096: Live Session with Lee: “Why is my wife trying to control me?”

096: Live Session with Lee: “Why is my wife trying to control me?”

Part 1 of 3 podcasts illustrating
the TEAM treatment model for a relationship conflict

With Drs. David Burns and Fabrice Nye, and special guest Dr. Jill Levitt,
Director of Training at the Feeling Good Institute in Mtn. View, California

Hi everybody!

For the past couple months, Fabrice has asked me to set up a live therapy session to illustrate how to treat troubled relationships using TEAM-CBT. I was fortunate to get an email request from a colleague named Lee who wanted help with his marriage. He explained that his wife was very controlling and critical of him and attributed this to the fact that she had a controlling mother. This is very typical in troubled relationships, most of us are convinced that the problem is the other person’s fault. Of course, Lee told us that his wife, in turn, blames back and feels that Lee is the one who needs to change.

Lee initially thought we’d do couples therapy, but in TEAM-CBT we actually prefer to treat just one person in a troubled relationship.

Two weeks ago, Jill and I sat down with Lee on a Saturday morning, linking to each other on the internet since he lives abroad, for a three-hour treatment session. The session has been broken down into three separate podcasts plus commentary from Fabrice, Jill and David on each of the three segments.

By way of disclaimers, Lee is a colleague who does coaching for individuals with alcohol addiction problems. We are not entering into a formal treatment relationship with Lee. Instead, he has offered to help us illustrate a therapy technique, using a real person problem, as part of his training and personal growth. We are deeply grateful to Lee for letting us share his intensely personal “session” with you!

Today, you will hear the first segment on T = Testing and E = Empathy. Lee will tell his story. Jill and I will listen without trying to “help” or “rescue” Lee. On the Brief Mood Survey, he indicated no depression or suicidal urges. He was mildly anxious and slightly angry. His Positive Feelings Survey indicated that he was quite happy except in two areas: He felt only moderately close to people and only slightly connected to others. His score on the Relationship Satisfaction Scale indicated significant marital distress. You will also hear him say that he felt like one of the loneliest people we would ever meet toward the end of the empathy phase of the session.

Lee Davy is the creator and founder of “The Truth about Alcohol.” He offers free weekly webinars for people who need help and support with their drinking. Check it out!

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Attend my 2018 Summer Intensive in San Francisco!

This year, I am again offering my annual SF summer intensive in August at the South San Francisco Conference Center. This four-day intensive is almost always my most exciting and rewarding workshop of the year.

Here are the details:

David’s TEAM-CBT Summer Intensive

August 6 – 9, 2018, South San Francisco Conference Center, California

For more information, click here, or call IAHB.org at 800-258-8411

Here are just a few of the really cool things about this intensive:

  • You will have the chance to practice techniques in small groups after I demonstrate each technique with a live demonstration in the front of the room.
  • You will get immediate feedback and personal grooming from me and from many of my colleagues from my weekly TEAM-CBT training group at Stanford. They’ll be there to help you, and I’ll be there to help you, too!
  • There will be a live demonstration on the evening of day 1. The amazing Dr. Jill Levitt will be my co-therapist. Last year’s live demonstration, and in fact all of them in recent years, have been jaw-dropping and incredibly inspirational!
  • You’ll get a chance to practice TEAM-CBT in real time the evening of day 3. This will be an incredibly challenging but rewarding “solo flight.”
  • You will be able to do your own personal work on the last day of the workshop using the Externalization of Voices and Acceptance Paradox. In previous workshops, at least 60% of the participants indicated they experienced jubilant enlightenment during this exercise. Their fears and insecurities suddenly vanished!
  • You’ll learn how to do Relapse Prevention Training (RPT).
  • You’ll learn how to improve your empathy skills.
  • You’ll learn tons of powerful cognitive, behavioral, and motivational treatment techniques for depression and all of the anxiety disorders.
  • You will have the abundant opportunities to schmooze with colleagues, network, and have fun.
  • You will have two fabulous free luncheon banquets featuring talks by Sunny Choi, LCSW, who is using TEAM-CBT successfully with an underserved population in primary care with limited resources and language skills (“I must apologize for my success.”), and the wonderful Vandana Aspen, PhD, who will speak on “New Treatment Strategies for Eating Disorders.”)
  • And much more.

If you can only attend one of my workshops this year, the South San Francisco August intensive is the one to attend!

 

077: Five Simple Ways to Boost Your Happiness–#4: Resolve a Conflict with a Friend or Family Member

This topic may SEEM simple, and the rewards can be tremendous–but it requires courage, lots of practice, and the death of the ego!

Most of us, and perhaps all human beings, run into conflicts with family members, friends, and colleagues from time to time. And as we all know, these conflicts can weigh us down and rob us of happiness. In this podcast, you will learn how to transform anger and bickering into intimacy and joy.

I’ll bet you know someone who

  • complains endlessly, but ignores your good advice and just keeps complaining
  • argues defensively and always has to be right
  • won’t listen
  • criticizes you unfairly
  • only cares about himself or herself
  • refuses to talk or express his or her feelings

Does any of that sound familiar?

And if you’re a therapist, I wouldn’t be a bit surprised if you run into conflicts with angry, critical patients from time to time as well. Sometimes that happens to me, and it can feel intensely demoralizing.  But when I resolve the conflict, and develop a deeper and more rewarding relationship with the person I was at odds with, it is exhilarating.

Here are some fairly common complaints therapists sometimes hear from patients:

  • You don’t “get me.”
  • You don’t really care about me. . . You’re just in it for the buck.
  • You’re not listening.
  • You haven’t helped me. . . in fact, you’re making me worse!
  • Aren’t you just a student? Do you think I need a real therapist?
  • This therapy sucks!

In today’s Feeling Good Podcast, you will learn about a powerful “Intimacy Exercise” which David has developed. This exercise is designed for therapists and for the general public alike. It’s designed to help you fine-tune your communication skills, so you can develop more rewarding relationships with the people you care about. You may have listened to some of the five previous podcasts on the Five Secrets of Effective Communication, but this is the first time this training technique has been illustrated.

David and Fabrice are joined by Jacob Towery, MD, as well as Lida Sharlin, LMFT, and Eleanor Scott, a certified marriage and Family Therapist. Jacob is one of the teachers at David’s weekly Tuesday evening psychotherapy training group at Stanford, and Lida and Eleanor attend the group as students. Jacob is a psychiatrist and author of the Antidepressant Book for teenagers, recently released as an audiobook. David and Fabrice are very grateful that Jacob, Lida, and Eleanor volunteered to participate in this podcast. Hopefully, their real-life examples will make the podcast far more dynamic and interesting for you!

This is not a trivial statement, since the key to learning involves the philosophy of “joyful failure”–Lida and Eleanor will have to be willing to learn from their mistakes, which will be pointed out immediately while they are role-playing. This exercise is especially challenging, since just about everybody makes all kinds of mistakes initially. For experienced therapists, this can be a shock to the system, since they thought they’d mastered empathy skills in graduate school–but that is rarely the case. If you check your ego at the door, as Lida and Eleanor have bravely done, the learning potential can be tremendous.

As you will see, the exercise involves one person who does the criticizing, and a second person who attempts to respond effectively, using the Five Secrets of Effective Communication. Then the role-play suddenly stops, and three types of feedback are provided for the person who was trying to respond effectively:

  1. Your letter grade (A, B, C, D, or F)
  2. Here’s what worked and what didn’t work.
  3. Here’s how you might improve your response, using the Five Secrets of Effective Communication.

I think you will enjoy seeing Lida and Eleanor, struggle to respond effectively to two patient conflicts, and two personal conflicts, while Jacob and David provide feedback and tips on how to improve.

Responses to two stinging (and real) patient criticisms are illustrated first:

  1. “This session sucked! I ended up feeling worse at the end.”
  2. “You’re so invested in giving me homework assignments during our sessions that you don’t pay any attention to me, and how I’m feeling!”

After that, two angry criticisms from loved ones are illustrated:

  1. “You’re selfish and only think about yourself!” (My sibling said this.)
  2. “You’re always so self-righteous! How could I ever confide in you!” (My son said this.)

How would you have responded?

If you would like to delve deeper into this topic, pick up a copy of David’s book, Feeling Good Together, on Amazon.com. There are many exercises to help you master the Five Secrets of Effective Communication.

Coming Soon

Next week David and Fabrice will conclude the last of five podcasts on how to boost happiness. The focus will be how to change the way you think and feel when you fall into a black hole of insecurity and self-doubt and beat up on yourself with negative thoughts. Sound familiar?

And the following week we will have Podcast 079: What’s the Secret of a “Meaningful” Life? Live Therapy with Daisy.” This will be a very special podcast that Fabrice and I feel very grateful to be able to share with you. The podcast will be based on an actual therapy session with a young woman who is struggling tremendously with depression, anxiety, and self-doubt because of fertility issues, along with strong. societal messages that women should have children and should want children.

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

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

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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.

 

 

057: Interpersonal Model (Part 4) — “And It’s All Your Fault!” The Relationship Journal

057: Interpersonal Model (Part 4) — “And It’s All Your Fault!” The Relationship Journal

 

Podcast 57, “And It’s All Your Fault!” Interpersonal Therapy, Part 4

In the previous three podcasts, David and Fabrice have reviewed the “TEA” of TEAM (Testing, Empathy, and Agenda Setting) for troubled relationships. In this podcast, they describe the “M” = Methods of TEAM Therapy, which involves the Relationship Journal (RJ).

David emphasizes that the goal of the RJ is not simply to learn how to transform troubled, adversarial relationships into loving ones, but also how to achieve Interpersonal Enlightenment, which is the empowering but shocking realization that we are creating our own interpersonal reality—for better or worse—at every moment of every day! And although the reward of the RJ is greater love and joy in your daily living, the price is steep—it requires the death of the ego, which the Buddhists have called “the Great Death!”

Together, David and Fabrice walk you through the five steps in the RJ, using real examples of individuals David has worked with in his workshops for the general public or for mental health professionals. One vignette involves a woman who complained bitterly that her husband had been relentlessly critical of her for 25 years. She said she came to the workshop because she wanted to know why men are like that. She found out why her husband was so critical, but the answer was not the one she expected!

You can view her completed RJ if you click here.

The other vignette involved a minister’s wife who complained that her husband was overly “nice” and unable to deal with negative feelings. As a result, she said their marriage was superficial and lacking in intimacy. She discovered precisely why their relationship was superficial—but it wasn’t exactly the answer she was looking for!

 

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

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056: Interpersonal Model (Part 3) — “And It’s All Your Fault!” Interpersonal Decision-Making and Blame Cost-Benefit Analysis

056: Interpersonal Model (Part 3) — “And It’s All Your Fault!” Interpersonal Decision-Making and Blame Cost-Benefit Analysis

Podcast 56, “And It’s All Your Fault!” (Part 3)

David begins this podcast with a story of a psychiatric resident named Bob who was treating a divorced woman who complained bitterly about her ex, and constantly argued with him whenever he came to visit with the children.

Their relationship was clearly acrimonious, so Bob asked the woman if she wanted some help with the way she was communicating with her ex. She bristled and said that she was an attorney and that she could communicate just fine, thank you! Bob’s error was the same that many therapists make—of thinking that people with troubled relationships want help. Clearly, Bob’s patient was not asking for help. She just wanted Bob to agree that her ex was a bum!

In many cases, and perhaps most, individuals who aren’t getting along with someone—such as their spouse, sibling, parent, colleague, or friend—aren’t really asking for help. They just want to vent and persuade you to buy into their negative view of the person they aren’t getting along with. They just want you to know what a loser the other person is!

So how do we help people with troubled relationships? David emphasizes that empathy is always the first step. You try to see the world through the eyes of the patient without jumping in to try to “help.” Empathy, of course, is the “E” of TEAM therapy.

Once the person feels understood and supported, the next step is called Agenda Setting. That’s the A of TEAM. One of the most important tools in Agenda Setting for individuals with troubled relationships is to first ask, “Is this relationship conflict something you want help with?” In many cases, the patient will say no, so you can ask if there’s something else he or she wants to work on.

In the language of TEAM, this is called “Sitting with Open Hands.” The therapist has to let go of his or her attachment to “helping.” This is difficult for many therapists, due to the therapist’s compulsive urges to help.

If the patient does want help, the next step is called Interpersonal Decision-Making. You ask what kind of help the patient wants, and make it clear that the patient has three choices.

  1. To leave the relationship.
  2. To improve the relationship.
  3. To stay in the relationship and behave in a way that will guarantee that the relationship will remain miserable.

David emphasizes that the last choice is by far the most popular. The second most popular choice is the decision to leave the relationship. And occasionally, you’ll find a person who wants help improving the relationship. As you can see, Interpersonal Decision-Making is simply a more sophisticated way of asking the patient if she or he wants help!

If the answer is still yes, the next Agenda Setting step is the Blame Cost-Benefit Analysis (CBA). You can ask the patient something along these lines:

“Who, in your opinion, is more to blame for the problems in the relationship? You? Or the other person? And who, in your opinion, is the bigger jerk? You? Or the other person?”

At least 80% of the time, the patient will say, “the other person!” You may feel the same way if you’re in a conflict with someone right now. However, blame is the most formidable barrier to intimacy, so before we can continue with the treatment, this issue must be skillfully addressed, or the treatment will probably fail.

David and Fabrice guide the listener in doing a written Blame CBA, listing the advantages and disadvantages of blaming others for the problems in our relationships with them. They encourage you to pause the recording and to the written exercise during the podcast, but warn you not to do it if you are driving!

Then they discuss how to process the results of the Blame CBA. If you would like to see a completed Cost-Benefit Analysis, click here. As you can see, the weightings at the bottom have not been filled out, so you can do that for yourself if you like. Make sure you put two numbers that add up to 100 in the two circles. Put the larger number in the circle under the column that feels more desirable. For example, if the advantages of blame greatly outweigh the disadvantages, you might put a 70 in the circle on the left and a 30 in the circle on the right.

If the patient concludes that the disadvantages outweigh the advantages, you can proceed to the M = Methods phase of the TEAM therapy session, which involves the Relationship Journal (RF). This is a powerful tool that David has designed to create interpersonal enlightenment and the death of the ego. David and Fabrice will discuss and illustrate the RJ in the next podcast.

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

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