In today’s podcast, David and Fabrice address two terrific questions submitted by listeners:
Greg: What’s the difference between Outcome and Process Resistance for dieting and weight loss?
Gary: How do you deal with motivation and resistance when dealing with habits and addictions, such as overeating, in TEAM-CBT?
David explains that in his workshops, he often asks his audiences, “how many of you would like to lose some weight?” And he asks you that same question now.
In his workshops, 65% of the hands go up. Did your hand go up too?
Then he say, “all of you who raised your hands just made a mistake! You definitely do NOT want to lose weight. You probably DO want to be thin and attractive, and in great physical condition, but you DON’T want to lose weight. Do you know why? There are only two things that you can do to lose weight–diet and exercise. And they both suck!”
David describes two new, powerful techniques he has created for resolving this dilemma–the Double Paradox and Devil’s Advocate Technique. David and Fabrice bring these techniques to life for you. If you are interested in losing weight, make sure you do the two exercises on paper while listening to this podcast. In fact, take a moment, but the podcast on pause, and get a piece of paper and a pen or pencil right now.
Here’s how they work:
Double Paradox: First, you draw a line down the middle of a blank sheet of paper, from top to bottom. Label the left-hand column “Advantages” (or ADV) and the right-hand column “Disadvantages” (or DIS). Now, in the left-hand column, list all the Advantages of eating as much as want of whatever you want, whenever you want. As you will see when listening, there are many! Then, in the right-hand column, list all the disadvantages of diet and exercise. As you will see, there are also many!
David asks, “given all of the tremendous benefits of eating as much as you want whenever you want, and all the overwhelming disadvantages and hassles of dieting and exercising, why in the world would you want to change?”
He explains why this paradoxical strategy can be so powerful and helpful. In essence, the therapist becomes the voice of the patient’s subconscious resistance instead of trying to “help” or persuade the patient to change.
Research and clinical experience confirms that trying to “help” people lose weight is usually doomed to failure. In fact, if you review the world literature on the treatment of habits and addictions, you will discover that practically ALL diets and weight loss programs have limited success AT BEST.
Devil’s Advocate: This is a powerful and fun role-playing technique. First, you list all the positive thoughts that tempt you to give in when you are tempted and craving your favorite food–such as pasta, chocolate, ice cream, donuts, or whatever your weakness is. Then you ask a friend or therapist to play the role of the tempting devil who will try to tempt and seduce you into giving in.Your job is to fight back and defeat the devil. You can record the interactions on your cell phone. if you defeat the devil, you can listen to the recording whenever you are tempted!
David also describes a third, time-honored technique that can be important in dieting (or in overcoming any negative habit or addiction):
Stimulus Control: Instead of constantly struggling with temptations, you simply avoid them.
David and Fabrice discuss paradoxical vs. straightforward treatment strategies for habits and addictions, and also raise the question of whether there is some “superior” type of diet or exercise, or whether most, if not all, of the action is in the motivation.
David and Fabrice also discuss strategies for maintenance of weight loss once you have achieved your initial goal.
David and Fabrice love your questions so keep them coming!
Fabrice and I hope you enjoy our Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing!
The following is an email I received from Dan Prine, a therapist receiving TEAM-CBT training from Dr. Maor Katz at the Feeling Good Institute in Mt. View, California. Dan had several questions about my recent podcast on single-session therapy with Fabrice Nye and Lisa Kelley.
Good morning David,
As I continue to learn and study the TEAM approach to CBT, I find it challenging and see it as so complex that it will present itself as a career long learning process. I have attended several of your intensive workshops, am currently involved in 2 web based programs and am receiving 1:1 supervision with Dr. Katz. I have several questions / thoughts I would like to get your thoughts on.
In the 1999 introduction to your workbook, “Ten Days To Self Esteem,” your referred to patients with schizophrenia and to those experiencing hallucinations who were treated at your hospital in Philadelphia (page 8). Most of the rest of your introduction has a focus on depression and anxiety. Perhaps you were referring to improvement in psychotic individuals who also were experiencing depression. If not, I am interested in knowing if your workbook was found to be helpful with symptoms of psychotic disorders without concurrent depression.
There was recently a challenge to your copyright policy on the list serve. [David’s explanation: Several therapists were rather forcefully asking permission to distribute the assessment tests and treatment tools from my Therapist’s Toolkit electronically. This would put me at great risk for online piracy, which is a huge problem for me already, and also risks violating HIPAA laws about sending confidential patient information electronically, with potentially huge fines, including jail time. I responded in strong language that this was not going to work for me.]
Dan Prine continues: I 100% understand and agree with all your arguments to maintain status quo. Based on the writer’s response, I think he now also agrees with your stance. It is refreshing in your books when you describe your humanness and talk about when you decide to back up, rethink your response and employ the Five Secrets to get a more productive result. You were “right” and your approach to the writer’s thoughts seem to have changed his perspective. I wonder if upon reflection you would convey the same message in a more gentle way. Just wondering.
In response to your recent post and podcast about the 2 hour “miracles” we see in your workshops, I am wondering if think a clinician in a private practice, offering a 2 or 3 hour initial sessions, could achieve the same results you have experienced so frequently?
Do you administer the EZ Diagnostic survey and /or the BMS before and after your demonstrations?
Could the following, in addition to the TEAM CBT, be responsible, at least in part, for the rapid changes you are seeing in your clinical demonstrations in workshops?
Since your workshops are for therapists, your volunteers are psychologically-minded and reasonably high functioning—could this be a factor?
Could there be a placebo effect, since the “patients” are receiving treatment from an expert?
Could increased motivation play a role, since they are willingness to volunteer for personal work in front of a live audience, which takes courage and determination?
Could your empathy and acceptance of them as humans be a contributing factor?
How important is it that you melt away their resistance during the live session?
If these factors play a major role in the improvements you have been experiencing, do you really believe that we, as private practice therapists, could ever achieve the same kinds of phenomenal results in 2 hour therapy sessions? I do acknowledge you made it clear none of us could ever expect these purported results consistently, no matter how skilled.
Thanks in advance for any response you might offer.
And as I have mentioned before, thank you for your kindness, perseverance and pioneering efforts you offer in promoting therapists worldwide to help the many who suffer from mental illness and their distortions.
If you’d like to read my response to Dan Prine’s thoughtful questions, and the email exchanges that followed, CLICK HERE. I really enjoyed the correspondence with Dan (aka Danny) and hope you enjoy it as well!