221: Ask David: What's Your Definition of a Violent Person? Five Cool Questions from Listeners Like You!

Podcast 221 Ask David December 21, 2020 Today’s Ask David features five challenging questions submitted by listeners like you! Sumaya asks: I recently bought Feeling Great and can’t find the chapters on Habits and Addictions in the book. Could you please clarify? Jay asks: Can you provide more specific information on the contrasts between Feeling Good, The Feeling Good Handbook, and Feeling Great? Rizwan asks: How would you use the Five Secrets to respond to a truly irate patient? Casey asks: How do you treat resistant autism patients with All-or-Nothing Thinking? Debby asks: What’s your definition of a violent person? Today’s podcast begins with season greetings for people of all (or no) religious faiths. Rhonda reads a moving email submitted by a listener who was helped by the recent two-part Sunny series on the Approval Addiction. David gives a plug for his upcoming workshop with Dr. Jill Levitt on “Defeating the Beliefs that Defeat You and Your Patients” on February 28. 2021 (include link.) We also give a shout for Sunny’s recently opened private practice, which offers super rapid treatment and a user-friendly fee schedule. Sunny can be reached at: Sunny Choi, LCSW [email protected] Better Mood Therapy rhonda's exciting new Feeling Great Treatment Center is now open for business as well. She can be reached at [email protected]. And now—your cool questions! * * * Sumaya asks: I recently bought Feeling Great and can’t find the chapters on Habits and Addictions in the book. Could you please clarify? David explains that the two “lost” chapters on habits and addictions are available for free on the homepage of www.feelinggood.com. I had to cut about ten chapters from Feeling Great due to length, but put them on the homepage since the techniques for treating habits and addictions are new, innovative and powerful, and may help some folks. * * * Jay asks: Can you provide more specific information on the contrasts between Feeling Good, The Feeling Good Handbook, and Feeling Great? Dr Burns Is it possible for you and Rhonda to do a podcast about Feeling Great book and Feeling Good and Feeling Good Handbook? I sat down to hear the similarities and differences and target audiences etc. Very in depth etc but podcast 213 seemed to me to get derailed into the four ego deaths of the therapist and the four ego deaths of the patient. I am not minimizing the value of discussing Ego deaths. But it seems like you never really addressed the similarities and differences in the three books. One thing I have not heard you discuss is that powerful section in Feeling Good on preventing setbacks. Love addiction etc. Addressing the core beliefs that trigger recurrent depression in some people. Also the expectations of doing a two-hour session vs doing the daily mood log for 15-20 minutes per day over a few months ( in the Self Esteem section of Feeling Good.) I thank you Sincerely Jay Thanks, I DO meander! Both a curse and a blessing, as my mind works like that, with new ideas popping in all the time. First, here are the differences between the three books: Feeling Good is a beautiful presentation of the basics of cognitive therapy, including how to crush distorted thoughts and modify self-defeating beliefs like the Achievement, Love, and Approval Addictions, as well as Perfectionism and Perceived Perfectionism. The books focuses on depression, including suicidal urges. This book was published in 1980 and has sold more than 4 million copies worldwide. It has received a number of awards and has been named the top depression self-help book, from a list of 1,000 books, by American and Canadian mental health professionals. The Feeing Good Handbook has more exercises and a broader range of topics, including depression, anxiety, and relationship problems, as well as a special section for therapists on how to help challenging, difficult patients. This book was published in 1988 and has sold roughly two million copies. Feeling Great was published in September of 2020. It updates all the tools and techniques in the prior two books, but also includes powerful new techniques to overcome therapeutic resistance. It also includes a section on more spiritual (but still practical) techniques, including the four “Great Deaths” of the self. Feeling Great has a special section on how to crush each of the ten cognitive distortions, plus many real case examples with links to the actual therapy that you can hear online in my Feeling Good Podcasts. This is important because some readers may not believe that people with chronic and severe depression and anxiety can recover more or less completely in a single, two-hour therapy session. Toward the end there of Feeling Great there is a special chapter by the famed neuroscientist, Professor Mark Noble from the University of Rochester, on how TEAM quickly modifies specific circuits in the brain to achieve ultra-rapid recovery. The stance of the therapist has changed significantly in Feeling Great, as compared with the earlier books. Instead of trying to “help,” the therapist becomes the voice of the patient’s subconscious resistance, and makes the patients aware that their symptoms of depression and anxiety are not the result of what’s wrong with them, like a “chemical imbalance in the brain,” or a “mental disorder” described in the DSM, but rather what’s right with them. And the moment the patient suddenly “sees” this, recovery ill be just a stone’s throw away. Feeling Great was based on 40 years of research on how psychotherapy actually works and more than 40,000 hours of therapy with depressed and anxious individuals, including many with severe and chronic problems. TEAM is not a new school of therapy, but a structure for how all therapy works. * * * Rizwan asks: How would you use the Five Secrets to respond to a truly irate patient? Dear David I suggest one imaginary statement from an irate patient: “Your therapy is not working. In last one year I paid you $1500. And I am nowhere near completing the therapy successfully with you. I am broke. I can’t pay you anymore. I need to quit. How you could you do such a thing to me?” How would a therapist reply to this using 5 secrets? Rizwan David and Rhonda emphasize the importance of session by session testing so this unfortunate situation does not develop, and role play how to respond effectively using the Five Secrets. The importance of the Disarming Technique is highlighted, and training methods are illustrated, along with the philosophy of "learning through failure" or "joyous failure." * * * Casey asks: How do you treat resistant autism patients with All-or-Nothing Thinking? I am a behavior support specialist working with people with Autism, all across the spectrum of the diagnosis, as well as with people with intellectual disabilities, cerebral palsy and down syndrome. Not to be confused with an ABA therapist, I am more of a traditional therapist who uses eclectic strategies and methods to help the people I support. I also work mainly with adults because, sadly, the system often forgets them and they do not have as many services as children. Because I work on helping people change their behavior, it is a logical conclusion that I have to help them work to change their thoughts first. Thankfully my graduate school program was very CBT focused (Go IU School of Social Work!). Since then I have found your podcasts and books immeasurably helpful in enhancing my practice and use the methods you teach whenever possible. When working with people with Autism I often run into All or Nothing thinking, catastrophizing, and unfortunately a lot of treatment resistance because most of the people I support are “Involuntary” clients who have been sent to therapy by their family members. I have two questions: First, what is the most powerful method for defeating All-or-Nothing Thinking? Second: I know you talk a lot about agenda setting to combat treatment resistance. How do you balance the wishes of the parents (or guardians) vs. the willingness on the part of the patient to change? I struggle with this daily and could use some advice. Thank you and Rhonda so much for the amazing podcast, the books, and the wealth of information about TEAM-CBT. I have also attended several of your trainings and plan to attend more this year because our annual conference was cancelled, so I’m left to get 10 CEUs on my own and your trainings have been very helpful in fulfilling this need! Also, Rhonda: You are amazing and I hope you know it! Casey P.S. I also promoted you a lot on my Instagram channel @passionplanhappiness when I did a series on unhelpful thinking styles. I couldn’t find an Instagram page for the podcast so I just mentioned it by name. Do you have an Instagram channel? Hi Casey, Thanks, I can include this in an Ask David, and you might also want to try out one of the introductory 12 week TEAM classes sponsored by FGI, feelinggoodinstitute.com, as a lot of practice is usually needed to grasp and implement techniques and ideas that might seem simple. I do not ever treat people against their will, who are involuntary. This is not treatment in my opinion, and is rarely or never effective. However, I would offer to treat the parents if they wanted help with parenting skills for the child. Also, you might want to check out the podcast on the best techniques to treat AON! Use search function on my website. All the best, david David D. Burns, M.D. David and Rhonda talk about techniques to combat All-or-Nothing Thinking as well as how to set the agenda and sit with open hands with patients who are in therapy involuntarily. * * * Debby asks: What’s your definition of a violent person? Hi Doctor Burns, I have a question on what you consider a” violent person” to be. For example, If someone feels like punching someone out, doesn’t does that make them a violent person just for feeling it? I would say no because they never acted on it. Debby Hi Debby, You may be trying to define something that does not exist. Violent urges exist in varying degrees at varying times in all human beings. Violent thoughts, feelings, urges and actions exist. But a “violent person” does not exist. My thinking only, and many will undoubtedly “violently” disagree, and not even comprehend, perhaps, what I am saying. Humans have a dark side, and the extent is on a bell-shaped curve. The denial of the dark side is arguably worse than the dark side, since violence is generally carried out in the guise of some religious principle, or some kind of “truth.” david Hope you enjoyed today's podcast! Rhonda and David