111: On the Road to Feeling Great! — Interview with Stephanie James

111: On the Road to Feeling Great! — Interview with Stephanie James

We sent this to you with the wrong audio earlier today, so Fabrice kindly fixed it. This version should have the correct audio. Thanks! David

Stephanie James’ Second Interview with Dr. David Burns

Hi everybody!

This is the second of three interviews with Stephanie James on her superb radio show and podcast, The Spark. Stephanie is an experienced therapist and dynamic radio personality from Colorado. She is co-authoring a book on how to live a “spark-filled life.”

This interview with Stephanie focused, in part, on the evolution of the new TEAM-CBT from traditional Cognitive Behavioral Therapy (CBT). Stephanie asks Dr. Burns questions on a wide range of topics, including:

  • How would you treat a case of social anxiety?
  • What is “therapeutic whitewashing” and how can therapists get over it? What should therapists do instead?
  • How would you work with violent teenagers, such as incarcerated gang members?
  • Why is it so important for therapists who are learning TEAM-CBT to check their egos at the door? What happens to therapists who won’t do this?
  • After you published your first book, Feeling Good, and the first research study on CBT was published, cognitive therapy swept the world. After your initial euphoria about CBT, your enthusiasm dimmed somewhat. Why? And in what new direction did your research lead?
  • What are the most common errors that therapists make in thinking about the causes of therapeutic resistance?
  • How can you overcome a patient’s resistance to change?
  • Can TEAM-CBT work rapidly for someone with horrific abuse and decades of failed therapy? Or is it mainly for high functioning individuals with mild problems?
  • How can you prevent or minimize relapses following the patient’s initial recovery?

Dr. Burns’ third interview with Stephanie will be on the interpersonal TEAM model—how to transform conflicted relationships into loving, rewarding ones. It can happen rapidly—but requires the death of the ego, or “self,” along with the willingness to give up blame and the role of victim so you can pinpoint your own role in the problem. This can be liberating—but painful!

[Apologies to our listeners—For a few hours this Monday, the old interview with Stephanie was posted ~Fabrice]

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Dr. Fabrice Nye currently practices in Redwood City, California and treats individuals throughout the world via teletherapy. You can reach him at fabrice@life.net. You can reach Dr. Burns at David@feelinggood.com.

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Three Cool Upcoming Workshops for YOU!

Coming Really Soon!

Act fast if you want to attend.

1.   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 (8:30 am-4:30 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.

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 from anywhere in the world.

The in person version is now sold out,  but limited spaces are still available if you would like to join online. There will be experts to assist the online participants with small group exercises in break out rooms, so you will have the same experience as those who attend in person. But act fast it you want to be included!

SOLD OUT in person, but limited spaces are
still available ONLINE

Learn from David and Jill–a dynamic teaching duo!

7 CE*s. $135

To register, go to the Feeling Good Institute

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2. Rapid Recovery from Trauma

a two-day workshop

by David D. Burns, MD

November 1-2, 2018–Woodland Hills, CA

You can attend in person or from home via Live Streaming

Includes a dramatic live demonstration on the evening of day 1

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

Register Now!

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3. TREAT ANXIETY FAST–

Powerful, Fast-Acting, Drug-Free Techniques 
to 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, 2018: 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!

Sponsored by PESI

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

 

Marilyn’s Intensely Personal Live Therapy is Touching / Inspiring Many

Marilyn’s Intensely Personal Live Therapy is Touching / Inspiring Many

More Heartfelt Feedback for Marilyn

Dear Dr. Burns,

I just listened to “0:59 ~The Tune Up” podcast and simply HAD to reach out to express my TREMENDOUS GRATITUDE to “Marilyn 😇”, Dr. May, Dr. Nye, and you!!! What a magnificent GIFT!

Marilyn… You are a gracious HERO!

Lisa

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Hello David,

So very moved and grateful to Marilyn, Matt, yourself (and Misty) for the latest live session.

Was weeping on the way into work as I was driving along – must have looked a bit strange.

Marilyn – you ARE making a difference! Very grateful for your deep honesty, bravery and vulnerability. I will never forget these sessions.

Wonderful, wonderful stuff.

Thank you!

Greg

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Hi Dr. Burns,

I just wanted to say a big thank you for the podcasts with Marilyn. I think she has been so brave sharing her story and I really admire her authenticity and openness in discussing this. I have had my fair share of anxiety around death and so really appreciate her sharing, and have found the podcast both inspiring and powerful.

I hope you can pass on my heartfelt gratitude and admiration to her!

Jonny

 

If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website, http://www.FeelingGood.com, as well. There you will find a wealth of free goodies, including my Feeling Good blogs, my Feeling Good Podcasts with host, Dr. Fabrice Nye, and the Ask Dr. David blogs as well, along with announcements of upcoming workshops, and tons of resources for mental health professionals as well as patients!

Once you link to my blog, you can sign up using the widget at the top of the column to the right of each page. Please forward my blogs to friends as well, especially anyone with an interest in mood problems, psychotherapy, or relationship conflicts.

Thanks! David

051: Live Therapy with Marilyn, Part 3, “Mind Blowing!”

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.

 

 

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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).

 

049: Live Therapy with Marilyn, Part 1, The Dark Night of the Soul

049: Live Therapy with Marilyn, Part 1, The Dark Night of the Soul

You FEEL the Way You THINK! . . . Or Do You?

The next three podcasts feature a therapy session with Marilyn, a woman recently diagnosed with Stage 4 (terminal) non-smoker’s lung cancer. We are enormously grateful to Marilyn for her courage and generosity in making this extremely private and intensely personal experience available to all of us. I believe the session will inspire you, and give you courage in facing losses, traumas and problems in your own life.

At the beginning of the therapy, Marilyn is in shock, experiencing, quite understandably, extreme levels of depression, anxiety, shame, loneliness, hopelessness, and anger. What’s the cause of her negative feelings?

According to the theory behind cognitive therapy, people are disturbed not be events, but rather by the ways we think about them. This notion goes back nearly 2,000 years to the teachings of the Greek Stoic philosopher, Epictetus, who emphasized the incredible importance of our thoughts—or “cognitions”—in the way we feel.

When you’re upset, you’ve probably noticed that your mind will usually be flooded with negative thoughts. For example, when you’re depressed, you may be beating up on yourself and telling yourself that you’re a loser, and when you’re anxious you’re probably thinking that something terrible is about to happen. However, it may not have dawned on you that your thoughts are the actual cause of your negative feelings.

In addition, you may not be aware that your negative thoughts will nearly always be distorted, illogical, or just plain unrealistic. In fact, in my first book, Feeling Good, I listed the cognitive distortions, such as All-or-Nothing Thinking, Overgeneralization, and hidden Should Statements, that trigger negative feelings. The notion that depression, anxiety, and event anger result entirely from your thoughts, and not upsetting events, can be enormously liberating, because we usually cannot change what’s actually happening, but we can learn to change the way we think—and feel.

But is this notion really true? Can’t traumatic events upset us? And can we really change the way we think and feel when the circumstances of our lives are genuinely awful? Or is this just a lot of pop psychology?

A lot of people don’t buy into the notion only your thoughts can upset you. It just seems to fly in the face of common sense. For example, you might argue that when something genuinely horrible happens, such as failure, losing a loved one, or being diagnosed with terminal cancer, it is the actual event and not your thoughts, that triggers the negative feelings. And you might also argue, perhaps even with some irritation, that your thoughts are definitely not distorted, since the actual event—such as the cancer—is real.

Would you agree? I know that’s what I used to think! If you’re interested, and you have not yet listened to the first Marilyn podcast, you can take the brief poll on the home page and let us know what you think!

The next three podcasts will give you the chance to examine your thinking on this topic, because Marilyn is struggling with a negative event that is absolutely real and devastating. At the end of the third podcast, you’ll have the chance to take the poll again.

In this podcast, Drs. Burns and May go through the T = Testing and E = Empathy phases of the TEAM-CBT session. If you’d like, you can review the Brief Mood Survey and Daily Mood Log that Marilyn completed just before the session began. You will see that her negative feelings are all severe, and that her negative thoughts focus on several themes, including

  • Her fears of cancer, pain, and death.
  • Her thoughts of spiritual inadequacy, doubting her belief in God, wondering if there really is an afterlife, and feeling that she’s perhaps been duped by religions.
  • Her feelings of incompleteness at never having had a truly loving life partner.
  • Her intense self-criticisms, beating up on herself for excessive drinking during her life.

The next Feeling Good Podcast with Marilyn will include the A = (Paradoxical) Agenda Setting phase of the TEAM therapy session, where David and Matt will attempt to reduce Marilyn’s resistance and enhance her motivation using the Miracle Cure Question, the Magic Button, the Positive Reframing Technique, and the Magic Dial. The third and final podcast will include the M = Methods phase, where David and Matt will encourage Marilyn to challenge her negative thoughts using Identify the Distortions, the Paradoxical Double Standard Technique, the Externalization of Voices, and the Acceptance Paradox, followed by Relapse Prevention Training, the end of session testing, and wrap-up.

Although the subject matter of these podcasts is exceptionally grim and disturbing, we believe that Marilyn’s story may transform your thinking and touch your heart in a deeply personal way. Because Marilyn is a spiritual person who suddenly finds herself without hope or faith, and totally lost, we have called part one, The Dark Night of the Soul, a concept from William Johnston’s classic book on religious mysticism entitled, The Inner Eye of Love.

We are hopeful these broadcasts will stimulate comments and discussions on the philosophical and spiritual messages embedded in the Marilyn session from you and our other listeners. Is it true that only our thoughts can upset us? And is the total loss of faith a necessary step on the path to enlightenment?

Live Session (Marilyn) — The Dark Night of the Soul (Part 1)

 

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048: Relapse Prevention Training

Relapse Prevention Training

Fabrice reads a question submitted by a reader on how to handle relapses following recovery from depression. David emphasizes the importance of this question, since there is a 100% probably that every patient will relapse following recovery. And if the patient has not been properly prepared, the relapses can be disastrous. But on the other hand, if the patient has been prepared, the relapses do not have to be problematic.

What is a relapse? David defines a relapse as one minute or more of feeling crappy. Given that definition, we all relapse pretty much every day. However, some people can pop out of a bad mood really quickly, while others can get stuck in these “relapses” for weeks, months, or even years.

David describes the Relapse Prevention Training (RPT) techniques he has developed, but cautions that RPT does not make sense until the patient has experienced a complete elimination of symptoms. If the patient is being treated for depression, that means that the score the depression test has fallen all the way to zero (no symptoms whatsoever) and that the patients feel joy and self-esteem.

There are four keys to David’s RPT, including:

  1. The patient must be informed that relapse is an absolute certainty. The question is not “will this patient relapse” but rather, “when will this patient relapse?”
  2. Patients have to know that the therapy technique that worked for them the first time they recovered will always work for them. It might be the Cost-Benefit analysis, Pleasure-Predicting Sheet, Acceptance Paradox, Double Standard Technique, Five Secrets of Effective Communication, Hidden Emotion Technique, or Experimental Technique, or simply recording their negative thoughts on the Daily Mood Log and identifying the distortions in them.
  3. Patients need to identify and modify the Self-Defeating Beliefs (SDBs) that triggered their depression and anxiety in the first place, such as Perfectionism, Perceived Perfectionism, or the Achievement, Love or Approval Addictions. In several previous podcasts, David and Fabrice have described the Uncovering Techniques that can be used to quickly pinpoint any patient’s SDBs.
  4. Patients need to write down and challenge the Negative Thoughts that will inevitably emerge at the time they relapse, such as “This relapse proves I’m hopeless after all,” or “This relapse proves the therapy didn’t work,” etc.

David and Fabrice illustrate step #4 using a powerful technique called Externalization of Voices. David has patients record this role play procedure on a cell phone or other recording device so they can play it and listen if needed during an actual relapse.

David explains that he used this approach with every patient he discharged, and encouraged them all to come back anytime they had a relapse that they couldn’t handle. In spite of having more than 35,000 therapy sessions with individuals with severe depression and anxiety, David says that he can count on two hands the number who every returned for “tune-ups” following termination of therapy, and in most of those cases, the patients were able to recover once again in just or two sessions.

In the next Feeling Good Podcast, David and his highly esteemed colleague, Dr. Matthew May, will begin their live work with Marilyn, a severely depressed colleague who is facing “The Dark Night of the Soul.” Fabrice, as usual, will narrate and elicit enlightening commentaries on the therapeutic strategies that David and Matt are using as the session with Marilyn unfolds.

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