Kelly asks: Would love to hear a podcast about to use or not to use touch in therapy. I personally feel touch is extremely helpful (what is more natural than to hug or put a hand on someone hurting), however I believe our profession has become so “professionalized” that is leaves out such a power act of healing. Did you ever use touch when you were practicing, and do you feel it is appropriate?
Against Machines Taking Over asks: You say that depression always results from distorted thoughts. But the sadness that results from a failure, rejection, or disappointment is not distorted. Can you explain a bit more about this?
Against Machines Taking Over also asks: Is there something you used to advocate for before but then you changed your mind?
Eduardo asks: How do you treat hypochondriasis. Almost all articles and advices I’ve read for hypochondriasis try to cover the writer’s back by first and foremost telling you that you should get yourself checked for real causes for your concern.
Eduardo also asks: I’ve been struggling with anxiety, and after reading When Panic Attacks, I got very interested in giving The Hidden Emotion model a try, but it seems to be structure-less. It seems to require a lot of detective work with no clear sheet or procedure. It’s just Detective Work, and then do something about it. Is there some newer technique to dig into what’s eating you?
You can reach Dr. Burns at firstname.lastname@example.org. Dr. Rhonda Barovsky practices in Walnut Creek, California, and can be reached at email@example.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.
* * *
You may have missed the Calgary and South San Francisco intensives, but there will be two more awesome workshops
for you 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
I also have a tremendous one-day workshop scheduled with my colleague, Dr. Jill Levitt, that will be potentially life- and career-changing (really!) You will learn powerful skills that will boost your clinical effectiveness and improve your relationships with friends, colleagues, and loved ones.
Advanced Empathy Tools for Connecting
with Challenging Patients,
Colleagues, Friends, and Loved Ones
With Drs. David Burns and Jill Levitt
Oct 6, 2019 | 7 CE hours, $135
Do you have a patient, colleague, friend or loved one who:
Complains endlessly but doesn’t listen to any of your good advice?
Appears irate, but insists s/he isn’t upset?
Refuses to express his / her feelings?
Argues, and always has to be right?
Always has to be in control?
Is relentlessly critical?
“Yes-but’s” when you try to make a point?
Insists you don’t really care—or understand—when you think you do?
Then you’re going to LOVE this workshop with David and Jill. You’ll learn about–
The Powerful “Law of Opposites”
How to find out how your patients really feel about you–if you dare!
How to transform therapeutic failure into success
How to talk to people who refuse to talk to you
You’ll also learn–
Why your worst therapeutic failure is actually your greatest success in disguise
The fine points of the Five Secrets of Effective Communication
Three Advanced Empathy Techniques: Multiple Choice Empathy, Changing the Focus, and Positive Reframing
There will be lots of small group practice with expert feedback and mentoring to help you refine your skills!
Attend in person or from your home via Live Streaming
Sign up early because we always sell-out for the in-person seats. Of course, there will be lots of skilled trainers to help the online participants with the small group exercises, so you’ll have a great experience either way.
My one-day workshops with Dr. Levitt are usually pretty awesome! It is always an honor to teach with Jill!
I talk a lot about how helpful TEAM can be–so here are some chances to learn how to use it with your clients / patients. The trainers listed below are superb! You’ll enjoy the technical skills you acquire and the warmth and support of the teachers as well as your colleagues at the training programs, too!
Feeling Good Institute (FGI) offers many training opportunities, as well as TEAM-CBT consultation groups for therapists. All of the course offerings are listed here and described below.
2. Daniel Mintie’s online training: CBT Skills, Training, and Practice: A Case-Based Course. This course meets every other week for three months. Daniel is a Level 5 TEAM-CBT Therapist and Trainer with Feeling Good Institute and a warm and thoughtful teacher. Each class in this biweekly series will begin with a presentation of one or more aspects of the TEAM-CBT model, followed by practice using case material from participants clinical work or instructor case examples. Daniel’s course meets every other week online for 3 months and the next quarter starts Friday 1/4/19 (12-1:45pm PST). 10.5 CE*s. $395.
4. Jill Levitt’s four-week training: Melting Away Resistance in CBT. Jill is a Master Therapist and Trainer in TEAM-CBT and the Director of Training at Feeling Good Institute and a warm and engaging teacher. This course teaches you tools to reduce resistance and boost motivation with your patients–a skill set most therapists are eager to learn! There will be ample opportunities for role playing and practice. Jill’s course meets weekly online for 4 weeks and starts Friday 3/8/19 (11am-12:45pm PST). 10.5 CE*s. $360
The Feeling Good Institute also welcomes clinical referrals onsite in Mountain View, CA, New York City, or via the video therapy program. FGI offers both traditional therapy (1 hr weekly sessions) as well as one-on-one intensive therapy consisting of many hours of individual therapy over a short period of time for more rapid and efficient results.
November 29 and 30, 2018–San Francisco, CA (in person only)
December 3 and 4, Portland, Oregon (in person and live streaming)
PESI is proud to offer an exciting workshop by David Burns, M.D., a pioneer in the development of cognitive behavior therapy (CBT). Achieve rapid and lasting recovery with all your anxious clients, just as Dr. Burns has done in over 35,000 therapy sessions with severely troubled clients. Become skilled at treating every type of anxiety without drugs.
In this unique 2-day certificate course you’ll master more than 20 treatment techniques to help your clients eliminate the symptoms of anxiety quickly – even your most challenging, resistant clients.
Dr. Burns will illustrate concrete strategies that provide rapid, complete recovery and lasting change for your patients. You’ll learn…
How to integrate four powerful treatment models to eliminate symptoms.
How to enhance your client’s engagement in therapy.
How to develop a treatment plan that specifically targets each client’s unique problems and needs.
…and so much more!
David will provide you with guided instruction and share powerful video sessions that capture the actual moment of recovery. You will take away practical strategies to use immediately with any anxious client. Leave this certificate course armed with tools you can use in your very next session!
Don’t miss this opportunity to learn from one of America’s most highly acclaimed teachers!
Note: I am republishing this because I published it in the wrong category last time. You have likely already received it, and if so, ignore this new version, as it is the same. I apologize for my error! david
Use the Anti-Procrastination Sheet!
This the second of five Feeling Good Podcasts on simple things you can do to boost your happiness. Procrastination is one of the most common causes of unhappiness, and this bad habit is almost universal. We all put off the tasks we dread because they make us anxious, and because we’re tempted to do other things that are way more rewarding. But the longer you procrastinate, the worse you feel, and this robs you of motivation. As a result, you fall into a vicious cycle where procrastination triggers negative feelings like depression, anxiety, and guilt, and your negative feelings, in turn, reduce your motivation and trigger more procrastination. A vicious cycle.
Fabrice and I are going to show you how to break the cycle and boost your happiness. To get started, please think of ONE thing you’ve been procrastinating on. It could be anything, such as working on your taxes, cleaning your garage, filing papers, working on a paper or presentation you’ve been avoiding, reading something you have to read for school or work–anything at all.
Now I want to ask you a question. Would you like to overcome the procrastination so you can get started on that task? If your answer is no, you can come back and listen later when you do want to solve this problem.
If the answer is yes, then I have a second question for you. WHEN would you like to overcome your procrastination and get started? Today? Or later on?
If your answer is today, then we’re ready to rumble. If you say, “tomorrow,” or some later time, then I’d encourage you to come back to this podcast when you are ready to solve the problem. I can ONLY help you overcome your procrastination today! NOT tomorrow.
Finally, I want to know if you’d be willing to devote a very small amount of time to getting started TODAY. I’m asking you to invest something like five minutes, and I’m also asking you to agree to limit your work this small amount of time. This is crucial, because if you tell yourself you have to do the entire job, that may take hours, and you’ll probably feel so overwhelmed that you won’t do a thing!
Finally, I want to know if you’d be willing to get started for five minutes even if you’re not “in the mood,” and even if you’re completely unmotivated, and EVEN if the very thought of the task makes you anxious and guilty. If the answer is YES, then we’ve got a deal. But if you want to wait for the motivation, I urge you to turn off the podcast and come back to it at some later time.
One philosophical principle is the approach we’re going to teach you is NOT to wait for motivation. Most procrastinators think that motivation comes first, followed by productive action, but this is an illusion, because you’ll probably NEVER feel motivated to do some awful task you’ve been putting off. If you’re waiting for motivation, you’ll be waiting forever!
As I wrote in my first book, Feeling Good: The New Mood Therapy, highly productive people know that ACTION comes first, followed by motivation. In other words, you have to get started on some task before you’ll feel motivated. You’re not entitled to feel motivated until you’ve start accomplishing something! Waiting for motivation is the trap that keeps your procrastination alive and prospering.
I’m going to make things simple for you using a tool I created years ago called the Anti-Procrastination Sheet! To make this podcast experiential, think about the specific task you’ve been putting off, like filing papers, preparing your taxes, cleaning the garage, a paper or report you have to prepare–anything at all.
Now take a look at the Anti-Procrastination Sheet. As you can see, it has five vertical columns, but they’re different from the columns on the Pleasure Predicting Sheet that we discussed in last week’s podcast. In the first column you break the task into small, or even tiny, steps, and number them. Make sure that each step can be completed quickly and easily–for example 30 seconds, or a minute or two.
You don’t have to outline the entire task, just the first four or five steps. And make sure the steps are small enough so you can complete all or most of them in five minutes or so. The philosophy behind this is called “little steps for big feats!” If you aim to do just a little, you may end up doing a great deal. But if you aim to do it all at once, the odds are high that you’ll just end up procrastinating, because the task will seem overwhelming.
After you’ve outlined the first few steps, predict how satisfying or rewarding each step will be in the second and third columns, on a scale from 0% (not at all satisfying) to 100% (tremendously satisfying.) Make sure you complete this column before you do the activity. And make sure you do it on paper, and not just in your head!
Now complete the first step, and indicate how satisfying and rewarding it turned out to be on the same scale, from 0% to 100% in the fourth and fifth columns. That’s all there is to it! Now do the same thing for the second step of the task.
You are welcome to print the attached copy and use it personally, but distribution or reproduction electronically is not permitted. Therapists who want to use this and hundreds of other assessment and treatment tools can purchase my Therapist’s Toolkit–you’ll find the order form on my website, www.feellinggood.com.
Now I’ll show you how the Anti-Procrastination Sheet works using a personal example of a task I hate and typically put off–and since this is something that I’m procrastinating on right now, we’ll see if the method works!
The task I’ve selected is listing my business expenses for our annual meeting with the accountant who prepares our taxes. This is something I always put off because it seems hard, boring, and anxiety-provoking.
Throughout the year, I save my receipts in file folders for various types of expenses–mailing expenses, professional entertainment expenses, software expenses, and so forth. So I have to list and total up all the expenses in each category, which involves a lot of busy work. I also have to do some complicated things like downloading our yearly charge card business expenses so I can list them as well, and I also have to download my PayPal receipts for sales of Therapist’s Toolkits and other things I sell on my website. And I nearly always have to call the help lines to figure out how to do the downloading, since I find it a bit complicated and confusing.
Yuck! No fun!
Take a look at my Anti-Procrastination Sheet. As you can see, I listed the first five steps of this task, beginning with something really simple–turning on the computer. I made sure the next four steps were reasonably quick and easy, too.
Then I predicted how difficult and satisfying the first step would be, on a scale from 0 (not at all difficult or satisfying) to 100 (extremely difficult or satisfying. As you can see, I did not expect it to be especially difficult or satisfying, since I turn on my computer all the time. But I thought it might be slightly satisfying because I could tell myself, “hey, I just got started!”
Once you’ve listed the first few steps and predicted how difficult and satisfying each step will be, go ahead and complete the first step, and record how satisfying and difficult it turned out to be in the third and fourth columns, on the same scale from 0 to 100. As you can see, my predictions for the first step were fairly accurate. It wasn’t at all difficult, but it was twice as satisfying as I had anticipated.
Then, I got a little boost in my mood–since I was facing the task I’d been putting off–and completed the next four steps, which were surprisingly easy, and somewhat more satisfying than I had predicted, as you can see. I’m sure you’ve heard the old Buddhist proverb that the longest journey begins with a single step–or, if you’re using the Anti-Procrastination Sheet, three or four small steps!
That’s all there is to it! Give it a try and email us to tell us how it worked for you!
Now let’s just suppose you’re not sold on what Fabrice and I have been teaching you in this podcast, and you’re telling yourself, “Oh, this is too hard for me, I just can’t get myself to outline the task on the Anti-Procrastination Sheet.” What should you do then?
Well, I have a suggestion for you, and another cool tool you can use. My suggestion is to stop telling yourself, “I can’t,” because this is not a valid statement. It isn’t true that you CAN’T get yourself to use the Anti-Procrastination Sheet. For example, if I held a gun to your head and told you to outline a task you’ve been putting off, you’d suddenly discover that you CAN do it!
But what is at issue here is that you may not WANT to do get started–for a whole variety of reasons! If that’s where you’re at, I would suggest that you list all the really GOOD reasons NOT to use the Anti-Procrastination Sheet today.
In fact, you may not even want to do that, so Fabrice will do it for you, and you can just look at this list that he and I came up with:
Really GOOD Reasons to Keep Procrastinating
Tomorrow will be a better day
I need more sleep
There’s something really good on TV right now
I’m not in the mood
I’ve done enough work for the day
I need some time to relax
It’s not necessary to do it right now
It will take too much time
It will be too hard
It will be too upsetting
I have other more important things to do.
Once you’ve complete your lists, or simply reviewed the list that Fabrice and I created for you, I would like to ask you this question: “Given all those many wonderful advantages and benefits of procrastination, and all the really good reasons NOT to get started right now, why in the world would you want to get started? Your procrastination makes all the sense in the world!”
Oh, I forgot to tell you how my own Anti-Procrastination Sheet worked out for me. Doing the first few steps got me into a flow, and over the next several days, I completed the entire task fairly easily, working a couple hours a day, even without having to outline any more steps on my Anti-Procrastination Sheet. I’m ready for the meeting with our accountant, and my wife informed me that I’m actually a month ahead of schedule. The whole secret was getting started, taking that first small step.
And DID it boost my happiness? Absolutely! I feel relieved, proud,and happy with what I’ve accomplished. That awful chore is no longer a heavy stone I have to carry around on my shoulders all day long! No guilt, either!
Next week, we’ll have another cool and simple tool you can use to boost your happiness–by confronting a fear. You may have a phobia, like the fear of cats or dogs, or heights. Or perhaps you’re shy and fear opening up in groups of people, or maybe you have public speaking anxiety. Since I’ve had and defeated tons of fears in my life, and since I’ve had thousands of therapy sessions with individuals struggling with every conceivable form of anxiety, this is one my favorite topics. I can’t wait to see you at next week’s Feeling Good Podcast!
Fabrice and I hope you enjoy our Feeling Good Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing!
In this podcast, David and Fabrice answer a question from a listener named Benjamin on the topic of procrastination. He wrote:
“The live therapy with Marilyn was very interesting – like other listeners, I was impressed by her character and strength.
“Towards the end of this most recent podcast, you were musing on what topics to cover in future podcasts. I would love to hear about how you treat people suffering from chronic laziness (“Do Nothingism”). In particular, there seems to be a strong potential of a Catch-22 with Process Resistance: The patient cannot find the motivation to do anything, yet they have to carry out the process (do the homework) to improve.
“Even worse, in “Feeling Good”, you categorize “Do Nothingism” into around 10 different categories, and suggest a different approach for each one. What should a lazy person do, who identifies with multiple categories, but is already starting to feel overwhelmed at the prospect of doing one of those activities, let alone five of them?
“I would love to hear David’s thoughts on this!”
David and Fabrice begin by thanking Benjamin, and David emphasizes how helpful and inspiring it is to receive specific questions like this, which makes it easy to create a (hopefully) informative and interesting podcast.
David says that his thinking about the treatment of procrastination has changed greatly since he wrote Feeling Good. One big change is that he no longer tries to “help” individuals who procrastinate, since this will cause them to continue to procrastinate, and the failure will now be the failure of the therapist, who’s “helping” wasn’t good enough.
Instead, David outlines a multi-step approach, based on someone who has ten years of unfiled papers that have piled up in his office, so that by now 15 feet of desk space is completely covered by piles of papers roughly one foot high. Fabrice plays the role of the resistant patient, and David plays the role of the therapist.
The steps include:
Paradoxical Agenda Setting: David asks, “The procrastination seems to be working for you. Why would you want to change? Let’s make a list of all the benefits of procrastination, and all the reasons NOT to change.” David emphasizes that the patient has to convince the therapist that this is something he really does want to change. It’s NOT the therapist’s role to help or to convince the patient to change!
Miracle Cure Question: What kind of help would you like in today’s session? Most patients say they need help with motivation. David declines to offer this, explaining that it isn’t on the therapeutic menu today—only the “Blue Plate Special!” The patient must agree to begin working on the filing in spite of having no motivation.
David also explains the underlying concept behind this strategy: most procrastinators are waiting for motivation, but that never works. You’ll be waiting forever, because you’re NEVER going to feel like doing all that filing! You aren’t entitled to motivation!
Productive individuals know that action comes first, and motivation comes second.
Specificity: What time would you like my help in overcoming your procrastination? The patient’s requests for help yesterday or tomorrow are declined by the therapist, so they settle on 6 PM today.
Little Steps for Big Feats: Let’s list the first five things you would need to do tonight at 6 PM, making sure that every step can be completed in 15 to 30 seconds. They list these steps:
Walk into my office
Choose one pile to start working on
Pick up the top piece of paper on the pile
Put it into a blank manila file folder
Label the file folder
Let’s Be Specific: David asks if Fabrice needs help with Step 1? Step 2? Etc. Fabrice finally admits he can do these five steps.
Five Minute Rule: David asks if Fabrice will agree to do these five steps between 6 PM and 6:05 PM, and if he will agree to work on his filing for ONLY those five minutes. At the end of the five minutes he has completed 100% of the assignment. The rationale is that if Fabrice tries to do it all, he’ll get so overwhelmed that he won’t do anything. But if he agrees to ONLY five minutes, that will be do-able. And if he surprises himself, and gets motivated to do more, he can, be he only gets credit for the first five minutes.
Problem – Solution List: David asks Fabrice to put a line down the middle of a piece of paper, from top to bottom, and list all the problems that will get in the way at 6 PM, and then to list convincing solutions to each problem in the right-hand column. Fabrice lists two problems: 1. I won’t feel like it. And 2. Traffic might be heavy, so I might not get home by 6 PM.
“I Stubbornly Refused” Technique: David asks Fabrice to agree to an unusual phone call at 6:05 PM!
TIC – TOC Technique: David plays the role of Fabrice’s “Task-Interfering Cognitions” (TICS) that will tempt him to procrastinate, and asks Fabrice to play the role of the “Task-Oriented Cognitions” (TOCS) he can use to combat the TOCs. The TICS include the familiar ones such as:
Five minutes won’t help, the job is overwhelming.
Even if I get started, I’ll just relapse, so there will never be a permanent solution.
It’s not such a big problem, I don’t need to do my filing now.
I can watch Game of Thrones on TV instead. That will be more fun.
It will be too anxiety provoking to get started.
It’s too late to get started anyway.
Tomorrow will be a better day.
David confesses the problem is one that he actually had, and describes how he solved it, using this exact approach!
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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.