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

459: Personal Work with our Beloved Rhonda, Part 2


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Part 2 of Our Personal Work with Rhonda The Surprising Conclusion of Rhonda's Session with Matt and David

Last week, you heard Part 1 of our personal work--a single two hour therapy session--with Rhonda, focusing on her recent shocking diagnosis of a cancerous and potentially fatal lymphatic tumor in her neck. We did initial T = Testing and E = Empathy. Today we do the A = Assessment of Resistance and the M = Methods, and of course, the final assessment of symptoms and teaching points.

A = Assessment of Resistance

How DO you help someone facing a terrifying diagnosis of cancer? What's the best method to use? How do you cheer them up, or is it impossible to do so and foolish to try? Or is there no correct answer to these questions?

Well, there IS a "correct" answer, at least according to the gospel of TEAM. You ASK the person if they want help, or if listening is enough. And if they want help, you ask them what they want help with. This personalizes the treatment and brings it alive for the patient.

Rhonda said she had difficulties accepting help, and extreme fears of being a burden on others.

She specifically wanted to stop comparing herself to her friend, Jack, who has so far survived for four years after a severe diagnosis of disseminated cancer requiring whole body radiation. She also wanted help feeling less guilty about her anger and her complaint about pain and side effects.

Because we didn't want the session to run overly long, we did some streamlined Positive Reframing, listing 11 positives embbeded in her negative thoughts and feelings, such as "I have no right to complain." What does each negative thought and feeling show about her that's positive and awesome? And what were some benefits of them?

The we asked Rhonda about her goals for each negative feeling on her DML, which you can see if you

CLICK HERE

As you can see, her desired reductions for most of her negative feelings were only modest, perhaps indicating some acceptance of her situation and the negative feelings that seemed inevitable. However, this can sometimes indicate some residual resistance that has not been addressed. We'll have to wait and see what happens next to find out!

M = Methods

We worked with Rhonda using several methods, especially the Externalization of Voices with frequent role reversal until she got to huge. My memory of the session is that the Counter-Attack Technique compared with the Acceptance Paradox got her to HUGE wins. You can see Rhonda’s ratings for each negative feeling at the end of the session if you

CLICK HERE

And were these rating genuine? Or was she just being "helpful" to us for the sake of the podcast?

At the end, Rhonda estimate her gratitude was 1,000,000%!

Thank you, Rhonda. We all love you for your incredibly important gift to all of us today, teaching us how to love, and to laugh, when we all have to face our inevitable fate of letting go and experiencing the "true Great Death" of the "self." And we are 1,000,000% grateful to your wonderful doctors at Stanford that this cancer will NOT get the last word!

Teaching Points

The first take home message is that you can’t effectively treat anyone with any kind of emotional problem without asking them to write down their negative thoughts. If you do this, you can find out exactly what's going on, and you'll know the only real cause of all the negative feelings that person is struggling with.

That’s why you can’t treat depression with “tips” or advice, like “spend time in nature,” or “spend time with friends.” That’s just junk and cheap advice and it will not work, above and beyond a possible placebo effect.

Second we don’t treat problems, like “cancer” or "depression" or any “mental disorder” with packages developed for just that problem. We treat people who are struggling, and find out what their negative thoughts are! You CANNOT know what someone is thinking without asking them. Everyone’s thoughts are different and unique. That's why packages, including ALL the so-called "schools" of therapy, will ALWAYS fall short.

There are, of course, common themes, like “I’m not good enough,” but we all put our own unique spins on these themes when we’re hurting.

And third, measure what you're trying to treat, with brief accurate scales worded in the hear and now at the start and end of each session. That's the ONLY way to know if you've been effective.

And finally, events no matter how traumatic, do NOT cause feelings. Only your thoughts can have impact on how you feel about yourself, other people, and the world. That statement is not intended to blame you for how you feel, but to liberate you from the traps you've fallen into.

Thanks for listening today!

Matt, Rhonda, and David

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

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