Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

458: Personal Work with our Beloved Rhonda, Part 1


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Part 1 of Our Personal Work with Rhonda The doctor said I have cancer! 

Are feelings of depression, fear, anger, hopelessness, and more inevitable if you have experienced a severely traumatic event? Nearly all human beings would say it IS inevitable.

But are they right? If your doctor just told you that you have a serious form of cancer, is it possible--or even desirable--to avoid intense distress and despair?

Today, Matthew May MD and I sit down with our beloved Rhonda who was diagnosed roughly six weeks ago with a cancerous follicular lymphoma. This is a type of lymphatic cancer that allows for a reasonably long life expectancy, but is almost universally fatal. With one exception—if you find and treat it super early. And that is where Rhonda finds herself. And today, she received her (hopefully) 12th and final radiation treatment to her neck, right under her right ear. She was told that the probability of a cure is 95%, but the effects, including painful side effects, of the radiation would be cumulative and increasing for a while after the series of treatments has been concluded. And she IS in considerable discomvort.

Which was good news, great news, actually, for all of us!

Still, it’s been a rocky and highly emotional road for Rhonda. So Matt and I sat down with her early this morning to see if we, with the help of TEAM CBT, might be able to bring her some accurate empathy and comfort.

In the session, Matt and I went through the T E A M sequence with Rhonda.

T = Testing

You can see Rhonda’s initial Brief Mood Survey if you

CLICK HERE

As you can see from her Brief Mood Survey, which was completed before the session began, she was only mildly elevated in depression, anxiety, and anger, but her positive feelings of happiness were very low (only 8 our of 20, with 0 being not happiness at all in any category and 20 being the highest possible happiness. in all categories.)

E = Empathy

However, as Matt and I empathized with Rhonda, we reviewed her partially completed Daily Mood Log, which you can see if you

CLICK HERE

This tool painted a radically different picture. Rhonda's scores in nearly all categories were extremely elevated, indicating about the most intense feelings of depression, anxiety, guilt, shame, inadequacy, hopelessness, frustration, anger, and shock, as you can imagine. She was also moderately self-conscious and embarrassed.

Four radically important question came to mind:

  1. What was causing these intensely negative and almost unbearable feelings?
  2. Is there any realistic hope of reducing them during today's session?
  3. And if you did want to "help," how in the world would you attempt to do this?
  4. And how much "help" could you realistically hope for?

If you're serious about these topics, I would strongly recommend that you take a piece of paper and jot down your answers to these questions right now, before you listen to the rest of session. Then, after you listen to the conclusion next week, you can compare what happened with your own ideas about the situation. ,

During the empathy phase, Matt and I used the Five Secrets of Effective Communication to understand exactly how Rhonda was think, and how she was really feeling inside. We also did a What-If / Downward Arrow Technique to find out what she was the most afraid of. If you haven't already listened to that portion of our work with her. What do you think she was most afraid of in having cancer? And why, do you suppose, she was feeling so guilty? And so angry?

We also explored the impact of the side effects of the radiation therapy, and the impact of the cancer on her personal and family relationships, the errors others made in trying to "help" when she was feeling down, and her fears of the future.

At the end of the empathy phase, we asked Rhonda to grade us in three categories:

  1. How well did David and Matt understand your thoughts?
  2. How well did David and Matt understand how you were feeling inside?
  3. How well did David and Matt so in creating an atmosphere of trust, warmth, and acceptance?

If you're a mental health professional and you do psychotherapy, I have another question for you before we continue: What % of your patients do you ask these three questions part way through your sessions? Raise your hand if the answer is "most, if not all, of my sessions."

Yikes! I don't see many hands going up! I don't want to upset you, and you may not take me seriously, but you might be missing the boat!

At any rate, Rhonda gave us a triple A +. That's definitely a passing grade, and she gave us the green light to go on to the final two steps of the TEAM session(/the A and the M steps), which you'll hear in their entirety on our very next podcast!

Thanks for listening today! And make sure you tune in next week for the awesome conclusion of our work with our beloved Rhonda!

Rhonda, Matt, and David

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Feeling Good Podcast | TEAM-CBT - The New Mood TherapyBy David Burns, MD

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