Avsnitt
-
Ask David: Getting Off Benzos How Does Music Stir Our Emotions? Combatting Negative Thoughts about the World Treating Schizophrenia with TEAM The Four Feared Fantasy Techniques and more!
Questions for today:
Mamunur asks: What’s the best way to withdraw from benzodiazepines? Gray asks: How does music evoke such powerful emotional reactions? Josh thanks David for techniques that have helped in his personal and professional life. Harold asks: How do you respond to negative thoughts about the world, as opposed to self-criticisms? For example, “The world is filled with so little joy and so much suffering.” Moritz asks: How do you help people with bipolar, schizophrenia, etc.? John expresses gratitude for our answer to his question on Positive Reframing, which triggered an “ah ha moment.” Rhonda asks: What are the four Feared Fantasy Techniques?The answers below were written prior to the podcast. Listen to the podcast for the dialogue among Rhonda, Matt, and David, as much more emerges from the discussions!
Mamunur asks: What’s the best way to withdraw from benzodiazepines?Ask David, Bangladesh question
Dear Sir,
I am writing to you from Bangladesh. Your book Feeling Good is a phenomenal work, and it has greatly helped in promoting the development of a healthy mind through logic and reason.
Sir, I have a question regarding benzodiazepine withdrawal, which is often prescribed for mental health disorders. Is there a specific CBT (Cognitive Behavioral Therapy) approach that can help in withdrawing from benzodiazepines? Your guidance on this would be invaluable, as many people have been taking it for years, either knowingly or unknowingly, without being fully aware of its severe withdrawal effects.
Thank you, sir, for your kind contributions to humanity.
Sincerely,
Mamunur Rahman
Senior LecturerDavid’s reply
Dear Mamunur,
Thank you for your important question! I am so glad you like my book, Feeling Good, and appreciate your kind comments!
As a general rule, slow taper off of benzodiazepines is recommended. This might involve slowly decreasing the dose over a period of several weeks.
When I was younger I used to take 0.25 mg of Xanax for sleep, because it was initially promoted as being non-addictive, which was wrong. It is highly addictive. The dose I used was the smallest dose.
When I realized that I was “hooked,” I tapered off of it over about a week, and simply put up with the side effects of withdrawal, primarily an increase of anxiety and difficulty sleeping. These disappeared after several weeks.
Abrupt withdrawal from high doses of any benzodiazepine can trigger seizures, as I’m sure you know. That is the biggest danger, perhaps.
I do recall a published study from years ago conducted at Harvard, I believe at McClean Hospital. The divided two groups of people hooked on Xanax into two groups. Both groups were switched to Klonopin which has a longer “half-life” in the blood and is supposedly a bit easier to withdraw from than Xanax, which goes out of the blood rapidly, causing more sudden and intense withdrawal effects.
After this initial phase, both groups continued with slowly tapering off the Klonopin under the guidance of medical experts. However, one of the groups also attended weekly cognitive therapy groups, learning about how to combat the distorted thoughts that trigger negative feelings like anxiety and depression.
My memory of the study is that the group receiving cognitive therapy plus drug management did much better. As I recall, 80% of them were able to withdraw successfully. However, the group receiving drug management alone did poorly, with only about 20% achieving withdrawal.
My memory of the details may be somewhat faulty, but the main conclusion was clear that the support of the group cognitive therapy greatly enhanced the success of withdrawal from benzodiazepines.
I decided early in my career not to prescribe benzodiazepines like Ativan, Valium, Librium, Xanax, and Klonopin for depression or anxiety, because the drug-free methods I and others have developed are very powerful, and the use of benzos can actually make the outcomes worse.
Years back, a research colleague from Canada, Henny Westra, PhD, reviewed the world literature on treatment of anxiety with CBT plus benzos and concluded that the benzos did not enhance outcomes. Here is the link: https://pubmed.ncbi.nlm.nih.gov/12214810/.
I hope this information is useful and I will include this in a future Feeling Good Podcast.
Gray asks: How does music evoke such powerful emotional reactions?Subject: Re: Podcast question: love songs
Hi David,
That's a really tough question. Music has a unique way of cutting straight to emotions for me, and it makes it especially hard to identify the thoughts behind them. My best way of explaining is with these two thoughts, which have to be viewed as a pair to get that emotional reaction:
My life would be perfect if I had that I'm so far away from thatThese thoughts don't resonate quite right for me, but it's something like that, going from imagining bliss to crashing to hopelessness within the space of a moment.
Thank you so much for your response.
Gray
David’s reply
You’re right. Music can be so beautiful, especially of course, the songs we love, that it is magical and emotional to listen to! It seems more like a sensory experience, than something mediated by thoughts, but we certainly have perceptions of beauty, etc.
Similar with some incredibly delicious food. Creates incredible delight and satisfaction, and no words are necessary other than “delicious!”
Sorry I can’t give you a better answer to your outstanding question!
Best, david
Josh thanks David for techniques that have helped in his personal and professional life.Dear Dr. Burns,
I am sure you are swamped with substantive emails and fan mail, but I just wanted to express appreciation to you for all I have gained from your publicly available content. I have learned so much that I have applied in my personal life. I have also benefited tremendously in my work with clients.
So much of what you say about anxiety, and especially the hidden emotion technique, has allowed clients to have in almost every session an aha moment. I have not yet been able to see a complete removal of symptoms in one session yet, but as a therapist, I too have many skills yet to improve and much work to do.
So, in short, thank you so much for making your experience and wisdom available for free, and thank you for doing it in such an engaging manner.
Sincerely,
Josh Farkas
David’s Reply
Thanks, Josh. You are welcome to join our weekly virtual free training group I offer as part of my volunteer work for Stanford, if interested.
For more complete change within sessions, a double session (two hours) in my experience is vastly more effective. Is it okay to read your kind note on a podcast?
Warmly, david
Harold asks: How do you respond to negative thoughts about the world, as opposed to self-criticisms? For example, “The world is filled with so little joy and so much suffering.”Dear Dr. Burns,
First of all, I would like to thank you for all your work and your outreach. Your books have profoundly influenced my thinking and value system. I really admire how you exemplify both scientific rigor and human warmth. Finally, I want to thank you for promoting the idea of “Rejection Practice! I haven't had a breakthrough yet, but some unexpected, very encouraging experiences.
I first came across Feeling Good 12 years ago when I developed moderate depression in the context of living with my ex-partner, who probably had borderline personality disorder. I tried the techniques in Feeling Good and also psychotherapy, but unfortunately without much success. I only started feeling a lot better when I began to rebuild my social life and leisure time activities (ballroom dancing, getting involved with a church, ...). Several months later, I also broke up with my ex-girlfriend. Since then, I've had ongoing mild depression.
I recently tried the techniques in Feeling Great but wanted to ask you for your opinion on a couple of negative thoughts I'm particularly stuck with. My issue is that I'm normally not attacking myself, but life in general. I keep on telling myself things like "Life is just one crisis after the other," "Life is for the lucky ones," "Really good things just don't want to happen," "Life is so much suffering and so little joy," and the depression itself makes these statements all the more convincing. (Triggering events can be rainy holidays, romantic rejections, grant interview rejections, etc.)
I think it could be helpful if in a podcast you could give more examples on resolving negative thoughts attacking life / the world rather than oneself. I also have many more questions for podcasts if you are interested.
Thank you for reading this, and thank you so much again for all your work!
With very best wishes,
Harold
David’s Reply
Happy to address this on an Ask David, and it would help if you could let me know what negative feelings you have, and how strong they are. I will be answer in a general way, and not engaging you in therapy, which cannot be done in this context. Is that okay?
I’m attaching a Daily Mood Log to help organize your thoughts and feelings. Send it back if you can with the Event, Negative Feelings and % Now columns filled out (0-100), and Negative thoughts and belief in each (0-100).
You can also fill in the distortion column using abbreviations, like AON for All-or-Nothing, SH for Should Statement or Hidden Should, MF for Mental filtering, DP for Discounting the Positives, and so forth.
Thanks!
If you were in a session with me, or if we were just friends talking, I would reply to your complaints with the Disarming Technique, Thought and Feeling Empathy, “I Feel” Statements, Stroking, and Inquiry, like this:
Harold: “Life is so much suffering and so little joy."
David: “I’m sad to hear you say that, but you’re right. There’s an enormous amount of suffering in the world, like the horrible wars in Ukraine and in the Mid-East. (I feel; Disarming Technique) It makes sense that you’d be upset, and have all kinds of feelings, even anger since there’s so much cruelty, too. (Feeling Empathy)
And even people who appear positive and joyful often have inner sadness and loneliness that they are hiding. (Disarming Technique) Your comment tells me a great deal about your core values on honesty and compassion for others. (Stroking) Can you tell me more about the suffering that you’ve seen that has saddened you the most, and how you feel inside? (Inquiry)
But I’m mainly interested in you right now. Can you tell me more about YOUR suffering, and especially if there’s some problem you might want some help with? (Inquiry; Changing the Focus)
I would continue this strategy until you gave me an A on Empathy, and then I would go on to the A of TEAM (Assessing Resistance), and ask what kind of help, if any, you’d be look for in today’s session. I might also use a paradox, like the Acid Test.
If you wanted to reduce some of your negative feelings, I might try a variety of techniques, such as “How Many Minutes?”
I’d also think about the Hidden Emotion Technique. Is there some problem in your life right now that you’re not dealing with, so you instead obsess about the problems in the world to distract yourself?
I would continue this strategy until you gave me an A on Empathy, and then I would go on to the A of TEAM (Assessing Resistance), and ask what kind of help, if any, you’d be look for in today’s session. I might also use a paradox, like the Acid Test.
If you wanted to reduce some of your negative feelings, I might try a variety of techniques, such as “How Many Minutes?”
I’d also think about the Hidden Emotion Technique. Is there some problem in your life right now that you’re not dealing with, so you instead obsess about the problems in the world to distract yourself? I ask this because your negative thoughts are very general, but I always focus only on specifics, specific problems and moments. What’s has been going on with your parents or in the past or present that you are distressed about? I’ve found that when I (or my patients) solve one specific problem that’s bugging me, everything seems to suddenly brighten up.
For example, you wrote : “I asked someone out I like; she surprisingly said yes. After 10 days of not hearing from her, I messaged her, . . . “ I wrote a book about dating, Intimate Connections, because I was a nurd and had a lot to learn about dating. One idea is that waiting 10 days might not be a good idea to arrange the specifics of the date, as that might make her feel uneasy. There’s a lot to learn about dating, for example.
A tool like the Pleasure Predicting Sheet can sometimes help, too. And finally, a good therapist can also often speed things up. Sometimes two heads are better than one. You seem extremely smart and willing to work hard, so there’s all kinds of room for growth, learning, and greater joy.
The Feeling Great App is NOT therapy, but the tools there might also be helpful, especially since you are willing to work hard a do a lot. That’s super important.
Can I use this email in my reply in the show notes if we discuss your excellent questions? And should I change your name to Harold?
Warmly, david
Best, david
Moritz asks: How do you help people with bipolar, schizophrenia, etc.?Hi David,
You have mentioned a few times that there are only a handful of "real" psychological disorders with known causes, as opposed to just a collection of symptoms.
Could you please tell a bit about how you would go about helping somebody with one of the "real" disorders (like Schizophrenia or Bipolar) using TEAM therapy?
Most of the episodes with personal work seem to fall into the other category (anxiety, depression, compulsive behavior), so I'd be really curious about some examples.
Best regards,
Moritz Lenz
David’s Reply
Hi Moritz, Thanks! Good question, and happy to address this on an Ask David. Here's the answer in a nutshell. When working with someone with schizophrenia, the goal is to help them develop greater happiness and interpersonal functioning, exactly the same as with anyone else, using TEAM. The goal is not to cure schizophrenia, because we still do not know the cause and there is no cure. But we can help individuals with schizophrenia with problems that they are having.
Bipolar: in the manic phase, usually strong meds are indicated, and often at least one hospitalization. For the rest of their lives, including depression, TEAM works great.
Can add more in the podcast.
Best, david
John expresses gratitude for answer his question on Positive Reframing, which triggered an “ah ha moment.”Hi David and Rhonda!
I have listened to Episode 415 and your response to my positive reframing question!
I had a bit of a aha moment! I think I had been approaching it in the cheerleading sense and trying to encourage myself with these positive qualities rather than attaching the positives to the negative thoughts and feelings themselves!
This has created a much stronger emotional response during the positive reframing section! The building up of the negative thoughts and feelings is a gamechanger! Thanks so much for the time and attention given to it during the podcast.
Thanks so much again, I appreciate you folks way more than you could know!
John
David’s Reply
Thanks, Rhonda and John. Yes, you’ve pointed out a huge error many people make when trying to grasp positive reframing. If it is okay, we can include your comment in a future podcast.
Warmly, david
Rhonda asks about the four Feared Fantasy Techniques:David’s Reply
Here are the four Feared Fantasy Techniques
Approval Addiction / Perceived Perfectionism: “I judge you.” Achievement Addiction: “High School Reunion.” Love Addiction: Rejection Feared Fantasy Submissiveness: No PracticeThere are quite a number of additional role plays, too, as you know. Maybe a question about all the role plays, bc we all have:
Self-Critical Thoughts:
Paradoxical and Straightforward Double Standard Externalization of VoicesUncovering Techniques
Man from MarsTempting Thoughts
Devil’s Advocate Technique Tic-Tok TechniqueResistance
Externalization of Resistance How Many Minutes?Five Secrets / Relationship Conflict
Intimacy Exercise One Minute-DrillI’ll bet you can think of more, too! This is one of the unique features of TEAM, but for whatever reason it seems like few therapists use them. As you know, on average they tend to be way more potent and emotional, and of course fast impact.
Warmly, david
-
Meet Tahn Palmetto Theravada Buddhism--the Thai Forest Tradition
Our dear colleague, Jason Meno, generously invited five high-profile Buddhist monks / teachers, to appear on our Feeling Good Podcast, hoping we could feature one every week during our "Enlightenment Month." He included his dear friend and ordained Buddhist monk, Tahn Palmetto. Happily, Tahn accepted Jason’s invitation, and we are thrilled to chat with him today about his feelings of depression as a young man in the army to his search for happiness and peace through meditation.
Tahn began his journey when we was young, 20 or 21 years old. After he enlisted in the army, he was lying on the floor, staring at the ceiling and realized he was depressed. He also realized that he didn’t actually want to go to war, and saw that the best of good intentions often lead to pretty terrible outcomes.
Jason and David described the basis of cognitive therapy, confirmed in Jason’s recent research on meditation, that the degree of upset from any negative thought depends on how strongly you believe it to be true. Tahn said he also realized that his negative feelings did not depend so much on what he was doing, but how much he believed his thoughts.
He got out of the army and searched for spiritual teachers, and eventually settled on Theravada Buddhism, also known as the Thai Forest Tradition. He said, “I found that you can have a lifestyle that triggers feelings of unhappiness, and committed my life to achieving happiness and peace.”
He said that some people who come to the monastery discover that they don’t want to commit themselves to the monastic life, and some commit to it but do it poorly. He said that your commitment will depend on how strongly you want to feel happy and enlightened. Believing that this is possible requires a paradigm switch.
It is possible to have a mind that is clear, but even on a clear day, there will be clouds. The clouds, however, are only temporary.
Our suffering comes and goes. If you twist your knee, it may hurt for life. But if you have a cold, you can recover completely. Even in a monastery, people have their squabbles. Within the Buddhist practice, Than explained that it is important to try to identify the disease and only then prescribe the effective treatment.
Jason mentioned that some people come to the monastery but leave feeling hopeless. Others stay and are successful. Tahn explained that in Asia it is common for someone to enter the monastic life for a brief period, for example when they are experiencing grief. He said that if you grieve over the loss of a loved one, time alone will heal your grief, and once the suffering is relieved, they leave the monastic life.
Rhonda asked if mindfulness meditation could be harmful to some people.
Tahn explained that mindfulness does not cause negative feelings, but often reveals the presence of negative feelings. If you have a condition that prevents you from experiencing enlightenment, the condition is getting in the way. Sometimes the practice will give you the stability and the peace of mind to deal with it.
If you come to the practice of mindfulness or the study of Buddhism for the wrong reasons, you might stay for the right reasons. If it does not work or help, you can always seek some other type of treatment.
Tahn explained that mindfulness or Buddhism addresses unhappiness caused by mental or physical pain, and that people are often surprised by how it helps them. He believes that mindfulness meditation is “the thing” that treats someone’s stress. It treats the “dukka,” which is a fundamental Buddhist teaching that refers to (according to the internet) the “suffering” or “unhappiness” of life. It is one of the first “noble truths” of Buddhism; namely, that suffering cannot be avoided.
Apparently dukka comes in three flavors:
Physical and emotional pain and discomfort Suffering from the inability to accept change The profound dissatisfaction of existence.Tahn said that you develop greater resources when you meditate. Then you may have extra resources to help others:
You learn to deal with everybody’s stuff. You learn to be aware of your body. This is your perspective for everything you do. It makes me happy to think about my eyeballs. When I meditate on this, it becomes funny, and I laugh.
Tahn suggested that when you meditate, you learn to be aware of your body, because that is the center point of your world. This is your perspective on everything that is going on in the world. When you become aware of your body and what it is doing, you know the context of everything in your life.
What does his day look like? Tahn said:
I answer emails, I troubleshoot problems. Lately we’ve had a problem with scorpions. But we don’t try to kill them.
Tahn talked about how Buddhism defines Truth as reality, and that the definition of happiness is “non-suffering.”
There are three patterns that lead to unhappiness:
Attachment, which he defined as greed and desire, especially when you seek some external object(s). An extreme example would be disregarding the needs of others or even endangering others to get the object of your desires, or an attitude of only wanting or caring for things that you like or want. Aversion which refers to feelings of aggression, anger, and hatred. Aversion’s opposite is loving kindness. When we experience Aversion, we push away (usually aggressively) the things that we dislike. If we allow our ignorance to take over, we can conjure up hatred for the things that we dislike and the people we see as blocking our desires. We saw from the meditation experiment that Jason described last week, how meditating on loving kindness brought about a reduction in people’s negative thoughts. Ignorance refers to delusion, confusion and dullness. Ignorance defuses understanding serving to confuse you and prevent you from doing something functional. This can be experienced as an inability to see the truth or reality of ourselves or the world around us. Asking questions like “Am I real” is the basis of the first two in this list.Tahn also discussed how the mind precedes the thoughts.
Then we talked about the concept of the Self, in that we think that we exist. However, there is no stable “I.” All we find are temporary phenomena. For example, you don’t need to have a “self” to drive to a picnic. All you need is a car and a tank of gas.
The group discussed the Buddhist concept of “laughing enlightenment.”
Thank you for listening today!
Tahn, Jason, Rhonda, and David
-
Saknas det avsnitt?
-
The Mindfulness Mystery Tour! And Two Mind-Boggling Discoveries about Meditation! Featuring Jason Meno
Today, Jason Meno, our beloved AI guy on the Feeling Great App team, shares some incredible and innovative research he recently did on the effect of meditation on how we think and feel. As you know, basic research is a high priority of our app team, and our major focus is to make basic discoveries in how people change, and especially on what triggers rapid and dramatic change. We use that information to develop and refine the app on an ongoing basis, and also to contribute to basic science.
Jason recently created a “New Cool Tools Club” which has 160 members who Jason can notify whenever he has a cool new app tool that he wants to test. If you are interested in joining, you can find his contact information at the end of the show notes. There is no charge if you’d like to join this group!
Jason had a strong background in Buddhism and has been working with our company for several years, focusing in the last year on the AI chat bot portion of the Feeling Great App. He has meditated for many years, and uses TEAM-CBT as well to deal with his personal moments of stress and unhappiness, something that most if not all of us experience at times!
Introduction
Jason was interested in evaluating the short-term impact of meditating, and did a literature review but found that most or all of the published studies had a focus on the effects of daily meditation over longer periods of time, like two months for example.
He was also interested in how long and how often people should meditate, and what types of meditations, if any, were the most effective.
So, he decided to test a one-hour meditation experience consisting of five ten-minute recorded meditations, including
A body scan meditation, systematically relaxing various parts of your body, beginning with your feet and toes. A breathing and counting meditation, where you focus on your breathing and count the breaths going in and out. A loving kindness meditation, starting with sending feelings of love, happiness, and health first to someone you love, then to yourself, then to someone you aren’t especially close to, or don’t particularly like, and on and on until you are projecting love and kindness to the entire universe. A mindfulness exercise where you notice if you are thinking, hearing, watching, remembering, and so forth as various thoughts pass through your mind. A “Do Nothing” meditation where you are instructed to simply “do nothing” for ten minutes.Because previous research on meditation did not use scales that assessed specific kinds of negative feelings in the here-and-now, he decided to use the highly accurate 7-item negative feelings sliders as well as the 7-item positive feelings sliders prior to the start of the medicine, after each meditation, and at the end of the app.
He also asked many questions about motivation and expectations prior to the start of the meditation experiences, all answered from 0 (not at all) to 100 (completely), including
How familiar are you with David’s work? How familiar are you with meditation? How strongly do you believe that meditation will make you feel better? How strongly do you believe that meditation will be rewarding? How strongly do you believe that meditation will only have a small effect? How strongly do you believe that meditation will be a waste of time? How strongly do you believe that meditation will make you feel worse? How strongly do you believe that it will be painful or difficult?You can find these data at this link.
He also asked every participant to generate an upsetting negative thought, like “I’m a loser,” and use 0 to 1000 sliders to indicate how strongly they believed that thought, and how upsetting it was.
60 individuals started the experiment, and 35 completed it, with 25 dropping out prematurely before they completed some of the meditations.
He presented the data as a two-group analysis, those who completed and those who failed to complete the hour of meditation. Here, are just a few of the preliminary findings, and more refined analyses are planned so we can look at causal effects.
Both groups were moderately to very familiar with David’s work and with meditation. The completers had higher scores on the questions about positive expectations than the dropouts, although the differences were not great. The dropouts had substantially higher scores on four questions about negative expectations for the experience, like “it will be a waste of time” or “it will be painful or difficult.” The initial scores on the belief in the negative thought were similar in the two groups (76% and 74%, respectively), but the Upsettingness of the thought was a bit higher in the completers (83% and 79%. The mean of the initial scores on the 7 negative feelings sliders was significantly higher in the dropouts (37% and 46%, respectively), while the initial scores on the 7 positive feelings sliders was somewhat lower in the dropouts (49% and 45%, respectively). Both groups expected a modest reduction in negative feelings and a modest boost in positive feelings during the hour of meditation.Results on the 35 completers
After the first ten-minute meditation, there were significant reductions in the negative feeling sliders (from 37% before to 25% after) and increases in the positive feeling sliders (from 45% before to 55% after). There did not appear to be any additional improvements in negative or positive feelings in the subsequent four meditations. There was a significant reduction in the belief in the negative thought after the first meditation, and the reduction continued throughout the next four meditations. (76% to 54%), for a reduction of 29%. There was a significant reduction in the upsetness caused by the negative thought after the first meditation, and the reduction continued throughout the next four meditations (79% to 47%) for a reduction of 40.5%.You can find the remarkable results if you click here!
There are many fascinating results, but one of the most amazing--which we've replicated almost exactly in independent beta tests--is the remarkable similarity between the changes in negative and positive feelings the participants predicted, and the actual results. They are so close it looks like somebody faked the data, but that's not the case at all.
We will have to do more analyses to figure out what this means, but in simple terms, this seems to be iron clad proof that our expectations of the mood changing results of any intervention can be tremendously powerful. In fact, you could argue--and it would need further statistical analyses to test--that the causal impact of the expectations eclipsed the causal impact of the actual intervention, which in this case was meditation.
One of the cool things about quantitative research is that it nearly always shoots down our favorite hypotheses, and also gives us new and totally unexpected gifts to stimulate our thinking! In this instance, there were at least two mind-boggling and toally unexpected results:
When people mediate, the improvement in negative feelings is accompanied by parallel reductions in participants belief in their negative thoughts. Participants predictions of the changes in seven negative and seven positive feelings by the end of the hour of meditation were spot on, and seemed almost impossibly accurate!Discussion
The findings are exciting and specific, and suggest that the reduction in negative feelings during meditation may be, and is, mediated by the reduction in the users’ belief in their negative thoughts. We will attempt to look into this more deeply using non-recursive analytic methods with SEM (structural equation modeling).
All samples are biased, and it can sometimes be extremely helpful to understand the bias in your sample when interpreting the results. The sample in this case included users favorably disposed to meditation, and responding to an email inviting them to participate in a meditation experiment. Only those who persisted the full hour were analyzed in the final outcome data, which could be another source of bias in the data. How much improvement would we have documented if we were analyzing completers (45) AND dropouts (35)?
Actually, this type of analysis is possible using Direct FIML (Full-Information Maximum Likelihood) with SEM techniques. I will, in fact, do these analyses as soon as I get the data set from Jason. This will allow me to estimate the scores at the end for all participants, including those who dropped out. It seems mathematically impossible, but it actually can be done.
If those who dropped out are systematically different from those who continued, it will “know” and correct for this. For example, if those who dropped out were, on average, doing more poorly, then the estimates based on those who persisted will be biased, and the degree of bias could potentially be infinite. The SEM analyses will also tell us if there are no significant differences in those who persisted and those who dropped out.
Finally, the data LOOKS like the meditation “caused” some fairly significant improvements, although the results were in some ways puzzling. Using SEM, I should be able to determine whether, and to what degree, the improvement was simply a “placebo” effect resulting from the participants expectations of improvement, as opposed to an actual result of the meditation.
So, stay tuned for updates on this amazing and deeply appreciated research initiative by our beloved Jason Meno!
Thanks for listening today.
Rhonda, Jason, and David
-
Ask David How Can I Change an SDB (Self-Defeating Belief)? How Can I Cope with Intense Public Speaking Anxiety? Featuring Rhonda Barovsky, Psy.D., Matthew May, MD, Jason Meno and David Burns, MD (Jason is an AI Scientist on our Feeling Great App Team) Anonymous asks: How can I change an SDB (Self-Defeating Belief)? Hiranmay asks: How can I deal with my intense anxiety before public speaking. Answers to Your Questions
Note: These answers below were written BEFORE the podcast, and the live discussion always adds new and different angles.
Today, Jason Meno, our beloved AI guy on our app team, also chimes in on the many super questions submitted by Andrew (#3 - #10.)
1. Anonymous asks: How can I change an SDB?
Dear Dr. Burns,
I’m an avid listener of the Feeling Good podcast and for the past few weeks, an avid user of the Feeling Great app. Thank you for your incredible work and dedication to making people everywhere feel better about themselves.
I have a question about self-defeating beliefs that I’m hoping you can address, either on the show or on your website. You have mentioned on several occasions that SDBs are the root cause of negative thoughts and consequently of negative feelings.
Yet, to me it doesn’t feel like SDBs are really addressed enough on the podcast. There seem to only be a handful of episodes covering the topic. It also seems there is a very limited toolbox of methods to use on SDBs, almost like dealing with them is considered an afterthought. If SDBs really are the cause of it all, shouldn’t the primary focus be on defeating them first and only then, on defeating negative thoughts?
I’m just a little bit lost when it comes to defeating SDBs, which seem to be way harder to deal with than negative thoughts. Any insights or thoughts on the subject will be greatly appreciated.
Sincerely,
Anonymous
David’s reply
Dear Anonymous,
Will start a new Ask David with your excellent question. Thanks,
david
First, you can look up Self-Defeating Beliefs in the search function on my website, and you'll find many great examples. Here's what I got just from "Self-Defeating Belief." You could also search for a specific type, like Perfectionism, Perceived Perfectionism, Achievement Addiction, Love Addiction, Approval Addiction, Submissiveness, etc.
In general, there are two approaches to any SDB. Four approaches can be used in this order:
Do a Cost-Benefit Analysis of the SDB. If Disadvantages outweigh Advantages, use Semantic Technique to modify the SDB. Do an experiment to see if the SDB is actually valid. Use the Feared Fantasy Technique to put the lie to the SDB at the gut level.Here's our latest thinking, which is a step beyond the four steps above. Do a Daily Mood Log on one specific moment when you were struggling with your SDB. We will discuss these ideas in greater depth on the show, of course!
You can also find a great deal on SDBs in my books, like Feeling Good, the Feeling Good Handbook, and more. But right now, I don't even know what SDB you might want help with / more information about.
Also, in the Feeling Great App, there's a terrific class called "Your PhD in Shoulds." It includes a lesson on perfectionism.
2. Hiranmay asks: How can I deal with my intense anxiety before public speaking without working on the negative thoughts I have afterwards, like
“I am going to mess this up” “People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool.“ “This talk is important, it must go well!Here’s his email:
Dear Dr. Burns,
I love your books and the feeling good podcast. They have made such a huge difference in my life (in a good way of course).
I have an “ask David” question on acute anxiety:
If I have to play a badminton match or give a presentation, I usually get some or a lot of anxiety the day before the big event as well as the morning of. I then use all the methods you have taught, and the anxiety reduces. However, it usually comes back with a bang just before I give the talk or play a match. Cognitive techniques are not very helpful to me 30 minutes or 5 minutes before the presentation or match. I don’t have the time to sit down and write my thoughts or cannot focus at all on my thoughts. Are there any strategies to reduce this form of acute “relapse” or nerves.
Here are some more details:
Event: 30 minutes before my presentation. I just entered the seminar room, and the first speaker is about to start their talk. I am next. I can feel my heart starting to pound and I am getting the familiar sense of anxiety and nerves.
Thoughts: “I am going to mess this up”. “People are going to notice something obviously wrong in my presentation that I missed, and I will look like a fool“. “This talk is important, it must go well”.
Although to be honest, this is my analysis of what my thoughts were after the fact. 5-15 minutes before the presentation, I usually just notice my thoughts racing.
To reiterate: I am not looking for help with working on these thoughts after the presentation. Any strategies to acutely deal with anxiety or rather relapse of anxiety when I don’t have time to use all the wonderful TEAM tools would be very helpful.
Thanks so much.
Best,
Hiranmay (pronounced he-run-may) living in Basel, Switzerland.
David’s Reply
Sure, as a starting point I’d like to see your work with these thoughts on a Daily Mood Log. Do you have one that you could send me, with the percents filled in, etc.
That will allow me to see what your strategies are on challenging these thoughts, and whether you can knock them out of the park, or only challenge them “somewhat.”
Best, david
You can see Hiranmay's excellent DML if you check here.David Continues
Hi Hiranmay,
It sounds like are not interested in help with the thoughts you recorded in your email below, since this, by definition, is “after the presentation.” If you like, you could perhaps “make up” some thoughts you might be having BEFORE you start to speak.
As someone who has had, and recovered from crippling public speaking anxiety, I have tons of powerful techniques, but would need some help from you so I’ll have something to go on.
By the way, I absolutely DO NOT BELIEVE you when you say those are not the thoughts you are having in the minutes before you begin to speak! So, your requirement that we are not allowed to work on them is a bit of a hindrance.
As an aside, I will include this in an Ask David podcast, if that is okay!
Sincerely, david
I asked H to send me a copy of his Daily Mood Log, which was really well done, and responded with a few suggestions.
Then I sent this note:
David’s Subsequent Response
One thing I noticed on your Daily Mood Log is your fear of making a mistake, or having a critical question from someone in the group, or not being able to impress your audience sufficiently. These fears are common in public speaking anxiety. We've all struggled with them at one time or another, I think!
I have changed my focus from needing to impress the audience with myself or my talk, and instead I try to remember to try to impress them with themselves, and how awesome they are.
Here's an example. I once gave a presentation on the serotonin theory of depression for about 1,000 psychiatrists at a prominent medical school in Texas. It was going well and suddenly a man at the rear stood up and started shouting something like this:
“I’m so sick of all you establishment researchers thinking you know so much and ignoring my work. I have discovered the cause and cure for depression in my laboratory. (He claimed it was some kind of vitamin deficiency.) But everyone is ignoring my work (and more ranting and raving.)
There was a chilled silence in the room. Here’s how I responded:
“I appreciate was you’re saying, and I agree. I think our current focus on deficiencies in brain serotonin is extremely misguided, and predict, as you say, that research will show that the chemical imbalance theory of depression is not valid. And often, the most important breakthroughs come from laboratories like yours, where someone who is unknown discovers the actual cause of an illness after being ignored for years and years. I’d be honored if you’d approach me at the end of my talk so I can learn more about your pioneering research!”
Notice I did not defend myself, but tried to make HIM feel good.
At the end of my talk, about 20 or more people came crowding up to the podium with questions and such. I saw him at the back of the group, pushing his way to the front. I braced for another attack. He said,
“Dr. Burns, that was the best presentation I’ve ever heard by far on the serotonin theory of depression. If you would give me permission, I would love to show your slides to my students and colleagues!”
I have very little fear of being attacked by people in the audience, and I now speak all the time in front of groups. I used to have paralyzing public speaking anxiety. But the monsters I feared were all in my brain!
Warmly, david
Andrew asks 8 cool questions! (#3 - #10) which are listed below, along with my answers. Jason Meno also sent some awesome answers, which you'll find below as well, right after my answers to the 8 questions.
-
418 The Fear of Driving Featuring Werner Spitzfaden, LCSW and Rhonda Barovsky, PsyD
Today, we feature Werner Spitzfaden, LCSW, a Level 3 certified TEAM-CBT therapist who recently treated Rhonda, who's driving phobia returned during the pandemic because she did very little driving at that time. After you overcome any fear or phobia, it has a way of returning if you don’t continue confronting your fear. Werner describes his skillful and compassionate work with Rhonda!
Werner is a dear colleague and friend with over 35 plus years of clinical experience treating phobias, such as the fear of flying, claustrophobia (the fear of being trapped in small places), and driving (especially over bridges and overpasses). He also treats depression, panic and other forms of anxiety, and works in corporate environments to improve communication and teamwork.
Let's dive right in, Please take a look at Rhonda’s completed Daily Mood Log,
As you can see, the upsetting event was thinking about driving over an overpass, and she rated her initial anxiety cluster at 100%, indicating extreme anxiety. She was also 90% ashamed, and 80% Inferior, worthless, inadequate, defective, and incompetent. She was also feeling 99% embarrassed, foolish, humiliated, and self-conscious, and 85% hopeless, despairing, frustrated, stuck, angry, annoyed, irritated, upset, and devastated. Her sadness was only modestly elevated at 25%.
There are several teaching points. First, most of Rhonda’s negative feelings were severely to extremely elevated. Second, although she is asking for help with a phobia, anxiety often goes hand-in-hand with a wide variety of negative feelings, including shame and inadequacy. This is because anxious individuals often feel like there’s something terribly and shamefully wrong with them.
Rhonda's feelings of shame are not unusual. Shame is a central feature of anxiety, whereas a loss of self-esteem is a central feature of depression. Werner added that the fear of driving often goes along with the fear of heights as well as claustrophobia.
Rhonda admitted to engaging in many “safety behaviors” which typically make anxiety temporarily better but worse in the long run. Rhonda's "safety behaviors" included going out of her way when driving to avoid scary overpasses as well as asking her husband to drive her many place. As you can see, these totally understandable “safety behaviors” relieve your anxiety in the here-and-now because they are forms of avoidance, but that’s why they makes anxiety worse in the long run. The urge to avoid of the thing(s) you fear is universal among individuals struggling with all forms of anxiety.
Werner emphasized the importance of empathy in the initial phase of treatment, and throughout the treatment, since trust and the courage to face your fears is so central in the treatment of all forms of anxiety and, of course, depression as well.
Rhonda invited Werner and another TEAM-CBT colleague, Lee Flowers, to stay with her in Berkeley during the recent TEAM intensive that David and Jill Levitt directed at the South SF Conference Center near the airport. She drove the group to and from the workshop to face her fears and get some motivation and support at the same time.
You can see many of her negative thoughts about driving on Rhonda’s completed Daily Mood Log, including these:
The bridge will collapse. 95% Other cars will make the bridge unstable. 100% I’ll have a heart attack. 95% I’m so dumb for not driving on this overpass. 1005 I’m an ass. 100% I can’t do this. 100% I’ll die. 100% Lee and Werner will see me at my worst. 100% I need to study the exact route before I start. 100% I’ll get into an accident. 100%As you can see, the list includes a mixture of fear-inducing thoughts as well as self-critical thoughts and shame-inducing thoughts, like "Lee and Werner will see me at my worst."
Whenever you are working with anyone with anxiety, you have to emphasize first, to create trust, warmth, and understanding. This won't cure anyone of anything, but will give your patients the courage to face their fears when you get to the M - Methods portion of your TEAM session.
After you get your A in empathy, you can move on to A = Paradoxical Agenda Setting. That where you bring Outcome and Process Resistance to conscious awareness. Then you melt them away using a variety of TEAM-CBT techniques. Outcome Resistance means that Rhonda may have mixed feelings about a “cure” for her driving phobia. In other words, although she WANTS to get rid of this fear, she may subconsciously NOT want to get rid of it.
Can you think of why? Take a moment to think about it, and make a guess. You’ll find the answer at the end of the show notes.
Process Resistance means she may WANT a cure for her driving phobia, but may not be willing to do what it takes to defeat this fear.
What will she have to do? Take a moment to think about it, and make a guess. You’ll find the answer at the end of the show notes.
Werner and Rhonda described a number of TEAM-CBT M = Methods that they used to reduce Outcome Resistance, including
The Miracle Cure Question The Magic Button Positive Reframing The Pivot Question The Magic Dial.To put this phase in a nutshell, Werner highlighted how Rhonda's intensely negative feelings helped her and revealed many positive things about her core values as a therapist and human being. This is a shame-reducing technique and you can use the Magic Dial to ask your patient what they would like to dial each negative feeling down to, without reducing them all the way to zero. You can see Ronda's goals on Rhonda’s completed Daily Mood Log in the Emotions Table
Next, Werner worked on Process Resistance, bringing the work on Paradoxical Agenda Setting to closure.
At the start of the M = Methods portion of their work, Rhonda identified the distortions in two of her thoughts (“I’m dumb,” and “I can’t do this.”). See how many distortions you can find. Wrote them down on a piece of paper and when you're done you can see the answers at the end of the show notes.
Werner pointed out that Rhonda’s anger, directed against herself, had become a springboard for agitation which intensified her anxiety.
Werner and Rhonda challenged some of her negative thoughts with Examine the Evidence, Externalization of Voices (illustrated live during the podcast),Double Standard Technique and the Paradoxical Double Standard Technique as well as a Fear Hierarchy, which you can see if you click here.
The also did Cognitive Flooding (also called Imaginal Exposure) three times, and by the third time Rhonda could only increase her negative feelings into the mild range, whereas they had started out in the extremely elevated range.
They also used breathing exercise plus getting into the here-and-now to calm herself while driving over overpasses.
All of this was background work for actually driving during the intensive, and the highlight was driving home in the dark on the third evening of the intensive. For Rhonda, this was the most fearful thing of all! She said at the start her anxiety was "greater than 100%," but she felt triumphant when she arrived home.
Werner gave her specific homework, like driving over a specific overpass four times, and also encouraged Michael, Rhonda’s husband, not to give in to her requests to do the driving on a planned trip to visit friends in Sacramento.
I am deeply grateful to Rhonda for giving us such a raw and real glimpse into her courageous and victorious win over her intense driving phobia, and a big thanks also to Werner for being such a kind and powerful TEAM-CBT therapist, teacher!, and beloved friend!
Thanks for listening today,
Rhonda, Werner, and David
Solution to puzzles above
Outcome Resistance: If she’s “cured,” she’ll have to start driving much more, and that will include driving over overpasses and bridges. This concept will freak her out now, because she’s still afraid something horrible might happen if she stops avoiding them. Process Resistance: To overcome her fears, she’ll have to face them and experience some fairly intense fear along the way. Werner can support her, and drive with her, as he did, but she will still freak out at first when driving on overpasses and bridges. The distortions in those two negative thoughts included All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Mind-Reading, Magnification and Minimization, Emotional Reasoning, Hidden Shoulds, Labeling, and Self-Blame. -
Podcast 417 Bullying Featuring Manuel Sierra, MD (pictured above)
Today, we welcome an old friend, Manuel Sierra, MD, who practices pediatric psychiatry in Idaho, and Dr. Matt May, a familiar and beloved colleague, to discuss bullying.
Below you’ll find a great list of questions Dr. Matt May submitted just prior to today’s podcast, along with some links you may wish to explore for more information. We addressed some of the questions, but certainly not all, during the podcast!
Manuel described bullying, and said the ¼ of children and adults have experienced bullying. The consequences can be severe, including suicidal urges or completed suicides, along with shame and a severe loss of self-esteem, and more. He pointed out that bullies are good at zeroing in on aspects of ourselves that we feel insecure about, including how we look, our ethnicity, our aptitudes, and more. He provided links to resources on bullying.
The bully picks on someone who is weak, so there is a power imbalance, and does the bullying to gain popularity and power, at the expense of the victim. David and Manuel emphasized that the bullying per se cannot cause the depression, shame, and so forth, but rather the victim must buy into the bully’s mean-spirited statements, like “you’re weak,” or “you have an ugly zit on your nose,” “your mother is a dirty whore,” and more.
Then, the inner dialogue of the victim often goes like this:
I must be a terrible and horrible person to get bullied like this. I’m worthless. All the kids are looking down on me. Everybody hates me! Everyone is laughing at me. I’m just a loser.And that, of course, is the voice of the “inner bully” who does all the emotional damage. Manuel and David both emphasized that the goal of treatment is to help the victim see that the “badness” is not with them, but rather with the kid (or adult) who’s doing the bullying.
Because the victims nearly always feel ashamed, they will often suffer in silence, keeping the bullying a secret. David described what he calls the “abuse contract” that many, and perhaps most, humans buy into when being hurt or exploited. It’s really a contract between the abuser and the abused, and there are there parts to the agreement.
I get to hurt you for my own pleasure. This might include sexual, physical, financial, or psychological torture or abuse. You, the victim are entirely to blame for this. You are the bad one. I am superior and totally innocent. You deserve what’s happening to you. We have to keep this a secret, even from ourselves. You cannot even hint that I am doing something wrong. If you try that, I will REALLY hurt you.David emphasized that the tendency to “accept” this type of horrible contract is not limited to children, but includes adults as well.
He emphasized that sometimes the child who is being bullied will tell parents, who then tell the teacher or school officials, who will tell the bully to stop. This is rarely effective, and often makes the situation worse, since the bully tells the victim that they are a snitch and now they will REALLY get what they “deserve.”
Matt described many types of bullying, including physical, psychological, and cyber bullying. Manuel described some of the signs to look for if you suspect a problem with your child, including:
Not wanting to go to school. Saying things like “everyone thinks I’m terrible.” Changes in sleep, eating habits, and energy. Somatic symptoms such as stomach aches and headaches.Manuel emphasized that the goal is not to eliminate negative feelings entirely, but rather to reduce the time you spend feeling anxious, humiliated and upset after being bullied. He also emphasized that ongoing practice talking back to your own negative thoughts is an important key to change, in exactly the same way that athletes must commit to ongoing daily practice to boost their physical skills and stamina.
Manuel emphasized the importance of empathy and support, as well as asking victims if they’d want some help combatting their automatic negative thoughts and feelings. He shared that he endured considerable bullying as a kid, and was bullied because he was poor, of Mexican heritage, short, wearing glasses (“four eyes”), and young, and sometimes called “a fag” and other hurtful things.
He said that reattribution is one useful strategy, among many, for combatting automatic thoughts and negative feelings. Instead of automatically blaming yourself for the bullying, you can ask questions like this: “What is it in their life that makes them want to do things like this.?” And “They are trying to hurt and embarrass me. Why are they doing that.”
The goal is to help the victim see that the “badness” and shame really reside within the bully, and not with them. The bully is trying to tear you down. Ask yourself why? The bully thinks that this is the best way for them to gain popularity, power, and importance.
Toward the end of the podcast, I, David, again emphasized that the Outer Bully can hurt us physically, by hitting for example, but only the Inner Bully can make us suffer emotionally. And if you’ve used the Externalization of Voices to crush the inner bully, and you no longer feel intimidated or ashamed when some tries to bully you, it becomes infinitely easier to respond effectively to the Outer Bully, using the Five Secrets, including Disarming and Stroking, as well as humor.
To demonstrate this, I invited the other guests to try to bully me as an old person (I’m about to turn 82), and urged them to say the cruelest things they could think of. This is called the Feared Fantasy Technique.
I was surprised and pleased at how incredibly easy it was to get “the edge on them. “ I hope you enjoy that aspect of the podcast.
We will likely approach this topic again, with a focus on cyber bullying, and will restrict our focus to children and teens.
How to Help!
Matt once worked with a child who encountered their own 'inner bully' in the form of negative thoughts that would occur when they were unable to assemble LEGO's. The child could express certain thoughts, but was too young to write, so Matt wrote these down:
I'll never be able to do it It’s impossible I'm not good at anything There is something wrong with meMatt asked the child if they would like to learn a trick for how to feel better and the child agreed.
Matt wrote down some new thoughts for the child to choose from to describe the situation that was upsetting to them.
Multiple Choice Positive Thoughts:
I really, really want to do this! It's ok if I can't do it, yet Some things take lots and lots of practice I may be able to do it later I can do lots of things really well already I can probably get better with practice People love me and like to help Nobody's good at everything all the time Everybody messes up sometimes It might help to take a break I can always choose to like myselfThe child said they really liked #11 and felt better right away and during future 'relapses'!
Thanks,
Matt
Thanks for listening today. Below you’ll find the email Matt sent prior to the show.
Manuel, Rhonda, Matt, and David
Matt wrote:
Just to stir up trouble and make you all sweat, I'm sending a few questions we might address:
What is bullying? How are we defining this term? Is it Liberal Propaganda? How dare I say that? What's the difference between bullying and micro-aggressions / gaslighting? Am I crazy, if I think I'm being gaslighted? If I avoid bullying, in-person, including physical, emotional and verbal abuse...am I safe, on the Internet, at least? Is there such a thing as 'Safety'? Isn't that the thing we need, the most? Whose job is it, to make me feel safe? Why do some people think that safety doesn't exist? What is the significance of bullying? Does it matter or have any tangible effects on individuals or society? Link: https://www.ncbi.nlm.nih.gov/books/NBK390414/What are some common misconceptions when it comes to bullying? Here are some that Matt has seen on DML's:
It was all my fault / I deserved it / This happened because I am (insert label: bad/weak/defective, etc.) Bullying is normal, nothing can be done about it. Everyone gets bullied. It builds character. I should just get over it. I shouldn't *still* feel upset. That was a long time ago and I've done a lot of therapy. I can't speak up or talk about it, it's just too disturbing and upsetting. People would judge me and reject me, if they knew what happened to me All conflict is dangerous and must be avoided, at all costs I'm just a loser, a born victim, worthless in every way. This will always happen to me and people who believe #2 are correct I should be more accepting of bullies, they're people, too. Bullies shouldn't be bullies and should be hunted to the ends of the earth, and destroyed.What is the *cause* of bullying behaviors? Why would anyone choose to be cruel, manipulative and selfish?
What is the 'Dark Triad'? Which feature of the 'Dark Triad' is most closely associated with bullying? Link: https://en.wikipedia.org/wiki/BullyingWhat can be done about bullying?
How can TEAM therapy help someone who is being bullied? Can TEAM therapy help a bully? What can parents do, if their child is being bullied? Can TEAM help? What can parents do, if their child is bullying? Can TEAM help? What can society do?Other Questions:
What is the “Internal Bully”? How does the “Internal Bully” relate to depression? What is the greatest predictor of bullying behavior and thinking? Who's to blame, anyway, here? -
Podcast 416 Ask David is it reckless to question the existence of the "soul?"' How can I make myself accountable? Do we have a "personality," or is that just another illusion? Do questions about the "self" and "free will" involve All-or-Nothing thinking?
The answers below were prepared prior to the podcast, and simply based on email exchanges. Be sure to listen to the live podcast discussion to get a variety of opinions and comments!
Questions for today’s podcast.
#1: Weren’t your comments on the self a bit reckless, given that the existence of / or belief in the “soul” is a prerequisite for most religions?
#2: How can I make myself accountable for doing the exercises in your books?
#3. Holy asks if the concept of having “a personality” is the same as the question of having “a self?”
#4. Could questions about the “self” and “free will” involve All-or-Nothing Thinking?
Question #1. (not question, just a comment worthy of a response)
Your comments on the “self” were shallow, mocking and restless.
The recent episode on ‘Do I have a self?’ (Episode 406) was very shallow and mocking of people who thought there was a soul/self. Given a soul is a prerequisite for most religions, dismissing it out of hand without meaningful discussion seems reckless.
David’s response
Thanks, there’s a lot of truth in your comment and we’ll definitely include this on an upcoming Ask David!
To give a brief response prior to the show, I would say that I am not trying to defend or attack any religion, but don’t want to give up my right to freedom of thought. I, David, am not saying that the “soul” does not exist, but what I am saying is hard to convey, and I probably won’t be successful now, either.
But, when you talk about a “soul,” I do not have any idea what you mean by that word, or what you are referring to, if anything. To me, words like “self” or “soul” are simply language that is “out of gear,” as Wittgenstein might say. Meaning can only occur in a specific concept. It is not the case that there are “pure meanings” for abstract concepts. Thinking along those lines was the huge error that Plato and Aristotle made.
Now, let’s say I go to YouTube and listen to some really kick-ass music that I totally love. I might say, “Wow, that guy (like James Brown, for example) really has soul!”
What I’m saying is that I tremendously admire and appreciate his talent, his energy, and so forth. I am not referring to something metaphysical.
My concern about your comment is that it sounds scolding, at least to my ear, like the “morality police,” perhaps. Personally, I have seen a great deal of evil done in the name of this or that religion, and I have no doubt that you have, too!
Still, I am sure you have strong religious beliefs, which I respect, and apologize for having offended you. But I admit I am ambivalent, and partially happy that you are offended, and speaking out, because I believe that critical thinking is also tremendously precious, just as your religious beliefs are precious to you.
In a selfish way, I have to confess I am also happy for the criticism, because controversy stirs up interest, and I am trying to interest people in our podcasts, which are ultimately dedicated to healing and relief of suffering.
Still, I cannot deny the truth in your comment, that my “critical thinking” can be a disguise for a put down.
When I wrote Feeling Good, I was very aware already (in the 1970s) that the chemicals categorized as “antidepressants” had few or no clinically significant effects above and beyond their placebo effects, and subsequent research has validated this.
But I did not emphasize this in that book because I did not want to pull the rug out from anybody, and hurt anybody’s feelings. After all, if you are getting a nice “placebo effect,” that’s a good thing, at lest to some extent.
Now, I’m older, so I’m more willing to speak my mind, and let the chips fall where they may.
And you have bravely spoken your mind, too. Kudos to you!
And that’s the end of my prayer! Keep those good thoughts rolling along.
Amen
Best, david (PS I’m sure you’ll get way better answers from the others on the podcast tomorrow!)
Question #2. How can I make myself accountable for doing the exercises in your books?
Good to have Fabrice back. Regarding your books I have a question. I have trouble holding myself accountable doing the exercises in the book. Do you have any advice on how to prioritize doing the homework and being disciplined with it? How did other depressed people get better using your books? I already filled out multiple notebooks but appear to be stuck. Any help appreciated!
David’s Response
Thanks, we will address your question on a future Ask David podcast, if that's ok.
Question #3. Holy asks if the concept of having “a personality” is the same as the question of having “a self?”
@HolyLoveQuest • 1 day ago
Thank you for this video on this topic, it was very clear to me!
It's a shame that this chapter of your Feeling Great book was removed, because to me this philosophical point is one important tool (among the many techniques that you propose) to get read of negative thinking, and to heal.
What you said about the DSM is refreshing, and I agree with it. So, you said schizophrenia and bipolar1 are mental disorders, and you explained why, but what would be the third: psychopathy? It would be nice if you do another video where you dig on this. Your voice on it is really important. What the APA is doing is really concerning. Other psychiatrists disagree with this business of labelling people. And you're right, it's detrimental to human beings.
There is another psychological concept that you didn't talk about, but who looks similar to the "self", which is the "personality". What is your take on it, the same or different?
Lastly, now in the spiritual domain, is the notion of the soul the same for you than the "self"? Or, in your opinion, could it be a possibility of an essential part of us which links us all to the Spirit, to spirituality?
Looking forward to watching the other philosophical videos!
David’s Response
Will include in next Ask David Podcast!
Question 4. Could questions about the “self” and “free will” involve All-or-Nothing Thinking?
Matt send me the following email he received and asked if we could include it in our next podcast, and my answer was “of course!”
Hi,
I'd like to tell you about my experience with my son. He is 14 years old and despite our honest attempts not to label, he has always been the problem child: selfish, disobedient etc.
Recently we started him on Prozac and the changes have been incredible. Things that have been way beyond his best times are now simple, like going to sleep on time or having a good time with his brother. Every night my wife and I tell each other about some new miracle.
So, I wonder what you can say about this from the lens of free will. An obvious conclusion would be that the choices he made until now were not "free" because his brain was not presenting him with the same set of choices that other kids experience. On the other hand, if he is acting better now, we could say that it is not his choice, just a pill making the decision for him. I feel like that would be insulting and degrading.
I wonder if a lot of resistance to therapy and especially pharmacotherapy is related to anxiety about the question: "If I can be changed by a pill, then who am I?"
I had another thought after listening to the episode on "self". The position that self doesn't exist seems extreme to me, maybe like "all or nothing thinking". Maybe we could answer that question with a "magic dial". How much do we agree that there are selves and free wills? I agree that there are problems associated with having a self and free will, but I think there are practical and theoretical reasons on the other side as well.
Maybe the golden path is in the middle?
David’s Response:
Will include your excellent question in the next Ask David Podcast! I am so happy to hear the good news about your son!
At this point I will briefly say that concerns about “free will” might definitely include all-or-nothing thinking in the following sense. There is an awful lot of our thoughts, beliefs, feelings, behaviors, preferences, and so forth that is kind of hard-wired by evolution, genetics, and who knows what.
For example, I really love blueberry pie that way my mother made it, but I never cared for pumpkin pie. I cannot “will” myself to like pumpkin pie! So I don’t have free will in that sense.
Similarly, I can’t “will” myself to want to stop breathing permanently, or to stop feeling hungry when I haven’t eaten, and I can’t “will” myself to levitate when mediating or being able to high jump over something five feet high.
The list goes on and on. And even when I freely chose something, like what type of new shirt to purchase, I have no doubt by genes and innate preferences, and possibly my upbringing, will strongly influence my choices.
We all have biases, preferences, and desires that we do not choose, at least not consciously, Like sexual preferences, for example. We’re kind of stuck with what we’ve got.
Now we can make free choices, of course, but we cannot be “totally free,” because we exist and are human. A cat can’t “not” get excited by a wiggly piece of string or a mouse that’s running away.
But we CAN make conscious choices, obviously, just as I made the decision to print your excellent question and type out this brief response!
Warmly, david
-
Question #1: John asks: Can you do TEAM on your own?
Question #2: John asks: Can you provide more insights or instructions on how to do Positive Reframing on your own? It seems to be an incredibly important key to TEAM-CBT.
Question #3: Ann asks: What can I do when I blush and my face turns bright red?
Question #4: Dylan asks: Can you have a delayed reaction to the CBT exercises?
#415 September 23 Ask, New questions
Question #1: John asks: Can you do TEAM on your own?
Oh, one other point that occurred to me, the people doing personal work on your podcasts are generally TEAM CBT therapists or people familiar with the TEAM model. They are obviously very familiar with the steps and techniques in TEAM, and yet they seem to require the insight and guidance from yourself and Jill.
Why do you think that is if they are so well versed in TEAM already? Does that mean that a person from the general public doing their own work using your books without the guidance of a TEAM therapist is futile? Or would you always recommend someone using a therapist?
Kind Regards
John
David’s response
Can we include it in another podcast? Would love to just read it and jam on it with R and M.
Warmly, david
Question #2: John asks: Can you provide more insights or instructions on how to do Positive Reframing on your own? It seems to be an incredibly important key to TEAM-CBT.
On Mon, Aug 5, 2024 at 9:24 PM John Macken wrote:
Hey there David and Rhonda,
I hope you're keeping well, this is John from Ireland, we had a previous correspondence on Should statements! David, thanks very much for asking for access to the beta app, I'm really enjoying the modules! I heard you say on one of your apps that you are planning some workshops in relation to the app, will they be available online do you think? Would love to tune in if possible!
I am always grateful for your inspiring work! I love your passion for the work that you and Rhonda do and that comes across from both of you during every podcast episode. Your FG community sounds amazing! Who knows, maybe one day I'll ditch the corporate career and join the cult!
I have another question on Positive Reframing! As someone who is still trying to find my own journey to enlightenment following many months of anxiety and depression, I feel I am falling at this positive reframing step. I still find I am bumping up against resistance and I feel that my positive values and benefits don't count. It’s almost as if there is some kind of discounting the positive going on like my negative points vastly outweigh my positive points. It’s like there is such a negative filter there is no space for recognizing positive qualities.
I was listening to the beginning of Episode 310 where a listener had an excellent contribution on Positive Reframing from your live work with Nasli. That got me thinking, would it be possible to hear more insights and detail on how to perform your own Positive Reframing work? Or do you have guidelines or a worksheet anywhere? It feels like the most powerful of all the steps!
Among the many incredible tools that have been created under TEAM it seems the Agenda setting piece is probably the most powerful and innovative. I have listened to many of your Live Sessions intently and it seems that your gift and that of Jill Levitt is in convincing the patient of the beauty of their depression and anxiety. It feels that they are almost recovered or very nearly once you go through that step.
On the face of it, it looks like what you're doing is very simple but there is a nuance and complexity to it that is incredible and without sounding too grandstanding or over dramatic this "gift" seems to be where the healing power lies. If you could bottle that gift you would change the world or be a billionaire or both! It is astounding to listen to. I would love to hear more about your insights into this area and how people can unlock this for themselves.
For example, I found podcast 387 on Acceptance and Daring to be average incredibly powerful and insightful and convincing and these are pieces I'm trying to implement in my life.
Love and admire your work and would love to make it over to one of your in person workshops someday when they are available to the general public,
Warm regards
John
David's response
We will address positive reframing on the show.
Question #3: Ann asks: What can I do when I blush and my face turns bright red?
Dr. Burns,
I hope you’re both doing well. I wanted to share with you that you have changed my life dramatically. I have always thought that everyone else had a problem as far as attitudes and behaviors. But you have taught me through all three of your books and podcasts that my thoughts are why I’ve been so anxious and depressed.
I have been on medication since I was 20 years old. Now, I’m weaning off of my medication because of all of the work I’ve done with your book and a therapist trained in TEAM therapy. My relationship is much better with my husband and it was me that was pushing him away from me. Talk about enlightenment!?
I’m anxious about getting completely off of my clonazepam because it helps me “control” my face from turning red. My red face makes me so anxious and I start sweating profusely whenever I’m in a situation that’s embarrassing. Thank God, my menopause has helped me with explaining why my face is so red. This has been going on since I can remember. I think I was 5 years old in school when it first happened. Most people stare at me because my face gets really red. I’ve repeatedly tried looking at people, while my face is turning red, to see if they are truly looking at me and sometimes they are and not. The redness lasts for around two minutes but if feels like hours. What can I do? I want to get off all of my meds but my psychiatrist says to do it slowly. I haven’t listened to all of your podcasts but I don’t think there’s one out there regarding a 49 year old lady suffering from a red face. Maybe an ask David? I hope I’ve been specific enough for you. I cannot thank you enough for everything you do for people.
Thank you,
Ann Zernone
David’s response
Yes, we actually had a podcast on this exact thing, and happy to add it to the next Ask David if you like. Best, david
88 Role Play Techniques: Feared Fantasy Revisited https://feelinggood.com/2018/05/14/088-role-play-techniques-feared-fantasy-revisited/
168 The Blushing Cure https://feelinggood.com/2019/11/25/168-ask-david-the-blushing-cure-how-to-heal-a-broken-heart-treating-anorexia-and-more/
Question #4: Dylan asks: Can you have a delayed reaction to the CBT exercises?
Hi David,
I’m a big fan of your work. Quick question: do you commonly come across people who do CBT exercises and they don’t get their anxiety or depression levels reduced super low right after doing the exercises but a couple days later they experience the results?
Dylan Aames
Unfit Productions, LLC
President
@JohnnyPlissken-xs7hq • 12 hours ago
David replies
Will talks about having this same experience on the live show.
-
Feeling Down? Try the Feeling Great App for Free!
The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com!
Life Coaching: A New Dimension in CounselingToday we discuss the recent upsurge in life coaching, and feature one of the leaders in this emerging field, Angela Poch, and one of her wonderful students, Lorna Bird.
Lorna Bird
Angela Poch (see featured photo) is a Registered Professional Counsellor (RPC) with the Canadian Professional Counselling Association, certified Master Life Coach, and TEAM-CBT Level 4 Advanced Therapist and Trainer. She has been teaching health and wellness for over 30 years and was Vice President of Education with the Adventist Association of Health & Wellness Coaching. She has written several articles and books on health and wellness including, “The Truth Will Set You Free.” She has a YouTube channel (@talkingteamcbt) interviewing clinicians about their journeys with TEAM-CBT. She also has a channel on psychology and health (@bodymindhealth4u).
Lorna Bird holds a Diploma of Counseling from Australia and is a certified Life and Health Coach. She is also a Level 3 certified TEAM-CBT therapist https://www.yestohealth.com.au/
Angela and Lorna will give us the true scoop on coaching. To get started, what IS coaching, and how does it differ from psychotherapy?
I am aware that our podcast goes worldwide, so the answer may differ depending on the country or state where you live. According to AI,
“In California, the term "psychotherapist" is defined in the Civil Code to include a number of mental health professionals, including psychologists, psychiatrists, and clinical social workers. In general, anyone who provides psychotherapy or counseling in California, whether in person, by phone, or online, must be licensed.in California.”
Coaching is quite different. Again, according to AI,
“In California, there are no specific state-mandated requirements for individuals to use the term "coach" or practice life coaching, meaning anyone can technically call themselves a coach without obtaining a specific license.”
Angela Poch resides in Canada, and she has been a leading and beloved member of the TEAM-CBT community. She emphasized several differences between a “coach” and a licensed mental health professional:
Diagnosis: A coach does not diagnose clients into the familiar DSM categories of “mental disorders,” such as “Major Depressive Illness,” “Bipolar Disorder,” “Schizophrenia,” or any of the hundreds of “mental disorders” listed in the DSM. In the same vein, licensed mental health professionals will typically screen for suicidal thoughts and urges, and will treat suicidal individuals, but this is forbidden territory for coaches.
Purpose / aims of coaching: The purpose or aims of coaching do not, as a rule, involve delving into your past to search for the “cause(s)” of your problems, such as adverse childhood experiences or traumas. Instead, the focus of coaching is primarily on making changes in the here-and-now in how you think, feel, and relate to others. This might involve learning to challenge distorted negative thoughts so you will think and feel more positively about your life, as well as how to relate to others more skillfully. Coaching is goal-oriented and forward-moving rather than dwelling on the past. Of course, good counsellors and licensed mental health professionals may also provide tools to move forward as well, so there can be overlap.
Training / credentialing: Because coaching is so new, there are not yet any widely accepted standards or requirements for calling yourself a “coach.” There is a varying degree of training to be “certified,” which might just consist of watching a couple videos to 100’s of hours of supervision with the ICF (International Coaching Federation), and everything in between.
Here’s a generalized diagram Angela created to help with further clarification. NOTE: many TEAM-CBT therapists also are client/goal focused as well as and will often use coaching-style tools.
Angela described a 20-hour “Feeling Great Coach” certification program she has developed. Her program is based almost entirely on TEAM-CBT and includes a final exam you must pass to get certified.
She also offers a TEAM-CBT Masterclass & Mentoring Program for both coaches as well as therapists that includes live training twice a month, online practice groups, case consultation in small groups, one-on-one mentoring sessions, and personal work as well. She said this integrates seamlessly with FGI’s Fast Track program, any of David’s intensives, or the Tuesday group for those who want more individualized support and training.
Lorna enthusiastically described her experiences learning from many of Angela’s training programs. I (David) have had the pleasure of knowing and working with Angela for many years now, starting with her attendance at a number of my intensives and two-day TEAM-CBT training programs in Canada. Lorna is really enjoying the Masterclass Mentoring Program and recommends you take Angela’s free workshop called “Effective Compassion.” You can check it out at
www.teamcbt.ca/effectivecompassion
How do I, David, feel about coaching? I am, for the most part, enthusiastic, but with a few reservations. I would have to confess that I spent 5 years in medical school, four more years in psychiatric residency, plus two years in post-doctoral research training at top institutions, but did not learn much at all, if anything, that has really helped me treat human beings who are hurting. Of course, I did learn how to prescribe drugs for those with severe difficulties, like Bipolar I Disorder, or Paranoid Schizophrenia, but that definitely did not require years and years of intensive medically oriented training.
All I ever really wanted to do was psychotherapy. In my last year or so of post-doctoral psychiatric training, I discovered cognitive therapy, although it was not a part of the required curriculum, and learned quite a lot that has been really helpful in working with patients.
But for the most part, all of the extensive medical training I received had very little, at best, to do with how I now work with patients, and an awful lot of what I do was things I had to figure out for myself. I do have great respect for psychology training (either clinical psychology or PsyD training), because of the emphasis on research and critical thinking, but I do think there is lots of room for new approaches such as coaching to emerge and evolve, and it seems to be the case that more people than ever are still struggling with depression, anxiety, addictions, rage, and more.
Like any field, I think coaching is vulnerable to misuse by narcissistic individuals who wish to deceive or exploit the general public, and individuals who are naïve or unaware of the background or training of their therapists are perhaps at great risk of abuse. But I would also say that this problem is in no way limited to coaching, since a great many licensed mental health professionals have been charged and convicted of all manner of unethical conduct and as well as malpractice over the years as well.
That’s why I’m enthusiastic about responsible leaders who, like Angela Poch, are blazing new trails and setting the bar high for those who wish to enter the field of life coaching. I’m also delighted to see that for years now, the Feeling Good Institute (FGI, feelinggoodinsititute.com) has included coaches in their superb training programs as well, and many high profile individuals you may be familiar with, like our beloved Professor Mark Noble, have taken and benefit from TEAM-CBT certification via the FGI.
To learn more, contact Angela at [email protected] or visit https://angelapoch.com/ to learn about Angela’s many training and treatment programs.
You can reach Lorna at:[email protected] or https://www.yestohealth.com.au/
And here is the contact information for TEAM-CBT Australia: https://www.teamcbtaustralia.com.au/
-
Ask David Disturbing Intrusive Thoughts--
where do they come from? Alone and Liking It--is that Okay? Help with those darned Shoulds, and more!The following show notes were written before the show. The actual live discussions will vary somewhat from the answers you will find here, which simply included David's email exchanges with those who asked the questions. .
Rodolfo asks about disturbing and unwelcome intrusive thoughts. Brittany asks if it’s okay to enjoy / prefer being alone. John, from Ireland, asks, “Help! I’m shoulding on myself again! What can I do? Please do another podcast on Should Statements.” Rodolfo asks about disturbing and unwelcome intrusive thoughts.1. Rodolfo asks about ADHD & Intrusive Thoughts
Hello Dr. Burns, my name is Rudy. First and foremost, your writings and podcasts have been life changing for me. You’re AMAZING!
I was recently diagnosed with ADHD and I started experiencing intrusive thoughts around November of last year. I thought I had OCD, but apparently intrusive thoughts are a common companion in ADHD. What would be the best course of action in defeating them? How would I apply TEAM to them?
David’s Response
In all my books, like Feeling Great, I outline a step by step approach to writing down and challenging thoughts. You can also listen to the podcast on the four models for treating anxiety.
Can we use your great comment on a podcast, and add your question to our next Ask David podcast?
Can you send me an example of the types of intrusive thoughts you’re having? Sometimes writing them down and challenging can be helpful, but need to see what we’re talking about.
Best, david
Rodolfo responds
Thank you for the swift response! Ok, so writing down my intrusive thoughts, regardless of their nature, and challenging them. I don’t, however, know which method/route to challenge them with. I have Feeling Great, so I will read through it again. I will also check out the podcasts.
My intrusive thoughts have been disgusting violent acts involving my wife and son. ***I HAVE NO INTENTIONS OR DESIRE TO COMMIT ANY OF THEM***. I’ve had images of my wife getting shot, not necessarily by me. Sometimes I’ll see my arms give out and my son will fall. I’ve seen my wife sitting down, and she gets hit in the back of the head.
When they appear, I begin to freak out immensely because they are the complete opposite of who I am and what I want to do, which is protect them. I know I’m not doing something right when it comes to your methods because I still freak out.
David Responds
Thanks! Although disturbing, this is a very common and often easily treatable OCD type of problem. Best, david
Rodolfo responds
What a relief. I thought I was going insane here! I would be honored if you all covered it in a podcast. All I listen to in my car now is the Feeling Good podcast!
David Responds
Often, intrusive OCD thoughts reflect suppressed problems / feelings people have, especially when the person is exceptionally "nice," and used to sweeping feelings under the rug, so to speak. I cannot treat you in this medium, obviously, but I'm wondering if you have some negative feelings, like anger or frustration, toward your wife and child? When these are "squashed," they can come out indirectly, disguised as anxious thoughts and feelings. This is called the Hidden Emotion Technique, which you can look up using the search on my website, if curious, or read about it in my book, When Panic Attacks.
Best, david
2. Brittany asks if it’s okay to enjoy / prefer being alone.
Hi Dr. Burns,
I was listening to your podcast on self-acceptance, and it was really interesting hearing the results. I like how you said that just because we accept something about ourselves doesn’t mean we aren’t still working on it. I think people confuse that a lot.
One thing I’ve accepted about myself is that I really do enjoy being alone. I think in the past I would try to find a buddy in uncomfortable situations like the first day of work or orientation or going to a baby shower alone etc. but now I find that I am most comfortable when I’m not included with everyone else. However, I think it can come across as off putting to some.
Sometimes I get the feeling they see me excluding myself as rejection to them. That’s not my intention and nobody’s ever actually said that but it’s a thought that pops up.
Just wondered if you think this form of acceptance is good or bad? I mean it’s been good for me. Just maybe it’s bad for others?
-Brittany
David’s response
This is a cool question and nice comment, too, about our podcast. Can we read this on a podcast and use it for an Ask David?
Personally, I am trying to say "no" more often when asked to do things with other people, and sometimes it's hard. But if I don't say no, I get way too much on my plate and can't keep up!
Warmly, david
Brittany’s reply
That makes perfect sense to me. I’ve kind of taken the position where I don’t really want to make more friends because I feel like I’m already falling short with spending enough time with my cats and everyone else. Let alone time for myself.
David’s reply
Exactly! Our culture has this myth that's it's somehow impossible or immoral to enjoy just being with oneself!
David
3. John, from Ireland, asks, “Help! I’m shoulding on myself again! What can I do? Please do another podcast on Should Statements.”
Hi David and Rhonda!
Love the podcast and the work you folks are doing! I listen to the podcasts regularly and you are both bringing such great benefits to the world!
I would love to hear another podcast on should statements. I've been going through a pretty bad and extended period of anxiety and depression in recent months and have been really trying to challenge my thoughts without much success. I'm addicted to shoulds unfortunately and beat up on myself relentlessly.
I've tried to do a cost benefit analysis and the motivation piece is a huge part of the benefits side that is keeping me stuck. I really want to give up my should statements, they are making my life a misery. But I'm finding I don't want to let go of the motivation piece.
I have given a sample below. I'd love to know if there were further steps/techniques I could use aside from the CBA to address the benefits and the perceived motivation piece so I can fully let go of the shoulds!
Thanks so much both, John from Ireland
Negative Thought: “I should have plans on a Saturday.” 99% SHLD, ER, SB, MF, DP.
Benefits
Lets me know when I’m not performing to the standard I set for myself Shows me my passion/goal in life for doing fun exciting things Motivates me to move to make plans, scolds me until I do so. Keeps me vigilant that I’m aware of my shortcomings Reminds me of the value of being socially connected, meeting and having fun with friends. It’s easy, it’s familiar, it’s such a habit. (process resistance)Costs
Emotional Cost. Beats me up relentlessly, makes me feel depressed, anxious and lowers my self-esteem. Reinforces perfectionistic beliefs Counterproductive in terms of motivation, makes me feel so low, Huge interpersonal cost, feel isolated alone. Prevents intimate connections Not able to be present or flow in a conversation, quality of conversation/connection drops Self-fulfilling prophecy, if I’m telling myself that then I ignore other possibilities.Benefits 40 / Costs 60
David’s reply
Feeling Great is now available in the app store, and you can try it for free. It also has a class called “Your PhD in Shoulds.”
I’ll add your question to our next podcast list for an Ask David.
Since you’ve told me you can’t yet get the app in Ireland, I’ll send you the script of that lesson.
Thanks!
David
John continues the exchange
Hi David,
Thank you so much for taking the time to correspond today and thank you so much for all the work you're doing for free. The world would be a better place with more Rhonda's and Dr. Burns' in the world. One of the things that has brought me some peace in the last few weeks is going for a long walk in the evening after work listening to your podcasts!
I have attached a DML that I've been working on to give a bit more context. I made some inroads on that original should statement, however, as you can see from the DML more shoulds keep popping up. I have identified the Self Defeating Beliefs that resonate with me at the bottom of the document. I'm working hard to find healthy acceptance, I know this is key for me. I'm not entirely sure a lot of the time what exactly I should be accepting. That I'm a flawed person with many defects, just like everyone else maybe?
To give some further context and without overburdening you with too much detail:
I feel my anxieties are one of the main parts of my problem and I would love to get over these. I feel defective that I'm not resilient enough for the challenges of life. I have fears mainly around people, fear of letting people down, fear of being judged or rejected and just feeling different to others I suppose. I've struggled with recurring anxiety and some depressive periods from when I was a young child (likely biological - my dad has the same issue). I have strong feelings of defectiveness and not being up to standard compared to my peers. I have a very busy corporate finance job where I've been working very long hours over an extended number of weeks and months. I don’t' love my job, fell into it really. Could be a hidden emotion thing going on. I started working from home more and more in recent months as my workload increased and my anxiety and mood really started to dip as work took over my life. I started to get really burned out in April. A lot of why I enjoyed the job previously was having fun with my teammates but that has become impossible in recent times due to everyone's workload. I do CrossFit which is probably an extreme form of exercise and between that and work I fell into some kind of perfectionism where I couldn't really find joy out of anything, aiming for higher and higher achievements. This brought on tons of shoulds and all or nothing thinking and self-blame, I think. My dad, who had been doing well for a good few years fell into a deep depression and anxious state around April time too and has been in hospital for a number of weeks and our family is trying to support him through this. We're finding the standard of mental health care in Ireland really really poor unfortunately. I find his issues quite triggering for me a lot of the time and I'll believe I'm defective because he is defective and there is nothing I can do about it. Dad is entirely dependent on medication to get him out of his slump and has a bad case of do-nothingism. He is beating himself up relentlessly too and I gave him a copy of Feeling Good to read but he hasn't looked at it at all. I have just turned 40 and I’m still single, so I feel like I'm letting my family down for not being emotionally able for a relationship or kids or be a better brother/son. I know I'm probably being harsh here as they say the opposite, but I feel I could/should be doing more.I have probably fired way too much detail at you, so I'll stop there!
Thanks so much again!
John
Listen to this podcast for the great discussions and commentary by Rhonda, Matt, and David
-
Feeling Down? Try the Feeling Great App for Free!
The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com!
What's a Give-Get Imbalance? What's the Best Treatment for Anxiety and Dysthymia? Can you do Externalization of Voices on Your Own?The show notes for today’s podcast were largely written prior to the show. Tune in to the podcast to hear the discussion of these questions by Rhonda, Matt, and David.
And keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks!
Suzanna asks: What’s a “Give-Get” imbalance? And how can you get over it? Martin asks: What’s the best treatment for anxiety and dysthymia? Eoghan (pronounced Owen) asks: Can you do Externalization of Voices on your own?1. Suzanna asks: What’s a “Give-Get” imbalance? And how can you get over it?
Description of Suzanna’s problem.
Suzanna is a woman with a grown daughter with severe brain damage due to a severe brain infection (viral encephalitis) when she was an infant. Suzanna was constantly giving of herself and catering to her daughter. She explains that her daughter can be very demanding and throws tantrums to get her way, and kind of controls the entire home in this way.
She can only talk a little and has the vocabulary of about a two-and-a-half-year-old. She can mostly express the things she wants or doesn`t want on a very basic level. She mostly understands what I want from her, but mostly does not want to do what I ask her to do. She can be very stubborn. And I cannot reason with her because she has her own logic and, in her eyes, only her logic is valid. Maybe all a little bit like a two-and-a-half-year-old.
Suzanna struggles with negative feelings including guilt, anxiety and depression, because she is constantly giving, giving, giving and feeling exhausted and resentful. And she tells herself, “I should be a better mum.” Can you spot any distortions in this thought?
Put your ideas in the text box, or jot them down on a piece of paper, and then I’ll share my thinking with you!
What are the distortions in the thought, “I should be a better mum”?
There are many distortions in this thought, including All-or-Nothing Thinking, Overgeneralization, Mental Filtering, Discounting the Positive, Magnification and Minimization, Emotional Reasoning, Self-Directed Should Statements, and Self-Blame. There may be one or two more, too!
The first step in change nearly always includes dealing with motivation and resistance. Suzanna decided to do a Cost-Benefit Analysis, as you can see below, and a revision of her Self-Defeating Belief, as you can see below.
Another helpful step might include “No Practice,” which simply means saying “no” so you don’t constantly get trapped by “giving,” as well as “giving in.”
A third critically important strategy involves the mom and dad making the decision to work together as a loving team in the management of a troubled child, rather than fighting and arguing with each other, as we've discussed on previous podcasts. However, in many, or possibly most cases, the parents are not willing to do this. They are more concerned about being "right" and so they continue to do battle with each other, as well as the child who needs a more loving structure.
David
Cost-Benefit Analysis Self-Defeating Belief: I should be a better mum to my daughterAdvantages of this belief
(How does believing this help me?)Disadvantages of this belief
(How does believing this hurt me?)This thought motivates me to:
Put myself out. Push myself to give what I have. Find ways to advance her development. Find ways to involve her in everyday life. Invest myself into her and her life as much as I can, physically, emotionally and time wise. Try to find ways that my daughter can have a fulfilling life. Try hard to connect to her, her pain, her needs, her sadness and her frustration. Try to make her life as easy as possible. Try my hardest to see her world through her eyes and gain deeper understanding of how she feels. Try to understand what is upsetting her when she throws a tantrum. Stay healthy and fit to have energy for her. Try to make her life rewarding and meaningful. Fulfill my duty as a mum to my daughter who needs my support. I can feel good about myself. I satisfy other people’s expectations of me. Protects me from criticisms from my husband I am a prisoner to my daughter. No matter how hard I try I don`t seem to make a meaningful difference to her life and to her development. I am a “Siamese Twin” to her. I cannot move or do anything if she doesn`t want to. I reason with my emotions instead of thinking rational at times. I let my daughter get away with “murder”. I find excuses for her behaviour. I find excuses for her why she cannot behave differently. I beat up on myself when I feel I failed her. I take all responsibilities away from My daughter and make them my own. I blame myself when I cannot motivate her to do something. I blame myself when she is bored and unhappy. I feel guilty doing my own things. I feel guilty when I do not involve her in my activities. I feel guilty when I expect her to do entertain herself for a while. I cannot live my own life. I cannot be myself at times. She rules my life, and she lives my life. I feel trapped and frustrated. I feel I need to constantly entertain her. I feel responsible for her happiness. I feel responsible when My daughter is sad and frustrated. I feel exhausted and overwhelmed at times. I feel unhappy and unfulfilled. Advantages: 20 Disadvantages: 80Semantic Method: Re write your personal value
I want to be a mum to My daughter and help her along and invest myself into her. But I also want to treat myself the way I treat her. She has a “right” to live a happy and fulfilling life, but so do I. Our needs and desires are equally important and deserve the same attention and care. I can only continue to look after My daughter well if I look after myself too and take myself and my needs and desires as seriously as I do hers. There needs to be a give-get balance so that both of us can be healthy and happy and stay healthy and happy. I want to help her to slowly take new steps into independence and support her lovingly along the way.
2. What’s the best treatment for anxiety and dysthymia?Hello Dr. Burns,
What method of treatment would you suggest for GAD and dysthymia? 3rd wave CBT, ACT? What is best based on science?
Can you recommend some books please?
thank you
Martin
David’s Reply
My books are listed on my website, FeelingGood.com. They all describe my approach, which is a bit like CBT on steroids. But every patient is treated individually and uniquely, following a structured and systematic approach that facilitates rapid and dramatic change.
I don’t recommend “methods of treatment” or “schools of therapy” based on so-called “diagnoses,” but treat the individual with TEAM. Every session with every patient is an experiment, with precise measures at the start and end of every session.
The new Feeling Great App, now available, gets a mean of 50% or more reductions in seven negative feelings, such as depression, anxiety, and more, in 72 minutes of starting to use the bot. You can check it out for free! Anxiety and depression often co-exist, and the app targets both.
My book, When Panic Attacks, describes my approach to anxiety, based on four models of treatment: the Motivational, Cognitive, Exposure, and Hidden Emotion Models. If you use the search function, you can find podcasts describing those models. Also, there's a free anxiety class on this website.
Thanks, Martín, for your excellent question!
Best, david
3. Can you do Externalization of Voices on your own?Hi David,
Long time listener of your great podcast and huge fan of your book Feeling Great.
I’ve often heard you mention that “externalization of voices” is one of, if not the most powerful CBT techniques. I am just wondering if it is still almost as effective when done solo without a therapist i.e. the person takes on both the roles of positive and negative by recording themselves talking or similar?
Also, have you any data comparing the efficacy of TEAM CBT work carried out solo using Feeling Great/your podcast as a guide vs. TEAM CBT performed with a trained TEAM therapist?
I am very much looking forward to the Feeling Great app launch in the UK as hopefully that will be a much more effective way to do personal work without a therapist.
Many thanks,
Eoghan (pronounced Owen)
David’s reply
Thank you, Eoghan! Appreciate your support and thoughtful question.
I don’t have any data on the use of EOV on your own. One could use a recording device, like your cell phone, and record your negative thoughts in second person, “you,” and try to defeat them when you play them back, one at a time.
But in my experience, people nearly always need an experienced role player to do role reversals to show them how to get to a “huge” win. People almost never get a huge win when doing it for the first time, because the therapist (in the role of positive self) can model unfamiliar strategies for the patient.
Generally, a hugely successful response involves a combination of self-defense, self-acceptance, and the CAT, or counter-attack technique. And sometimes other methods as well, like Be Specific, for example
Radical new learning is definitely the key to success with EOV.
Now, thanks to the app, everyone can practice, since we’ve trained our Obie Bot to role-play with users, do role reversals, give feedback, and so forth.
Great question that I will include in the next Ask David if that’s okay!
We are also exploring the combination of the Feeling Great App plus a trained TEAM therapist from the Feeling Good Institute in Mountain View, California.
We are hoping that 1 + 1 may equal 3. Wouldn’t that be awesome?
What I’ve found when doing research is that the results are virtually always wildly unexpected! Somethings come out great, and some things come out dismally. I always tell myself that “the Lord giveth, and the Lord taketh away!”
Seems to be the rule in research! Especially when you’re wanting to be guided by the truth, and not so much by your hopes and expectations.
Best, David
-
Ask David: What’s Self-Esteem? What’s Self-Acceptance?
In today’s podcast we address six common questions about self-esteem, including:
What is Self-Esteem? How does it differ from self-confidence? How does it differ from self-acceptance? What’s the difference between conditional and unconditional self-esteem? What’s the best way to develop self-esteem? What do you mean when you say that once you develop unconditional self-esteem, you should get rid of it as fast as possible?Please keep the questions coming. We enjoy the exchange of ideas with all of you. Thanks!
Brandon Vance and Heather Clague begin today’s show with a pitch for their upcoming Feeling Great App Group, an 8 week experience that will begin in September. If you use the Feeling Great App, or plan to get it, this group would be an inexpensive and incredible enhancement, so you can meet with like-minded people once a week to schmooze, practice the techniques in the app, and get your questions answered by compassionate and personable experts.
For more information go to www.FeelingGreatTherapyCenter.com/appgroup.
Feeling Great App Group Sept-Nov 2024Led by Brandon Vance MD and Heather Clague MD, meets online for 80 minutes for 8 weeks, offered Mondays 4-5:20pm Pacific Time, September 23rd - November 11th. Cost is $12 per session ($96 total) plus the cost of the app ($99 per year after 7 day free trial). Sliding scale for both the group and the app are available. No one turned away for lack of funds.
Feeling Down? Try the Feeling Great App for Free!It's now in the IOS and Android app stores, and you can check it out for free. It's works super fast. Let us know what you think! Thanks!
Rhonda, Matt, and David appreciate your support. Keep your questions and testimonials coming. They mean a lot to us!
-
Feeling Down? Try the Feeling Great App for Free!
The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com!
What's the Meaning of Life?Before we start today, I have a special shoutout to Max Kosma, our new colleague, friend and brilliant technical guru who helped make our new video studio possible! Next week, we’ll see if we can pipe him in to say hello to all of you. His spirit is joyous, infectious, incredibly generous and supportive.
Thanks, Max!
Rhonda opened today’s podcast with a vibrant and inspiring endorsement from Jeff, a podcast fan who was raving about the Feeling Great App. Thank you Jeff, and please check out our new app at FeelingGreat.com.
Important Announcement
Rhonda, along with a group of dedicated TEAM Therapists, including Amy Berner, Brandon Vance, Leigh Harrington, Mariusz Wirga, and Mark Noble, has just created a new non-profit organization called TEAMCBT International (TCI). TCI will provide seed money in the form of no-or-low-interest loans for groups around the world who want to offer TEAM-CBT intensives for therapists in your country. Rhonda has been instrumental in the organization of successful intensive workshops in India, Poland, Mexico, England and Ireland. They have been well received, but can be somewhat costly to produce, so Rhonda’s new group is ready to provide a helping hand.
I’ve had the honor of presenting keynote addresses, live therapy demos, and Q and A sessions in many of those programs, and have totally enjoyed them. A big hug and THANKS to Rhonda once again! To learn more, just go to TEAMCBT.International.
Today, Matt joins us for a discussion of the meaning of life, something young people often worry about, but people of any age can be concerned. So, today, you may finally find the answer to that lofty question!
But first, I (David) mentioned a little about one of last week’s questions, “Is the universe real?” I provided the type of answer the famed philosopher, Ludwig Wittgenstein, might have provided. Namely, that the question is nonsensical, it is language “out of gear.” So, we can dismiss the question, as opposed to trying to answer it.
HOWEVER, the question DOES make a ton of sense when we ask if human beings are “real.” And I am not referring to some metaphysical nonsense, but rather the tendency of many people to present a happy or confident false front, all the while feeling empty, lonely, anxious and ashamed inside.
Two of the now more-than-140 TEAM techniques include Self-Disclosure and the Survey Technique, where you take the chance of opening up about some of the secrets you’ve been hiding, and ask others what they think about you. Although this takes tremendous courage, it often results in tremendous warmth and connection to others.
I provide a description of a young man who disclosed a tremendous amount he’d been hiding in our recent Tuesday group at Stanford, and he was convinced the group would judge him and look down on him. But just the opposite happened. He encountered a flood of warmth, admiration, and respect from the people in our group.
A small miracle, perhaps, but a real and meaningful miracle at the moment when his universe suddenly became “real” and radically different from the dangerous and critical world he’d feared and imagined.
Then we tackled today’s philosophical question: “What’s the Meaning of Life?” As usual, our brilliant and beloved Matt May began with a description of an extraordinarily depressed patient he once treated who’d been hospitalized for 180 days with no improvement, including a very dangerous suicide attempt.
Matt was worried for the patient’s safety, so told the referring doctor that he’d been willing to talk with the patient while the patient was still in the safe environment of the hospital. The patient called Matt and, after some listening and empathy Matt said he would like to help and that there would be committed to helping the man and thought he could help him make a complete recovery, work with this man, and thought there was an excellent chance for significant progress, perhaps even complete recovery, but the patient probably wouldn’t want to work with him.as long as he’d be willing to give Matt what he needed in order to work together effectively. Matt suggested the patient give him a call.
On the call, Matt told him he might not be able to afford treatment, since part of the “cost” of therapy was that the patient had to make a commitment to life, and that he must agree never to attempt suicide no matter what, for the rest of his life.
After a couple days of reflection, the man convinced Matt that he WOULD make that commitment.
Then Matt described the man’s problem. Both of his parents were world famous, successful scientists, and during his upbringing, his parents emphasized how fantastic and rewarding a career as a scientist could be, and he was convinced that his parents expected him to follow in their footsteps. He had "learned that doing science was the "meaning of life" and would inevitably result in his feeling satisfied, joyful and proud.
So. sure enough, this young man, who was extremely bright, pursued a scientific career, and eventually one of his papers was accepted for publication in one the world’s most prestigious research journals.
There was a big party at his laboratory, and everyone congratulated him and sang his praises.
But there was one big problem. He felt nothing!
Of course, he smiled and didn’t let on that he felt nothing. He tried to act happy, but simply WASN’T. He said, “I faked it.”
He concluded that he must be defective, since he’d done what he was supposed to do, in order to feel joyful and happy, but he felt nothing, even though he had fulfilled his parents dreams and expectations for him. This plunged him into his severe depression, with the familiar theme of “I’m not good enough. In fact, I am deeply flawed and defective, incapable of feeling joy or happiness. There must be something terribly wrong with me!”
Sound familiar? Did you ever feel like YOU weren’t good enough?
During an early session, Matt asked his patient what he really enjoyed, what he’d really LIKE to do with his life.
The patient confessed, after much resistance, that he felt that his fantasies were totally ridiculous, but what he really loved were trains, photography, and painting. He said his dream job would be to be a conductor or engineer on a train where he could take pictures of the scenery and especially, the people on the train.
BUT, he said, that would be meaningless, since he wouldn’t be contributing to science and would be letting everyone down., etc. etc. etc.
I bet you can guess what followed! If you were his shrink, what would you say or do?
Put your ideas here, into the text box, and then I’ll tell you!
If you took a guess, thanks! If you didn’t, no problem.
Matt suggested he do those very things—take a train somewhere, start snapping photos, and do some painting. Predict how satisfying each thing will be (0 to 100) BEFORE you do it.
Then do it, and record how satisfying each activity actually was on the same scale of 0 to 100.
He exclaimed, “I’d LOVE to do that,” and started crying. His depression score immediately fell to zero.
The next week he brought a large cardboard box to his session. It was filled with books on ancient philosophy and how to find the “meaning of life.” He said, “I don’t need these anymore, so they’re a gift to you!”
Matt said, “I don’t need them either!”
Now you know about the “meaning of life.”
We discussed some of the many meanings in this story, including:
Rhonda pointed out what Kurt Vonnegut said on the meaning of life. He said, “We’re all here to fart around!” David discussed the basic idea that it’s not what we’re doing, but our thoughts, that trigger ALL of our feelings. And at the moment you learn to turn off that critical voice in your brain, you will experience your own “enlightenment. David has also said, over and over, that when you discover that you no longer need to be “special,” you can experience the “Great Death” of the “self,” but it’s not like a funeral. It’s more like a celebration, because when you lose your “self,” and discover you didn’t “need” the things you wrongly thought you needed (like love, achievement, perfection, etc.), at that moment you’ll experience enlightenment and you’ll inherit the world, and life, and deeper connections with the people you love. There’s not one “meaning” to life. There are many meanings every day. And today, for Matt, Rhonda and David, it is VERY meaningful and joyful just to hang out with each other, and with you, so we can shoot the breeze together! Or, as Kurt Vonnegut said, so we can "fart around" together.Please keep your wonderful questions and comments flowing, and be sure to catch us in our new video version on my feeling good YouTube channel.
Warmly,
Rhonda, Matt, and David
-
Feeling Down? Try the Feeling Great App for Free!
The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it out at FeelingGreat.com!
Is the Universe One? Is the Universe Real? Is the Universe Real?These two philosophical problems used to seem nonsensical to me, and certainly not relevant to much of anything in my life—or anyone’s! But now the picture has changed a bit!
When I was a student at Amherst College, I majored in the philosophy of science. On this show, I’ve often talked about my hero, Ludwig Wittgenstein, who attempted (successfully in my opinion) to “solve” all the problems of philosophy. He wanted to help those of us who were “afflicted” by an attraction to philosophical problems to see through them and understand precisely how and why they were nonsensical. He hoped to provide a “treatment” for philosophers so we could give up the need to obsess about nonsensical philosophical problems.
Once you see through the these problems, they become kind of like a joke, and you can use jokes to help other people see through them. For example, here’s a kind of lame joke about the question of whether or not the universe is “real.” Wittgenstein said that before we try to answer questions like that, we might want to ask ourselves if these questions even makes sense! And if it a philosophical problem doesn't make sense, it isn’t a real question, so we won’t need to deal with it. In other words, questions that don’t make sense don’t need to be answered because they’re not real questions.
Take the question, "Is the universe real?"
You could ask, “Well, what would it be like if the universe weren't real? What would that look like? How would things be different?” If you can't answer that question, the question might not make sense.
To most of us, philosophical questions wound nonsensical because we are taking words, like “real,” out of the contexts in which it DOES make sense. For example, we can ask : “Is this painting real? Or is it a fake?” That question does make sense. It has an obvious meaning, since many valuable paintings are copied and are fakes, and they try to pass them off as the “real” thing.
But what would a "real" or "fake" universe look like? How would it differ from our universe?
Now let’s think about another example that is mildly humorous. Let’s imagine you’re driving through Iowa in the summer, and you spot a farmer working in his corn field. You’re interested in speaking to him because you are writing a story about your travels in Iowa, and want to talk about the lives of farmers.
So, you pull your car over to the side of the road and shout, “Howdy! What are you doing in the field?”
The farmer seems pleased and grabs a gorgeous stalk of corn and holds it up and proudly shouts, “I’m growing corn, and it is real!”
Well, that’s great that he's happily growing corn, but what does the tag-on, “and it is real” mean? It doesn’t actually mean anything, because farmers don’t grow “unreal corn.” So, in this context, the word has no meaning.
Now, if you were on a movie set, they might actually be using artificial corn as a prop, so now the contrast between real and unreal corn becomes meaningful.
This is a very humble point, but it’s the very heart of what Wittgenstein was trying to make us aware of. Philosophical problems kind of sound meaningful and puzzling, but most of the time, they are simply a kind of nonsensical use of language.
Now, in personal relationships, we might also have a notion of when people are being “real” or fake. And we often act fake because we don’t think we’re good enough just the way we really are. So, for example, you may hide your shyness in social situations because you’re ashamed, and telling yourself that your shyness is incredibly weird and abnormal, and makes you “less than” other people.
One method of helping people overcome shyness is simply to disclose it to others. This TEAM-CBT technique is called "Self-Disclosure." Instead of hiding your shyness and feeling awkward and ashamed in social situations, you share your feelings openly. Shame depends on hiding, so when you open up, the feelings of shame will often disappear.
For example, in a recent podcast of a dramatic, live therapy session, a man named Chris revealed many troubling things about his teenage years that he’d been hiding for years. When he opened up, he began sobbing intensely, thinking he’d let his father down with his wild behavior when he was a high school student.
His grief, he was incredibly compelling, and his courageous self-disclosure was appealing to most of us who were privileged to witness that session. Showing us his “real” self became his path to enlightenment, joy, and deeply meaningful relationships with himself and with all of us who witnessed that amazing session.
So, although the question, “is the universe real” is silly and nonsensical, the question, “are we being real with each other,” is definitely NOT silly or nonsensical. Being real and vulnerable is an important key to connecting with ourselves as well as other human beings.
Is the Universe One?How about “Is the universe one?” This philosophical question also seemed nonsensical to me for years, although I was intellectually aware that some Buddhists make claims that the universe IS one and that the failure to “see” this is the basic of all evil. That's because if you see other humans, for example, as being "external" to yourself, you may feel you have the right to abuse and exploit them.
However, for years I thought the idea that the universe is "one" seemed like sheer nonsense. For example, I am sitting in a chair typing, and there is a cup on the desk. People have never call that cup “David,” and no one has ever called me a coffee cup (although lots of people have sad some pretty bad things about me!) So, I concluded that the cup and I are not “one,” and so the whole thing about the universe being one seemed nonsensical and silly.
But when I began to think about it in the context of my work with patients, my thinking suddenly changed. For example, the TEAM interpersonal model I’ve developed was based on research I did early in my career that suggested that Blame was one of the main causes of troubled relationships, and perhaps the most important and powerful cause.
And this is certainly true in my personal life and in my work with individuals with troubled relationships who are unhappy in their marriages or people who are angry with their neighbors, or family members, or anyone. We almost always see ourselves as victims, and the other person as the one who is to blame for the problem. This triggers feelings of frustration, anger, and moral superiority, and can easily and often lead to arguments, mistrust, divorce, hostility, and violence, murder, and even war.
Now, I’m beginning to see that the idea that we are separate from others, who are doing something TO us, does, in fact, lead to hostility, and arguably to evil. And once you “get it,” the same insight applies to our relationships, not just with loved ones, friends, and other people in general, but also our relationships with animals, with the environment, and with the planet earth. If we think of them as “other,” then we may conclude that it is okay to exploit or use them for our own advantage.
In the interpersonal TEAM model, we focus more on circular causality, or interpersonal connectedness and ask the question, how do we actually shape and cause the very behavior in the other person that we complain about so vigorously? I have developed a fast, powerful tool that allows any to pinpoint their own role in a relationship problem very quickly and with reasonable accuracy. It’s called the Relationship Journal (RJ), and we’ve talked about it often on this show.
Essentially, it’s simple to use the RJ, but it can be startling and illuminating but incredibly painful. All you have to do is write down ONE thing another person said to you that you found upsetting, and EXACTLY what you said next. Choose an interaction that did not go well; otherwise, it’s a waste of time.
Then, the RJ will take you through a step by step analysis of your response, and it's implications.
When you discover how you are actually forcing the other person to treat you shabbily, it can hurt. This is one of the four ‘Great Deaths” of the self, and it’s the most painful of all, in my experience. This is the "Great Death" of the angry, blaming "self."
I hate this great death! But if you have the courage to use it and take a look, it can be incredibly illuminating and liberating, and can put you on the path to far more loving relationships.
As an exercise, I will list a number of common complaints that people have about loved ones, friends, or family that they find irritating. Your job will be to show how you could FORCE them to do the exact thing you are complaining about. The other person could be your partner, friend, son or daughter, etc. Your complaint about that person might be that they
Refuse to talk to me. Can’t (or won’t) open up and express their feelings Constantly whine and complain, and ignore and resist my good advice. Constantly argue, and always have to be right. Won’t listen. Are relentlessly critical. Always have to get their way. Doesn’t treat me with respect.In each case, see if you can figure out how you could FORCE the other person to do that exact thing. We will discuss a couple of these on the show and lustrate solutions to give you a feel for how this works.
Rhonda’s and Matt shared their wise and interesting thoughts on both of these philosophical questions, and how you can understand them in the context of your own lives, and, if you're a shrink, how you can use them in your work with patients.
Thanks for listening today!
Matt, Rhonda, and David
-
Special Announcement #1 The Legendary Summer Intensive Starts on Thursday of this week! Featuring Drs. David Burns and Jill Levitt August 8 - 11, 2024 Click for registration / more information!
This workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Special Announcement #2Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it
Today's Podcast #408-- Does God exist?We started today’s podcast with a beautiful testimonial and a shout out for the intensive from August 8 to 11, 2024 at the South San Francisco Intensive in person or virtually if you prefer. To learn more, contact www.CBTintensive.com. Act fast because the intensive is on Thursday of this week when today’s podcast will be published.
Today, we tackle another popular and intensely debated philosophical / religious puzzle: Does God exist? People have very heated views, one way or the other. I (David) will start with a brief explanation of a Wittgenstein answer to this question, and then for the most part, we will focus instead on the question of how we all incorporate spirituality into TEAM-CBT.
Wittgenstein emphasized that philosophical problem exist when we debate about the meanings of words or terms that are vague, or poorly defined. Traditionally, we think there are three positions one could take:
Theism: You believe that God exists. Atheism: You do not believe in God. Agnosticism: You say that you do no know whether or not God exists.My own thinking, which is strongly influenced by Wittgenstein, would be that I don’t understand any of those three stances because I have no idea what you mean by your use of the word, “God.” What is it, exactly, that I’m supposed to believe in, or not believe in?
To me, the question, “Do you believe in God,” is nonsensical, so I simply do not deal with it. All of the three positions listed above are based on the idea that the word, “God,” has some kind of clear meaning that we can all agree upon. But it clearly does not.
You might define “God” as the “creator of the universe.” Well, there is certainly something magical and mysterious about the existence and creation of the universe (assuming it did begin with some kind of “big bang.”) Some questions might include “Where did all the energy come from all of a sudden?” Or “Are there many universes?”
These are valid questions, and physicists are pursuing the answers, which is very exciting and fantastic. But they are generally not invoking the concept of a “God,” although some undoubtedly would say that they do “believe in Gad.”
Regardless, I cheer them on and find every new discovery about the nature of the universe, and how the universe works, endlessly fascinating!
For today, we will ask a much simpler question of whether and how we include some kind of spiritual dimension into our work as shrinks. This is a topic that is equally exciting, and definitely meaningful.
Rhonda got us started by explain that she sees the belief in God as a matter of faith, and is not something that can be tested empirically, which is certainly true. She says she does believe in God, or some “higher power,” but does not believe in a God who “rules over things.”
She was raised in the Jewish religion, and says that many Jews believe that God exists in everyone . This sounds a little like Hinduism, which traces back at least 2500 years ago, and possibly as early as 5000 years ago. I believe that the Hindus believe that God exists in everything.
The practical impact of the belief that God exists in all of us, is that we will treat each other with love and respect, since we are all an expression of God. She also said that we can “create God among us as a community.”
Matt said that he was raised as a Christian and that when he was growing up he had heard about miracles, like Jesus raising Lazarus from the dead in the New Testament on the Gospel according to John. He said that he views our work with individuals who are severely depressed as a kind of spiritual healing, even though we are working with purely secular methods. This is especially true when we are working with individuals who appear to be paralyzed by depression, claiming they are unable even to get out of bed, people who bombard themselves with harsh criticisms, and feel hopeless and ashamed.
Matt said that self-acceptance (accepting ourselves exactly as we are) is one of the many tools we use, and that he (Matt) loves to think about the ripple effects of our work, which not only transforms the lives of individuals who awaken from their depressive trance, but this also has enormous positive effects on their friends and family as well.
He asks, “How do we achieve this?”
I (David) loved hearing from Rhonda and Matt on spirituality in TEAM, and pointed out many areas of overlap between TEAM and the Christian theology I was raised on, since my dad was a Lutheran minister. For example,
The TEAM concept that you do not, and cannot, earn genuine feelings of worthwhileness or self-esteem through achievement. In other words, your worth is not your work, but something you give yourself unconditionally. In Christianity, we are sometimes taught that you cannot get to “heaven” through your good works. Enlightenment is a gift, a decision, and not something you have to earn. We also teach that humans are not purely good, but have a mixture of positive and negative motives, and that many people suffer because of guilt and regret about past errors or sins. When we are teaching the Acceptance Paradox, we are teaching a “letting go” of the inner abuse we endure from that relentless, critical voice in our brains, labeling us and telling us that we aren’t good enough, we’re “bad,” we’re “losers,” and so forth, using powerful tools like the Externalization of Voices.In Christianity, this message is delivered in my ritualized ways, including the act of communion, confessing your sins and accepting the blood and body of Christ who “died for your sins.” This is just another way of sending the message that it is okay to accept the fact that you are flawed and fallen, and yet still worthy of God’s love—and your own love!
In the interpersonal TEAM model for troubled relationships, the entire emphasis on pinpointing your own role in a problem with a friend, colleague, loved one, or stranger, instead of casting blame on the other person and feeling angry and morally superior. My Relationship Journal is a tool designed to facilitate this process very rapidly.In Christianity there are many messages about taking out the moat in your own eye, as well as the idea that when you blame others, and cast judgment, you condemn yourself.
There is a strong emphasis on humility and accountability in TEAM-CBT. This often comes up during positive reframing; we talk about how the patient’s self-criticisms are often an expression of high standards, honesty, and humility, and that these are beautiful qualities that are real, important, and powerful.And this similar, it seems to me, to the Sermon on the Mount, where Jesus talked about “blessed are the meek, for they shall be called the Children of God.”
There are many, many additional areas of overlap, and many books have been written on this subject. During the podcast I provided examples of how the spiritual and psychological realms can meet and reinforce each other at the moment the patient recovers and discovers their own enlightenment. I am proud to have developed TEAM-CBT, and it is clearly infused with many spiritual dimensions, even though it is entirely secular.
I mentioned that I was born on a Sunday morning, and my dad said it was the only time he was unable to preach his sermon. He was too excited, especially since my parents had become reconciled to the notion that they could not have children. He called me David Dean Burns, and hoped that someday I would become D.D. Burns, D.D. DD is an honorary degree in theology, and he (and everyone) assumed that I would one day be a minister, like was. He was L.C. Burns, DD. (Lyle Charles Burns)
I went in a different direction, but have kind of returned to my original calling, though threw an unexpected route, and hope you have all enjoyed our “sermons” this morning.
I would add that I would never impose my beliefs or spiritual orientation on any patient, and only ask about the integration of their successful recovery with their own religious beliefs AFTER they have recovered, so as to add a deeper level of meaning to the work and transformation that they experienced. We only emphasized the Jewish and Christian approaches to spirituality because that was our upbringing, but the spiritual “discoveries” during TEAM treatment are actually compatible with nearly all, if not all, religions and spiritual paths.
Warmly,
Rhonda, Matt, and David
-
Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information!
Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Special Announcement #2Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it
Today's Podcast Practical Philosophy Month Part 2, Do Humans have “Selves”?This is our second podcast in our Practical Philosophy Month. Last week, in our first episode, we focused on the “free will” question. As humans, we all feel like we have “free will,” but is it just an illusion, especially if all our actions are the result of the physical processes in our brains and the laws of the universe?
The Bible certainly dealt with this in the book of Genesis, where we learn that the first humans, Adam and Eve, were given a wonderful Garden of Eden to live in, but they had to choose whether or not to obey God’s rule NOT to eat the forbidden fruit from the tree of knowledge of good and evil. They chose to eat the fruit, implying that humans have free choice. But the philosophical arguments rage on.
In today’s podcast, we are joined by two beloved and brilliant colleagues, Drs. Matthew May and Fabrice Nye, as we explore the question of whether or not the “self” exists. We all feel like we have a “self,” but is this real or just an illusion? When you try to define your “self,” you may run into problems.
For example, you might think that the “self” has to be the part of us that does not change from moment to moment, and is always ‘the same.” For example, I might think back on my childhood and feel convinced that I was the “same David Burns” then that I am now. And, if you are religious, you might also be comforted by the idea that your “self” is the same as your “soul,” and that you will therefore live on after you die. This concept of a “soul” is a core belief in many religions.
But are we fooling ourselves? And what was the Buddha thinking about 2,500 years ago when we talked about enlightenment as resulting from the “Great Death” of the “self.” He seemed to be hinting that something wonderful can happen when you give up the idea that you have a “self.”
In the original draft of my book, Feeling Great, I had a chapter on entitled, “Do you need a “self?” Join the Grateful Dead.” I tried to persuade readers that the existence of a “self” is nonsense, based on the philosophy of Ludwig Wittgenstein in his famous book, Philosophical Investigations. But readers found the chapter so upsetting that I decided, on their urging, to delete it from the manuscript, which I did. My goal is not to disturb people, but to provide a path to joy and to loving connections with others.
But to this day, I still get emails from people asking me to offer that chapter, or to deal more deeply with this concept of the “self” vs “no self” in a podcast. So, here is my attempt today.
I will start with my own take, and then summarize some of the views about the self that were expressed by Fabrice, Matt, and Rhonda during the show.
Here’s my thinking. There are many key questions you could ask about the concept of the “self?” including:
Do we have a “self?” And if so, what is it? Does the first question even make sense?I’m sure you would agree that if a question doesn’t make sense, then it isn’t a “real” question, and there really isn’t anything to talk about. Then we can just stop feeling frustrated and perplexed, and move on with our lives.
That is the precise position that the late Wittgenstein would probably have taken. He stated that words have no ultimate or “true” meaning outside of the various contexts in which we use them in daily life. Most words have many meanings, because they are used in different ways, and you can find most of the meanings in any dictionary.
So, if you think of the word, “game,” you will quickly realize that it does not have one “true” or essential meaning. It can mean a sports competition, with two teams competing against each, like soccer. But you can have two teams competing in some way other than a sport.
And you don’t even need two teams to have a “game.” For example, some games are played by one individual, like solitaire with a deck of cards.
Or you can think about the “dating game,” or refer to “game birds,” or a “game boxer.” In short, there is not some single “correct” meaning to the word, “game.” Some uses have overlapping meanings, and some uses do not overlap at all with other uses.
So, there is no point in trying to figure out if “games exist,” or what the ultimate or essential meaning is of the word, “game.”
Now, how do we use the word, “self,” and what does it mean in each context?
You might tell your child to behave themself. This simply means that they are misbehaving and will be punished if they don’t behave more politely. You do not have to tell the child that their “self” also has to behave better, because that would be meaningless. We already told the child to change their behavior.
You could ask friends, as I did this morning, if they are planning to join me on the Sunday hike. Two of them confirmed and said that “they” would join me today on our hike. I did have to ask them if they would be bringing their “selves,” because I just do not know what that would mean! They already told me they’re coming to the hike. (They did come and we had a lot of fun.)
In my extremely challenging freshman English class at Amherst College, we had to write two or three papers per week on odd topics. The teachers were relentlessly critical in their feedback, and would nearly always point out that we sounded incredibly phony and need to find our true voices, which came from our real selves, as opposed to the false fronts we often used to try to impress people. Almost every student got dumped on constantly!
The professors weren’t referring to some metaphysical “true selves.” They were just referring to the fact that our writing didn’t sound natural, compelling, or vulnerable, and so forth. Our writing was, for the most part, an enormous turn-off. Most of us never could figure out quite what that class was all about, but it was useful as I became more sensitive to the “tone” or “voice” in any writing.
I would have to concede that it was a sobering but helpful class. But they were not referring to some mystical “true self” we had to find. They just wanted us to stop writing in such a sucky way!
So here is my point, which you might “not get.” When you keep the word, “self,” in the context of everyday life, it is obvious what it means, and it never refers to some metaphysical “thing” that we could “have” or “not have.” It is just a vague, abstract concept that is devoid of meaning when it’s all by itself. A “self,” just like “free will,” is not some “thing” that we might, or might not, have.
The question, “Does the self exist,” according to Wittgenstein (or his big fan David) has no meaning and so we can just ignore it. It’s not a real question. It is, as Wittgenstein was fond of saying, “language that’s out of gear.”
Now, does this discussion have anything to do with emotional problems, or TEAM therapy? It absolutely does. That’s because nearly all depression results from some version of “I’m not good enough,” including:
I’m inferior. I’m a loser. I’m a “hopeless case.” I’m a failure. I’m unlovable. I’m a bad parent. I’m defective.And so forth.
If you buy into these “self” condemning proclamations, thinking that they mean something, you’ll probably feel depressed, ashamed, inadequate, hopeless, and more. As you can probably see, all these self-critical thoughts contain tons of cognitive distortions, like All-or-Nothing Thinking, Overgeneralization, Labeling, Mental Filtering, Emotional Reasoning, Self-Blame, Hidden Shoulds, and more
And to put it in a nutshell, they ALL involve the belief that you have a “self” that’s broken, or simply not “good enough.” And all of those statements are meaningless.
My goal in therapy is NOT to persuade you that you ARE worthwhile, or “a winner,” or a “good” parent, but rather to show you how to let go of these meaningless but painful ways of belittling yourself. I might use techniques like Empathy, Positive Reframing, Explain the Distortions, Let’s Define Terms, Be Specific, the Double Standard Technique, the Externalization of Voices, the Downward Arrow, and many more.
That’s because the VERY moment you suddenly “see” that these kinds of statements are both untrue and unfair, and you stop believing them, your feelings will instantly change. So, you could say that TEAM really IS a “Wittgensteinian” therapy.
And when people ask me how to develop better self-esteem, I would not try to get them to discover how to have some magical and wonderful “thing” called self-esteem, because that concept is just as nonsensical as the concept of a “self.” You might say that “self-esteem,” if you want to use the term, is more about what you DO.
And there are two things you can do if you want to change the way you feel. First, you can stop beating up on yourself with hostile criticisms like the bulleted statements listed above, and talk to yourself in the same encouraging way you might talk to a dear friend or loved one who was hurting.
And second, you can treat yourself in a loving way, in just the same way you might treat your best friend who was coming for a visit. In other words, you can do nice things for yourself.
The day my first book, “Feeling Good,” was finally published, my editor called me with some bad news. She told me that the publisher, William Morrow and Company, loses money on 9 out of 10 of the books they publish, so they decide which ones are most likely to sell, and those are the only ones they’ll promote. The rest of the books go on a “loser list,” and the company does little or nothing to promote them.
She said my book was #1 on their “loser list,” since the president of the company felt it had no commercial potential, and that very few people would be interest in a long book on depression. She added that the one thing they did do was to send my book to ten popular magazines for first serial rights. That means they get to publish an excerpt from your book as an article, so that stirs up some media interest in your book. Sadly, she said that all ten had turned them down.
She said that I’d have to be in charge of any further marketing of my book, so I asked what I should do. She said to call all ten magazines right away and persuade them to change their minds.
In a panic, I called them all, including Ladies’ Home Journal, Reader’s Digest, and on and on. Every magazine said the same thing—they did not want my book, had turned it down, had zero interest in it, and to please top calling since authors shouldn’t call them and they considered it a form of phone harassment since they’d already made a decision.
Yikes! No fun!
When I jogged home from the train station that night, I shouted, “You’re a loser, you’re a failure.” That didn’t sound so good so then I shouted, “No, you’re not! You’ll figure out how to make it happen! Just keep plugging away.”
That sounded a lot more loving, so when I got home, I told my wife that the book at just been published and that I’d been turned down by all ten magazines for serial rights, and the publisher decided not to spend any money on marketing or advertising, so we needed to go out and celebrate.
She why we would celebrate?
I said, “You don’t need to celebrate when you win, because you already feel great. But when you lose, that’s when you need to celebrate, because you’re feeling down. So, tonight we’ll celebrate!”
We went out for a fancy dinner and celebrated and had fun. And the rest, they say, is history. I just kept trying and getting turned down by newspapers, radio stations, television programs, and more. But eventually, the tide started to turn. To date, Feeling Good has sold more than 5 million copies and it achieved best-seller status. And the reason was that researchers discovered that the book actually had antidepressant properties, so excitement about it spread by word of mouth.
I am hopeful that the new Feeling Great App will help even more people.
Fabrice made some interesting and wise comments on the notion of the “self.” He said that the idea that we have a “self” is a sense that we nearly all have. Some people feel like the “self” that is located somewhere behind the eyes or in the middle of the head. But, he emphasizes, there is no such “thing” as a “self.”
He has quoted someone who has “said it all,” but the statement only makes sense IF you “get it!” Here’s the quote:
“No Self? No Problem!”
This is actually the title of a book by Chris Niebauer, PhD, and the subtitle is How Neuropsychology Is Catching Up to Buddhism. If you want to check it out, here’s a link to it on Amazon: https://www.amazon.com/No-Self-Problem-Neuropsychology-Catching/dp/1938289978
Fabrice emphasized that the concept of “self” is “nebulous.” He asked, “Is there a ‘David’?” He explained:
You wouldn’t be able to prove this in court. Well, you could show ID, but that would not be proof. Where does the information on the ID come from? Birth certificate? Who wrote the information on the birth certificate? Probably some doctor back in 1942. And where did he get that information from? Probably some caregiver said “Write ‘David’ here.” Was that from a credible source?
Not at all. That info was made up on the spot!
Now, you can say that there’s a “sense” of a David going around, and that there are some patterns that show signs of “David-ness,” but there is no “David.”
Matt added that your body is not your “self.” When you break your arm, you don’t say that you have broken a part of your “self.” You just say, “I broke my arm.”
Rhonda raised the question of whether the “self” is just the same as “consciousness” or “awareness.”
Someone in our group added that the “self” is what we DO, and not what we ARE. And, of course, what we are doing is constantly changing from moment to moment.
My understanding of all of this is that once you let go of the notion that you have a “self,” you will no longer worry about whether or not you are “good enough” or “special,” or whoever. You can focus instead on living your life and solving the problems of daily living and appreciating the world around you. If you screw up, you can focus on what specific error you made, rather than obsessing about your inferior or defective “self.” You can actually welcome failure as just another teacher, so you can grow and learn, and simply accept your screw ups, or both.
In fact, two of the most popular TEAM techniques for challenging the distorted thoughts in bullets above are called “Let’s Define Terms” and “Be Specific.” These techniques are right out of Wittgenstein’s playbook, and they are prominently featured in the “Learn” section of the new Feeling Great App. If you’re feeling depressed, and thinking of yourself as a “loser” or as being “inferior” or even “worthless,” the goal is NOT to “become a ‘winner,” or more ‘worthwhile,’ but rather to give up these notions as nonsensical.
But once again, many people cannot “get it,” or “see it,” and that’s where a caring and skillful therapist can help. Some people wrongly think that letting go of the notion that you could be “worthwhile” would mean a huge loss of something precious.
Many people who don’t yet “see” what we’re trying to say are terrified of the “Great Death” because they think that giving up the notion that you have a “self” means giving up all hope for improvement, for joy, for intimacy, and so forth. But to my way of thinking, the truth is just the opposite. When your “self” dies, you and your world suddenly wake up and come to life. When you accept yourself and your world, exactly as they are right now, everything suddenly changes. Of course, that’s a paradox.
I believe that leading our patients to the “Great Death” of the “self” is like giving them the understanding and courage they need to throw some garbage in the trash instead of carrying the garbage around with them all the time!
I hope some of this makes a little sense, but if not, don’t worry about. Sometimes, it takes a little time before you suddenly “see it!”
Thanks for listening today. We love all of you!
Rhonda, Fabrice, Matt, and David
-
Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information!
Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Special Announcement #2Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it
Today's Podcast Practical Philosophy Month Part 1, The Free Will ProblemWelcome to Practical Philosophy month. For the next five weeks, we will discuss some of the most popular and challenging problems in philosophy, such as these:
Do human beings have free will? Or is free will just an illusion? Do human beings have a “self?” Or is the “self” just another illusion? Is it possible to be more or less “worthwhile?” Are some humans “better” or “worse” than others? Does God exist? Is the universe “real” or “one”? What’s the meaning of life? What is “self-esteem”? How does it differ from self-confidence? What’s the difference between conditional and unconditional self-esteem? What’s the difference between self-esteem and self-acceptance? What do you have to do to experience joy and feelings of worthwhileness?We will try to complete the list in five weeks, so some weeks we may include more than one topic, since many of these topics are related to one another.
Rhonda and David will be joined by our beloved Dr. Matt May, a regular on our Ask David episodes, and for the first and second sessions we will be joined by our beloved Dr. Fabrice Nye, who created and hosted the Feeling Good Podcasts several years ago.
Each week, you will also hear about the linkage between these philosophical dilemmas, and emotional problems, like depression, anxiety, and relationship conflicts. For example, nearly all depressed individuals believe that they aren’t sufficiently “worthwhile.” I see my goal as a psychiatrist not as helping people feel “more worthwhile,” but rather showing people, if interested, how to give up this notion entirely and become free of certain kinds of damaging judgments of the “self” and others.
You will also learn how these types of philosophical problems continue to play a large role in psychiatry and psychology, including the DSM5 diagnostic system. For example, is the diagnosis of “Generalized Anxiety Disorder” a true “mental disorder” that you could “have” or “not have?”
And might some or most of the so-called “mental disorders” listed in the DSM be based on faulty philosophical / logical thinking? And if many or most of the “mental disorders” are based on goofy, faulty thinking, is there a more productive and effective way to think about most emotional problems?
And how did we get into this mess in the first place?
Worrying certainly exists, and we all worry at times. But how much or how often do you have to worry before you develop or have a “mental disorder” called “Generalized Anxiety Disorder” that can be diagnosed like any medical illness and treated with drugs?
Or is “Generalized Anxiety Disorder” (and hundreds of other “mental disorders in the DSM” based on a certain kind of nonsensical thinking? And if so, why? What is the goofy, faulty thinking in the DSM? And are there some “mental disorders” that are valid and real?
We HAVE touched on all of these themes in previous podcasts, but I thought it would be nice to put them all in one place and bring in a variety of “solutions,” controversies, and experts. I David, will often represent (hopefully, and to the best of my ability) the thinking of Ludwig Wittgenstein, as expressed in his famous book, Philosophical Investigation, published in 1950 following his death.
That book consists of a series of numbered brief essays (a few paragraphs each) that were based on notes found in a metal box under his dormitory room at Cambridge University. He’d written these in preparation for his weekly seminars in his dormitory room. Wittgenstein, although now widely regarded as one of the greatest philosophers of all time, did not think he knew enough to teach in a classroom. In fact, because of his feelings of depression and self-doubt, he sadly never tried to publish anything when he was alive.
Wittgenstein’s philosophy also played an indirect but significant role in the evolution of several modern psychotherapies. His philosophy created new ways of thinking that gave rise to the work of Dr. Albert Ellis, the famous New York psychologist who created Rational Emotive Therapy during the 1950s.
Ellis emphasized that the “Should Statements” that trigger so much guilt, shame, depression, anxiety, and rage are based on illogical thinking. He might often say, “Where is it written that people or the world “should” be the way you want them to be?” Of course, this idea actually traces back to the Greek Stoic philosophers like Epictetus and Marcus Aurelius.
Wittgenstein’s thinking also seems to have played a role in the thinking of Dr. Aaron Beck, who adapted the work of Ellis and called his version of the “Cognitive Therapy.” Beck emphasized many thinking errors, like All-or-Nothing Thinking, and Overgeneralization, that trigger depression, anxiety, and more.
Sadly, Wittgenstein struggled with severe depression and loneliness throughout his life, and three of his four brothers tragically died by suicide. Wittgenstein also had prolonged periods of time when he considered suicide. It is also sad that he did not know how to apply his brilliant philosophical breakthroughs to his own negative thinking, but that application of his work did not develop at the time he was still alive.
Part of Wittgenstein’s depression was related, I believe, to the fact that very few people, including the most famous philosophers of Europe, could understand his thinking when he was alive. From time to time, I think he glimpsed the enormous importance of his work; but I believe that he also had prolonged moments of self-doubt when he thought his work was of little value at best.
To be as correct as possible, Wittgenstein did write a manuscript called Tractatus Logico Philosophicus as a young man, although he never tried to publish it. He wrote it when he was a prisoner of war. He thought this book solved all the problems of philosophy, which had plagued him since he was a child, and he felt great relief. He sent a copy of his manuscript to Bertrand Russell, who was a famous British philosopher.
Bertrand Russell was incredibly impressed with the Tractatus and distributed it to many European philosophers. Bertrand Russell thought it might be the greatest book in the history of philosophy, and a number of the 20th century philosophical movements including Logical Positivism, were inspired by that book.
However, Wittgenstein left the field of philosophy, thinking that his work was done, and that he’d found the solutions he was looking for. He tried teaching grammar school for a while, but was fired because he became frustrated and violent toward some of his students. He also tried to survive as a fisher in a Norwegian fishing town, but was not successful at that, either, because he didn’t know much about fishing, much less supporting yourself through fishing.
One day, he learned that a brilliant Swedish economics student had found a flaw in his Tractatus, and his inner turmoil about the puzzling problems of philosophy flared up again. He decided to return to the study of philosophy.
He applied to be an advanced undergraduate at Cambridge University, but when someone in the admissions office spotted his application, they recognized his name and showed his application to Bertrand Russell, who had been wondering what had become of the young man who once sent him such a brilliant manuscript. Russell, who was the chair of the department of philosophy, said to being Wittgenstein to his office immediately for an interview.
Russell explained that he would have to reject Wittgenstein’s application to be an undergraduate at Cambridge University. Deeply disappointed, Wittgenstein asked why. Russell told him it was because he was already recognized as the greatest philosopher of the 20th century.
Bertrand proposed that if Wittgenstein would agree to skip college and graduate school, they would immediately award him a PhD for the manuscript he’d sent to Russell years earlier. Russell also offered him a full professor ship in the department of philosophy.
Wittgenstein protested and said he needed to study philosophy again, because of the error in Tractatus, and that he didn’t know anything, and definitely could not teach in a classroom. Bertrand Russell insisted, and they finally struck a deal where Wittgenstein would agree to be a professor of philosophy but all he would have to do was to have a conversation session with anybody who wanted to talk to him at his dormitory room once a week.
Wittgenstein accepted and met for years with students and famous philosophers who came from around Europe to crowd into his dormitory room for his weekly seminars, and he began to shape a radically different philosophical approach from the one he’d described earlier in his Tractatus. He was determined to find a new way to solve all the problems of philosophy.
And, to my way of thinking, along with those few who really understand him, he was successful.
But he was often frustrated because, so few understood him. This was unfortunate, because what he was saying was incredibly simple and basic, and it was pretty similar to, if not identical to, the thinking of the Buddha 2500 years earlier.
The Buddha apparently had the same problem—almost nobody could understand what he was trying to say when he was still alive. They couldn’t “get it” when he was talking about the so-called “Great Death” of the “self,” or talking about the path to enlightenment. The Buddha’s frustration resulted from the exact same problem Wittgenstein encountered 2500 years later.
The Buddha was saying something that was extremely simple, obvious, and basic—and yet, it was rumored that of his more than 100,000 followers when he was alive, only three actually “got it” and experienced enlightenment. When I read Philosophical Investigations my senior year in college, it was rumored that only seven people in the world understood what Wittgenstein was trying to say.
Wittgenstein’s dream was that philosophy students would “get” his thinking and give up philosophy when they realized that most if not all philosophical problems are sheer nonsense. He wanted them to do something practical and real in the world instead of studying philosophy.
He was verry disappointed when his favorite student, Norman Malcolm (one of the seven who “got it,”) pursued an illustrious career teaching philosophy in America at Cornell University.
I always wished I could have known Wittgenstein when he was alive, so I could have told him this:
I loved you, too, and I got it after several months of confusion, trying to understand your Philosophical Investigations, but eventually understood it with the help of your student, Norman Malcolm. His book about you was very inspiring. And that’s why I left philosophy for something more practical in the world. I decided at the last minute to go to medical school to become a psychiatrist instead of philosophy graduate school. Hopefully, I am doing something that you might be proud of!
But oddly enough, your thinking has also influenced my approach to people who feel depressed and worthless. They are also under a kind of destructive “enchantment,” thinking that there is some such “thing” as a more or less worthwhile human being! And this is a major cause of depression and anxiety and feelings of worthlessness and hopelessness.
I wonder if you, Wittgenstein, ever felt that you weren’t “good enough” when you were feeling down. hopeless and suicidal? I sure wish I could have helped you with that!
If you want to understand Wittgenstein’s work, the best book in my opinion is Norman Malcolm’s moving and affectionate tribute to his beloved teacher, entitled “Ludwig Wittgenstein: A Memoir.” It’s a short moving tribute to his beloved teacher, and tears go down my cheeks every time I read it, or even think about it. If you ever visit my office here at home, you’ll find that memoir proudly sitting on my bookshelf, with a handsome photo of Wittgenstein on the cover.
Toward the end of his life, Wittgenstein appears to have become more or less homeless, and he died from prostate cancer. His doctor said he could live in his home, where he was befriended by the doctor’s wife in his final days. His dying words were, “Tell them that I had a wonderful life.”
He died on April 29, 1951, just a few hours before my wife was born in Palo Alto, California. Surprisingly, she is the only person I’ve ever met who understood Wittgenstein’s thinking entirely the first time I explained it to her. She “already knew” what Wittgenstein, the greatest philosophical genius of the 20th century, spent a lifetime figuring out!
Reincarnation is pretty “out there,” and fairly silly, to my way of thinking, but sometimes it can be fun to think about it!
Here is my understanding of how the thinking of the “later Wittgenstein” actually developed. His first book, which is nearly impossible to understand, was called the Tractatus Logico Philosophicus. It is a series of numbered propositions, which he compared to climbing up a ladder, rung by rung, as you read the book until you got to the roof at the top of the ladder.
Then you could throw your ladder away and give up philosophical thinking, since he thought his book contained the solution to all the problems of philosophy that had tormented him since childhood, as mentioned previously.
The philosophy of language in the Tractatus is based on the thinking of Aristotle and Plato, who thought that the function of language was to name things that exist in the real world. Plato’s idea was that our real world consists of imperfect examples of a “Platonic Reality” which consisted of “perfect” representations of everything.
So, for example, Plato believed there could be a perfect “table,” a perfect “lamp,” and so forth. In other words, he thought there was an ideal essence to the concept of a “table.” And, I suppose, there might also be a “perfect” version of you! The early Wittgenstein also thought that the logic inherent in our sentences reflected the logic inherent in an external reality.
If that doesn’t make much sense to you, join the club! But that’s kind of what Plato and Aristotle were promoting, at least in my (David’s) understanding.
When Wittgenstein’s Tractatus was debunked, he was devastated, and desperately wanted to find another way to solve the problems of philosophy, since they started tormenting him again. It was much like a relapse of OCD or some other emotional problem. In fact, he thought of philosophy as a kind of mental illness that needed treatment.
Here’s an example of the types of philosophical problems that tormented him. Do human beings have free will? Do we have a “self?” Is the universal “real?”
Of course, we THINK we have free will, and it SEEMS like we make “free decisions” all day long, but is this just an illusion? For example, some people would argue that we cannot have “free will” because we “have to” follow the laws of science that govern everything, including how the brain works. So, since we “have to” do what we are doing at every moment of every day, we must not have free will!
Here is an argument that we do NOT have “free will.” When a powerful storm or hurricane destroys a portion of a city, and people die, we see this as a tragedy, but we don’t get angry at the hurricane because it does have “free will.” It is just obeying the laws of physics that govern the forces of wind, air pressure, heat and cooling, and so forth. A storm cannot behave in any other way.
So, the argument goes, we are also following the laws that govern the functioning of our bodies and brains, and so we cannot do other than what we do, so we, too, have no “free will.” We THINK we are acting freely but it is an illusion, so our brains are obeying the laws of the universe at every moment!
For hundreds of years philosophers have struggled with this puzzle, and many people still wrestle with this problem today. It was one of the problems that drew me to philosophy. Impractical for sure, but still tantalizing.
Another way to express the free will puzzle is via religious thinking. I was taught when I was growing up that God is omnipotent (all powerful), omnipresent (present everywhere) and omniscient (all knowing.) So, God knows the past, present, and future.
And if God knows the future, then God knows what we will do at every moment of every day, and we are helpless to do otherwise. Therefore, we have no “free will,” even though we “think” we do!
This free will problem can definitely be unsettling, with troubling moral consequences. If we do not “free will,” then are serial killers really responsible for, or guilty, or accountable for their actions? If we do not have free will, then wouldn’t that give us license to do whatever we want whenever we want?
Clever arguments for sure! We may “feel” like we have the freedom to do whatever we want at almost any moment of any day, but are we fooling ourselves and living in some gigantic hoax, or illusion? Are we total slaves with the delusion that we are actually acting “freely?”
How do we resolve this problem?
Well, one day Wittgenstein was walking past a soccer game at the park, and the soccer ball hit him on the head.
He wasn’t hurt, but had the thought, “What if the function of language is NOT to name things (like trees, or lamps, etc.) that exist in some “external reality,” like Plato and Aristotle thought? What if language actually functions as a series of “language games,” with rules, just like the game of soccer?
Then the meaning of any words would simply be the many ways the word is used in different real world situations. In fact, that’s what you find in the dictionary when you look up the meaning of a word. The dictionary doesn’t ever give you some “correct” or ”pure” meaning, since most words have many meanings.
This would be the opposite of the philosophy of Aristotle and Plato who argued that there were “true” meanings for every word, noun, or concept. What if, instead, words had NO true or essential meanings, and their meanings were simply embedded in the context in which they are used in ordinary, everyday language?
If so, this might mean that philosophical problems emerge when we try to pull words out of their ordinary meanings, which are always obvious, and put them into some metaphysical realm where philosophers argue about “ultimate truth.”
Let’s say we wanted to find out if humans have “free will.” Well, not being sure if there is such a “thing” as “free will,” we could look up “free” and “will” in the dictionary. (I know this sounds incredibly obvious and almost ridiculous.) What does “free” mean?
Well, we could talk about the many ways we use “free.” Political freedom means that in some countries you cannot contradict the leader (the dictator) without the danger of being thrown in prison or even murdered. But in other countries, you are, In fact, free to express your own ideas and opinions, without fear of punishment.
Free also means getting something without having to pay for it, like a seventh bottle of soda is free at the local grocery store if you purchase a six pack.
Free can also mean “available.” I am starting up my Sunday hikes again, and I might say, “If you are free this Sunday morning, meet at my front door at 9 and we’ll go for a hike and have a dim sum feast afterwards at a Chinese restaurant on Castro Street in Mountain View, California,
Now notice that when you talk about “free will” you have taken this word, “free,” out of the familiar contexts in which we find it, and given it some type of metaphysical “meaning.” But in this metaphysical, philosophical arena, it has no meaning.
So, instead of trying to “solve” the so-called “free will” problem, we can dismiss it as nonsensical, and ignore it as having no practical meaning, and move on with our lives. We can say, “I just don’t understand that problem! I don’t know what you’re talking about when you ask the general question of whether we have something called ‘free will.’”
That either works for you, or it doesn’t work for you! Your choice. It does work for me, but it took me months of thinking until I suddenly “got it.”
My way of describing this philosophical error is “nounism.” You think that nouns always refer to things that could “exist” or “not-exist,” just like Plato and Aristotle thought. So, you ponder and try to figure out if this notion of “free will” exists or does not exist. But it’s arguably a meaningless question.
That’s why I say, and Wittgenstein might say, I have no idea what you’re talking about.
Today we’ll discuss the free will problem and how it might relate to our field of psychotherapy. Next week, we’ll deal with another thorny problem: Do we have a “self?” Or is that also just some kind of illusion?
I (David) wrote these show notes before the show, and we have had fairly extensive email exchanges, with a variety of points of view on whether or not we have something we can call “free will.” First, I’ll put a great email by Matt, followed by a comment by Fabrice.
Here’s Matt’s email first:
Subject: Re: question
Yes, that's getting very close to what I'm trying to communicate. I don't believe you are 'slow' or 'super lame', either. In fact, quite the opposite.
I suspect I'm failing to do an adequate job of disarming your claims that 'free will' and 'self' are words taken out-of-context and, therefore, can't be shown to exist or not-exist.
I apologize, as I am pretty excited about the potential to help people, suffering with self-blame and other-blame, by realizing that we and others don't have a 'self' or 'free will'. I believe we have a brain that makes decisions and creates experiences, including the experience of having a 'self' and 'free will'. I believe that the experience of 'making' a decision is an illusion, as is the idea of a static, unchanging 'self' that controls decision-making.
I asked you to pick a movie and you said, 'Green Mile'. You acknowledged that this movie title simply 'popped into my head'. That's correct. Your 'self' didn't control what you selected, using 'free will'. Your brain just came up with that movie title. There was no 'self' that made a decision to choose that word.
I agree that we have a brain which is incredibly powerful. I'm claiming that we don't have an auxiliary 'self', with extra super powers, controlling our brain. We can make decisions, but we don't have 'free will', meaning, the ability to control those decisions.
I do think you have some resistance to seeing through the illusions of 'self' and 'free will', all of which say awesome things about you, e.g. morality and justice. I'm not trying to convince you, one way or another, and I don't expect to. I'm more interested in the listening audience, as many people are significantly relieved when they realize that we are more the victims of our biology and circumstance rather than defective 'selves' lacking 'willpower'.
To put a slightly finer point on the subject, when people say they have 'free will', they don't mean that 'decisions are made'. Obviously, decisions are made. You decided to keep reading this email, for example. Or you didn't. I'm not sure. Either way, a decision was made. When people say they have 'free will', they are saying that they (really, their 'self') are/is free to decide whether to continue reading this email, and that this power goes above and beyond what their brain is doing, according to the laws of physics. I am claiming that this is a ridiculous and dangerous thought, for which there is no evidence.
You're saying these terms haven't been defined. I'm pointing out that they already have been, intuitively, by anyone who thinks, 'I shouldn't have done that', or 'they shouldn't have done that'. These thoughts require a belief that they 'could have' done something different, that they had free will.
Aside from rage and guilt, let's examine the narcissism and excessive sense of confidence a patient might have, if they believe that they can simply 'decide', through sheer 'willpower', not to beat up on themselves anymore. Or a patient who believes they can simply 'decide' to always use the 5-Secrets, rather than criticize and blame. Can they? I've never seen that happen. That's why I assign homework. I know that the goal is to rewire the brain so they can feel and perform better, later.
We can't simply decide to feel good all the time. We all drift in-and-out of enlightenment. If we want to increase the likelihood that we will be able to set aside self-criticism or communicate more effectively, we have to practice new thoughts and behaviors. If we do, we will develop greater skills at defeating negative thoughts and communicating effectively. Otherwise, our brains will do, in the future, what they are programmed to do, now. It's because we lack 'free will', that we must do homework.
Similarly, you couldn't simply 'decide' to be the world's best ping-pong player. You realized you would have to work hard to re-wire your brain, if you wanted to have a chance at that.
Let's use the murderer/cat example:
A cat tortures and kills mice for the same reasons that a murderer does: their brains are programmed to do so. Murderers don't have a defective 'self' that is failing to express 'free will' adequately, when they murder. They're doing precisely what the atomic structure of their brain caused them to do, according to the laws of physics, in that moment, when presented with those precise stimuli. We don't have to judge or punish the cat or the murderer's 'self' and insist they should have used their 'free will'. We can accept that neither creature had the ability to decide differently from what their brain decided, in that moment. That is where the therapeutic element of this realization comes into play. I think it's important on a lot of levels, to stop blaming cats for being cats and murderers for being murderers.
Similarly, if a patient doesn't want to do homework, will it do any good to blame them and think they're bad and should decide differently? No, it helps to accept them where they are, and to accept ourselves where we are, with open hands.
Realizing nobody has a 'self' operating their brain and making decisions that are better than their brains' decisions doesn't mean we have to let all the murderers go or trust our cat with a new mouse companion. We can still be aware that their brains are programmed to murder. We would still be motivated to do whatever is necessary to protect society and mice. The difference is the attitude towards the murderer. We aren't trying to 'punish' or 'get vengeance' but to protect and, instead of 'labeling' them as having a 'bad self' or even being a 'murderer', but someone who has murdered and, left to their own devices, likely to do so again.
Instead of judging and demanding vengeance, we would see a murderer as the victim of their biology and environment. Instead of condemning them as permanently evil and bad, we could recognize that their brain is currently wired to do bad things and they might still learn new ways to interact with others. Perhaps they're not hopeless cases, after all. From the other side, if I ever committed murder, and sentenced to death, I wouldn't want to be feeling defective, thinking what a bad self I have and guilty/ashamed for not flexing my 'free will' in the heat of the moment. Instead, I might feel a sense of relief, purpose and meaning, that I was protecting others by being put to death.
Alright, enough out of me!
Thanks,
Matt
And now, the response from Fabrice:
Matt’s thinking is exactly in line with mine. I don’t know if the topic came up in your discussion, but some people argue that actually someone could have done something differently than they did, because there is some randomness in Nature. But that argument doesn’t hold water because even if the decision “made” by their brain is different, it has nothing to do with their will but only with the Heisenberg principle.
Cheers!
Fabrice Nye
[email protected]David’s wrap up comment. Matt and Fabrice have quite a different view of “free will” and the “self.” They are arguing, very thoughtfully and persuasive, that we do not “have” a “self” or “free will.” People have been involved in this debate, as I’ve mentioned, for hundreds of years, taking one side or another.
My own thinking is different, and reflects my understanding of Wittgenstein’s thinking. They have take these words out of the contexts in which they exist in everyday language, (which is a huge temptation) and involved in a debate about abstract concepts which have no meaning.
Very few people, it seems, were able to grasp this idea when Wittgenstein was alive, or even today.
So, if what I’m saying makes no sense to you, be comforted, since it seems likely that 99% of the people reading this, or listening to the show, will agree with you!
And that’s still a puzzle to me. It is not clear to me why so many people still cannot “see” or “get” this idea that words do not have any pure or essential “meaning” outside of the context of everyday use of language.
The best psychotherapy example I can use is the fact that nearly all depressed individuals are trying to figure out, on some abstract or philosophical level, whether they are “worthwhile” or “good enough,” or whatever. This seems to be a “real” problem, and so they believe that they are not sufficiently worthwhile.
This belief can be so convincing that many people commit suicide, out of a sense of hopelessness and self-hatred.
But there is not such thing as a human being who is more or less “worthwhile.” Of course, your actions can be more or less worthwhile at any moment, and we can evaluate or judge our specific behaviors. Yesterday, we had our first recording session in a video studio we have set up for our Feeling Great App.
We had a lot of fun and recorded some (hopefully) interesting stories we’ll publish on our two new YouTube channels. I really appreciated the colleagues who made this possible. It was a relief for me because I tend to have performance anxiety, which impairs my ability to speak naturally and with emotion. But this time, there was no anxiety at all, so it was fun.
Did this make me or my colleagues more worthwhile human beings?
No! But it did show that we’d become a bit more effective and communicating messages that will trigger healing and understanding in our fans, and hope that includes you!
When you “see” this, perhaps for the first time, it can be incredibly liberating, since you no longer have the need to have a “self” that’s “special” or worthwhile.
And, as some of you know, my beloved teacher and cat, Obie, taught me that when you no longer need to be “special,” life becomes special. When your “self” dies, you inherit the world! There’s no funeral, only a celebration!
Feel free to contact us with your thoughts, ideas and questions!
Thank you for listening today!
Rhonda, Matt, Fabrice, and David
-
Special Announcement #1 Attend the Legendary Summer Intensive Featuring Drs. David Burns and Jill Levitt August 8 - 11. 2024 Learn Advanced TEAM-CBT skills Heal yourself, heal your patients First Intensive in 5 years! It will knock your socks off! Limited Seating--Act Fast Click for registration / more information!
Sadly, this workshop is a training program which will be limited to therapists and mental health professionals and graduate students in a mental health field Apologies, but therapists have complained when non-therapists have attended our continuing education training programs. This is partly because of the intimate nature of the small group exercises and the personal work the therapists may do during the workshop. Certified coaches and counselors are welcome to attend.
Special Announcement #2Here's some GREAT news! The Feeling Great App is now available in both app stores (IOS and Android) and is for therapists and the general public, and you can take a ride for free! Check it
Today's Ask David PodcastWe have lots of great questions today. The answers in the show notes were written prior to the podcast, and the answers in the live podcast as we discussed these questions may differ somewhat or amplify the written materials in these show notes.
We love your questions. Remember to send them to [email protected].
Ask David Questions for Today
Bosley asks: My father can be very critical of my plans for the future. What’s the best way to respond to him? Willie asks: I have a dating questions. Why do women keep ghosting me? Should they be more willing to work out differences with the Five Secrets of Communication? 1. Bosley asks: My father can be very critical of my plans for the future. What’s the best way to respond to him?"To explain somewhat concisely, I just want to move to the nearest major city (Seattle) since I feel really really happy there. I also love volunteering for a specific organization and have some community there that I care about, and I feel very isolated having been away from for months.
I'm willing to carry the load of all the work I would need to do to make it happen, and do a business training my dad wants me to complete.
He has other thoughts. He looks down on volunteering and his thoughts on friends are simply that I can make new ones anyway. He is very aggressive and intimidating in his arguments, full of insults and many factually incorrect statements that are difficult to disarm on the fly.
He shoots down the idea upon mention, so it's difficult to collaborate to find mutually beneficial solutions. He is a successful businessman, despite recent financial issues, and has a sort of strict plan for me that he has wanted me to follow, although I really don't feel this conflicts with his goals to have me run things in the future.
I'm just worried since he has a long past of being emotionally abusive and of going back on his word. Plus, I just want some autonomy.
In the end, it's his way or the highway. He says “You keep scheming and going down a twisted path instead of doing what I tell you.”
David’s replyI suggested he might complete the first four steps of the Relationship Journal so we could see how he’s communicating with his dad. Here is Bosley’s partially partially completed Relationship Journal (showing steps 1 to 4, but not 5.)
Step 1 – S/he said: Write down exactly what the other person said. Be brief:
You keep scheming and going down a twisted path instead of doing what I tell you!
Step 2 – I said: Write down exactly what you said next. Be brief:
What?
Circle or bold the emotions S/HE might have been feeling Circle or bold the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated Angry, mad, resentful, annoyed, irritated, upset, furious Angry, mad, resentful, annoyed, irritated, upset, furious Other (specify) Other (specify)Step 3 – Good Vs. Bad Communication: Was your response an example of good or bad communication? Use the EAR Checklist to analyze what you wrote down in Step 2
Step 4 – Consequences: Did your response in Step 2 make the problem better or worse? Why?
It probably made things worse. I came off dismissive, which probably confirmed for him that I automatically ignored any advice or direction that he gave me. I wasn’t assertive in fear of escalating anger or just being shut down anyway, but that also maintains the status quo. I didn’t, and typically don’t, show a caring respectful attitude. This, I think, allows his anger to continue snowballing into more intensity.
2. Willie asks why women he’s dating “ghost” him instead of working out the problems in the relationship using the techniques in your book, Feeling Good Together.Good morning, Dr. Burns!
I hope you are doing well! I want to start off by saying that I love your books and they've played a massive role in changing my personality for the better.
However, there is a question I struggle with. In feeling good together, you say that one can keep status quo, solve their problem, or walk away from a relationship.
I lean very strongly on the side of always wanting to solve problems. However, at my age, most of girls I date err on the side of just walking away and this opens me up for unnecessary headache and pain.
I don't know where to draw the line? My heart says that any two reasonable adults can always make a relationship work given that at least one wants to make things better and, unfortunately, this does not seem to be the case in my experiences.
Your insight would be greatly appreciated! Thank you for taking the time!
Best Regards,
Willie
David’s replyThank you, Willie,
I’d love to use this as an Ask David question for one of the podcasts, if that’s okay, using your first name or a fake name if you prefer.
Here’s the super short answer. I wrote a book on that exact topic called Intimate Connections. Essentially you probably need to learn a little more about how to “play the game” when dating. You’ll see what this means when you read the book.
Warmly, david
Willie's Response: Good morning, Dr. Burns!Frankly, I was not expecting a response at all, much less as quick as it was. For this, I truly want to thank you for taking the time to do so.
Secondly, it will be my honor if you do bring it up to your podcast. Please don't use my first name - I'd prefer staying anonymous. Please do let me know which podcast this will be so I can give it a listen as well.
Lastly, thank you so much for referring me to your book. That will be my next read so I am super excited. If you have any other books which you believe are worth reading which will be beneficial in the dating world, corporate world, etc., please point me to those. I absolutely love your books and their effects on me have been immeasurable.
Thank you!
Willie
I wrote back and suggested we could use the fake name Willie, as he wanted to remain anonymous, and he responded:
Now that you say, Willie is definitely sexier!
Question: when are you planning on doing the next episode with this question in it? I wouldn't want to miss it.
Here was my response to “Willie.”We’ll just read your question, and then provide opinions. My career in private practice has a majority of single individuals who were trying unsuccessfully to connect in the dating world. That’s why I wrote that book, which is intensely personal as I was the biggest loser of all for a long time because I was a minister’s son and never learned how to “play the game” or be a “bad boy.” But I learned from a friend who was a “hustler” when I was in medical school.
I learned a tremendous amount, including that there is a game-playing phase in dating, and a time to be more serious, open and vulnerable. The biggest mistake men make is trying to get too serious when they should be playing the game.
What’s the game? Well, you’d know if you ever had or loved a cat. If you chase them enthusiastically, you force them to run away.
You have to learn how to make them chase you.
Many men are stubborn about this, and lamely insist, “But I shouldn’t have to play the game!”
My answer would be, “You don’t! Especially if you don’t want to get laid and have lots of ladies chasing you!”
Warmly, david
Willie’s responseThis is extremely valuable to me. I never knew that you come from a religious background and I do too so I do want to ask you some more questions / share my experience.
One pattern I am noticing is that either Muslim ladies have a lot of religious trauma or they have very strict conservative values - usually a combination of both. In the modern world, I try using dating apps and might get matched with someone 2-3 states away so usually we would hop on a FaceTime and the topic of religion almost always comes up. And, due to differing opinions, they just walk away which deeply upsets me because they make the false assumption that humans are snapshots in time i.e., opinions / perspectives don't change.
In fact, a personal experience I would like to share with you. I was in a relationship for 1.5 yrs (long distance) and it just ended 1-2 months ago. Our intention was always to get married. However, a few weeks before breaking up with me, she basically said "oh you don't pray and I cannot even imagine my future husband not praying etc etc" and she ended things with me on that. I even tried using the 5 methods of effective communication to acknowledge and validate her opinions while simultaneously sharing mine but she was dead set and did not even want to think about working on problems.
How could I "play the game" in such instances or over long distances?
David’s responseHi Willie,
The principles of dating are the same in all cultures for the most part, and one rule is “Never chase a distancer.”
So, when she switches to religion, you could use the listen skills subset of the Five Secrets, and buy in to what she’s saying, WITHOUT arguing or presenting your own thinking. You can admire her, urge her to tell you more about her religious feelings and spiritual life, using liberal Thought and Feeling Empathy, and lots of Disarming Techniques, and Stroking, with Gentle Inquiry. You would NOT chase, or try to persuade, or argue, or defend yourself. Be totally admiring and other-centered at those times.
If she says she wants to break up, you might say that you’ve been sensing some distance, and are relieved that she is doing that, because you, too, would like to date other women, but that the two of you can still be friends if she promises not to get romantically involved with you, and that you will be on the lookout for some really great guys she might want to date.
This is a paradoxical approach, and it is an art form. And I can also tell you to date other women immediately, and the moment you find one you like better than her, she will find out, even if no one tells her, and she will likely want you back again. That’s because of the Burns rule, which states: “People NEVER want what they CAN have; they ONLY want they CAN’T have!”
Now, if you tell me this approach is phony, I would tell you that you’re 200% right! And it’s not only incredibly phony, it’s amazingly effective! And a kinder word that “phony” might be to say that when someone starts pulling away, you have to switch into this style and strategic approach, and stop trying to be loving and sincere or logical, etc. Do NOT chase, simply open your hands and let go.
It’s the exact same strategy you might use to get close to a cat!
Best, david
Hi Willie,
If you’d like, you can send me an example of what one of the Muslim ladies said to you, and exactly what you said next. Please select an interaction that didn’t go well. Then I can analyze your response and suggest some alternative ways to respond in a dating situation. In fact, if you like, you can record it on the Relationship Journal that I’ve attached. Please fill in steps 1 through 4.
Please do this right away as we record tomorrow.
Best, david
Hi Dr. Burns,
I cannot even tell you how much these emails are already changing my outlook. I truly want to thank you for taking the time and responding to these.
One thing that caught my eye is the paradoxical approach. I never thought about it. In my mind, I feel you should work on relationships / never let go but if letting go is working on it, then that is something I really need to do.
I am attaching two copies of the Relationship journal. One dealing with the topic of drugs and one with prayer. One thing I will tell you is that I usually bring these topics up myself because, in my mind, I don't want to deceive anyone and get these big topics out of the way as early on as I can and I think I am making a mistake somewhere here.
Thank you, again, for taking the time and responding to these emails! Looking forward to what you think about the topics of conflict I have been having!
Best Willie 😉
Willie’s Relationship Journal #1Step 1 – S/he said: Write down exactly what the other person said. Be brief:
Religion is super important to me. As a Muslim, I want my partner to pray 5x a day.
Step 2 – I said: Write down exactly what you said next. Be brief:
Religion is super important in today’s day and age. It is a part of our culture and I definitely want to introduce my kids to it.
However, I don’t think that prayer in and of itself makes you religious - if anything, the more external your religion means the higher likelihood of hypocrisy. In my mind, everyone’s religion is between them and god so the best you can carry is one that no one else even knows of - kind of like charity.
Circle the emotions S/HE might have been feeling Circle the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated Angry, mad, resentful, annoyed, irritated, upset, furious Angry, mad, resentful, annoyed, irritated, upset, furious Other (specify) Other (specify) Taken for granted, unappreciated Willie’s Relationship Journal #2Step 1 – S/he said: Write down exactly what the other person said. Be brief:
All kinds of drugs are bad and I don’t want to date anyone who does them.
Step 2 – I said: Write down exactly what you said next. Be brief:
I strongly agree. Any kind of drug that can open you up to addiction can have a lot of negative effects and that’s one of the reasons why I don’t even drink coffee.
On the other hand, latest research does suggest that drugs like hallucinogens can have positive effects on people so even though I don’t do them, I have tried once and keep an open door for them primarily because they are not addictive.
Circle the emotions S/HE might have been feeling Circle the emotions YOU were feeling Sad, blue, depressed, down, unhappy Sad, blue, depressed, down, unhappy Anxious, worried, panicky, nervous, frightened Anxious, worried, panicky, nervous, frightened Guilty, remorseful, bad, ashamed Guilty, remorseful, bad, ashamed Inferior, worthless, inadequate, defective, incompetent Inferior, worthless, inadequate, defective, incompetent Lonely, unloved, unwanted, rejected, alone, abandoned Lonely, unloved, unwanted, rejected, alone, abandoned Embarrassed, foolish, humiliated, self-conscious Embarrassed, foolish, humiliated, self-conscious Hopeless, discouraged, pessimistic, despairing Hopeless, discouraged, pessimistic, despairing Frustrated, stuck, thwarted, defeated Frustrated, stuck, thwarted, defeated David's Reply to Willie's RJsThis is the analysis of his initial RJs
Thanks good start. You might have time to redo them a bit. You failed to circle the feelings she might be having (or use bold face) as well as your own feelings. This will help you with the E and A of the EAR Checklist. You got the general idea, but you’re missing some crucial details. Also, your responses are both argumentative, all about you, and not using any real disarming or empathy / inquiry to draw her out.
You are trying to “win” an argument, which is a a 100% guarantee that you will lose! And you are trying to persuade, which is a 100% guarantee to push her way and force her to reject you.
Best, david
In the show, We analyzed Willie’s responses to the two examples from the Relationship Journal. Rhonda, Matt, and David agreed that Willie was not acknowledging her feelings or empathizing with her at all. She likely had many feelings that we listed on the show, along with his. We focused on how he might respond with Other- rather than Self-Centered conversational skills.
It was clear how he was “forcing” the ladies to reject him, and how could respond in a radically different and far more appealing manner.
Both Matt and Rhonda did a superb job of role-playing and teaching in this podcast segment!!
After the podcast was recorded, Matt had some thoughts about how his response (when playing the role of Willie during the podcast) could be improved. Here's his commentary:
Hi Rhonda and David,
I had some follow-up thoughts on the role-play with Willie, which I hope are potentially helpful for him. If you agreed, maybe they could go into the show notes?
I had given myself a B, but wasn’t sure why. I think I have a better understanding now.
First, I agree with Rhonda that suggesting I simply fulfill her request to pray five times per day and that that would mean my dreams come true if it might lead to being with her was an error. I think it was probably problem-solving, as well as an agenda-setting error with Willie, who will likely want to stick to his decisions around what’s right for him in terms of practicing his faith.
Instead, I think my error might have been “chasing”, and the missing ingredient was probably “Open Hands”.
While Rhonda really appreciated my empathic response, it is also possible that such a response would backfire, at the “intensity matching” level, especially if what willies ex is saying is that she doesn’t want to be with him. It would then be an error to push her towards talking more about her feelings.
Something like (in addition to other 5-Secrets)…
“On the other hand, it would make sense if you didn’t want to talk about those feelings with me. Perhaps you’re just letting me know that this isn’t going to work for you. That would be sad, but also totally understandable and we could just end the conversation, here. I’d be sad if that were the case because I really like you. On the other hand, prayer is very important to you and it’s perfectly valid that you wouldn’t want to be with a guy who doesn’t pray”.
This would have better demonstrated the paradoxical element of being a “bad boy” or just interpersonally effective, than what I had said.
Thanks again for having me in the podcast!!
Fondly, Matt
And here is Rhonda's response to Matt:
Hi Matt: Now your response jumped from A+++ to A++++. I think acknowledging their differences is so respectful. The conversation may indeed have ended there, but it would have ended with respect and understanding and good feelings instead of the confusion, betrayal and other challenging feelings we mentioned on the podcast.
Thank you for following up, Rhonda
Thanks for listening today!
Next week we will start Practical Philosophy month. We will provide solutions to the five most popular puzzles in philosophy, and will also show how they related to emotional problems as well as The DSM and how we think about and diagnosis so-called "mental disorders."
Rhonda, Matt, and David
-
A Riveting Story of Raw Emotion. . . “Dad, I let you down!" Part 2 of 2 Special Announcement The long awaited Feeling Great App is now available in app stores. IOS and android! Check it out. Take a free ride!
And now, on with the exciting conclusion of the personal work Dr. Jill Levitt and I did with Chris, along with a fabulous followup interview you will hear at the end of the session.
I hope you enjoyed the session with Chis, and hope you found it inspiring. His message of hope and joy could be helpful and inspiring to any of you who may be struggling, and feeling, as he was, that you're just "not good enough." His work is, of course, important from a psychological perspective, because it illustrates the powerful steps of TEAM in a sequence that brought Chris from the depths of despair to the peaks of enlightenment. However, as you will hear in the postscript dialogue, the work for sure takes on a spiritual and mystical quality for sure!
When you hear Chris live during the follow-up interview at the end of Part 2 of this two-part podcast, you will not be disappointed!
PostscriptAs I mentioned earlier, I was overjoyed when I learned that Chris had unexpectedly changed his mind and offered us the chance to publish his personal work and provide a follow-up recording of how he’s doing now.
Here’s my email to him just prior to the follow-up recording.
Hi Chris,
I’m assuming that Rhonda will coordinate this and she has us scheduled for this Friday, I believe. When it is 4 PM in your time zone, what time is it in our time zone? Are you two hours later?
I just reviewed my chart notes from a year or so ago, and it will be terrific to reconnect with you. I deeply appreciate the chance to share your session with our many listeners, as it is full of raw emotion and is riveting. You are making a super strong statement to the world, to my way of thinking, and it takes incredible courage to say, “This is me! I am very real, and sometimes very raw!”
I think many people suffer due to thinking that everyone else is somehow “better” than they are, and that they are somehow “not good enough.” That is perhaps the main theme I hear when doing clinical work, and that includes my work with mental health professionals who are equally vulnerable to this kind of thinking.
What triggered your decision to go public, so to speak. And how might this impact your students, and their parents, and so forth?
Hopefully, we can chat this Friday about those and any other questions or topics that touch or interest you. It will be great to get caught up on your past year!
If Jill or Rhonda want to add your thoughts, please do! To me, this is a very significant occasion to have the chance to connect with you, Chris, again! The work you did is among the most powerful and impactful ever in my memory, although every time we do live work it is pretty incredible to my way of thinking, especially when people become “real,” whatever that means!
Humans have a dark side, to be sure to my way of thinking, but something incredibly beautiful and amazing can emerge.
I am babbling so will stop. But I am so excited to talk to you again, Chris!
Warmly, david
Thank you for listening, and please let us know what you think.
if you are a therapist, and want to learn how to do this, consider attending the summer intensive from August 8 to 11, on line, or in person at the South San Francisco Conference Center (ten minutes from the SF airport.) See the details and a link below, or go to www.cbtintensive.com.
Chris, Rhonda, Jill, and David
Click for registration / more information! -
A Riveting Story of Raw Emotion. . . “Dad, I let you down!" Special Announcement The long awaited Feeling Great App is now available in app stores. IOS and android! Check it out. Take a free ride!
And now, on with today's podcast!
Part 1 of 2Our work with Chris started with this email:
Hi David and Jill,
I am 40 years old and have never been in a relationship. I've only had a handful of sexual experiences.
I used to carry a lot of shame around this, but have done some work on myself, have more or less come to terms with where I'm at, and actually really enjoy my life and am pretty happy most of the time. However, I recently developed some strong feelings towards a coworker, and this led me to re-evaluate my stance on being single.
The DML (LINK) details an incident from last week concerning this coworker. I haven't had extensive interactions with her and she works at a different site. Our clinical team meets twice monthly for online zoom meetings. She recommended a book to the team a few months ago, I read the book and enjoyed it, and was hoping to meet up with her and talk about it sometime. I was feeling a little terrified and didn't know if it was the right thing to do, but ultimately sent her an email asking if she'd like to speak with me about the book sometime.
She politely declined the invitation. The daily mood log documents the hour or two immediately after I sent the email, as well as some of the thoughts that happened after I received her reply.
There were a lot of negative thoughts, so I only included a few. There were also a number of hidden thoughts/beliefs that occurred to me over the last few days, which I have not included.
It seems worth noting that for 2-3 hours after I sent the email, I experienced a lot of emotional turmoil. However, at 4pm when I got off work, from the long drive home until I went to bed, I was in a euphoric state. I was happy about what I did, how I responded to the rejection, and was optimistic about my future. I was working out at the gym and had a hard time keeping a smile off my face.
I went to bed feeling great, but woke up in the middle of the night and felt terrible again, the painful sting of rejection kept me from sleeping. Since then, I've mostly felt just fine about it, only a few brief moments of really feeling that sting and they don't last long.
My goal isn't to necessarily get into a relationship or have more sex; it's to feel more confident in my interactions with women. After being rejected, I think 15 seconds of agony is enough, no need for more than that. In the past, when I've developed strong feelings towards a woman, I notice that I am prone to both negative and positive distortions, some version of:
"It's the end of the world if she isn't attracted to me," or "She's perfect for me; there is no one else like her," or "Sex with a beautiful woman will complete my life, or completely fulfill me".I think I'd be better off without these distortions, but find the positive distortions to be somewhat addictive. They also make it hard for me to let go and move on. I still feel somewhat attached to this woman and haven't been able to let go and move on.
Also, I want to note that there are a few experiences from high school that really impacted my sexuality, relationship with women, and probably inform some core beliefs on these subjects that have recently come to surface. I'm not sure how much to share about this or whether it's even necessary to, but I suppose that could be addressed in the empathy phase on Tuesday.
One other thing that I didn't include in the DML, is when I'm in that negative state, sometimes I have intense thoughts directed at me that come in the form of the second person, like
You're a piece of shit. I fucking hate you. Cut your throat You don't deserve to be alive. I'll fucking kill you.I don't really believe these thoughts, but they do make me sad.
Hope this all makes sense, let me know if you have questions or if I'm missing something. Looking forward to working with you.
Thanks,
Chris
This email led to personal work with Chris in our Tuesday TEAM-CBT training group, roughly one year ago. Dr. Jill Levitt, the Director of Training at the Feeling Good Institute in Mountain View, California, was my co-therapist. It was one of the rawest and most riveting sessions that I can recall.
Here is the Daily Mood Log he sent, along with his Daily Mood Log:
Daily Mood Log
Due to the intensely personal, explosive revelations Chris shared with us during his session, he decided he did not want us to publicize his work as a podcast, which was totally understandable. Our highest priority is always the peace, safety, confidentiality, and well-being of the people we work with.
However, roughly a year later, Chris contacted us and said he’d changed his mind, which was fantastic news. He said he’d changed his mind because he had a relapse, and decided to listen to the recording of the work you’re about to hear. He said it was extremely helpful, and so he decided to let go and share it with the world.
I think you will find his personal work, published as usual as two consecutive podcasts without editing, to be mind-blowing, jaw-dropping, intensely inspiring and moving.
One word of caution is that his voice is soft and at times difficult to hear. We decide to publish it in spite of this because of the overwhelming power of his work. We are now setting up a professional quality recording studio and hope to record more sessions for you in the highest possible video and audio quality so we can bring you more inspiring Feeling Good Podcasts as well as live therapy sessions.
In the meantime, here is part 1 of our work with Chris. Next week, you’ll hear part 2.
Thanks so much for listening today!
Chris, Rhonda, and David
End of Part 1Thank you for listening. Tune in next week for the exciting conclusion of our work with Chris!
Chris, Rhonda, Jill, and David
- Visa fler
