by, I was planning my own suicide.  That book saved my life.

Thank you.”

Then my patient’s mother said, “God Bless Dr. Burns.”

Bob
Robert Schachter, Ed.D.
Licensed  Psychologist

 

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

041: Uncovering Techniques (Part 3) — The What-If Technique

041: Uncovering Techniques (Part 3) — The What-If Technique

Uncovering (and Facing) Your Deepest Fears

In this podcast, David and Fabrice discuss the third uncovering technique called the “What-If” Technique, developed by the late Dr. Albert Ellis. The What-If Technique can will help you identify a terrifying fantasy under the surface that fuels your fears. David brings this technique to life with an inspiring story of a woman from San Francisco suffering from more than 10 years of mild depression and paralyzing Agoraphobia—the intense fear of leaving home alone. You may be surprised when you discover the Negative Thoughts that triggered her fear of leaving her apartment alone, as well as the core fantasy at the root of her Agoraphobia. David and Fabrice also discuss the dramatic techniques that helped her completely defeat her fears and overcome her depression.

Below, we have included a PowerPoint presentation for you so that you can follow along when David and Fabrice do the What-If Technique together on the podcast.

In the next podcast, David and Fabrice will discuss Shame-Attacking Exercises. This is a powerful and bizarre exposure technique that can helpful in the treatment of shyness–but there’s a hook. Therapists must be willing to do Shame Attacking Exercises themselves before they can ask patients to do them! And that can be intimidating!

 

 

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Recognition for Feeling Good!

Recognition for Feeling Good!

Hi, Dr. Burns:

I hope this email finds you well!

Your book Feeling Good was featured in our Top 10 list of Best Books for Depression and Anxiety recently on Live Happy. Here’s the Story

I am sharing this story with you here in hopes that you might share it on your website and social media channels as well with a link back to Live Happy, which your readers will find by clicking on the link above!

We appreciate your expertise to our Live Happy community.

I hope you have a wonderful day!

Warmly,

Sandra Bilbray (Bienkowski)

Hi Sandra,

Thanks! I am honored, to say the least!

Warm regards,

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 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 firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

 

Uncovering Self-Defeating Beliefs (SDBs)–For Therapists (and Interested Patients) Only!

Uncovering Self-Defeating Beliefs (SDBs)–For Therapists (and Interested Patients) Only!

oThis is a technical memo for therapists who use a technique I developed years ago called the Individual Downward Arrow Technique. The goal of this technique is to uncover each patient’s (client’s) Self-Defeating Beliefs (SDBs), such as Perfectionism, Perceived Perfectionism, or the Brushfire Fallacy. I developed this memo for my Tuesday evening TEAM-CBT group at Stanford following a session practicing this technique earlier in the week.

Why would a therapist want to uncover SDBs? Cognitive Therapists work with (at least) two types of cognitions that can cause emotional distress. First, Negative Thoughts happen in the here and now and only cause emotional distress at specific moments in time. Let’s say you have public speaking anxiety, and you’re about to walk up to the podium. You are probably telling yourself things like this: “I’ll blow it. My mind will go blank. I’ll make a total fool of myself. People will laugh at me and judge me.” These kinds of Negative Thoughts happen in there here-and-now, when you are feeling anxious or depressed. The Negative Thoughts are usually not present when you are feeling happy and confident.

The SDBs represent a second category of cognition. These belief systems represent some of our core values, and they are always there in the background, whether or not we are upset. So, for example, you may have a belief called Perceived Perfectionism, thinking that people will not accept, respect or love you if you screw up or appear vulnerable. Or you may have the Approval Addiction, thinking you need everyone’s approval to feel happy and fulfilled. Or you may have the Achievement Addiction, basing your self-esteem on your intelligence or accomplishments. There are a great many kinds of SDBs.

The cognitive theory of emotional distress works like this: the combination of a Self-Defeating Belief (such as the Achievement Addiction) plus a negative event (such as screwing up or doing poorly when you give a talk) triggers emotional distress. That’s when you are flooded with negative thoughts and feelings, such as “Gosh, my talk was kind of a dud. People seemed bored. I’m a loser,” etc.

So the SDBs appear to explain the timing and reason for episodes of depression and anxiety.  And if we can pinpoint and change the patient’s (client’s) SDBs, we can not only help the patient to feel better in the here-and-now, but we may also help to prevent painful mood crashes in the future.

In this memo, I discuss the finer points of how to use the Individual Downward Arrow Technique to pinpoint each patient’s Self-Defeating Beliefs. If you are interested, I could address how to change SDBs in a future blog or in an upcoming Feeling Good Podcast.

I will be curious to find out if this type of information is of interest to my readers, so please let me know what you think! If the information that follows is too technical, no problem! I just want to get a feel for what people like and want so I can serve you in the best possible way. Thanks!

David

Tips for Therapists When Using the Individual Downward Arrow Technique

By David Burns, MD*

I would like to thank Daniele Levy, PhD for conceptual and editing help!

What is the Individual Downward Arrow Technique? This technique will help you pinpoint the Individual Self-Defeating Beliefs (SDBs) that make the patient vulnerable to depression and anxiety. For example, the patient may base his or her self-esteem on accomplishments, the so-called “Achievement Addiction,” or may struggle because of Perfectionism, Perceived Perfectionism, Entitlement, or the Approval or Love Addiction. You can find a list of “23 Common Self-Defeating Beliefs” in the Therapist’s Toolkit or my Feeling Good Handbook. The Individual SDBs are often “self-esteem equations,” of the form, “To be a worthwhile human being I need substance X.” Substance X could be great achievement, wealth, love, perfection, approval, or always pleasing others, for example.

To use this technique, draw a downward arrow under a Negative Thought on a Daily Mood Log and ask your patient, “Why would it be upsetting to you if this thought were true? What would it mean to you?” This will trigger a new Negative Thought. Tell the patient to write it down under the arrow and repeat the process several times. The NTs you and your patient generate will lead to the underlying beliefs at the core of his or her suffering.

There are three additional Uncovering Techniques. The Interpersonal Downward Arrow Technique helps you pinpoint the beliefs and attitudes that trigger conflicts and difficulties in the patient’s personal relationships. The What-If Technique helps you pinpoint a core feared fantasy that trigger’s the patient’s anxiety. And the Hidden Emotion Technique helps you bring suppressed hidden problems and conflicts to the patient’s conscious awareness.

Here are some important tips to keep in mind when using the Individual Downward Arrow technique:

SET UP

  1. Always start with a Negative Thought (NT) from a Daily Mood Log when doing the Downward Arrow Technique. Don’t do the Downward Arrow Technique for some problem the patient has, or based on some emotion the patient has.
  2. Both patient and therapist must be writing during the Downward Arrow Technique. Usually, I use a blank sheet of paper, because the DML gets too filled up with the chain of NTs. But keep in mind that your blank sheet of paper is really an extension of the NT column on the DML.
  3. Remember to be compassionate when doing the Downward Arrow, and not overly harsh or intellectual. For example, if the patient says, “That would mean I was a total failure,” you can say, “Of course, that would be pretty painful for almost anyone to feel like you were a total failure, but I’m wondering what it would mean to you? Why might that be upsetting you?”
  4. If the patient becomes tearful, perhaps recalling a painful childhood memory during the Downward Arrow process, put your techniques on the shelf and empathize, encouraging your patient to vent and open up. These moments can be quite important to the patient.

WORDING OF NTs

  1. Convert rhetorical questions into statements. “Why am I so screwed up?” can become “I’m screwed up,” or “I shouldn’t be so screwed up.”
  2. When doing a Downward Arrow from a “Should Statement,” such as “I shouldn’t have left my husband,” you can say, “Let’s assume it’s true that you shouldn’t have left your husband, but you did. What does that mean to you? Why is that upsetting to you?”
  3. Never put emotion words or descriptions of upsetting events in the NTs column when doing the Downward Arrow. Instead, ask for the NT that is associated with the emotion or event. For example, if the patient says, “Then I’d feel ashamed,” you can say, “What is the NT that would make you feel ashamed? What would you be telling yourself?”
  4. If the patient comes up with a wish or a positive thought when you’re doing the Downward Arrow Technique, you can convert it to an NT. For example, let’s say a patient has this thought about dropping out of school: “I’ll be letting my parents down. I’ll be a disappointment to them.” Then you ask, “If this were true, what would it mean to you? Why would it be upsetting to you?” The patient might say, “Well, I really want my parents to be proud of me.” You can easily convert it by saying, “So let’s assume you really want your parents to be proud of you, but they’re actually disappointed in you for dropping out of school. What would that mean to you? Why would that be upsetting to you?”

PROBING

  1. If the patient says, “I don’t know,” use Multiple Choice Empathy. For example, the patient may have the NT, “Then I’d be all alone forever,” when you are doing the Downward Arrow Technique, but when you ask, “And what would that meant to you, and why would that be upsetting to you,” he or she might say, “I don’t know.” Using Multiple Choice Empathy, you might say, “Of course, probably no one would want to be alone forever, but it could mean different things to different people. Some people might think that if they’re alone, they can’t survive, or if they’re alone, it means they’re unlovable and worthless, and others might think it’s impossible to feel happy and fulfilled when you’re alone. Do any of those possibilities ring true for you?”
  2. You can also use the “Man (or Woman) from Mars” approach if the patient says, “I don’t know why that would be upsetting for me.” Let’s say the patient comes up with this thought during the Downward Arrow Technique: “That would mean I failed,” but can’t explain why failure would be upsetting or bad. You can say, “Let’s assume I’m a man (or woman) from Mars, and I don’t know how things work here on the surface of the earth. So I might ask you to explain why failure is considered a negative thing here on the earth. What happens to people who fail at something?” This will usually make it easier for the patient to continue the Downward Arrow Chain.
  3. Using Bracketing when the patient cycles back and forth between two NTs. For example, the patient might say, “Then I’d be a failure,” followed by “Then no one would love me,” followed by “Then I’d be a failure,” etc. You can bracket them in this way: “And suppose you were a failure, and no one loved you. What would that mean to you? Why would that be upsetting to you?”

GOAL CONSIDERATIONS

  1. The purpose of the Downward Arrow Techniques is uncovering the patient’s SDBs, not change. You can change SDBs, but change is not the goal when you are doing an Uncovering Technique. If you think about an NT on a Daily Mood Log, most of the time we are doing horizontal arrow techniques. In other words, we want to move from the NT column on the left to the Positive Thought (PT) column on the right, and this involves trying to challenge and crush the NT so that emotional change will suddenly happen. In contrast, when you use a downward arrow technique, you are drilling down deeper into the patient’s psyche to uncover the beliefs that give rise to the negative thoughts and feelings. You are moving to a deeper level.
  2. Sometimes, a patient will begin to recognize the absurdity of the NTs when doing the Downward Arrow, and will begin to come up with convincing and effective Positive Thoughts (PTs). This is okay, and you can encourage the patient to write the PTs in the PT column on the Daily Mood Log.
  3. The Self-Defeating Beliefs are the logic behind the negative thoughts on the Downward Arrow Chain, since the thoughts do not logically follow from one another. For example, a psychologist’s favorite patient unexpectedly committed suicide, and one of his NTs was: “I should have seen this coming. I should have known he was suicidal.” His next thought on the downward chain was, “This means I’m a failure and a fraud.” Notice that the second thought does not follow logically from the first thought, but the SDB that links them is Perfectionism. His third thought was, “My colleagues will judge me and reject me.” Again, this does not follow logically, and the SDB that links them is Perceived Perfectionism—namely, the belief that others will not accept, love, or respect him if he is vulnerable, or human, or makes a mistake.

* Copyright © 2017 by David D. Burns, MD

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 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

 

Wonderful Email!

Wonderful Email!

IMG_1288Hi web visitors,

I just got an amazing email that I wanted to share with you! I’m on the road this week teaching my trauma workshop in three east coast cities, and look forward to returning home again so I can do more blogs and podcasts! David PS the picture is from out living room just prior to a Sunday hike, thanks to Maryam Hamidi.

Comment: Dr. Burns,

I just wanted to write a quick note to say thank you! 20 years ago (when I was only 15!) I found your book, Feeling Good, at my local bookstore and brought it home with me. I’ve carried it with me EVERYWHERE I’ve moved (and I’ve moved a lot!) — because it literally changed my life. And it continues to ground me and bring me comfort/relief whenever I have an anxiety or depression relapse.

Recently, I discovered your Feeling Good Podcasts. What a thrill ! I love to put it on after a long day and learn about your new techniques, behind-the-scenes vignettes, and enjoy your humor and humility. What a GIFT you have given so many people for so, so many years.

Thank you, thank you !!

Amy Maloof
Amy,

Thank you, thank you for you kind note!! Means a great deal to me. Will let Fabrice know, too!

All the best,

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 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 firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

 

Latest Hiking Report

Latest Hiking Report

Hi friends and colleagues,

As you probably know, in addition to the volunteer teaching I do at Stanford each week, I also conduct Sunday morning hikes for therapists who want more time for personal work and practice with various TEAM-CBT techniques. The hikes generally last several hours, and are fabulous, but the “interior hiking” is what really makes them great experiences.

I was lucky to enjoy three hikes in the past week or so—two fabulous Sunday hikes, plus a Saturday hike, which was also great. We worked on so many topics and personal issues that I can’t recall all of them, but these were included:

  1. Therapy problems: How to work with extremely severe patients who are hungry for talking and support, but who resist taking responsibility for their lives, doing psychotherapy homework, or developing a meaningful agenda for their therapy sessions. This is one of the most important and frustrating issues in all of psychiatry and psychotherapy, and is the therapeutic dilemma that inspired me to create the new TEAM-CBT.
  2. Personal relationship problems: How to deal with someone who is pulling away from making a commitment to you, and giving you the run-a-round.
  3. Personal relationship problems: How to help someone who gets mad and resists your efforts when you try to help.
  4. Personal relationship problems: How to deal more skillfully with a romantic partner who I am pursuing and afraid of losing.
  5. Personal relationship problems: How to overcome the fear of rejection or being alone. AND how to help patients who have been rejected.
  6. Personal relationship problems: How to deal with a family member who won’t pay back borrowed money.
  7. Personal relationship problems: How to deal with fears of failing as a father. How to deal with your child’s criticisms, so you can transform a conflict into a deeper and more loving relationship.
  8. Personal insecurities: How to deal with fears of growing old and being alone and thinking you are simply “old and boring.”

If any of these themes interest you, let me know and perhaps I can post on some of them in a little more depth.

There was a lot more, but that will give you a feel for what we do on the hikes. The participation and experiences have been simply fantastic, due to the vulnerability, including the tears, and the compassion and fabulous teamwork people show on the hikes. This is my favorite way of hanging out with folks and getting to know people, and it really beats cocktail parties! Plus the extremely rapid changes we nearly always see make it seem like we are witnessing little miracles on each hike.

One of our beloved group members, Maryam Hamidi, has been taking great photos on Sundays, and in our Tuesday training group at Stanford, so I am including are some of them for 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 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 firward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationshp conflicts.

Thanks! David

Upcoming Trauma Workshops!

Hi web visitors and friends on FB and Twitter,

The brief video below invites you to my three upcoming workshops on high speed treatment for patients who have experienced depression and anxiety from traumatic experiences. You will learn the latest TEAM-CBT skills to improve your clinical outcomes, and have the chance to see TEAM in action in the live demonstration on the evening of day 1. And on day 2, you can do some personal healing as well!

You’ll find the dates, locations, and links right below the video! It is my first video of this type, and it is only okay, so I hope you will be kindly in your assessment! I’ve had a severe camera phobia since I was a child, only only finally overcame it just a month or so ago. So now I can smile in front of a camera! Wow, I am so happy about this!

 

Rapid Recovery from Trauma: New High-Speed TEAM-CBT Treatment Techniques

April 24 – 25, McLean, VA 22102, Crowne Plaza Tysons Corner (link to brochure)
April 26 – 27, Newark, NJ, Hilton Newark Penn Station (link to brochure)
April 28 – 29, Philadelphia, Wyndham Philadelphia Historic District (link to brochure)
For more information, contact IAHB phone: 800-258-8411

Hope to see you at the workshop!

David

PS Here are several unsolicited anonymous comments on the evaluation forms for this workshop:

  • The live demonstration in the evening was freaking incredible!
  • The live demonstration was dynamite! . . . It was beautiful!!
  • The entire process was fantastic!
  • I liked all of it! I appreciated Dr. Burns willingness to be vulnerable with his own flaws and fears.