Solution to David’s Tuesday Tip #5*

Solution to David’s Tuesday Tip #5*

This was yesterday’s paradoxical tip–

Most therapeutic failure–and patient resistance–results from the therapist’s compulsive urge to “help” or rescue to the patient.

When patients are stuck and not improving in spite of the therapist’s most sincere efforts, the problem nearly ALWAYS results from the fact that the therapist has not dealt with the patient’s resistance. There are two forms of resistance for depression, anxiety, relationship problems, and habits and addictions. In TEAM-CBT, we bring the patient’s resistance to conscious awareness and melt it away with a variety of powerful and compassionate techniques. If the therapist learns how to do this skillfully, it vastly accelerates recovery!

Many (perhaps most) therapists entered the field because they have been wounded personally, and because they want to help others. But this very understandable and compassionate urge can also get in the way of effective treatment. When you jump in and try to help someone who is suffering, they will nearly always resist your efforts. This is not only true in therapy, but also in your interactions with friends, colleagues, and family members who are depressed and anxious.

Of course, compassion IS important and helping IS crucial–but you have to know how to go about it, and that takes training, in my opinion!

Thanks for tuning in today! I have to exit as I am about to supervise one of the Stanford psychiatric residents this afternoon.


* Copyright © 2018 by David D. Burns, MD.

Coming This Week! Register Now!

High-Speed TEAM-CBT for Depression and Anxiety Disorders 

I warmly invite you to attend this fabulous, one-day workshop by Drs. David Burns and Jill Levitt on Sunday, May 20th, 2018. Click on the link above for registration information.

  • 6 CE Credits
  • The cost is $135
  • You can join in person or online from wherever you live!

You will enjoy learning from David and Jill, working together to bring powerful, healing techniques to life in a clear, step-by-step way. Their teaching style is entertaining, funny, lucid, and inspiring. This is a day you will remember fondly!

In the afternoon, you will have the chance to do some personal healing so you can overcome your own feelings of insecurity and self-doubt. David and Jill promise to bring at least 60% of the audience into a state of spiritual and psychological enlightenment, WITHOUT years of meditation. That’s not a bad deal!

You will also leave this workshop with renewed confidence as well as specific, powerful tools that you can use right away to improve your clinical outcomes!

You will LOVE this workshop. Seating for those who attend live in Palo Alto will be strictly limited, and seats are filling up fast, so move rapidly if you are interested. Online slots are also limited.

Jill and I hope you can join us!



The Solution to Tuesday Tip (#2)*

The Solution to Tuesday Tip (#2)*

This was my “puzzle” (the paradoxical Tuesday tip) for yesterday:

The failure to set the agenda is the cause of nearly all therapeutic failure.

Several of you commented, and a couple of you nailed it. This one was, perhaps, a bit too easy or obvious.

But what it means is that we all have mixed feelings about recovery, or change. If you’re depressed or anxious, you may be miserable, but a part of you may want to hang on to your depression and anxiety. One of the key features of TEAM-CBT is that we bring the patient’s resistance to conscious awareness quickly, and before using any M = Methods to help the patient change. The methods I have developed will be unfamiliar to most therapists, but they can be incredibly helpful and can greatly accelerate recovery.

But most therapists do not know how to reduce resistance, and may not even know that they need to do this. So they jump right in to help, save, or rescue the patient. But if the patient has ambivalent feelings about change, he or she will probably resist the therapist’s efforts. And this is why therapy fails.

Hundreds of therapists have approached me during breaks at workshops, or during my training groups at Stanford, and asked for help with this or that challenging patient who appears to be stuck in therapy. In 100% of these cases, the therapist did not know how to address resistance and did not know how to make the patient accountable.

In all of the many controlled outcome studies for depression that I’m familiar with, using any school of psychotherapy, it seems that a good 50% of the patients, or even more, do not reach the criteria for improvement during the study. I believe this is because tools to deal with resistance are almost never included in these studies.

Well that’s it for today!

Next Tuesday, look for “Tip / Puzzle #3!”


* Copyright © 2018 by David D. Burns, MD.

Coming Soon! Live Session Sold Out! Still space online. Register now!

High-Speed TEAM-CBT for Depression and Anxiety Disorders 

I warmly invite you to attend this fabulous, one-day workshop by Drs. David Burns and Jill Levitt on Sunday, May 20th, 2018. Click on the link above for registration information.

  • 6 CE Credits
  • The cost is $135
  • You can join in person or online from wherever you live!

You will enjoy learning from David and Jill, working together to bring powerful, healing techniques to life in a clear, step-by-step way. Their teaching style is entertaining, funny, lucid, and inspiring. This is a day you will remember fondly!

In the afternoon, you will have the chance to do some personal healing so you can overcome your own feelings of insecurity and self-doubt. David and Jill promise to bring at least 60% of the audience into a state of spiritual and psychological enlightenment, WITHOUT years of meditation. That’s not a bad deal!

You will leave this workshop with renewed confidence as well as specific, powerful tools that you can use right away to improve your clinical outcomes!

You will LOVE this workshop. Seating for those who attend live in Palo Alto will be strictly limited, and seats are filling up fast, so move rapidly if you are interested. Online slots are also limited.

Jill and I hope you can join us!



Training Opportunities with Dr. Jill Levitt!

Training Opportunities with Dr. Jill Levitt!

Hi all!

See below for two announcements about two upcoming training opportunities from the Feeling Good Institute. Both presentations will focus on David’s amazing Paradoxical Agenda Setting methods. Hope to see some of you there!

Warmly, Jill Levitt, PhD

Happy Holidays!

Give yourself the gift of renewed energy and excitement in your therapy practice with new motivational and resistance-busting tools. At Feeling Good Institute we have years of experience practicing and teaching Dr. David Burns’ techniques to reduce resistance and boost motivation. These techniques help us avoid power struggles with our patients, increase patient motivation, and energize the work we do. We are excited to share what we have learned with our fellow therapists! Please join me and my colleagues for one or both options:

1. Melting Away Resistance in CBT with Jill Levitt, Ph.D. LIVE ONLINE. Four Mondays. Starts Monday January 22nd, 11am-12:45pm PST (2-3:45pm EST). $245 for four weekly 1 hr 45 min. classes. 7 CEs. Space is limited to 25 participants to maximize individual attention and learning.

Online using group video conferencing

Instruction includes didactic teaching, large group demonstrations and small group role play to reinforce skills learned.

2. Step by Step Methods to Reduce Resistance and Boost Motivation with Challenging Patients: A Daylong Workshop for Therapists with Maor Katz MD, Jill Levitt Ph.D., and Angela Krumm Ph.D. Sunday January 21st 9am-4pm PST (12-7pm EST) $135. 6 CEs. ON SITE OR LIVE ONLINE from Palo Alto, CA.

Step by Step CBT Methods to Reduce Resistance and Boost Motivation with Challenging Patients. A Daylong Workshop for Therapists.

Sunday 1/21/18, 9am-4pm PST (12-7pm EST)

Online using group video conferencing or On-site in Palo Alto, CA.

Both courses can be used towards TEAM-CBT certification.

Click on each link below to learn more

Learn More

Learn More

Click on my Facebook tab on if you’d like to watch me each week on my Live Facebook broadcast each Sunday afternoon around 3 p.m. PST. Make sure to “like” my Public Facebook page: so you can watch it on my page or yours.How to Find My FB Broadcasts

Join me as I answer mental health questions from viewers — therapists and non-therapists alike — from all over the world. Type your question in the Facebook feed and I’ll do my best to answer it.

If you miss the broadcast you can watch the saved videos on my Facebook page! Also, viewers can watch these Live Facebook broadcasts as well as other interesting TEAM-CBT videos on the Feeling Good Institute’s YouTube channel!

The David and Fabrice Feeling Good Podcasts

Fabrice and I hope you also enjoy our Feeling Good Podcasts, and also hope you can leave some positive comments for us and some five star ratings if you like what we’re doing! We are already enjoying 25,000 downloads per month from listeners like you. Thank you so much for your support of our podcasts!


At least one listener has had problems leaving an iTunes review from his i-phone, so Fabrice has created some simple to follow instructions if you need help.


Jill’s Journey

Jill’s Journey

Jill’s Journey from CBT to TEAM

Dear web visitors, friends, and colleagues,

You might enjoy this brief (six-minute) video from my dear colleague, Jill Levitt, PhD, who I teach with at my weekly Stanford psychotherapy training seminar, which is free to local mental health professionals. In the video that follows, Jill describes her personal journey from traditional CBT to TEAM-CBT.


Jill is a fabulous therapist because she combines masterful technical skills with great compassion and empathy. In addition, she is director of training at the Feeling Good Institute in Mt. View, California. She also offers weekly online training groups for therapists as well, so you can join from anywhere in the world. Check it out if you want to give your clinical skills a shot in the arm!

Some of you may remember Jill from the live therapy podcasts that she and I did with Mark in the spring of 2017 on the theme, “I’m a failure as a father.”  If you haven’t yet listened to those podcasts, you might find them compelling. The response from listeners was tremendous.

Perhaps that’s because so many of us, perhaps including you, sometimes feel that we’ve fallen short in our role as a father, mother, partner, teacher, or whatever. The session documents Mark’s extraordinary recovery / enlightenment occurring in real time in a single TEAM therapy session. You will witness decades of depression suddenly transformed into overwhelming joy.

If you want to see Jill and David in action, we will be doing a half-day and a full-day workshop on TEAM-CBT at the upcoming ABCT conference (Association for Behavioral and Cognitive Therapies) in San Diego in November, and we’d love to see you there. If you live in northern California, and you’re a licensed mental health professional or graduate student, you’d also be welcome to join our free Tuesday training group at Stanford.

Here are the particulars on our ABCT presentations, in case you want to join us!

ABCT Conference
(Annual Meeting of the Association for Behavioral and Cognitive Therapies)

November 16 – 17, 2017, San Diego

Jill and I will present two workshops on the latest developments in high-speed psychotherapy (TEAM-CBT) for depression and anxiety disorders. I LOVE teaching with Jill at our weekly psychotherapy training seminar at Stanford every Tuesday. She is a tremendous teacher and therapist, so these promise to be fun and highly educational presentations.

Thursday, November 16, 8:30 AM to 5:00 PM
Building a Better CBT-An introduction to the TEAM-CBT model (6 hours)

Friday, November 17, 3:00 PM to 6:00 PM
When Helping Doesn’t Help: Overcoming Therapeutic Resistance With TEAM-CBT (3 hours)



If you are reading this blog on social media, I appreciate it! I would like to invite you to visit my website,, 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

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,
  • Tons of free resources for patients and therapists at 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 or
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.


Why Does Therapy Fail? What’s the Solution?

Hi Web Visitors,

One of my colleagues, Dr. Daniele Levy, who helps teach the Tuesday training group at Stanford, created a neat brief quiz for members of the TEAM-CBT list-serve. I have modified it slightly. If you want to submit your answers, I will try to publish a few of them!

  1. What is the #1 cause of therapeutic failure?
  2. What is the therapist’s role in addressing therapeutic resistance?
  3. What is the patients role?

She is offering free wine and cheese to the winner. I’m not offering that, but you might still enjoy taking a crack at it. And if you like the quiz, I might create some more of them for you!

By the way, I have an article on this topic that will be featured in the March, 2017 edition of Psychotherapy Networker. The title is “When Helping Doesn’t Help.” If possible, I will try to link to it when it appears, but don’t yet know if they permit this. If not, I might be able to print the final draft here.


David’s Video Interview with Lee Davy

Hi Web visitors,

If you’d like to take a peak at my recent video interview with Lee Davy, CLICK HERE!

Here’s Lee’s description, with a tad of editing from David: “In this episode, David and I talk about the role that tears and laughter play in therapy, Resistance and some tips and techniques to melt it, the importance of developing metrics to understand if therapy is working, relapse prevention, the human condition, how a cat taught him about to transcend the need to be special, or even to need ‘self esteem,’ and much more.” Thank’s Lee. It was really fun shooting the breeze with you, and I wish you the best in your podcasts on overcoming addictions.



021: Ask David — Shameful Sexual Fantasies

In this podcast, David and Fabrice discuss a question posed by a listener with Obsessive-Compulsive Disorder who is plagued with intrusive and shameful sexual fantasies. David discusses his treatment strategies for a young man from Argentina who was struggling with forbidden fantasies of Jesus having sex with the Virgin Mary in all positions of the Kama Sutra, but the harder he tried to control them, the more intense and tantalizing they became. Being a good Catholic lad, he was terrified and tearful he would burn in hell if he didn’t overcome this problem.

If you’ve ever struggled with shameful sexual fantasies, you might be intrigued by this fascinating discussion of Cognitive Flooding, therapeutic resistance, and the Hidden Emotion Technique!

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.