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119: Can you Change Self-Defeating Beliefs?

119: Can you Change Self-Defeating Beliefs?

In today’s show, Fabrice and David focus on this question: How can you get rid of Self-Defeating Beliefs?

Although any of the 100 + TEAM-CBT methods can be used to modify an SDB, four methods will be highlighted in today’s show.

  • Cost-Benefit Analysis
  • Semantic Method
  • Experimental Technique
  • Feared Fantasy

For more information on how to change SDBs, you might want to watch the extremely popular David and Jill  FB Live show on Overcoming Perfectionism (recorded on November 11, 2018).

What research has been done on SDBs?

This topic was not discussed in the show, but individuals with an interest in research might want to read David’s study with Dr. Jackie Persons on the causal connections between depression and SDBs about dependency (attachment) as well as achievement (perfectionism) in several hundred patients in Philadelphia during the first 12 weeks of their treatment at David’s clinic.

The study confirmed That both types of SBS were significantly correlated with depression severity at intake and at the 12-week evaluation. In addition, changes in depression were correlated with changes in SDBs. However, a sophisticated statistical analysis with structural equation modeling techniques did not confirm that SDBs had causal effects on depression, or that depression had causal effects on SDBs. Instead, SDBs and feelings of depression appeared to share an unknown common cause.

  • Persons, J. B., Burns, D. D., Perloff, J. M., & Miranda, J. (1993). Relationships between symptoms of depression and anxiety and dysfunctional beliefs about achievement and attachment. Journal of Abnormal Psychology, 101(4): 518 – 524.

 

 

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Dr. Fabrice Nye currently practices in Redwood City, California and also works with individuals throughout the world via teletherapy (although not across U.S. state lines). 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.

 

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118: The Beliefs that Defeat You, Part 1

118: The Beliefs that Defeat You, Part 1

The shows today and next Monday will focus on Self-Defeating Beliefs. These shows were triggered by two excellent questions from listeners.

Rajesh asked:

  • Is it possible to change an SDB?
  • Does the mere knowledge of an SDB change it?
  • How long does it take to change an SDB?
  • How do you change SDBs?

Nikola asked:

  • Aaron Beck said the SDBs never really go away. They just get activated and deactivated and activated again. Does this mean that depression is an incurable disease that will keep coming back over and over again?
  • What’s the point in battling against a core belief if it cannot be changed?

Fabrice and I appreciate your questions–they often give us ideas for shows! In today’s Podcast you’ll learn the answers to several questions about Self-Defeating Beliefs.

What’s the difference between Self-Defeating Beliefs (SDBs) vs. Cognitive Distortions?

The thoughts that contain cognitive distortions, such as All-or-Nothing Thinking, Overgeneralization, Discounting the Positive, and Self-Blame are distortions of reality, they are the cons that trigger depression and anxiety. When you’re upset, these thoughts will flood your mind. These thoughts can be show to be false, and when you crush a distorted negative thought, you’ll immediately feel better.

Self-Defeating Beliefs are stipulations, values that you’ve set up for your self. For example, you may base your self-esteem on your accomplishments due to your belief that people who accomplish more are more worthwhile as human beings. SDBs like this cannot actually be shown to be false–they are simply your personal, subjective values, and they are thought to be with you all the time, and not just when you’re depressed, anxious, or angry.

The question with an SDB is this: What are the advantages and disadvantages of having this value system? How will it help me–what are the benefits–and how might it hurt me? What’s the downside?

Why are Self-Defeating Beliefs thought to be important?

When you challenge and defeat a distorted thought, you feel better in the here-and-now. When you challenge and change an SDB, you change your value system at a deep level. This is thought to make you less vulnerable to painful mood swings and relationship conflicts in the future.

What are the different kinds of SDBs?

  • David’s list of 23 Common SDBs is attached. This list is not comprehensive, as there are many more, but the ones on the list are very common. There are several categories of SDBs.
  • Individual SDBs are often “Self-Esteem Equations”
    • Perfectionism
    • Perceived Perfectionism
    • Achievement Addiction
    • Approval Addiction
    • Love Addiction
  • Interpersonal SDBs are expectations of what will happen in certain kinds of relationships, or relationships in general
    • What’s your understanding of the other person’s role in your relationship? What adjectives describe him or her?
    • What’s your understanding of your person’s role in the relationship? What adjectives describe you?
    • How would that kind of relationship feel?
    • What rules connect the two roles?
  • Other kinds of SDBs
    • Anger / conflict cluster
      • Entitlement
      • Truth
      • Blame
    • Anxiety cluster
      • Niceness
      • Conflict Phobia
      • Anger Phobia
      • Emotophobia
      • Submissiveness
      • Spotlight Fallacy
      • Brushfire Fallacy

How can you identify your own, or a patient’s, Self-Defeating Beliefs?

  • Look at the list of 23 individual SDBs (easiest). You might want to do that right now. Review the list, and you’ll probably find many of your own beliefs!
  • Individual Downward Arrow
  • Interpersonal Downward Arrow

Next week, Fabrice and David will show you how to modify an SDB.

 

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Dr. Fabrice Nye currently practices in Redwood City, California and also works with individuals throughout the world via teletherapy (although not across U.S. state lines). 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.

 

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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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039: Uncovering Techniques (Part 1) — The Individual Downward Arrow

039: Uncovering Techniques (Part 1) — The Individual Downward Arrow

Diving Beneath the Surface: The Uncovering Techniques

What are the root causes of depression? Anxiety? Relationship problems? In this, and the next two podcasts, you will discover the answer!

Cognitive Therapists believe that negative thoughts, or cognitions, can exist on two different levels. When you’re upset, you’ll have Automatic Negative Thoughts (ANTs) in the here and now, and they’ll usually be something like this:

  1. Depression: You may be telling yourself that you’re a loser, or a failure, or that you’ll be miserable forever.
  2. Anxiety: You’re probably telling yourself that you’re in danger, and that something terrible is about to happen. “When I get up to give my talk at my church group, my mind will probably go blank and I’ll make a total fool of myself!”
  3. Relationship conflicts: You may be telling yourself that someone you’re ticked off at is a self-centered jerk who only cares about himself or herself and shouldn’t be that way!

Individual Downward Arrow

But why do we get these ANTs in the first place? Cognitive therapists believe that Self-Defeating Beliefs, and other deeper structures in the brain, make us vulnerable to painful mood swings and conflicted relationships with the people we care about. To help you pinpoint your own Self-Defeating Beliefs, David has created two uncovering techniques called the Individual Downward Arrow and the Interpersonal Downward Arrow, and Albert Ellis, the noted New York psychologist, created a third called the “What-If” Technique. In today’s podcast, Drs. Burns and Nye illustrate the Individual Downward Arrow technique, using as an example a psychologist named Harold who was understandably devastated when his patient unexpectedly committed suicide.

You can follow along on this PowerPoint presentation starting with Harold’s Daily Mood Log with David and Fabrice while they illustrate the Individual Downward Arrow technique.

Harold’s Daily Mood Log and Downward Arrow

Once they come to the “bottom of the barrel,” they will ask you to pause the recording, and see if you can pinpoint five or six or more of Harold’s Self-Defeating Beliefs, using the list of 23 Common Self-Defeating Beliefs.

David emphasizes that we create our own emotional and interpersonal reality at every moment of every day, but we aren’t aware of this, so we often feel like victims of forces beyond our control. We are really talking about emotional and interpersonal enlightenment, and the uncovering techniques will make this ancient Buddhist concept more understandable for you.

If you’d like more tips on precisely how to do the Individual Downward Arrow Technique, you can read David’s recent Feeling Good Blog on this topic!

In our next Feeling Good Podcast, David and Fabrice will illustrate the Interpersonal Downward Arrow Technique, which will allow you to complete a course of psychoanalysis in just 5 to 7 minutes, rather than the 5 to 7 years free associating on the couch. It is truly psychoanalysis at warp speed, and is pretty amazing! And when you change the beliefs that trigger interpersonal conflicts, you can change them and enjoy greater satisfaction in your relationships with the people you care about. But sometimes, that requires a little bit of courage!

And in the third Feeling Good Podcast on the uncovering techniques, David and Fabrice will illustrate Dr. Albert Ellis’ famous “What-If Technique.” If you struggle with any type of anxiety, including fears and phobias, this technique can help you uncover the feared fantasy at the root of your fears, so you can challenge the monster and attain freedom from the fears that hold you back!

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