028: Scared Stiff — The Motivational Model (Part 6)

028: Scared Stiff — The Motivational Model (Part 6)

In this Podcast, David and Fabrice discuss the fourth powerful model in the treatment of anxiety—the Motivational Model. The key here is bringing the patient’s subconscious resistance to conscious awareness, and melting it away with paradoxical techniques. This is absolutely critical if you are hoping to see a complete elimination of symptoms in any type of anxiety.

You may recall that the Outcome Resistance for anxiety disorders usually results Magical Thinking—the anxious patient may be suffering intensely and asking for help, but secretly believes that something terrible will happen if the treatment is successful and the anxiety disappears. In other words, most anxious individuals are convinced that the anxiety is protecting him or her from some catastrophic event.

David brings this concept to life with a dramatic description of his treatment of a young man named Sam who’d been struggling with intense PTSD—Post-Traumatic Stress Disorder— for six months following a traumatic interaction with two sadistic gunmen.

David and Fabrice also discuss metaphors for understanding how healing actually occurs. Most therapists think of depression and anxiety as mountains that have evolved slowly, over years or decades. They sometimes also believe that treatment and recovery will also requires years and years of treatment, with very slow progress. Of course, if the therapist and patient believe this it will function as a self-fulfilling prophecy.

In sharp contrast, David describes a new way to think about recovery, as something extremely rapid, a personal transformation that happens suddenly, within a very brief time period within a therapy session. But this remarkable phenomenon is only possible when the patient’s resistance to change has been skillfully and compassionately addressed by the therapist. At that point, the patient and therapist are on the same TEAM, working together collaboratively. Then, amazing changes can often unfold quickly.

Plans for future Feeling Good Podcasts will include a series of fascinating podcasts that will feature an actual live therapy session, with David and his colleague, Dr. Jill Levitt, acting as co-therapists, including commentaries on how each step of T.E.A.M. is being implemented. This will give you the unique opportunity to look behind closed doors so you can observe actual healing taking place.

In addition, a future “Ask David” podcast is planned, as well as a podcast on “The Truth about Benzodiazepines,” plus podcasts featuring more treatment methods for anxiety such as Interpersonal Exposure Techniques and Cognitive Flooding. Dr. Burns also promises a fascinating Feeling Good Podcast on the use of the Five Secrets of Effective Communication with violent individuals who are threatening, hostile, and dangerous.

016a: Special Interview: Can Depression and Anxiety Be Treated in a Two-Hour Therapy Session? with Lisa Kelley

In this Podcast, David and Fabrice are joined by Lisa Kelley, a certified TEAM-CBT therapist and former journalist from Littleton, Colorado. Lisa interviews David about an interview / blog David has just published on this website. For the full PDF of the article, click here.

Lisa begins by asking how people responded to a survey on David’s website asking this controversial question: “Do you believe that a depressed individual could experience a complete elimination of symptoms in a single, two-hour therapy session?” More than 5,000 individuals completed the survey and most were extremely skeptical.

David states that ten years ago, he would have felt exactly the same way, and would have dismissed anyone making such a claim as a con artist. However, he has now changed his mind and believes that sometimes it is possible.

David explains that he has done more than 50 live demonstrations in workshops and other teaching settings with individuals who are struggling with severe feelings of depression, anxiety, shame and anger. Many of these individuals who volunteer to be the patient have experienced horrific personal traumas. This gives David the opportunity to demonstrate how TEAM-CBT works with someone who is really suffering, and not just a role-playing demonstration. Usually, these live demonstrations are the highlight of a workshop because they are intensely emotional and real. Surprisingly, in the vast majority of these sessions, the individuals who were in the patient role experienced a complete, or near-complete, elimination of symptoms in roughly two hours.

David emphasizes that while we would not expect this to generalize to a clinical practice situation, it does seem to suggest significant improvements, or even breakthroughs, in psychotherapy. Many of the new developments have to do with helping patients overcome their resistance to change. Although David makes these techniques look easy, they are challenging to learn, and require a radically new and different way of thinking about why patients sometimes resist change and fight the therapist.

Lisa, Fabrice, and David explain exactly how the new techniques work, using as an example an Asian-American woman who had experienced decades of domestic violence and rape.

Can Depression Really Be Treated in a Single, Two-Hour Therapy Session?

Hi, I hope you will find my latest blog interesting! It is based on an interview with Lisa Kelley, a TEAM-CBT therapist and former journalist, and is intended for therapists and for the general public alike, although a few sections may seem somewhat technical.

I’ve been running a survey on this site about whether single-session treatment for depression and anxiety is possible, and the vast majority of you have indicated the very idea is somewhere between unrealistic and absurd. Ten years ago I would have agreed with you, and written off anyone who made such a claim as a con artist.

For my latest thinking on this highly controversial topic, you can click here.  You’ll also learn the secrets of melting away therapeutic resistance using the latest TEAM-CBT techniques. Make sure you provide your feedback and ideas about this, too, as our understanding is evolving, and you can be a part of that process!