Crushing Negative Thoughts / Resurrection / Relapse Prevention Training
In this third and final podcast featuring live therapy with Marilyn, David and Matt move on to the M = Methods phase of the session along, and encourage Marilyn to challenge the Negative Thoughts on her Daily Mood Log. The use Identify the Distortions, the Paradoxical Double Standard Technique, the Externalization of Voices, and Acceptance Paradox. Marilyn emerges as a powerful partner and begins to crush the negative thoughts that had seemed so real, devastating and overwhelming at the start of the session.
David emphasizes that the perceptions of therapists can often be way off base, so even though Marilyn appeared to change—fairly dramatically—during the session, David, Fabrice, and Matt will not know for sure until they review Marilyn’s end of session mood ratings on the Daily Mood Log as well as the Brief Mood Survey, and Evaluation of Therapy Session.
David defines a relapse as one minute or more of feeling lousy. Given this definition, all human beings will “relapse” frequently, including Marilyn. Relapses nearly always feel demoralizing and painful, but do not have to be devastating, or even long-lived, if the patient is prepared for them. No one is entitled to feel happy all the time, but it is entirely possible to keep our inevitable and occasional trips to the gates of hell rather brief. You will hear David and Matt doing Relapse Prevention Training with Marilyn using a number of techniques, including the Externalization of Voices.
Fabrice, Marilyn, Matt and David discuss the session, and what it meant to Marilyn from a personal and spiritual perspective. You can view this session as a powerful psychological experience—Marilyn described it as a “mind-blowing” experience. You can also see it as a profoundly spiritual experience: the emergence, resurrection, or rebirth from the “Dark Night of the Soul.” And you can ask yourself—did a genuine miracle happen here today?
Matt, Fabrice, and I are deeply indebted to Marilyn for making this phenomenal and intensely personal experience available to all of us. Thank you, Marilyn. We love you!
I want to thank my co-host, Fabrice, for making these podcasts happen! What a joy it is to work with you every week, Fabrice!
I also want to thank you, Matt, for support and friendship over these many years! Matt, as you know, I often sing your praises in my workshops around the country, telling people how amazing you are. Now they will see what I mean first-hand!
I hope that through these three podcasts, Marilyn has touched you and many people. If you were helped by these recordings, please let your friends and colleagues know, so that they might have the chance to “tune in” as well.
In the show notes for the first session with Marilyn, I mentioned the highly controversial theory that our pain usually results from our thoughts, and not from the circumstances of our lives, and put a link to a survey on the home page to see what you thought.
What do you think now? If you are interested, take thirty seconds to indicate your thinking on the survey below. Then we can look at the results of our informal experiment, and see if your thinking has changed.
Note: We’ll publish the raw, uncut version of the complete session separately (iTunes does not seem to distinguish it from the regular podcast episode).
Fabrice asks David about the title of his TEAM-CBT eBook for therapists—Tools, Not Schools, of Therapy. David explains that the field of psychotherapy is dominated by numerous schools of therapy that compete like religions, or even cults, each claiming to have the answer to emotional suffering. So you’ve got the psychodynamic school, and the psychoanalytic school, the Adlerian school, the Beckian cognitive therapy school, the Jungian school, and tons more, including EMDR, behavior therapy, humanistic therapy, ACT, TMT, EMT, and so forth. Wikipedia lists more than 50 major schools of psychotherapy, but there are way more than that, as new schools emerge almost on a weekly basis.
David describes several conversations with the late Dr. Albert Ellis, who argued that most schools of therapy were started by narcissistic and emotionally disturbed individuals. Ellis claimed that most were self-promoting, dishonest individuals who claimed to know the true “causes” of emotional distress and insisted they had the “best” treatment methods. And yet, research almost never supports these claims.
David, who is a medical doctor, points out that we don’t have competing schools of medicine. Can you imagine what it would be like if we did? Let’s say you broke your leg, and went to a doctor who prescribes penicillin. You ask why he’s prescribing penicillin for a broken leg, and he explains that he’s a member of the penicillin school. He says he always prescribes penicillin—it’s good for whatever ails you!
That would be like an Alice in Wonderland world. And yet, that’s precisely how psychiatry and psychotherapy are currently set up. If you’re depressed and you go to a psychiatrist, you’ll be treated with pills. If you go to a psychoanalytic therapist, you’ll get psychoanalysis. Or if you go to a practitioner of EMDR, TFT, or Rational Emotive Therapy (RET), you’ll get EMDR, TFT, or RET. David argues that this just doesn’t make sense.
David argues that the fields needs to move from competing schools of therapy to a new, science-based, data-driven psychotherapy. He emphasizes that we’ve learned a lot from most of the schools of therapy, and that many have provided us with valuable insights about human nature as well as some useful treatment techniques. But now it’s time to move on, leaving all the schools of therapy behind. David acknowledges that this message may seem harsh or upsetting to some listeners, and apologizes for that ahead of time.
David and Fabrice also discuss the spiritual basis of effective psychotherapy, and David describes the reaction of his father, a Lutheran minister, on the day that David was born, as well as a tip his mother gave him when he was in third grade.
In the next Feeling Good Podcast, David and Fabrice will describe Relapse Prevention Training, since the likelihood of relapse after successful treatment is 100%. But if the patient knows what to do, the relapse doesn’t have to be a problem.
Diving Beneath the Surface: The Uncovering Techniques
What are the root causes of depression? Anxiety? Relationship problems? In this, and the next two podcasts, you will discover the answer!
Cognitive Therapists believe that negative thoughts, or cognitions, can exist on two different levels. When you’re upset, you’ll have Automatic Negative Thoughts (ANTs) in the here and now, and they’ll usually be something like this:
Depression: You may be telling yourself that you’re a loser, or a failure, or that you’ll be miserable forever.
Anxiety: You’re probably telling yourself that you’re in danger, and that something terrible is about to happen. “When I get up to give my talk at my church group, my mind will probably go blank and I’ll make a total fool of myself!”
Relationship conflicts: You may be telling yourself that someone you’re ticked off at is a self-centered jerk who only cares about himself or herself and shouldn’t be that way!
Individual Downward Arrow
But why do we get these ANTs in the first place? Cognitive therapists believe that Self-Defeating Beliefs, and other deeper structures in the brain, make us vulnerable to painful mood swings and conflicted relationships with the people we care about. To help you pinpoint your own Self-Defeating Beliefs, David has created two uncovering techniques called the Individual Downward Arrow and the Interpersonal Downward Arrow, and Albert Ellis, the noted New York psychologist, created a third called the “What-If” Technique. In today’s podcast, Drs. Burns and Nye illustrate the Individual Downward Arrow technique, using as an example a psychologist named Harold who was understandably devastated when his patient unexpectedly committed suicide.
You can follow along on this PowerPoint presentation starting with Harold’s Daily Mood Log with David and Fabrice while they illustrate the Individual Downward Arrow technique.
Once they come to the “bottom of the barrel,” they will ask you to pause the recording, and see if you can pinpoint five or six or more of Harold’s Self-Defeating Beliefs, using the list of 23 Common Self-Defeating Beliefs.
David emphasizes that we create our own emotional and interpersonal reality at every moment of every day, but we aren’t aware of this, so we often feel like victims of forces beyond our control. We are really talking about emotional and interpersonal enlightenment, and the uncovering techniques will make this ancient Buddhist concept more understandable for you.
In our next Feeling Good Podcast, David and Fabrice will illustrate the Interpersonal Downward Arrow Technique, which will allow you to complete a course of psychoanalysis in just 5 to 7 minutes, rather than the 5 to 7 years free associating on the couch. It is truly psychoanalysis at warp speed, and is pretty amazing! And when you change the beliefs that trigger interpersonal conflicts, you can change them and enjoy greater satisfaction in your relationships with the people you care about. But sometimes, that requires a little bit of courage!
And in the third Feeling Good Podcast on the uncovering techniques, David and Fabrice will illustrate Dr. Albert Ellis’ famous “What-If Technique.” If you struggle with any type of anxiety, including fears and phobias, this technique can help you uncover the feared fantasy at the root of your fears, so you can challenge the monster and attain freedom from the fears that hold you back!
In this podcast, David and Fabrice discuss a question posed by a listener with Obsessive-Compulsive Disorder who is plagued with intrusive and shameful sexual fantasies. David discusses his treatment strategies for a young man from Argentina who was struggling with forbidden fantasies of Jesus having sex with the Virgin Mary in all positions of the Kama Sutra, but the harder he tried to control them, the more intense and tantalizing they became. Being a good Catholic lad, he was terrified and tearful he would burn in hell if he didn’t overcome this problem.
If you’ve ever struggled with shameful sexual fantasies, you might be intrigued by this fascinating discussion of Cognitive Flooding, therapeutic resistance, and the Hidden Emotion Technique!
In this Podcast, Dr. Burns describes his work with a severely depressed, suicidal, hospitalized woman with rapidly cycling bipolar illness, who’d had 15 years of failed treatment with drugs and psychotherapy. She was telling herself:
This f___ing disease has ruined my life.
I’m a burden to my family.
My family and doctors would be better off if I were dead.
She was absolutely convinced that each of these negative thoughts was 100% true. Dr. Burns used several T.E.A.M. methods to help her challenge those thoughts, including Identify the Distortions, Examine the Evidence, the Experimental Technique, the Externalization of Voices, and the Acceptance Paradox. Listen to this podcast and find out about the shocking and rather unexpected impact of those techniques.