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#176: Ask David: My suicidal daughter refuses to talk to me! / How can I deal with my jealousy?

Rhonda and David discuss two challenging questions submitted by listeners like you. 

Question #1: Cindy asks: My suicidal daughter refuses to talk to me! What can I do?

Comment: Dear David,

I stumbled upon you teaching in another podcast a few months ago. Immediately I was stunned by how much your words echoed in my mind. I have listened to your book three times in Audible and many of your podcasts. You Changed my life!!!

I am much more relaxed now and I can sleep!!! I talked about you with my massage therapist and she bought your book for her daughter (who has anxiety attacks) and her niece. Her daughter is an aspiring artist who said that she would buy your book and give them away to teens when she becomes famous.

I now ask you to change another life, that of my daughter’s. She has been depressed for more than 20 years, suicidal (bought a noose, watches suicide movies, talked about ways to kill herself) and no therapists could help. We went to therapy together this past summer and it only ended that she abruptly canceled and is no longer responding to me by any means: phone, text, card, or email. The last time I saw her was late August and she was very down and had very poor personal hygiene. I have since sent her a loving text at least every other day, I offer to drive to her city (an hour away) to have dinner with her, I sincerely apologized for everything I could think of that I have done wrong since she was a child, I sent gifts to her by mail, I invite her to come for holidays, I ask her cousins to call (she did respond to them). No response to me at all. I am wondering how to communicate with a loved one who just totally shut you off.

Always your fan,

Cindy

Thank you, Cindy. Sorry to hear about your daughter, very concerning. My heart goes out to you. Our own daughter had a rough time as a teenager, too, but now is doing great. I hope things evolve with your daughter, too.

This podcast may help: https://feelinggood.com/2019/10/28/164-how-to-help-and-how-not-to-help/ as well as this one:

https://feelinggood.com/2019/02/04/126-how-to-communicate-with-someone-who-refuses-to-talk-to-you/

The first podcast highlights common errors in trying to “help” someone who is hurting, and emphasizes how to respond more effectively, using the Five Secrets of Effective Communication.

The second podcast illustrates how to get people to open up using one of the advanced secrets called “Multiple Choice Empathy / Multiple Choice Disarming.

My book, Feeling Good Together, explains these techniques in detail, with practice exercises, and includes an entire chapter on how to talk to someone who refuses to talk to you. You can learn more on my book page. (https://feelinggood.com/books/). Some support from a mental health professional might also be helpful to you, as these techniques sound simple, but are actually challenging to master.

Your daughter might also benefit from my book, Feeling Good: The New Mood Therapy (https://feelinggood.com/books/). It is not a substitute for treatment from a mental health professional, but research studies indicate that more than 60% of the people who read it improve significantly in just four weeks. It is inexpensive, and I’ve linked to it if you want to take a look.

All the best,

David

Question #2: Lorna asks: How can I deal with my jealousy?

Comment: Hi David,

I’ve recently discovered your books and your podcast and CBT has really been helping me in my personal life. I really want to thank you for all the amazing work you do!!

The issue I’m having however seems to still really get my moods down and I was wondering if perhaps you could offer some general advice via the podcast.

I’m in a great relationship but the ex-girlfriend of my partner has recently moved back to the city where we live and now we are in similar social circles. They were together for a very long time and now I’m really struggling with the prospect of spending time with her.

When we all spend time together, it’s actually fine, but afterwards I really struggle with thinking about them together, getting to know her and thinking about her personality and how we compare.

I think most people would find this uncomfortable, but it really has triggered a downward spiral for me. My partner and I argued about it and I struggle to let things go that were said in arguments.

Do you have any advice on dealing with a situation of an ex-partner being on the scene and perhaps how to not dwell on things that were said during arguments?

Thanks,

Lorna

Hi Lorna,

Thanks, might work. What does this mean: “Do you have any advice on dealing with a situation of an ex-partner being on the scene and perhaps how to not dwell on things that were said during arguments?”

The rest of the email seems to suggest feelings of jealousy, insecurity, and so forth, as if she is a threat to your current relationship. is this correct?

david

Hi David,

Thanks so much for getting back to me!

I don’t actually think she is a threat to our relationship, and don’t feel that they have feelings anymore for each other, but it just makes me super uncomfortable to think about how long they spent together.

I’m always comparing our relationship to what I think their relationship was like in the past. I know I should stop thinking about those things but I really struggle to stop!

I know my partner and I are very much in love but I keep having thoughts like

  • “It’s not fair that I have to spend time with her,” or
  • “I feel really guilty because he wants to be friends with her but can’t due to how I feel about the situation.”

I also feel like he blames me.

I was hoping you could shed some light on what you think in general is a good strategy for dealing with situations where an ex-girlfriend/boyfriend of your partner is on the scene and you all have to spend time together.

I do have feelings of jealousy and insecurity but I struggle to understand why as I don’t believe they want to be together anymore at all.

We had a few arguments about it initially where he said things like “you are just angry that I have an ex-girlfriend” or “what’s the big deal about it all?”

I was so hurt by the way he made my feelings seem petty and trivial. We have both apologized but I keep remembering what he said and how hurt it made me feel.

Do you have any advice on letting go of past arguments when the ‘problematic situation’ (ex-girlfriend being around) is still on-going?

Thank you so much!

Lorna

David and Rhonda discuss this question, and include David’s story in Intimate Connections as a medical student when David had a broken jaw and the ex-boyfriend of Judy, the girl he was living with in Palo Alto, charged into his house with a tough-looking friend and demanded to see Judy. David called the police, and the two fellows left and set, “we’re going to get you!” David was terrified, since his jaw was still broken, and got some jaw-dropping advice the advice from his buddy, Sergio. You will be surprised to hear about what happened next!

In addition to learning to “let go” of jealousy, Rhonda and David discuss many additional strategies for dealing with jealousy, including:

  1. Use of Self-Disclosure
  2. Positive Reframing: do you really want to give up your jealousy and vigilance?
  3. Cost-Benefit Analysis: Is it worth the hassle of constantly being suspicious, as opposed to simply deciding to trust and let the chips fall here they may?
  4. Downward Arrow: What are you the most afraid of?
    1. Love Addiction
    2. Fear of Rejection
    3. Fear of Being Alone
  5. Overcoming the fear of being alone and the “need” for this man’s love, or any man’s love, is discussed in the first section of Intimate Connections.
  6. Exposure: You could fantasize the two of them together, making yourself as anxious and jealous as possible, until the feelings diminish and disappear.
  7. Self-Monitoring: Counting your thoughts about them on a wrist counter or cell phone for four weeks. David describes his work with an intensely jealous law student after his girlfriend broke up with him so she could date another fellow in his class.
  8. Understand the frequent ineffectiveness of apologizing, and why it doesn’t work! This is really important. David describes a powerful vignette about a troubled couple, where “I’m sorry” was CLEARLY a way of saying “shut up, I don’t want to feel about how hurt and angry you feel.” The Five Secrets of Effective Communication are a vastly more effective way of dealing with negative feelings. David and Rhonda contrast effective vs. dysfunctional “apologizing.”

While it can be important to say “I’m sorry,” this formulaic response is usually insufficient because it often ends the conversation but the difficult or hurtful feelings remain. What’s important to add is talking about the other person’s feelings, thoughts and experiences of the conflict and sharing your own thoughts and feelings.

 When you say, “I’m sorry,” it’s sometimes insufficient because it often ends the conversation, but the difficult or hurtful feelings remain.

What’s important to add is talking about the other person’s feelings, thoughts and experiences of the conflict and sharing yours.

After David emailed Lorna with the outline for the podcast, Lorna replied:

Hi David,

Thank you sounds great! Can’t wait to listen to the episode. I think I will definitely order your book – I think it’s the only one missing for me to have the complete collection. Thanks again!

Lorna

Thanks for listening today! By the way, if you are looking for CE credits or training in TEAM-CBT, my upcoming workshop on therapeutic resistance on February 9, 2020 will be a good one. You’ll learn how to use the techniques described in today’s podcast.

See below for details and links!

David

Subscribe

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. She is a Certified TEAM-CBT therapist and specializes in the treatment of trauma, anxiety, depression, and relationship problems. She also does forensic work in family court, but finds TEAM-CBT to be way more rewarding!

If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.

 

Coming up in 2020

High Speed Methods to Reduce Resistance
and Boost Motivation

This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.

Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!

This workshop will be live-streamed (and in person in Palo Alto, CA) so you can join from anywhere in the world! There will be many expert online helpers to assist you with the small-group exercises.

With Drs. David Burns and Jill Levitt

Feb 9. 2020 |  7 CE hours. $135

Learn More & Register

 

The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts

TEAM-CBT includes more than 100 powerful techniques to change the distorted thoughts that trigger negative emotions. But what techniques should I select for my patient who feels depressed, anxious, or angry?

As you know, in my book, Feeling Good, I listed the ten most common cognitive distortions, like All-or-Nothing Thinking, Should Statements, Emotional Reasoning, and more, and you probably use that list all the time in your clinical work. But do you know which techniques work the best for each distortion?

Come to this workshop and find out! You’ll learn with tons of cool techniques you can use every day to boost your clinical effectiveness.

This workshop will be live-streamed (and in person in Palo Alto, CA) so you can join from anywhere in the world! There will be many expert online helpers to assist you with the small-group exercises.

With Drs. David Burns and Jill Levitt

May 17, 2020 | 7 CE hours. $135

Learn More & Register

 

173: Dr. Amir Sabouri on the Human Side of High-Tech Medicine

173: Dr. Amir Sabouri on the Human Side of High-Tech Medicine

This will be our last podcast of 2019, so we wanted to make it something special. We also want to thank all of you for your support over the past year, and wish you all the very best in 2020!

Thanks to all of you, we surpassed 1.5 million downloads this year, and will likely hit 2 million in the spring of 2020. If you like the Feeling Good Podcasts, please tell your friends and family members, as word of mouth is our best marketing by far. In addition, if you are a member of any mailing lists, send them this link to the list of all the Feeling Good Podcasts. On any given day, 30% of human beings are feeling depressed and / or anxious, so you’ll be doing lots of  people a favor, since the podcasts, as you know, are entirely free.

We are joined today by Amir Sabouri, PhD, MD, a highly esteemed neurologist from Iran with extensive medical training in the United States in addition to his PhD research in molecular immunology in Japan. Amir specializes in the treatment of horrific neuromuscular disorders such as ALS (the dreaded Lou Gehrig’s Disease) at one of our local Kaiser Hospitals here in the San Francisco Bay Area. In today’s riveting and inspiring interview, Amir describes how he discovered that, in spite of his extensive technical training, his strongest and most effective medicine by far is sometimes a healing dose of humility and compassion, delivered with the Five Secrets of Effective Communication.

We are also joined by our wonderful host, Dr. Rhonda Barovsky, as well as my friend and neighbor, Dave Fribush, who has joined many of our podcasts recently, as well as Steve Reinhard, a certified coach and TEAM-CBT therapist who flew in from Colorado for the Sunday hike and podcasts. Steve will be the featured guest on next week podcast, along with his wife, Barbara, on the topic of “Sadness as Celebration.”

Amir Steve podcast

Back row: Amir, David, Rhonda, and Dave Fribush. Front row: Steve and Barb

Amir and I have had a friendship and professional collaboration that goes back several years, when Amir first joined one my Sunday hikes, along with his wife, Dr. Sepideh Bajestan, PhD, MD, who was one of my students during her psychiatric residency at Stanford. In the past couple years, Amir has attended the Sunday hikes regularly and has worked hard to learn and master TEAM-CBT, especially the Five Secrets of Effective Communication, which have begun to play a huge role in his clinical and professional work.

Amir begins with a description of the first time he did personal work on one of the Sunday hikes.  At the time, Amir was struggling with feelings of sadness, guilt and inadequacy about his role as a physician and neurologist. That’s because, in spite of his incredible background training and research in molecular immunology and neuromuscular pathology, the bottom line was that he had no cure to offer his many patients he had to diagnose with incurable diseases, such as ALS, and he confessed that he often felt like a failure in his attempts to help these unfortunate patients and their families.

However, by looking at his own negative thoughts, and pinpointing the distortions in them, he was able to challenge and crush those thoughts, and accept the incredible value of the immense caring and compassion he brought to his work with his patients. The change he experienced on that hike was quite pronounced, and was arguably his first “enlightenment.” It was a very moving experience for me, too.

Next, Amir tackled the Five Secrets of Effective Communication, and worked extremely hard to practice and master these techniques, which have also been invaluable in his medical work. He describes two recent patient encounters where these skills were invaluable. One involved an angry new patient who aggressively criticized Amir from the very moment he walked in the door. The many also criticized bitterly all the other doctors he’d seen. He complained that he didn’t want to be there, that nobody could help, and that nobody cared about him.

Amir responded using the Five Secrets of Communication, empathizing and disarming hat the man was saying, and using “I Feel” Statements, Feeling Empathy, Stroking, and Inquiry as well. The man suddenly began to sob and share his deepest feelings throughout his entire encounter with Amir. At the end, Amir was concerned that he’d given him “nothing” other than his efforts at skillful listening using the Five Secrets, and was afraid the man might issue yet another complaint.

One hour later, Amir received a touching email from the patient, filled with praise and gratitude, and he said he felt hope for the first time! We talked about the paradox of “giving nothing,” just listening with compassion, without trying to help or fix. and how this is often the greatest gift of all.

Amir and David 2

Amir and David on the Sunday hike, 10/28/19, practicing the Five Secrets while hiking. The Five Secrets can be incredibly helpful in professional and personal relationships, but requires lots of commitment, humility and practice.

Amir also talked about his interaction with a young woman who suffered horrific complications from a powerful medication that Amir had prescribed for her neurologic problem, and Amir was flooded with guilt and fear, thinking that he had failed her and that he might get sued. But once again, his use of the Five Secrets transformed their interaction into a deeply meaningful connection.

We discussed how training in the Five Secrets should perhaps be mandatory for medical students, and residents as well, since rigorous training in communication with patients is not really a part of medical training, although the doctor patient relationship is, of course, given lip-service. Of course, we also strongly feel that Five Secrets training should be mandatory for all human beings!

I mentioned an experience I had as a medical student working in the medical outpatient clinic at Stanford under the direction of Dr. Allen Barbour, who wrote a beautiful book on the human side of medicine, Caring for Patients. I was assigned to a mailman who had been struggling with intractable angina, which is relentless chest pain due to problems with the blood supply to the heart. He was scheduled for one of the first open heart surgeries at Stanford. The idea was to improve the blood circulation to the heart, and the surgery was brand new and still somewhat experimental, and potentially quite risky.

While I was examining the patient, I had a hunch that something was “off,” and asked the man if there were any problems in his life that were bothering him. This led to an unusual and unexpected set of events you can hear about on the podcast. Telling the story so many years later brought tears to my eyes.

After the podcast, Steve Reinhard, who had been in our “live audience” at the “Murietta Studios” today, began to cry and mentioned his own struggles with cancer. He told us how hard it has been for him to find compassionate doctors who seem to care, and how wonderful it would be if he could find a gentle, humble and loving doctor like Amir! We decided to edit Steve’s comments into today’s podcast as well.

High tech medicine is wonderful, and evolving rapidly, with new healing miracles every day. But the doctor’s most powerful medicine, by far, is still the bedside manner, just as it has been for the last two thousand years.

The Five Secrets of Effective Communication can enrich your life, too, and can vastly improve your interactions with loved ones, friends, and colleagues. These tools can also make you more effective in the business world, or in any human interaction. Our world seems very troubled these days, to say the least, and we can all start some healing by changing the way we relate to others and learning to speak with our third “EAR,” which stands for Empathy, Assertiveness, and Respect.

I hope that doesn’t sound hopelessly corny, elderly, or demented, but if so, I will have to plead guilty as accused.

Thanks so much for tuning in today, and if you like these shows, please tell your friends!

If you would like to learn more about the Five Secrets, a great first step would be to read my book, Feeling Good Together. Make sure you do the written exercises while you read, and make sure you practice as well!

Feeling Good Together

On the right hand panel of every page on my website, www.feelinggood.com, you’ll find a Search function. If you type in “Five Secrets” or “Relationships,” you’ll find many helpful podcasts on this topic as well.

Learning the Five Secrets takes lots of commitment and practice. It’s like learning to play the piano or learning to play tennis. You’ll have to work at it. Amir is incredibly brilliant, and he had to work at, too. If you’re willing to do the same thing, the results can change your life, too!

All the best,

Amir, Rhonda, Dave, Steve, and David

Note: As an Amazon Associate I earn from qualifying book purchases. My books are available from virtually any online or in-person book seller.

Subscribe

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. She is a Certified TEAM-CBT therapist and specializes in the treatment of trauma, anxiety, depression, and relationship problems. She also does forensic work in family court, but finds TEAM-CBT to be way more rewarding!

If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.

 

Coming up in 2020

High Speed Methods to Reduce Resistance
and Boost Motivation

This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.

Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!

This workshop will be live-streamed (and in person in Palo Alto, CA) so you can join from anywhere in the world! There will be many expert online helpers to assist you with the small-group exercises.

With Drs. David Burns and Jill Levitt

Feb 9. 2020 |  7 CE hours. $135

Learn More & Register

 

The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts

TEAM-CBT includes more than 100 powerful techniques to change the distorted thoughts that trigger negative emotions. But what techniques should I select for my patient who feels depressed, anxious, or angry?

As you know, in my book, Feeling Good, I listed the ten most common cognitive distortions, like All-or-Nothing Thinking, Should Statements, Emotional Reasoning, and more, and you probably use that list all the time in your clinical work. But do you know which techniques work the best for each distortion?

Come to this workshop and find out! You’ll learn with tons of cool techniques you can use every day to boost your clinical effectiveness.

This workshop will be live-streamed (and in person in Palo Alto, CA) so you can join from anywhere in the world! There will be many expert online helpers to assist you with the small-group exercises.

With Drs. David Burns and Jill Levitt

May 17, 2020 | 7 CE hours. $135

Learn More &

 

Coming this summer!

The Annual South San Francisco Intensive!

August 10 – 13, 2020

It’s Going to Be Awesome!

Videos, Live Demonstrations

Small Group Practice with Personal Feedback and Mentoring,

and Chances for Personal Work and Healing

Ultra-Rapid TEAM-CBT for Depression and Anxiety Disorders

Learn More and Register

165: Ask David: Why do shrinks kill themselves? How to find out if your loved one is suicidal.

165: Ask David: Why do shrinks kill themselves? How to find out if your loved one is suicidal.

In today’s podcast, David and Rhonda answer two questions about suicide submitted by podcast fans.

Question 1. Why do shrinks kill themselves?

Dear Dr Burns,

Before I get to my question (which I hope you will consider addressing in your ‘Ask David’ segment of the podcast), I would like to extend my gratitude to you. Your book, Feeling Good, came to me at a time when I was struggling to make sense of my depression and anxiety, and it has been a vital part of my recovery journey. The exercises and the podcast have been such lifelines, and I am grateful to you for the incredible and life-changing work that you do.

I know you have addressed the topic of suicide in a previous episode, but I recently was struck by a piece of news from my alma mater, the University of Pennsylvania, where a senior member of the college’s counselling services (CAPS) died by suicide. Here was someone who had spent his life’s work on promoting suicide prevention, and had a great deal of knowledge on resilience. How can we process/understand the decisions that someone like this might make to take his life. How can I arrive at the understanding that his decision doesn’t necessarily spell doom for the rest of us? What TEAM-CBT exercises can we do to make sense of the world when it might not make much sense at first glance, during situations like these?

Thank you very, very much,

Sindhu

Dr. David’s Answer

Thanks, Sindhu, this is a really great question.

I’ll put this in the Ask David folder. Should I use your name?

Here’s the short answer. It’s a lot like saying that an infectious disease expert shouldn’t get pneumonia, or that an orthopedic surgeon shouldn’t have back pain, or a broken leg. I know of at least three mental health professionals who have committed suicide, but my knowledge based is tiny. I’m sure there are thousands of mental health professionals who have committed suicide.

People can commit suicide for many reasons, and I can only mention a few here, as my knowledge, like yours, is limited.

  1. Hopelessness is one of the most common causes of suicide in depressed individuals. Hopelessness always results from cognitive distortions, and never from a valid appraisal of one’s circumstances. Depressed people often turn to suicide, thinking (wrongly) that it is the only escape from their suffering.
  2. You may have done something that you are profoundly ashamed of, and fear it is about to be made public. Like the fellow in New York arrested for child abuse who hung himself just a few weeks ago.
  3. I am convinced that sometimes people commit suicide to get back at someone they are angry with, someone perhaps who rejected them.
  4. Physician-assisted suicide. I believe that physician assisted suicide is absolutely indicated and compassionate if someone is in excruciating pain from an irreversible terminal illness.
  5. The Achievement Addiction. Feelings of failure and worthlessness. In our culture, we sometimes (wrongly) base our feelings of self-esteem on our success in life, our income, or our achievements. And so, if your achievements are only “ordinary,” you may feel worthless, like “a failure,” and kill yourself.
  6. The Love Addiction: Many people (wrongly) tell themselves they must be loved to feel happy and worthwhile, and then kill themselves when they are rejected by someone they thought they loved and “needed.”
  7. Drug and alcohol abuse: These habit, when severe, can greatly disrupt a person’s life. They can also make someone more impulsive, and more likely to jump or pull the trigger when intoxicated.

There are likely way more causes than just these common ones. For example, a psychotic process like schizophrenia might sometimes play a role as well.

I suspect you may have a hidden “Should Statement,” telling yourself that a mental health professional “should not” get depressed or have the urge to commit suicide. But to me, that would be a nonsensical claim, and it isn’t even clear to me why you might think that way. In fact, most people are drawn to this profession because of their own unresolved suffering. There is, I suspect, MORE depression and anxiety in mental health professionals, but I have not seen data, so I’m not certain of this. But I’ve trained tens of thousands of mental health professionals, and pretty much ALL of the ones I’ve known personally have struggled at times, and sometimes intensely.

People also ask, “Why did so and so commit suicide? S/he was so famous and loved and wealthy!” Well, famous and loved and wealthy people often suffer and commit suicide, too.

Finally, I would say that suicide is both tragic and devastating—for the patient for sure, for the family and friends who typically suffer for years, and for the therapist as well. Fortunately, the family and friends can be helped, if they ask, but it is too late for the person who was depressed. And the tragedy is needless in most cases, since the patient’s intense negative feelings can be treated effectively in nearly all cases.

David

Question 2. How can you find out if a friend or loved one is suicidal?

Many people are afraid to ask a depressed friend or family member if they are feeling suicidal, fearing this will create conflict or may even cause the person to become suicidal. For the most part, these fears are unfounded, and the biggest mistake could be avoiding the topic.

Most people who are feeling suicidal are willing to discuss their feelings fairly openly. Several types of questions can be useful.

Suicidal thoughts or fantasies. Most people with depression due have suicidal thoughts or fantasies from time to time, and these are not necessarily dangerous.

First, you can ask, “do you sometimes feel hopeless, or have thoughts of death, or wishing you were dead?” If s/he says yes, you can ask him / her to tell you about these thoughts and feelings. You can also ask if s/he thinks of suicide as the only way out of his / her suffering.

Second, you can ask if s/he simply has passive suicidal thoughts, like “Sometimes I feel like I’d be better off if I were dead,” or active suicidal thoughts, like, “Sometimes I have fantasies of killing myself.”

Suicidal urges. You can ask if s/he sometimes has urges to kill himself / herself. Suicidal thoughts or fantasies without suicidal urges are usually not especially dangerous.

Suicidal plans. You can ask if s/he has made any plans to actually commit suicide. If so, what method would s/he use? Jumping? Shooting? Hanging? Cutting?

You can also ask if s/he has been acting on these plans. For example, if shooting is the choice, you can ask if s/he has access to a gun and bullets. If jumping is the choice, you can ask where s/he plans to jump from.

Deterrents. When evaluating suicide, you can also ask if there are any strong deterrents, such as religious beliefs, impact on family and friends, and so forth. If there are no strong deterrents, the situation is more dangerous.

Desire to live, desire to die. You can also ask the person how strong their desire to live is, and how strong is their desire to die?

Past suicide attempts. If the person has made suicide attempts in the past, the risk of a future suicide attempt is greater.

Drugs and alcohol. You can ask if the person drinks or uses drugs, and has ever has a stronger urge to commit suicide when intoxicated. This is a danger sign.

Impulsiveness. Some people make suicide attempts when they’re feeling impulsive, kind of on the spur of the moment. You can ask if they every have these kids of sudden impulses.

Willingness to reach out. You can ask if they’d be willing to reach out and ask for help if they ever have a suicidal urge.

Honesty. You can ask if they were felt reasonably open and honest in asking your questions, or if it was difficult to answer some of the questions.

Once you have explored these types of questions, you can decide whether action is necessary. If the person seems in danger of making a suicide attempt, you can bring him / her to an emergency room for an evaluation.

If s/he refuses, you can dial 911 and ask for help. Generally, the police will come immediately and do a safety check, and bring the person to an emergency room involuntarily if necessary. You can also call his or her therapist and alert that person to the situation.

This may all sound grim and very unpleasant, but these kinds of conversations can sometimes be lifesaving, and can protect you from much greater pain later on.

In a future podcast, we will focus on this question: How do you treat someone who is suicidal using TEAM-CBT?

David D. Burns, M.D. & Rhonda Barovsky, Psy.D.

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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. Today’s featured photo is courtesy of Nancy Mueller–www.nancymuellerphotography.com.

If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.

* * *

I have two tremendous one-day workshop scheduled with my esteemed colleague, Dr. Jill Levitt, next year–

Workshops in 2020

High Speed Methods to Reduce Resistance
and Boost Motivation

This is the most important, and least understood, topic in psychotherapy. Nearly all therapeutic failure results from the failure to address resistance effectively. Therapists do not understand what causes resistance or how treat resistant and oppositional patients who “yes-but” you or fail to follow through on homework assignments.

Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!

You can join this workshop in person or online (live streaming) from anywhere in the world!

With Drs. David Burns and Jill Levitt

Feb 9. 2020 |  7 CE hours. $135

Learn More & Register

 

The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts

TEAM-CBT includes more than 100 powerful techniques to change the distorted thoughts that trigger negative emotions. But what techniques should I select for my patient who feels depressed, anxious, or angry?

As you know, in my book, Feeling Good, I listed the ten most common cognitive distortions, like All-or-Nothing Thinking, Should Statements, Emotional Reasoning, and more, and you probably use that list all the time in your clinical work. But do you know which techniques work the best for each distortion?

Come to this workshop and find out! You’ll learn with tons of cool techniques you can use every day to boost your clinical effectiveness.

You can join this workshop in person or online (live streaming) from anywhere in the world!

With Drs. David Burns and Jill Levitt

May 17, 2020 | 7 CE hours. $135

Learn More & Register

Coming this summer!

The Annual South San Francisco Intensive!

August 10 – 13, 2020

It’s Going to Be Awesome!

Videos, Live Demonstrations

Small Group Practice with Personal Feedback and Mentoring,

and Chances for Personal Work and Healing

Ultra-Rapid TEAM-CBT for Depression and Anxiety Disorders

Learn More and Register

A Podcast Fan Comments on “How to HELP, and how NOT to Help!”

A Podcast Fan Comments on “How to HELP, and how NOT to Help!”

Hi David and Rhonda,

I just wanted to tell you I LOVED the latest podcast on when not to help. I know you mentioned you’ve covered many of these ideas before, but this podcast really helped it all sink in for me, especially as a non-therapist. Also, I can’t seem to find Dave’s email, but I wanted to say I thought he added some especially valuable perspectives as a non-therapist.

Rhonda, I absolutely loved the story you shared about your son. And I’m so grateful for the therapist that allowed her 5 secrets response to be played. Listening to that was incredibly eye-opening – I’ve made the same mistake countless times but didn’t really get it until now.

Thank you both for all your amazing work on these podcasts!

best,

Daisy

David’s Reply

Thanks Daisy for your kind and thoughtful comment! I’m so glad this message is “getting through” at last! Some ideas are so hard to convey, because they seem to go against our natural human impulses, like the urge to jump in and “help” or “rescue” a friend or loved one who is in distress.

David

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.

If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.

* * *

You may have missed the Calgary and South San Francisco intensives, but there will be one more awesome intensive this fall.

High-Speed Treatment of Depression
and Anxiety Disorders

A Four-Day TEAM-CBT Advanced Intensive

November 4 – 7, 2019
The Atlanta, Georgia Intensive

Sponsored by Praxis

* * *

I also have two tremendous one-day workshop scheduled with my colleague, Dr. Jill Levitt, next year–

Coming up in 2020

High Speed Methods to Reduce Resistance
and Boost Motivation

This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.

Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!

With Drs. David Burns and Jill Levitt

Feb 9. 2020 |  7 CE hours. $135

Learn More & Register

 

The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts

TEAM-CBT includes more than 100 powerful techniques to change the distorted thoughts that trigger negative emotions. But what techniques should I select for my patient who feels depressed, anxious, or angry?

As you know, in my book, Feeling Good, I listed the ten most common cognitive distortions, like All-or-Nothing Thinking, Should Statements, Emotional Reasoning, and more, and you probably use that list all the time in your clinical work. But do you know which techniques work the best for each distortion?

Come to this workshop and find out! You’ll learn with tons of cool techniques you can use every day to boost your clinical effectiveness.

With Drs. David Burns and Jill Levitt

May 17, 2020 | 7 CE hours. $135

Learn More & Register

 

Coming this summer!

The Annual South San Francisco Intensive!

July 6 – 9, 2020

It’s Going to Be Awesome!

Videos, Live Demonstrations

Small Group Practice with Personal Feedback and Mentoring,

and Chances for Personal Work and Healing

Ultra-Rapid TEAM-CBT for Depression and Anxiety Disorders

Learn More and Register

164: How to HELP, and how NOT to Help!

164: How to HELP, and how NOT to Help!

Lately, I’ve received numerous emails asking, in essence, “how can I help my loved one who has this or that problem?” I would say that I get several emails like that every week.

For example, here’s one from a man we’ll call “Karl.”

Love you podcasts. Listen as often as I can. keep reading your books.

Our son is in an unhappy marriage. Last night we talked and he mentioned that there is no love in their marriage. Just coldness. The children “feel” the chasm. There is a lack of trust in the home.

Our son feels he did not protect the children in defense of their mom, even though he disagreed with her. Now the children feel their father does not have their best interests. Our daughter-in-law feels that everything is fine. She uses the passive-aggressive “silent treatment” to punish others.

Our son says she is controlling and manipulative, and that the children have become that way also. There’s no truth in the home. Years ago, she wanted them to go to counseling, but our son refused; now the tables are turned.

Sad. We want to help but don’t know how to approach it.

What podcasts would be helpful to us? And to our son and daughter-in-law? We visit our grandchildren often, sometimes one-on-one. Communications are open with them and with our son.

Daughter-in-law feels, and tells others, we are conspiring against her

Karl

Thank you Karl, for that moving email. It can be really sad and frustrating to see a couple in conflict who are at odds with each, especially when your son and grandchildren are involved. And I can imagine you might also be feeling anxious and a bit helpless, and deeply concerned!

When I wrote Feeling Good forty years ago, I tried to make it clear that the cognitive therapy tools I described in that book are for people to use to help themselves. It is okay to correct your own distorted negative thoughts in order to break out of a bad mood. But it is generally NOT a good idea to try to correct someone else’s distorted thoughts, because they’ll just get ticked off at you!

This is a very understandable error, because you may get really excited by the things I’m teaching, and how helpful they can be when you’re feeling depressed, anxious, or insecure. So it just makes sense that you would want to share these tools with others.

But those are generally NOT the tools to use when you’re talking to your son, daughter, spouse, or friend who’s feeling down in the dumps. There is a way to help someone you love who’s hurting—but you’ll have to use an entirely different set of tools and skills—the Five Secrets of Effective Communication—WITHOUT trying to “help.”

So, the short answer to your question is—skillful listening is all that’s called for. Anything more runs the risk of getting you into trouble. But this may require a radical change in the way you communicate, as well as your personal philosophy.

Let’s talk about what TO do, and what NOT to do when patients, friends or people you care about express angst, or seem troubled, or describe problems in their lives, and they seem to be hurting a lot.

DO NOT

  1. Give advice
  2. Try to help
  3. Try to cheer the person up
  4. Try to solve the problem s/he is struggling with
  5. Try to get the other person to think or act more positively
  6. Try to minimize the problem by saying it’s not that bad, or things will get better.
  7. Point out ways the other person may be thinking or acting in a self-defeating manner.

Before we tell you what does work, let me focus on just one of these errors, to bring it to life for you. Recently, Rhonda and I recorded a live therapy session with a man named who was upset because his mother had lost the use of her legs to due a rare neurological disorder, and needed much greater care in an assisted living facility. This required selling the house his mother was living so they could afford the assisted living facility, and it was a great loss for everyone, since Kevin was raised in that house, and his parents and grandparents had lived there, too.

After Rhonda and I empathized with him for about thirty minutes, we asked the other therapists to offer empathy as well, as part of their practice and training that evening. We stressed the importance of simply summarizing what Kevin had told us (Thought Empathy) and how he was feeling (Feeling Empathy), without trying to “help.” One of the therapists, who was new to the group, kind of missed the mark, She did what we call “cheerleading,” telling Kevin what a wonderful and heroic person he was without acknowledging what he’d be saying and how painful it was for him.

You’ll hear this brief excerpt from the session in the podcast. When we asked Kevin how he felt about her comment, he had to tell her that he was embarrassed, and not helped, by what she’d said.

Here’s why. When you don’t acknowledge someone’s profound negative feelings of loss, anxiety, sadness, anger, and more, you might unintentionally convey the message that you don’t want to hear about how they really feel inside. And when you cheerlead, it also conveys the message that the person is not very intelligent, and simply has to be cheered up, and then everything will be okay!

We cannot be too hard on this therapist, because her efforts came from the heart, and I’m sure she felt sad for this man. And most of us have made the same mistake at times, or even often. I frequently hear parents trying to cheer their children up, or trying to tell their children what to do, or how to change, without really listening.

But, most of the time, it just doesn’t work like that!

Now that you know what NOT to do, what can you do that WILL help?

DO

Use the Five Secrets of Effective Communication, with an emphasis on the listening skills. One of the most important skills is called Feeling Empathy—simply acknowledging how the other person is feeling, and asking them to tell you more, and if you got it right.

For example, let’s say a friend or family member is procrastinating on something important, like a research report or college application, and is feeling pretty upset and self-critical. You could say something like this: “It sounds like you’re beating up on yourself for procrastinating, I’m wondering if you’re feeling

  1. down, sad or depressed?
  2. anxious, worried, pressured, or nervous?
  3. guilty or ashamed?
  4. inadequate, worthless, defective, or inferior?
  5. alone or lonely?
  6. humiliated or self-conscious?
  7. discouraged or hopeless?
  8. stuck or defeated?
  9. angry, annoyed, hurt, or upset?”

I find that people really like it when I ask these questions, and I let them answer each one. Then I ask them about their negative thoughts. What are they telling themselves? What are the upsetting messages?

When you use this approach, you are literally doing nothing to “help” the other person, but if you listen skillfully, she or he will probably really appreciate your listening, and you may end up feeling really close. In fact, I (David), had this exact experience just a couple days ago with a student who was struggling and feeling down.

Often, the person who’s depressed will be someone you love, like a family member, so your concerns for him or her, and your desire to “help,” are an expression of your love. But listening skillfully will likely be a whole lot more effective. And you can express your own feelings, too, with “I Feel” Statements, like “I feel sad to hear how down you’ve been feeling, because I love you a lot.”

Example

A woman named Clarissa was concerned because her son, Billy, who is in his early 20s, had been severely depressed for several years, and had not responded to treatment with antidepressants and even lithium. Clarissa had read my book, Feeling Good, and listened to almost all of the Feeling Good Podcasts. She described herself as a true “TEAM-CBT convert because she’d worked with a therapist trained in TEAM-CBT and no longer suffered from the depression and anxiety she’d struggled with most of her adult life. She agreed with a lot of what I’d said on the podcasts about the chemical imbalance theory (there’s no convincing evidence for it) and antidepressants (recent research suggests they do not outperform placebos to a clinically significant degree).

But Billy was saying things like this:

“Mom, I KNOW I have a chemical imbalance because this cloud will suddenly come over me, and I feel TERRIBLE. It’s not about negative thoughts—I don’t have any negative thoughts. My depression is clearly the result of a chemical imbalance, and I feel doomed by my genes.”

Then Clarissa would try to cheer him up, which always failed, or would try to convince him that it’s not about a chemical imbalance and that if he really tried TEAM-CBT, he could overcome his depression, just as she had done. These are such common errors!

How could Clarissa respond more effectively? If she focuses on good listening skills, instead of trying to win an argument, she might say something like this:

“Billy, I really love you, and feel so sad to hear about your depression. You’re absolutely right, too. Sometimes a bad mood seems to come from out of the blue, with no rhyme or reason. And genes can be important. I’ve struggled with depression in the past, and maybe you’ve inherited some of my genes. Tell me more about how you’ve been feeling. Have you been feeling down, anxious, ashamed, hopeless, or angry? What you’re saying is so important, and I really want to her what’s it’s been like for you.”

Can you see that Billy would be more likely to open up and might even share some things that he’s been hiding, out of a sense of frustration, anger, or shame? And can you also see that providing some love and support—pure listening, with compassion—might be a lot more helpful than getting into an argument about the causes of depression? He might open up about all sorts of things that have been eating away at him—problems with girls, sex, sports, or his studies, or concerns about his looks, or even feelings of shame about his depression.

The next question is—when DO you help someone? And HOW do you help them.

The approach I use as a therapist might be the same approach you’d want to use. At the beginning of every therapy session, I empathize without trying to help, exactly as I’ve been teaching you in this podcast, and in this document, and I give the other person some time—typically about 30 minutes or so—just to vent while I use the Five Secrets of Effective Communication—listening skillfully—without trying to “help.”

Then I ask the patient to grade me on empathy. I say, “How am I doing so far in terms of understanding how you’re thinking and feeling? Would you give me an A, a B, a C, or perhaps even a D?”

Most of the time, the other person WILL give you a grade. If they give you an A, you’re in good shape. But if they give you an A-, or a B+, or worse, ask them to explain the part you’re missing, or not getting right.

When they tell you, you can use the Five Secrets again, summarizing the part you missed, and then ask what your grade is, to see if you’ve improved. Usually, your grade will improve a lot.

Do NOT try to “help” until you received an A!

So, let’s assume you’ve gotten an A. What then?

Then I do what’s called the Invitation Step in TEAM therapy—I ask if the other person wants help with any of the problems s/he has been discussing. You can ask the same question.

If the other person does NOT want help, but just wanted to talk and get support, your job is done. You can also ask if they want to talk some more. Most of the time, all people want is a little listening and support, and they’re not looking for help or advice.

But if the other person DOES want help, you can ask what kind of help they’re looking for. Then you can decide if you’re in a position to provide that type of help. Sometimes, the help they’re looking for might not be something you can provide. For example, they may be angry at someone they’re not getting along with, and may want you to tell the other person to change. I explain that this is not something I would know how to do, but I could possibly help them change the way they interact with that person.

This may sound really simple, but it takes a lot of practice and determination! It can be a lot harder than it looks.

Many people will NOT want to go down this road, and will insist on jumping in to help or cheerlead. You can do that if you want, but in my experience, pushing help on people who are hurting is rarely helpful. The “need” to help or rescue can result from your love and compassion, but it can also result from narcissism, codependency, or the desire to control or dominate another person. I see it as a kind of an addiction, too.

If you want to learn more about this, here are some things you can do:

  • You can read my book, Feeling Good Together, and do the written exercises while reading, so you can master the Five Secrets of Effective Communication. This is a BIG assignment, but the reward, in terms of more loving and satisfying relationships with the people you love, will be equally great.
  • You can try using “I Feel” Statements and Feeling Empathy with at least one person every day this week.

Feeling Good Together

David D. Burns, M.D. & Rhonda Barovsky, Psy.D.

Subscribe

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. Today’s featured photo is courtesy of Nancy Mueller–www.nancymuellerphotography.com.

If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.

* * *

You may have missed the Calgary and South San Francisco intensives, but there will be one more awesome intensive this fall.

High-Speed Treatment of Depression
and Anxiety Disorders

A Four-Day TEAM-CBT Advanced Intensive

November 4 – 7, 2019
The Atlanta, Georgia Intensive

Sponsored by Praxis

* * *

I also have two tremendous one-day workshop scheduled with my colleague, Dr. Jill Levitt, next year–

Coming up in 2020

High Speed Methods to Reduce Resistance
and Boost Motivation

This is the most important, and least understood, topic in the behavioral sciences. Nearly all therapeutic failure results from the failure to address resistance. Therapists do not understand what causes resistance or how treat it effectively.

Come to this workshop and learn how to melt away resistance for incredibly high-speed recovery!

With Drs. David Burns and Jill Levitt

Feb 9. 2020 |  7 CE hours. $135

Learn More & Register

 

The Cognitive Distortion Starter Kit:
How to Crush Negative Thoughts

TEAM-CBT includes more than 100 powerful techniques to change the distorted thoughts that trigger negative emotions. But what techniques should I select for my patient who feels depressed, anxious, or angry?

As you know, in my book, Feeling Good, I listed the ten most common cognitive distortions, like All-or-Nothing Thinking, Should Statements, Emotional Reasoning, and more, and you probably use that list all the time in your clinical work. But do you know which techniques work the best for each distortion?

Come to this workshop and find out! You’ll learn with tons of cool techniques you can use every day to boost your clinical effectiveness.

With Drs. David Burns and Jill Levitt

May 17, 2020 | 7 CE hours. $135

Learn More & Register

 

Coming this summer!

The Annual South San Francisco Intensive!

July 6 – 9, 2020

It’s Going to Be Awesome!

Videos, Live Demonstrations

Small Group Practice with Personal Feedback and Mentoring,

and Chances for Personal Work and Healing

Ultra-Rapid TEAM-CBT for Depression and Anxiety Disorders

Learn More and Register