052: Your Responses to the Live Work with Marilyn — Are People Honest in Their Ratings, and Do the Improvements Stick?

052: Your Responses to the Live Work with Marilyn — Are People Honest in Their Ratings, and Do the Improvements Stick?

The responses to the Marilyn session were extremely positive. At the start of the podcast, Fabrice reads a response from a listener who was moved and inspired by the work Marilyn did.

David and Fabrice discuss two questions commonly raised by people who have seen David’s live demonstrations with individuals experiencing severe depression and anxiety. Since the change in Marilyn’s scores were so fantastic, some skeptical listeners have asked, “Was this real, or was it staged?” Others have asked if patients are simply giving favorable answers on the Brief Mood Survey and Evaluation of Therapy Session forms as a way of being “nice” to the therapist.

David points out that the opposite is true. If patients are in treatment voluntarily, without some kind of hidden agenda such as applying for disability, they tend to be exceptionally honest in the way they fill out the forms. In fact, most therapists find that they get failing grades from nearly every patient on every scale at every session at first. This can be very upsetting, especially to therapists who are narcissistic and defensive about criticism. But if the therapist is humble and open to the feedback, the patient’s feedback on the Brief Mood Survey as well as the Evaluation of Therapy Session forms can provide a fabulous opportunity for growth and learning.

So in short, it is not true that patients fill out the forms just to be “nice” and to please the therapists. The scores are brutally real! If you are a therapist and a doubters, you can give the assessment instruments a try, and I think you’ll be surprised, and perhaps even shocked when you review the data!

Still, David acknowledges that the rapid and phenomenal changes he now sees most of the time when using TEAM-CBT are hard to believe, especially when you’ve been trained to think that recovery is a long, slow process. David discusses a model of brain function proposed by a molecular biologist / geneticist, Dr. Mark Noble, that allows for extremely rapid change.

David and Fabrice also address the question—can these kinds of miraculous results last, or are they only a flash in the pan? David emphasizes the importance of ongoing practice whenever the negative thoughts return. The “one and done” philosophy is not realistic. Part of being human is getting upset during moments of vulnerability, and that’s when you have to pick up the tools and use them again!

David describes experiencing three hours of panic just a few days ago, and Fabrice asks what techniques he used to deal with his own negative feelings, including Identify the Distortions, Examine the Evidence, Reattribution, and the Acceptance Paradox.

David agrees with the Dalai Lama that happiness is one of the goals of life, but emphasizes that it is not realistic to think one can be happy all the time. Fortunately, you can be happy most of the time–but you have to be willing to pick up the tools and use them from time to time when you fall into a black hole!

David and Fabrice

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 Podcast 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

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035: Live Session (Mark) — Final Testing, Wrap Up (Part 7)

035: Live Session (Mark) — Final Testing, Wrap Up (Part 7)

Part 7: T = Testing Revisited, Conclusion of the Live Therapy Session with Mark

This is the last live therapy podcast with Mark, the physician who was convinced he was a failure as a father because of his difficulties forming a close, loving relationship with his oldest son. Although the session appeared to go well, we can’t be sure until we see Mark’s end of session mood ratings on the Daily Mood Log and on the Brief Mood Survey and and Evaluation of Therapy Session. David emphasizes that therapists’ perceptions of patients are notoriously inaccurate, but most therapists are unaware of this because they don’t use the rigorous testing procedures at the start and end of sessions.

To review Mark’s partially completed Daily Mood Log, CLICK HERE. Jill and David will ask him to complete the additional negative thoughts on his own after the session.

To review mark’s end of session Brief Mood Survey and Evaluation of Therapy Session, CLICK HERE.

After David review’s the phenomenal changes Mark reported from the start to the end of the session, David asks if the ratings were genuine, or, as some listeners might suspect, faked in order to try to please the therapists. Mark bursts into tears and says, in a choked voice, that it was a life-changing experience.

After the end of the session, David and Fabrice discuss a number of highlights from the work with Mark:

  • The testing indicated a complete or near-complete elimination of symptoms. In 2 ½ hours, Jill and David have essentially completed an entire course of psychotherapy. Although there may still be some work to be done with Mark, the hard part has already been completed.
  • David emphasizes that he now views psychotherapy as a procedure to be done at one sitting, much like surgery, with brief follow-up visits, rather than a long, drawn out procedure meeting once pre week for months or even many years. And although a single 2 or 2 1/2 hour session may be more costly than a traditional 50-minute hour, it can be vastly more cost-effective Than dozens of sessions with little or no progress. In addition, it is vastly better for the patient who walks out feeling good today, rather than having to endure weeks, months, or even many years of traditional talk therapy or antidepressant drug therapy.
  • David and Fabrice talk about the fact that no one is permitted to feel happy all the time, and that Mark’s negative thoughts and feelings WILL return, David defines a “relapse” as one minute or more of feeling lousy. Given that definition, we will ALL relapse forever! But it doesn’t have to be a problem for Mark if he is prepared for this, and knows how to pop out of the relapses quickly, rather than getting stuck in them. This is where Relapse Prevention Training (RPT) becomes so important following the initial dramatic recovery. RPT only takes about 30 minutes and is easy to learn, and will perhaps be the topic for a future Feeling Good Podcast if our listeners express an interest in it.
  • David discusses the difference between an Internal Solution and an External Solution. In this session, David and Jill have guided Mark in the Internal Solution—this means crushing the negative thoughts that triggered Mark’s feelings of unhappiness, anxiety, shame, failure, and anger for years, if not decades. Now that he is feeling so much better about himself, he may want some help with the External Solution. This will involve learning how to develop a more loving relationship with his son using tools like the Relationship Journal and the Five Secrets of Effective Communication. This will be far easier now that Mark is no longer using up all his energy beating up on himself and feeling depressed and inadequate.
  • David wraps up by talking about the true wealth we have as therapists. Although we won’t develop the riches of a Bill Gates doing psychotherapy, we do have the fabulous and precious opportunity to see people as they really are inside, and to witness miracles like the one we saw in the session with Mark.
  • David expresses the hope that listeners have benefitted by listening. Although we are all different, most of us have had the painful experience, like Mark, of believing we were somehow failures, or inferior, or defective, or simply not good enough. We are deeply indebted to Mark’ courage and generosity in giving us the opportunity to see the solution to this ancient and almost universal human problem!

There are many resources for listeners who want to learn more about TEAM-CBT, including:

  • David’s exciting two-day and four-day training workshops, listed on his website, feelinggood.com.
  • Tons of free resources for patients and therapists at feelinggood.com. Please sign up using the widget in the upper right hand corner of any page on his website and you will receive email notifications and links to every post.
  • David’s psychotherapy eBook entitled Tools, Not Schools of Therapy.
  • David’s Tuesday psychotherapy training groups at Stanford, which are co-led Jill Levitt, PhD and Helen Yeni-Komshian, MD. The training is free of charge to Bay Area and northern California therapists. You will have the chance to do free personal work, too!
  • David’s famous Sunday hikes, also free to members of the training groups.
  • Paid online and in-person weekly TEAM-CBT training groups, plus intensive TEAM-CBT treatment programs, at the Feeling Good Institute in Mt. View California.
  • In addition, many TEAM-CBT training and treatment programs are now offered in many cities throughout the US and Canada. For more information, visit feelinggood.com or www.feelinggoodinstitute.com.

029: Live Session (Mark) — Introduction & Testing Phase (Part 1)

Podcast Live Therapy Session: “I’ve been a failure.”

Introduction

Jill & DavidThis is the first in a series of podcasts that will feature live therapy. As you listen, you’ll have the opportunity to peak behind closed doors to see how TEAM-CBT actually works in a real-world setting, and not role playing.

The patient is a physician named Mark who has been haunted for decades by a problem with his oldest son, and he feels like a failure as a father. Although the facts of your life are likely to be very different, you might understand what it’s like to feel like a failure, or to tell yourself that you’re defective, or simply not good enough.

The two co-therapists include David and his highly-esteemed colleague, Dr. Jill Levitt. We have broken the session down into a number of podcasts that will include excerpts from the session along with commentaries on the thought patterns of these two master therapists as the session unfolds.

Part 1—T = Testing

As the session begins, David and Jill review of Mark’s scores on the Brief Mood Survey (BMS), which he completed just before the session began. The scores indicate that Mark is only feeling mildly depressed, anxious, and angry, but is extremely dissatisfied with his relationship with his son.

Click here to view Mark’s initial Brief Mood Survey.

At the end of the session, David and Jill will ask Mark to complete the BMS again. By comparing his patient’s scores at the start and end of the session, they will be able to see exactly how effective, or ineffective, the session was. Mark will also rate David and Jill on Empathy, Helpfulness, and several other important dimensions.

Testing at the start and end of every therapy session is one of the new and unique components of TEAM therapy. The testing can revolutionize psychotherapy, because therapists can fine-tune their therapeutic strategies based on the scores, and make critical important changes if the session was not particularly helpful. However, the assessment instruments are extremely sensitive and pick up the smallest therapeutic errors. This can be quite threatening to therapists who don’t want to be held accountable.

002: T = Testing — A Boring Topic with Exciting Implications

In this podcast, Dr. David Burns describes the “Testing” part of the T.E.A.M. model. Topics include:

  • The shocking results of a study of therapist accuracy at Stanford
  • Why therapists who don’t test usually get it wrong
  • How session-by-session testing can revolutionize your practice

(Repost for submission to iTunes)

001: Introduction to the TEAM Model

In this podcast, Drs. Fabrice Nye and David Burns discuss an exciting breakthrough in psychotherapy.

Leave your questions and comments below. Also, let us know if you’d like to see certain topics addressed in future podcasts.

(Repost for submission to iTunes)