126: How To Communicate with Someone Who Refuses to Talk to You!

126: How To Communicate with Someone Who Refuses to Talk to You!

Advanced Communication Techniques

We’ve had many podcasts on the Five Secrets of Effective Communication, and we’ve featured these powerful techniques in the live sessions with Lee (sessions #96 to #98)), a man who was upset because his wife was constantly criticizing him and trying to control him.

Here are the links to the first two podcasts on the Five Secrets (14 and 15). For more practice you can listen to podcasts 54 – 57 and 65 – 69.

Learning to use the Five Secrets skillfully requires strong motivation and lots of practice, but the benefits can be tremendous. The Five Secrets have transformed my clinical work as well as my personal and professional relationships. And they’ve also had a huge impact on my teaching.

But there are even more communication techniques that can be immensely helpful. In this podcast, we discuss three advanced techniques:

  1. Changing the Focus. This technique can be tremendously helpful when there’s an “elephant” in the room.
  2. Multiple Choice Empathy. This technique can be transformative when you’re trying to connect with a teenager, friend or loved one who refuses to talk to you.
  3. Positive Reframing. This technique can be invaluable when you’re fighting with a colleague, patient, friend or family member, and you’re both feeling frustrated, angry, and upset.

These techniques may look easy, but they are actually difficult to learn. They require humility, determination, and lots of practice. Success also depends on a strong desire to develop a more loving relationship with the person you’re not getting along with.

People who are serious about learning can read Feeling Good Together and do the written exercises while you read!

Thanks!

David

Subscribe

Dr. Fabrice Nye currently practices in Redwood City, California and treats individuals throughout the world (but not across U.S. state lines) via teletherapy. You can reach him at fabrice@life.net. You can reach Dr. Burns at david@feelinggood.com. If you like our jingle music and would like to support the composer Brett Van Donsel, you may download it here.

* * *

A COOL UPCOMING WORKSHOP FOR YOU

TEAM-CBT Methods for Anxiety Disorders–

Step-by-Step Training for Therapists

by David D. Burns, MD and Jill Levitt, PhD

jill-david

Dr. Jill Levitt and I are offering what I think will be an outstanding workshop on the treatment of anxiety disorders on Sunday, May 19, 2019. Our Sunday workshops are tremendously fun, so consider attending if you are interested. 

The last Sunday workshop in February sold out quickly so register soon if you are interested. You can join in Palo Alto in person or online from anywhere in the world.

THERE WILL BE MANY EXPERT TRAINERS TO GUIDE THE ONLINE PARTICIPANTS DURING THE SMALL GROUP EXERCISES

WHEN: May 19, 2019, 8:30 am – 4:30 pm PST
(11:30 am-7:30 pm EST)

WHERE: Join us live online or in person at the Creekside Inn, Palo Alto, CA.

HOW MUCH DOES IT COST? $135,

WILL I GET CE CREDITS? YES! 7 CE hours available

WILL I GET CREDIT IN THE TEAM LICENSURE PROGRAM? YES!
Completion of this workshop also counts towards TEAM-CBT Level 1, 2 or 3 Certification

WHO CAN ATTEND? Therapists of all levels are welcome

CAN I REGISTER IF I’M NOT A THERAPIST? Although the workshop is geared for therapists, it will be taught in a clear and basic way that anyone can benefit from.

WILL I HAVE FUN? Yes!

WILL I HAVE GET TO HANG OUT WITH SOME COOL COLLEAGUES? Yes!

WILL I GET AN AWESOME FREE BREAKFAST AND LUNCH? Yes!

You will love this lively, amusing, and immensely useful day of training with Drs. Burns, Levitt and the Feeling Good Institute Staff. The trainers will use a combination of didactic teaching, live demonstrations, video, and breakout group practice to enhance skill-building.

REGISTER / LEARN MORE

Act fast if you want to attend!

* * *

And there will be two awesome summer intensives for you this year!

THE INTENSIVES ARE ALMOST ALWAYS
THE BEST WORKSHOPS OF THE YEAR!

July 15 – 18, 2019
Calgary four-day intensive
Sponsored by Jack Hirose & Assoc.

 

July 29 – August 1, 2019
South San Francisco four-day intensive
Sponsored by Praxis

 

109: David’s Top 10 List!

109: David’s Top 10 List!

A fan named Tanuj asked:

“I’ve heard Dr. Burns mention that he is most proud of a few of the techniques he’s developed, and he mentioned that the Disarming Technique would be near the top of the list. I believe he said there were three or five of them. I was wondering what the others were. Does he have a top 5?”

Thank you, Tanuj. I got to thinking and actually came up with 10. Fabrice and I will briefly discuss each one on today’s podcast. So here they are!

  1. The list of Ten Cognitive Distortions that I created for my first book, Feeling Good: The New Mood Therapy. This list has been reproduced enormous numbers of times in the media and has been translated into more than 30 languages.
  2. The Disarming Technique and Law of Opposites. This means that you can nearly always put the lie to a criticism by finding the truth in it. However, this can be difficult because it requires the death of the ego, or self, the so-called “Great Death” that the Buddhists have emphasized as a key to enlightenment. This method has transformed my clinical practice and personal life and has been very helpful to many of my patients as well. However, it is not easy to learn, in part because it does involve the death of the “self.”
  3. The Externalization of Voices plus Acceptance Paradox. This was one of the first cognitive therapy techniques I developed, and I have used it more than any other technique during my career. It’s totally mind-blowing.
  4. The two classic Uncovering Techniques: the Individual and Interpersonal Downward Arrow. You can use these techniques to quickly pinpoint the Self-Defeating Beliefs that trigger painful mood swings, such as Perfectionism, Perceived Perfectionism, the Love Addiction, and Brushfire Fallacy, and more.
  5. The Feared Fantasy and Acceptance Paradox. This is a powerful and innovative exposure technique that can help people overcome the fear of being judged or rejected. It can also help people modify Self-Defeating Beliefs like Perfectionism and the Achievement Addiction, and the Approval Addiction.
  6. The Experimental Technique for extremely rapid treatment of patients with Panic Attacks. With this technique, you can sometimes—often—cure Panic Disorder in a single session. But this requires great courage on the part of the therapist and patient, and a great therapeutic alliance with lots of trust.
  7. My published research with colleagues in the mid-1970s did not support the popular notion that depression results from a chemical imbalance in the brain. In other words, we found that depression probably does NOT result from a deficient of the neurotransmitter, serotonin. Although we published this research in the top psychiatric journal, it was largely ignored for 25 years because people were so hooked on the “chemical imbalance” theory of depression. Now the study has been quoted frequently, and most neuro-scientists no longer give that theory a great deal of credibility.
  8. Brief Mood Survey. I believe I was the first, or one of the first, therapists in the world to require testing of every patient at every treatment session. I started with the Beck Depression Inventory, but have since developed briefer and more accurate scales that patients can complete in the waiting room before and after every sessions. These scales indicate the severity of symptoms such as depression, anxiety, anger, suicidal urges, positive feelings, and relationship satisfaction or conflict. Patients also rate therapist empathy and helpfulness after each session. This simple procedure has revolutionized treatment, because therapists can now see, for the first time, how effective, or ineffective, they are in every single therapy session. The testing has also made data-driven, science-based psychotherapy possible. However, it requires courage on the part of the therapist because the information will often be surprising to the therapist, and disturbing!
  9. Positive Reframing, and all of the new, paradoxical Agenda Setting techniques have made super-high-speed TEAM-CBT treatment methods possible. I now see recovery at speeds I would have thought impossible 20 years ago.
  1. The use of extended, two-hour therapy sessions rather than weekly 50-minute sessions has also been huge. That’s because I often see a complete elimination of symptoms of depression and anxiety in a single extended session of TEAM-CBT, as opposed to months or even years of conventional treatment. Many of my students are reporting similar results. This,  I think, is truly revolutionary!

Well, that’s it. That’s what I’m the most proud of! I suppose I could also include my first book, Feeling Good: The New Mood Therapy, which has sold more than 5 million copies worldwide, and has helped many people recover, as well as the development of TEAM-CBT.
Thank you again for your question, and please accept my apology if I am bragging too much, which can be really offensive. However, my mother once said, “If you don’t toot your own horn, no one else is going to toot it for you,” so hopefully the podcast and write-up will be okay.

David

Subscribe

* * *

Coming Soon!
October / November / December 2018–
Cool Workshops for You!

TEAM-CBT Methods for the Treatment of Relationship Difficulties

Step by Step Training for Therapists

by David Burns, MD and Jill Levitt, PhD

Sunday October 28th, 2018 (9 am-4 pm PST)

Live in Palo Alto plus online streaming

Learn how to reduce patient resistance and boost motivation to change. Master skills that will enhance communication skills and increase intimacy with loved ones. This workshop will be highly interactive with many case examples and opportunities for practice using role plays.

Join us for a day of fun and inspiring learning on site in Palo Alto
OR online from anywhere in the world.

Learn from David and Jill–a dynamic teaching duo!

6 CE*s. $135

To register, go to the Feeling Good Institute

or call  650-353-6544

* * *

Rapid Recovery from Trauma

a two-day workshop

by David D. Burns, MD

October 4-5, 2018–Pasadena, CA

and

November 1-2, 2018–Woodland Hills, CA

The November workshop includes Live Streaming
if you cannot attend in person)

For further information, go to www.IAHB.org
or call 1-800-258-8411

Register Now!

* * *

TREAT ANXIETY FAST–
Powerful, Fast-Acting, Drug-Free Treatment Techniques
that Defeat Anxiety & Worry

a 2-day workshop by David D. Burns, MD

November 29 and 30, 2018–San Francisco, CA (in person only)

and

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 psychiatrists and teachers!

Sponsored by PESI

To register, or for more information, call: 800-844-8260

050: Live Therapy with Marilyn, Part 2, Is Depression a “Mental Disorder?”

050: Live Therapy with Marilyn, Part 2, Is Depression a “Mental Disorder?”

The Hidden Side of Depression, Anxiety, Defectiveness, Hopelessness and Rage

We nearly always think about negative feelings, such as  severe depression or anxiety, as problems that an expert must try to fix, using drugs and / or psychotherapy. And there are a multitude of theories about why humans become depressed, including, but not limited to:

  • Reality. We think we get depressed because reality sucks. We believe our mood slumps result from the negative circumstances in our lives, such as being alone following a rejection, experiencing the loss of a loved one, not having enough money, education or resources, social prejudice, or (as in Marilyn’s case) facing some catastrophic circumstance, such as severe illness.
  • Upbringing. We think we get depressed because of insufficient love and nurturing in childhood, or because of traumatic childhood experiences.
  • Biological factors. We believe that feelings of depression and anxiety result from problems with our genes, or diets, or because of a chemical imbalance in our brains.

Certainly, there can be some truth in all of these theories. Reality does kick us all in the stomach from time to time, and the pain we feel is understandable. My wife and I lost her father to Parkinson’s Disease a few years ago. We loved him tremendously, and his loss was extremely painful for everyone in our family.

Most of us have experienced less than ideal circumstances when growing up as well, and many have been victimized by horrific experiences, such as child abuse or bullying. And clearly, some psychiatric illnesses, such as schizophrenia, do result from some kind of biological abnormality in the brain.

But the problem with all of these theories is that they put us at the mercy of forces that are largely beyond our control—since we often cannot do much to change reality, rewrite our childhoods, or modify our brains short of taking this or that medication. And, in addition, these theories all suggest that negative feelings like depression and anxiety show that there is something wrong with us.

In this podcast, Matt and David take a radically different approach, and argue that Marilyn’s intense feelings of depression and anxiety are not “mental disorders” that reflect some defect in Marilyn, but rather the expression of what is most beautiful and awesome about her. They also argue that there are large numbers of advantages, or benefits, of feeling the way she does. They use several Paradoxical Agenda Setting Techniques, including the Invitation, the Miracle Cure Question, the Magic Dial, Positive Reframing, and the Magic Dial. The results are stunning and unexpected.

At the end of this segment, David and Matt argue that it might be desirable for Marilyn to continue to feel some of her negative feelings, and ask her how depressed she would like to feel at the end of the session, using the “% Goal” column on her Daily Mood Log. She also indicates how anxious, ashamed, defective, alone, hopeless, frustrated, and angry she would like to feel.

The third and final podcast next week will include the M = Methods phase of the session along with the end-of-session T = Testing and wrap-up, including Relapse Prevention Training.

Subscribe

032: Live Session (Mark) — Agenda Setting Phase (Part 4)

032: Live Session (Mark) — Agenda Setting Phase (Part 4)

Part 4—A = Paradoxical Agenda Setting (PAS, cont’d

As the session continues, Jill and David encourage Mark to develop his list of positives. Mark draws a blank at first. This is very common among patients and therapists alike. Most of us have not been trained to think about depression, anxiety, shame, defectiveness, hopelessness and anger as being good or positive. In fact, we think of them as symptoms of “mental disorders,” according to the DSM (Diagnostic and Statistical Manual of the American Psychiatric Association.) So we think of them as bad, something to get rid of, something needing treatment.

IMG_1860But after David and Jill prime the pump, Mark is surprised that they quickly come up with a list of 16 positives that are real and powerful. At this point, they ask Mark why in the world he’d want to press the Magic Button and have all of his symptoms suddenly disappear–given all these positives. This is called the Acid Test and it’s also paradoxical. David and Jill have now become the resistant part of Mark’s subconscious mind–the part that clings to these symptoms. And when the therapists become the voice of the resistance, the patient will nearly always become the voice that argues for change.

The paradox is resolved with the Magic Dial. Toward the end of this podcast, you will want to review Mark’s Daily Mood Log, with the Goal column filled out on the table of negative emotions.

David points out that there is no single tool or technique that triggers recovery in patients. Instead, each component of T E A M contributes in radically different ways to the substantial or even dramatic improvement the therapists are hoping to bring about it today’s session.

In the next Podcast, David and Jill will begin the M = Methods portion of the session.

031: Live Session (Mark) — Agenda Setting Phase (Part 3)

031: Live Session (Mark) — Agenda Setting Phase (Part 3)

Part 3—A = Paradoxical Agenda Setting (PAS), Initial Segment

IMG_6023    115-1504_img

In the early days of my career, I (Dr. Burns) would have assumed that Mark definitely wanted to change–after all, he’d been in a lot of pain for a long time, and he came to the session because he wanted help. So, following the empathy phase of the session, I would have jumped in with a variety of cognitive therapy techniques to help Mark challenge his Negative Thoughts, such as “I’ve been a failure as a father,” or “my brain is defective.” Although this might have been effective, there’s a good chance that it might not have worked. That’s because Mark might have “yes-butted” me or insisted that he really was a failure and that I just wasn’t “getting it.”

In fact, the attempt to help the patient without first dealing with the patient’s resistance is the cause of nearly all therapeutic failure. But most therapists make this mistake over and over–and don’t realize that their well-intentioned efforts to help actually trigger and reinforce the patient’s resistance.

Instead, TEAM Therapists use a number of Paradoxical Agenda Setting (PAS) techniques designed to bring the patient’s subconscious resistance to conscious awareness. Then we melt the resistance away before attempting to change the way the patient is thinking and feeling. I (DB) have developed 15 or 20 PAS techniques, and Jill and I  used several of them in our session with Mark:

  • The Invitation Step
  • The Miracle Cure Question
  • The Magic Button
  • Positive Reframing
  • The Acid Test
  • The Magic Dial

When Jill and I use Positive Reframing, we are hoping that Mark will make an unexpected discovery–that his negative thoughts and feelings, such as his sadness, shame, discouragement, and inadequacy actually reflect his core values and show what a positive, awesome human being he is. In other words, he will discover that his core values are actually the source of his symptoms as well as his resistance to change.

This approach represents a radical departure from the way many psychiatrists and psychologists think about psychiatric symptoms as well as resistance.  When I was a psychiatric resident, I (DB) was trained to think about resistance as something negative. For example, we may tell ourselves that resistant patients cling to their feelings of depression and worthlessness because they want attention, because they want to feel sorry for themselves, because they fear change, or because they are afraid will lose their identity if they recover. While there’s some truth in these formulations, they may not be helpful because they tend to cast the patient in a negative light, as if their symptoms and their resistance to change were somehow bad, or childish, or based on some kind of chemical imbalance in their brains. As you will see, the TEAM-CBT approach approaches resistance is radically different manner.

We will give you the chance to pause the podcast briefly and try your own hand at Positive Reframing before you hear it live during the session. Specifically, we will ask you to review Mark’s Daily Mood Log, and ask yourself these two questions about each of his negative thoughts and feelings:

  • What does this negative thought or feeling show about Mark that is beautiful, positive, and awesome?
  • What are some benefits, or advantages, of this negative thought or feeling? Are there some ways that this thought or feeling is helping Mark?

As you so this, make a list of as many Positives as you can on a piece of paper. See what you can come up with.

I want to warn you that it may be difficult to come up with your list of Positives at first. If so, this is good, because when you hear the next podcast, you’ll have many “ah ha!” moments and it will all become quite obvious to you. Then you will have a new and deeper understanding of resistance–an understanding that can help you greatly if you are a therapist or if you are struggling with your own feelings of depression and anxiety.

Jill gives a great overview of why the paradoxical approach is necessary during the Paradoxical Agenda Setting phase of the session.

To learn more about Paradoxical Agenda Setting, you can read David’s featured article in the March / April 2017 issue of Psychotherapy Networker entitled “When Helping Doesn’t Help.” You will see how he helped a woman struggling with intense depression, anxiety and rage due to decades of horrific domestic rape and violence.