By David Burns, MD
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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:
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
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
"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 response
Hi 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, unappreciatedWillie’s Relationship Journal #2
Step 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, defeatedDavid's Reply to Willie's RJs
This 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
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!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:
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
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
We 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].
Special Announcement 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.
But there's some good news, too! 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!
Today’s Questions
Hi David and Ronda, and if Matt is on
I have been listening to your wonderful podcast for about the last 3 years as I drive to work. It has really opened my eyes about how your thoughts create your interpersonal reality. Loved the podcasts on jealousy addiction, perfectionism, achievement addiction and many more.
My questions would be: What about if someone wants to achieve more but it isn't based on worthwhileness? They would buy and own things that they happen to like and not to impress others.
Let's say they wanted to be able to afford a nice house, healthier higher quality food and water. As the quality does have an effect on health especially in the US as the regulations are not the greatest.
However, the fact that they couldn't afford to buy these upsets them? Thoughts: 'It's not fair that I can't afford quality food but there are millionaires that will have access to better food, lifestyle which has an effect on overall health and longevity'
Or if someone has to pay for unexpected expensive dental treatment.
Thoughts: 'It's not fair that I have to pay £14,000 for this treatment'. 'It should be more affordable to lower income households, as it is essential to have functional teeth'
I hope I have explained this well, I would love to hear your thoughts. Keep doing what you are doing and all the best.
Kieran
David’s response
Sure Kieran, if you like I will make this an Ask David question for a podcast. LMK if that’s okay, and if it is okay to use your first name.
Great question, and has to do with the theme of acceptance: should I or shouldn’t I?
Here are the quick versions, but we can discuss in more detail on the live podcast. First, I do not find it useful to base my worthwhileness on my achievements or on my failures. I do work hard and like creating things that are helpful to people, and I enjoy earning money to support my family. I can be motivated to work hard to get things we want or need, but I don’t base anyone’s worthwhileness on how much money they have, or anything, to be honest.
In fact, I could also easily accept wanting to buy something really cool, not just because I like it, but because it might impress others, or because they might find it fascinating, too! I don’t try to regulate my life with a lot of shoulds and shouldn’ts, and find that I am happier and more peaceful without lots of shoulds.
In the Feeling Great App I have created a class called “Your PhD in Shoulds.” You might enjoy it!
Second, you can say that it is unfair that some people have more money and resources than other people if you like. And you have every right to feel angry if that’s what you want, as well.
Acceptance is more of a decision than a technique. Take the fact that lions kill deer when they are hungry. You can say, “they should not do that. It’s unfair!” But that won’t stop a hungry lion.
You don’t have to LIKE seeing a lion kill an innocent deer, but you can accept it. Again, that’s a choice. The behavior of a lion is dominated by millions of years of evolution. Humans are no different.
One thing that sometimes helps is to make a list all the REALLY GOOD reasons NOT to accept the “unfairness” in the world. I’ll bet you could come up with at least ten to fifteen strong reasons.
Then you can ask yourself, “Given all those good reason NOT to accept the fact that some people have more and some people have fewer resources, maybe I should just stay good and angry! Why in the world would I want to change?”
Also, when you find an injustice, you can use your energy being good and angry, and complain about it, or you can use your energy to do something about it. Or, you can also work to change yourself, instead of complaining about the world.
I also have a new class on acceptance. It’s called, “Accept this shit? Hell NO!” You might like it as well.
I am babbling so will stop.
Warmly, david
2. Brittany asks: Can you “erase” feelings of sadness and depression by shining lasers in the patient’s eyes?
Hi David,
My husband’s boss was telling him she’s going to be doing some laser therapy to “cure” her depression. She had to undergo 9 hours of testing to see if she’d be a candidate.
Apparently, they plan to shine lasers in her eyes to “erase” her sadness.
Obviously, I assume this is a load of garbage. But have you ever heard of such a thing? Is this just hypnosis?
Best, Brittany
David’s ReplyHi Brittany,
Probably. As they say, follow the money! There is a placebo effect if you believe something will help, so tons of garbage gets served up as costly gourmet food.
You can read up on this on the internet I suspect. Let me know what you learn!
Best, david
Brittany responds to DavidLove your answer! I was looking into it and read they use a cold laser in the eyes which allegedly releases endorphins. I already know from you that just like with exercise and that study about the endorphin blockers, it made no difference. People just feel better because they think they are doing something good for their body by exercising.
They also allege that the lasers aid damaged neurological tissue. They claim it has helped many patients but there is no data backing it up that I see.
They really lost me when I read that lack of activity, stress, and maternal deprivation cause depression in the first place.
Thanks! Brittany
David addsAs it turns out, I know two laser experts who are regulars on my Sunday hikes. Dr. Alexander Makowski is a brilliant scientist who is involved in the research and development of lasers and their marketing. Here is his email, along with some terrific links to articles about the hype of “low light lasers.”
Hope you enjoy the email and links from Alex:
Hi David,
I'll chime in too! From a different angle.
Zak knows some great doctors who are doing real work, but the general field of low-level laser/ light therapy (LLLT) for medical issues has been fraught with charlatans for some years.
(David note: Zak is a laser expert at the Stanford Medical School and is currently preparing a blog on the topic of LLLT. I will include a link to her blog when it is published, likely in a couple weeks. She is awesome and also often joins our Sunday hikes!)
Dr, Alex Makowsy continuesGood work by Tiina Kaaru (https://www.spiedigitallibrary.org/profile/Tiina.Karu-8010) and Juanita Anders (https://www.usuhs.edu/profile/juanita-anders-ms-phd) on mechanisms behind using light to stimulate our mitochondria or deactivate infectious bacteria are well documents
However, the good work done by the few was overshadowed and worse, was perverted for many years into crackpot devices using bad stats and poorly designed studies. Or sometimes just straight preying on vulnerable people. It is the great shame of the laser industry. Worse yet, some of these devices were actual lasers that led to people getting hurt.
I can't recommend in good conscience that lasers be shone into eyes at any time other than diagnostic devices meant to diagnose the eye itself. It may be that some day soon a good scientific body of evidence changes my stance but not yet...
The story starts in the origin of my journey into light and lasers. I got involved in this field in 2005 while taking an elective class on optics and lasers when I got a call from my mom that she was seeking a laser therapy for her fibromyalgia.
My mother's desire to get her fibromyalgia treated with a "cold laser" pulled me into this field since I was taking a class with a professor who later became my doctoral mentor. A full semester of my free time disappeared as I tried to source out of print articles and do a deep dive on whether this was real or garbage.
A research term paper and a conference visit later I could finally see the same trends you saw with medication. I talked her out of the potentially dangerous unproven device usage.
[As you may have suspected, In fact my mom was having significant issues in her marriage and life and a very good doctor set her straight. My mom divorced and is now happily remarried, about 95 pounds lighter, no fibromyalgia or serious insomnia. If only we had known you back then she would have recovered in a session or two rather than 3 years]
However, in the process, I dug into some of the real research that small doses of light can affect our bodies in ways we don't understand fully due to lack of research.
Fast forward several decades and some of the best researchers survived the public scandal of LLLT and found a scientific mechanism (cytochrome c oxidase activation) to explain observed changes in mitochondrial activity. However, the scientists don't claim to cure everything or anything. Then they published this mitochondrial activation and suddenly:
This, of course, proves that blogablum does in fact exist and now the truth about the panacea is available for all!!
David note: “blogablum” is a fake nonsense word I made up that refers to nothing meaningful. Now continuing with the Alex email:
This is a good review of the history and current evidence about it : https://www.mcgill.ca/oss/article/medical-critical-thinking/hype-around-photobiomodulation
But if you want the real goods, the hard truth about cold lasers has been out there for over 15 years:
Introducing the New Low Level Laser Treatment!
youtu.be
The following search on YouTube will reveal the secrets of the universe:
"cold laser before:2009"
Warmly,
Alexander J Makowski, Ph.D.
Dr. Matt May’s replyHi David,
Thank you for forwarding this question to me. I am very concerned and wonder if this may fall under the category of 'malpractice'.
For one, I am unaware of any FDA approved treatment for depression that involves shining lasers into people’s eyes to erase their sad memories. For a list of FDA approved treatments for depression, you could refer to:
https://www.ncbi.nlm.nih.gov/books/NBK559078/
It's possible that there is new evidence I'm not aware of, but I searched online for studies of light in treatment of depression and was unable to find any placebo-controlled trials. This is a problem because placebo responses can be so high in the case of depression and anxiety. There were some studies on light therapy, but nothing fitting the description of 'shining lasers into eyes to erase sad memories'.
Other concerns I have relate to the high cost of such an extensive “evaluation”, as well as possible risk of shining lasers into someone’s eyes. In the absence of evidence supporting the treatment, it seems like a high cost, and potential risk, to the patient, hence my concern for malpractice.
It's pretty common for people with depression to feel a sense of desperation, especially after many failed efforts to address their symptoms. This group of individuals are likely to be extremely susceptible to scams and purveyors of 'snake oil' (sham treatments).
It's also concerning to me because the theory behind the idea of shining light into people's eyes to erase sadness doesn't make logical sense to me. It's a potentially-testable hypothesis, but it's such an absurd hypothesis that I don't see it as worth testing or entertaining.
If we are defining depression as some combination of worthless, hopeless, ashamed and guilty feelings, then the hypothesis that such feelings could be meaningfully addressed by such a crude instrument as a laser or a pill or an electrical impulse is absurd.
This is because our feelings arise from our thoughts/perceptions. I've never met a single person or patient who was suffering from depression but had healthy positive thoughts about themselves. I've also never met someone who had patterns of negative thinking, but felt fine, up-beat and positive.
The idea that a pill, a laser, a magnetic pulsation or electrical current could selectively alter the specific thoughts that cause depression doesn't make sense with what we know about the brain and thoughts and feelings. How could a pill, for example, which crosses the blood-brain barrier and impacts every neuron in the brain, selectively target only the neurons that give rise to depressed thinking? It's like imagining that we could carpet-bomb a city but only kill the murderers and rapists.
I'd encourage all potential clients who are receiving treatment for depression or other conditions to ask their providers for literature that documents the effectiveness of the treatment and to get a second opinion if they are unsure.
These are my 2-cents on the topic and I could be completely wrong about it all. Hoping to hear from others what they think.
Also, David, I saw several other people included in the invitation to respond to this question but I didn't see them cc'd. Perhaps they were bcc'd?
Wishing you the best,
fondly,
Matt
David’s reply to MattThanks, yes, I have a fantastic response already in the show notes from Dr. Alex Makowski who does research and development of lasers with valid medical applications. His thrust is similar to yours.
Our field is littered with junk “scientism” intended to fool and exploit people, similar to the snake oil salespeople who use to go from town to town in America selling magical “elixirs” that “cured” just about everything!
But people are endlessly gullible, and con artists are still in endless abundance these days, it seems!
Best, david
Will add your kind and thoughtful comment to the show notes!
3. James asks about the use of TEAM methods in the NHS in the UK.
Hi Rhonda,
I hope you are well. I had a couple of questions for an 'ask David' on the podcast if that's okay. A bit of background....
I am Level 1 Team and have attended David's training in Atlanta. I live in the UK and have recently changed career to work in the NHS delivering CBT interventions for patients because David's work inspired me so much.
The NHS uses specific interventions for particular diagnoses and because I am in training I have to try and stick to this. I do use the TEAM materials and approach when I can and have already seen some great results.
The NHS uses 'Behavioural Activation' for certain patients with Depression and I just wondered what David thought about the effectiveness of this (perhaps compared to Cognitive Restructuring). I believe Beck introduced this into the CBT model as he thought it was useful.
Another question was regarding treatment of GAD and whether dividing worries between hypothetical and practical, and then using a certain time to actually worry rather than letting the worries dominate throughout the day was something he thought was useful or had heard about.
Thanks so much for all the great work you are all doing and inspiring people all over the world!
Kind Regards James Bibby.
David’s responseHi James,
Thanks for the great questions. In today’s recording of an upcoming Ask David podcast, we can address:
Best, David
Matt’s Thots:Great question! I’m looking forward to discussing.
There are certainly some techniques that are more effective, than others, for addressing specific negative thoughts. Meanwhile there are a number of problems that come up when we are, as clinicians, throwing solutions at diagnoses, rather than treating the human being who is suffering.
Studies on the treatment of PTSD at the VA, for example, showed veterans often got worse after this approach, in which their diagnosis was matched with a method, ‘prolonged exposure’, without any agenda-setting. This just retraumatized lots of veteran!
Similarly, if someone is secretly blaming, and haven’t experienced the ‘death of the blaming self’, they might be assigned ‘communication skills training’, only to see this backfire, because their intent is still to try to change someone, rather than accept them.
You might tell a patient with depression that they should go exercise, only to cause them to resist you, ‘you don’t understand, I can’t even get out of bed!’. In short, most therapy fails or even makes patients worse because it doesn’t consider the good reasons to continue to blame, give up, criticize ourselves, etc.
4. Brian asks: Is positive reframing the most successful technique you have used with your patients?I can see how it would cure someone in 2 hours!
Feel free to use my question and do and use my name if you wish. I'd be honored.
Best,
Brian
David’s replyHi Brian,
Thanks. Great question! It’s one of the latest powerful techniques, but Ext of Voices might still be the “champion.” Using them in the T, E, A, M sequence is especially powerful. Positive Reframing often gets them closer, but not quite all the way to enlightenment.
Externalization of voices (EOV) often gets them over the finish line, especially if you know how to use it skillfully, incorporating Self-Defense with the Acceptance Paradox and Counter-Attack Technique! In fact, you can incorporate many of my > 100 techniques when using EOV, such as Be Specific, Semantic Technique, Examine the Evidence, and a host of other.
Best, david
Matt’s commentsI agree, Positive Reframing and Externalization of Voices are incredibly powerful and it’s often what we’re doing when we see recoveries. What works for a given individual, however, is quite hard to predict, in advance and there’s a ‘process’ to therapy, such that we can’t really skip steps, except in some unusual circumstances.
Some other super-powerful methods include Externalization of Resistance, Double Standard, Flooding, Feared Fantasy, and the Hidden Emotion Technique. I’m probably forgetting some.
Thanks for listening today!
Matt, Rhonda and David
We 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].
Announcement: Our awesome summer intensive is returning after a long, five years due to the pandemic. It is typically the most outstanding and rewarding TEAM-CBT training of the year, and it will take place again and the wonderful South San Francisco Conference Center from August 8 – 11, 2025.
You can attend in person if you register soon, since in-person seating will be strictly limited and only a small number are still available. You can also attend the online, live-streamed version of this program at a substantial discount. The online experience and small group exercises will be similar for the in-person and online participants.
Check out the details, including early-bird discounts, at www.cbtintensive.com
www.cbtintensive.com
Hope to see you there!
Warmly, david
Today’s Questions
1. Alison asks: I have bipolar Disorder and I have had trouble challenging my negative thoughts. I’m suffering. What can I do?
Hi David,
Many years ago I used your book to beat depressive thinking… in the last three years I’ve been diagnosed with Bipolar Disorder and have found my depressive thinking too difficult to budge with your book.
I’m really suffering; any ideas about what I could do?
Thank you for your service to humanity. I always recommend your book.
David’s response
Hi Alison,
A therapist could help. The new Feeling Great App could help. And tons of free resources at www.feelinggood.com.
In addition, can you please give me an example of the negative thoughts you can’t budge. Then we can point things out in the podcast and try to figure out why you’re getting stuck!
I have found that doing cognitive therapy / TEAM-CBT with individuals with Bipolar Disorder is exceptionally helpful during the depressed (not manic) phase, and works pretty much the same way as with anyone who’s feeling down.
Best, david
2. NAME WITHHELD asks: Can or should a person really and truly accept their dark side?
Hello David,
My name is NAME WITHHELD and I am doing my PhD degree in Neuroimmunology in LOCATION WITHHELD. I had come across your book feeling good and your podcasts by one of my therapists - they have had an immense impact on my way of thinking.
I really love disarming and using “I feel” statements to connect! I had also realized that by finding some genuine truth in a person’s belief even if it sounds ridiculous, I would automatically develop certain level of respect for that person! I really love that! I feel really happy that I can respect a person even without accepting his/her beliefs!!
I am now working on my distortions. I really love working on my mind that way.
Anyway, I have wanted to ask you if a person CAN accept his/her dark side? I seemed to have loathed myself for quite a long time and couldn’t stand living alone without a partner or a person around. I hated myself for disrespecting my mother whilst growing up.
But, sometime during Dec last year, I had had an epiphany of why things happened the way they did and somehow, I learnt that the reason why I had disrespected my mother was because my father, after their separation, kept filling my mind about how wrong my mother was for breaking up the family and I believed him because I had a good rapport with him, than I had with my mother.
Also, my mother was very awkward in building a relationship with me and I had misconstrued that with her indifference towards me. After that, I stopped hurting myself over it because I had learnt to empathize with myself then. I sobbed profusely that day.
Is it really possible to truly accept yourself? I feel at ease a lot more these days than I used to before. But I also have to battle my distortions too on a regular basis!
Please help me out here! Thank you so much for everything that you have done!! I really love your work!!
Regards,
NAME WITHHELD
David’s reply
Thanks so much. I hid your name and location, and hope that’s okay, and we WILL include your excellent question on our upcoming podcast. My brief reply is that all human beings have a “dark side,” and that we are far better off accepting it, as opposed to denying it and seeing ourselves as “totally good,” because then we might see others as “totally bad,” and feel morally superior. This dynamic is the cause of wars and a great deal pf hatred and suffering.
3. Trainor asks: In TEAM there is a strong emphasis on changing the way you think. But is it sometimes also important to change your behavior, or to make real changes in your life, or to help others who need help changing their circumstances--for example, people who are struggling in poverty.
Hey David!
I have asked several questions over the years (I asked about A.I. which I much enjoyed the episode on that!), so feel free to ignore this email if you feel I've overburdened you guys.
Anyway, I had a question about changing thoughts versus circumstances.
You often say that our thoughts create all of our emotional and interpersonal realities. I thought maybe a better or more nuanced definition would be to also mention that events CAN change our feelings but they do so through changing our thoughts.
I have heard Matt May mention this idea in some circumstances as the "low road to recovery." Where you actually get the thing you think you need and as a result feel better.
However, I thought about certain situations where changing the circumstance could also be a valid solution to an individual's problems. Take someone living in poverty, I am certain that CBT could help this person change their emotions around the experience of living in poverty. But would bringing the individual out of poverty be considered a "low road to recovery"?
Or could we say that bringing someone out of poverty is also a valid way of changing their emotional distress? Like sort of how therapists use both exposure and cognitive techniques to quell phobias or certain anxieties.
I personally like this definition because it includes the ability to change your circumstances as a method to change your thinking, without it being the only method. It also makes sense in a world where people want to make changes in society (giving women the right to vote, ending child labor) and create environments that foster positive thinking.
I think so much focus on the cognition (while fundamentally true) makes it feel like people should focus exclusively on changing the way they think about a situation. When, in reality, it seems like we can both change our circumstances and thinking simultaneously to make our lives better. Anyway, just wanted to know what you thought about this idea.
Thanks for everything you do,
Trainor Peters
P.S. I have nearly completed my first year of my psychology undergrad to become a counselor. In great part to you and all the wonderful people on your podcast. So, thank you!
David’s reply.
Thanks, Trainor,
I will add this excellent question to our Ask David list, if that’s okay, and discuss with Matt and Rhonda on a podcast.
My hospital in Philadelphia was located in an inner-city neighborhood, and many (perhaps most) of our patients have very limited resources. Some were homeless, and many had not completed the 5th grade. This gave me abundant opportunities to work with people with “real” problems in addition to their distorted perceptions.
In addition, I have always emphasized that sometimes you need to change the way you behave in the “real” world in addition to changing the way you think about it.
We’ll give these topics a deeper dive on the live podcast discussion.
And, best of luck in your ongoing training! Once you are in a graduate program, you will be eligible, if interested, to join one of our two free weekly TEAM-CBT training groups, which are both virtual.
Warmly, david
Thanks for listening today!
Rhonda and David
Special Announcement 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 long 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.
But there's some good news, too! 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!
Today, Rhonda has prepared a special celebration for our 400th podcast, and still going strong! She has invited a number of our favorite people and podcast guests to celebrate with us, starting with our beloved friend and frequent Ask David contributor, Matt May, MD, who officially joined us in early 2000.
Matt’s presence on the show had meant a great deal, personally and professionally, because I supervised Matt when he was a Stanford psychiatric resident, and had been missing our weekly chats! Our reunion via the Feeling Good Podcast has been special for that reason, but also because of Matt’s kindly but scholarly answers to the many questions all of you submit. Keep them coming, and send them directly to Rhonda or David. We love reading and answering them!
Next, we were joined by two more extraordinary psychiatrists and human beings, Drs. Heather Clague and Brandon Vance, who song their rendition (with guitar accompaniment) of “Help Dr. Burns!” (Based on Beetles’ Help, I need somebody!”
With their kind permission, here are the brilliant lyrics!
Help! I need a podcast!
Help! Not just any podcast!
Help! Pushing the Magic Button for ....
Help!
When I was younger, 8 years younger than today
I thought I could help everybody; help them in every way.
I got so grandiose; I was so self-assured.
I’d push my brilliant techniques, but my patients were never cured.
So, Help me not to Help oh Dr. Burns
Will they like me if they have to do the work?
If I set an ultimatum, am I a jerk?!
Won’t you please, please stop me?!
So many times, I tried to help, but then got stuck
I didn’t know but my patients were also thinking what the #?@!
Your podcast said to test at the start and after every session.
And then my eyes they opened wide
Boy, was that a lesson!
Oh Help me not to help, oh Dr. Burns!
Help me unlearn the bad habits I have learned
I’ll do homework when my urge to help returns
Won’t you please, please help me?!
Now I explore my patients’ reasons not to change.
I learned to sit with open hands if they choose to stay the same.
Only when they fight for change and want to do the work,
That’s when I offer tools, and know the changes will endure.
You’ve helped me not to help, oh Dr. Burns
‘Til my patients show me that they really yearn
To do the work and ask me really firmly
Won’t you please, please help me?
Your podcasts helped ME!
Oooooooh!
Much warmth to each of you!
Heather and Brendan
Our next guest was the brilliant and beloved Dr. Jill Levitt who joined my weekly Stanford training group when she and her husband, Brian, and two boys moved to the Bay Area from New York in 2007. Jill has moved up in the ranks and now co-leads the Tuesday group with me, and also joins me as co-therapists in a great many live sessions we have published as two consecutive podcasts.
The idea is to document exactly how TEAM-CBT works, and how we can nearly always get such blow-away results in a single, extended session. That was my dream as a young man, since the methods I was taught as a psychiatric resident almost never got rapid results, or even any noticeable changes in my patients. Now that dream has become a reality, and a great many people in our TEAM-CBT community have contributed to that evolution.
Next we were joined by our beloved Dr. Amy Huberman. Her riveting personal work on perfectionism was published recently on two consecutive Feeling Good Podcasts. Amy was glowing and filled with joy, which gave us great feelings of joy as well!
And then we were graced by a visit from Mina, who has starred in many Feeling Good Podcasts on a number of personal issues. I will be seeing Mina and her beloved husband in a few minutes for our Sunday morning hike and dim sum feast afterwards. It is always a highlight of my week!
Next was another Amy Berner who reported on her recent and wildly successful Intimate Connections Book Club with yet another psychiatrist, Dr. Leigh Harrington. Amy did some personal work with me on dating and sex appeal three years ago, when we discussed the Queen Bee phenomenon.
Apparently, it was successful, because she brought her fantastic husband, Randy Kolin, as proof of the effectiveness of the many dating strategies and tips in that book. Randy is also a mental health professional who works with stressed-out scientists working on nuclear fusion at the Lawrence Livermore Laboratories.
We wish him all the best since the work of those scientists is well on the road to creating commercially viable nuclear fusion, which will transform life as we know it on the surface of the earth by supplying unlimited, clean, low-cost energy.
Their visit was followed by Zane Pierce, whom I hadn’t had the chance to chat with much for a number of years. He led a recent “delight” and “gratitude” hike that we published on podcast # 361entitled “Finding Joy in Everyday Life,” with Dr. Angela Krumm from the Feeling Good Institute in Mountain View, California.
We have done previous podcasts with Zane, and his lovely wife, Daisy, including one of our most popular podcasts ever on “What’s the Secret of a Meaningful Life,” Episode 079.
And then came the magnificent colleague and friend, Indrani Mookerjee. Indrani joined our community after attending the 2019 intensive, and recently did one of the most explosive and jaw-dropping podcasts, Episodes 359 & 360, “You Wowed Me, A Mother-Daughter Conflict,” featuring her personal work on her relationship with her daughter.
Indrani had struggled, unsuccessfully, to get close to her daughter, whom she loved greatly. She made a mind-blowing discovery of why during her personal work, and instantly achieved what I call “interpersonal enlightenment.) She now provides the joyous follow up on how her relationship with her daughter has blossomed and evolved since that momentous moment.
Next, we were joined by Mike Christensen, who is our top TEAM therapist in Canada. Mike became familiar with my work when he read Feeling Good in 2006 and then heard a keynote speech I gave at a conference in 2009. Since that time, he attended many of my two-day workshops in Canada, and now is a leading TEAM-CBT therapist and teacher. He’s been a featured guest on seven Feeling Good Podcasts or episodes of Facebook Live, when I was doing televised work on Facebook every Sunday afternoon.
Mike describes himself as “joyously average,” a idea that really resonates with me. It is a form of “invisible enlightenment” which nearly everyone fears, but you cannot understand the incredible liberation of this “Great Death” of the “self” until you’ve experienced. We recollected a Feared Fantasy exercise we once did together while hiking one evening following a workshop in Canada.
We also got updated on his beautiful and brilliant daughter, Katlin, who is now studying psychology in college and hopefully heading for her own career doing TEAM-CBT.
And finally, one my most favorite people in the, our brilliant, wonderful, and funny Sara Shane, whose life-changing enlightenment has been a fantastic source of joy and inspiration to me and to many. Sara came from humble roots, as a Mexican immigrant picking fruit with her parents for survival in the US, and is now living in the Central Valley and attending not one, but two weekly TEAM-CBT training groups.
She specializes in brief intensive treatments for the patients she treats. You may recall her from podcast #162, High Speed Cure for OCD, where she described her single-session treatment for 20 years of OCD / contamination phobia. She also did a lot of personal work to achieve liberation from her fairly severe social phobia and feelings of inferiority that were embedded from early childhood.
We love you and so much appreciate you, Sara!
That’s about it for today, but than you all for listening. Next week, we will likely have two consecutive Ask David podcasts with Dr. Matt May, followed by two consecutive podcasts called “Raw Emotion: Personal work with Chris,” featuring the work that Jill and I did with a young man with social fears and an almost unbelievably traumatic childhood, growing up in Palo Alto. The sound quality is not always top-notch, sadly, but the unbelievable quality and impact of this session easily makes up for that, so we have decided to publish it anyway, and hope you find it as amazing as we did.
David, Rhonda, and the whole gang!
Special Announcement 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 long 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.
Hey, another special announcement! The long-awaited Feeling Great App is finally available in the Apple and Google stores. Check it out! You can try it for free!
Today, you will hear the exciting conclusion of the work that Jill and David did with Cody, a young man who sometimes freezes in social situations due to feelings of anxiety. He actually froze up when Jill and David were working with him in part 1 last week. What will they do?
Tune in today and you'll find out!
Before I describe Cody’s session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements.
For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at
Intensive Information / RegistrationThe online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year!
But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree!
In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. 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.
Beginning of Part 2 with CodyYou will hear some of the tools that seemed especially helpful, including
Whether you are a shrink or general citizen, I think there might be a lot for you to learn from Cody, not only about techniques to treat social anxiety and feelings of inadequacy, but also about enlightenment as well. ‘
That’s because the goals of a TEAM-CBT session are not just the reduction of negative feelings, but the complete obliteration of negative feelings, along with jumping on a psychic trampoline that catapults you into a state of profound self-acceptance and enlightenment.
At least, that’s my take on it!
Did it really happen?
Here's how Cody was feeling at the start of the session, along with his goals for each feeling at the end of Positive Reframing, and his feelings at the end of the session. As you can see, all of his negative feelings went to zero.
Emotions% Before
% Goal % After Sad, blue, depressed, down, unhappy40
10 0 Anxious, worried, panicky, nervous, frightened 95 15 0 Guilty, remorseful, bad, ashamed 20 5 0 Inferior, worthless, inadequate, defective, incompetent 40 10 0 Lonely, unloved, unwanted, rejected, alone, abandoned 50 10 0 Embarrassed, foolish, humiliated, self-conscious 100 30 0 Hopeless, discouraged, pessimistic, despairing 50 15 0 Frustrated, stuck, thwarted, defeated 50 15 0Angry, mad, resentful, annoyed, irritated, upset, furious
30
5 0Confused
60 100
What explains these seemingly impossible changes in a single therapy session? And are they real, or is this all just a bunch of hype?
Stay tuned and let us know what you think at the end!
Early, I had a challenging exercise to do on Cody’s SDBa. Here’s the solution.
To my way of thinking, Cody’s Downward Arrow chain of thoughts suggest a number of related Self-Defeating Beliefs, including:
You always have to be the patient’s point of view about the SDBs, so these are just my guesses.
End of Session
Thanks so much for listening, and a big hug for Cody for sharing his inner self with all of us! To me, this is the best teaching because it is real, and you can see what the shrinks REALLY do behind closed doors.
You also get to see shrinks as struggling, vulnerable, and imperfect human beings, just like yourself!
Cody, Rhonda, Jill, and David
In today’s, and next week’s, podcasts. we present the next episode of live work with Cody. The first, which featured Rejection Practice for social anxiety, was published as Podcast #326 on January 9, 2023 at this LINK.
My co-therapist for this session was the wonderful Dr. Jill Levitt, the Director of Clinical Training at the Feeling Good Institute in Mt. View, California (LINK.).
Before I describe Cody’s session, I want to remind you that I am bringing back my annual, four-day summer intensive at the South San Francisco Conference Center this year, for the first time in five years. We had to abandon it due to the pandemic, and this year we are bringing it back to life on August 8 to 11. It will cover TEAM-CBT for depression and anxiety, but with a few changes, hopefully innovations and further improvements.
For one thing, you can attend in person or online this year, and Dr. Levitt will be teaching with me. This will make the experience even better, since Jill is a brilliant psychotherapy teacher, certainly among the top in the world! The in-person seating will be strictly limited to 100, so register early if you are interested, at
Intensive Information / RegistrationThe online version will be identical, with many skilled experts to guide you in the many interactive exercises, making both the in person and online versions identical. However, the online will be roughly half the cost, so that could be an appealing option if you are cost-conscious or if you live far away. No travel needed this year!
But perhaps most important, this annual intensive always proves to be the best training experience of the year, with chances to learn sophisticated and magnificent TEAM techniques to use with your patients. But you will also have the chance to do your own personal work. Many, many people have said that the intensives are absolutely magical, and I totally agree!
In fact, the summer intensive might be the training you always dreamed about, but never really received, in graduate school!. 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.
Now, back to the podcast, in which you’ll hear some additional TEAM-CBT magic. Cody asked for help with a problem that’s been bugging him for some time. He sometimes freezes up when asked to do a role play or answer a question during psychotherapy training sessions. This typically leads to an awkward silence, and feelings of intense anxiety, inadequacy, frustration, embarrassment and more.
Here's how he described it:
Upsetting event: I was doing a suicide screening role-play with our clinical supervisor and other therapists. After working through the first step of the role-play, I froze and did not say a word!
Here's how Cody was feeling.
Emotions
% Before % Goal % After Sad, blue, depressed, down, unhappy 40 Anxious, worried, panicky, nervous, frightened 95 Guilty, remorseful, bad, ashamed 20 Inferior, worthless, inadequate, defective, incompetent 40 Lonely, unloved, unwanted, rejected, alone, abandoned 50 Embarrassed, foolish, humiliated, self-conscious 100 Hopeless, discouraged, pessimistic, despairing 50 Frustrated, stuck, thwarted, defeated 50 Angry, mad, resentful, annoyed, irritated, upset, furious 30 Confused60
As you can see and might imagine, the most intense feelings were anxiety and embarrassment, but several other feelings were fairly intense as well: such as feeling alone, discouraged, frustrated, and confused.
These were some of his negative thoughts on the Dailly Mood Log that he brought to the session, and the percent he believed each one. Thought 5a, b, and c are an Individual Downward Arrow series, designed to get at the Self-Defeating Beliefs underneath the Negative Thoughts.
What do you think Cody’s SDBs are? Take a guess, and then you can look up the answers, or at least my own thinking, at the end of the show notes.
Negative Thoughts
% Belief
1. I shouldn’t have screwed up. 80 2. I’m not good enough. 80 3. I don’t belong here/I shouldn’t be here. 50 4. Something is wrong with me (my brain) 100 5a. Everyone thinks I’m an idiot ↓ 100 5b. I should not be in this ↓profession ↓ 70 5c. I failed to find something I’m good at. ↓ 70 6. I’m worthless 60
Although freezing in social situations is fairly common, it can be incredibly challenging and painful for those who experience it. Cody said:
Sometimes they try to help, or may switch to someone else. It sucks, and everyone feels awkward.
The hangover can last a few hours or a day, and keeps me up at night. Over time, some emotions get worse, especially the feelings of depression and inferiority.
I asked if there was also some hidden anger behind his anxiety when called on to perform in a group setting. He said,
Definitely. I feel irritated if I didn’t sleep that well the night before. My heart may not be into it 100%. I sometimes feel forced into it (performing), and just don’t want to be put on the spot. . . What makes it bad is the belief that everyone is looking at me and the belief that I’m being evaluated.
One of the most challenging and exciting events in the work with our courageous Cody was when he actually froze during the session! This gave us the chance to demonstrate and apply in real time. As you know, TEAM is extremely rich in specific methods to help patients within and between therapy sessions. What would be YOUR approach to helping Cody? Or, if you also struggle at times with social anxiety SDB, what is your prescription for yourself?
As usual, Jill and I went through the T, E, A, M. sequence in our session with Cody, which, of course, is highly and totally individualized for every person we work with. In today’s podcast, you will hear the T = Testing and E - Empathy portions of the session. Next week, you will hear the A = Assessment of Resistance and M = Methods portions of the session.
You might be curious to find out which techniques we used, and what approach was the most effective. So tune inn next week to find out!
End of Part 1Some of the tools that seemed especially helpful included
Whether you are a shrink or general citizen, I think there might be a lot for you to learn from Cody, not only about techniques to treat social anxiety and feelings of inadequacy, but also about enlightenment as well. ‘
That’s because the goals of a TEAM-CBT session are not just the reduction of negative feelings, but the complete obliteration of negative feelings, along with jumping on a psychic trampoline that catapults you into a state of profound self-acceptance and enlightenment.
At least, that’s my take on it!
Did it really happen?
Here's how Cody was feeling at the start of the session, along with his goals for each feeling at the end of Positive Reframing, and his feelings at the end of the session. As you can see, all of his negative feelings went to zero.
Emotions% Before
% Goal % After Sad, blue, depressed, down, unhappy40
10 0 Anxious, worried, panicky, nervous, frightened 95 15 0 Guilty, remorseful, bad, ashamed 20 5 0 Inferior, worthless, inadequate, defective, incompetent 40 10 0 Lonely, unloved, unwanted, rejected, alone, abandoned 50 10 0 Embarrassed, foolish, humiliated, self-conscious 100 30 0 Hopeless, discouraged, pessimistic, despairing 50 15 0 Frustrated, stuck, thwarted, defeated 50 15 0Angry, mad, resentful, annoyed, irritated, upset, furious
30
5 0Confused
60 100
What explains these seemingly impossible changes in a single therapy session? And are they real, or is this all just a bunch of hype?
Stay tuned and let us know what you think at the end!
Early, I had a challenging exercise to do on Cody’s SDBa. Here’s the solution.
To my way of thinking, Cody’s Downward Arrow chain of thoughts suggest a number of related Self-Defeating Beliefs, including:
You always have to be the patient’s point of view about the SDBs, so these are just my guesses.
End of Session
Thanks so much for listening, and a big hug for Cody for sharing his inner self with all of us! To me, this is the best teaching because it is real, and you can see what the shrinks REALLY do behind closed doors.
You also get to see shrinks as struggling, vulnerable, and imperfect human beings, just like yourself!
Cody, Rhonda, Jill, and David
Rhonda began with a lovely endorsement and a cool reminder of the classic book, Robinson Crusoe, who created cognitive therapy (the double column technique) when he was stranded on a deserted island! I believe I wrote about it in one of my books, possibly Feeling Good. It’s pretty cool! You will hear Matt playing the role of the “evil” thoughts, like, “I am stranded alone on a deserted island,” and Rhonda will play the role of the “good” thoughts, like, “Yes, but my life was spared, and all of my shipmates died.”
Here's what it looks like in the novel:
Evil. Good. I am cast upon a horrible, desolate island, void of all hope of recovery. But I am alive; and not drowned, as all my ship’s company were. I am singled out and separated, as it were, from all the world, to be miserable. But I am singled out, too, from all the ship’s crew, to be spared from death; and He that miraculously saved me from death can deliver me from this condition. I am divided from mankind—a solitaire; one banished from human society. But I am not starved, and perishing on a barren place, affording no sustenance. I have no clothes to cover me. But I am in a hot climate, where, if I had clothes, I could hardly wear them. I am without any defence, or means to resist any violence of man or beast. But I am cast on an island where I see no wild beasts to hurt me, as I saw on the coast of Africa; and what if I had been shipwrecked there? I have no soul to speak to or relieve me. But God wonderfully sent the ship in near enough to the shore, that I have got out as many necessary things as will either supply my wants or enable me to supply myself, even as long as I live.I know this novel is a couple hundred years old, so it certainly deserves nomination of the earliest cognitive therapy!
Now, for the answers to today’s Ask David questions. Keep in mind that these answers were written BEFORE today’s recording, so the actual live answers will differ in some regards from the written answers below.
1. Chris asks if I have a book about assertiveness.
Hi Dr. Burns,
I hope you're doing well. Do you have a book on assertiveness training?
I've used your books to help me with my hidden "should" statements, which has enabled me to be less angry or anxious whenever someone treats me less than satisfactorily.
While this has helped immensely, I realize it's still in my interest to reduce the behavior I disagree with. For example, my sibling scheduled an early morning shift after I had a long day of work. Because they can't drive, they expect me to take them to work, which means I'll only get about 5 hours of sleep; this in itself isn't a bad thing... except this is the 3rd time in a row they've done this.
After using your techniques, I'm less angry and anxious, but I still want to address the behavior to reduce the likelihood that they do something like this again, which is why I'm reaching out.
Thanks for your help.
Kind regards,
Chris
David’s Reply
Sure. I like my own book, Feeling Good Together, and have often recommended Manuel Smith’s When I Say NO I Feel Guilty.
There is a LOT to be said about assertiveness training, including the fact that it doesn’t always work! I can give a great personal account of that!
Sometimes, or always, skillful listening is also effective. Assertiveness without listening makes it sound like only your own feelings are important, which is obviously pretty self-centered.
One of the most helpful things to me is the difference between healthy and unhealthy anger, and how to express tough messages in a loving, respectful way.
Can discuss more on the show. For example, what are the problems with the assertiveness movement? And where can it be helpful?
And what mistakes do unassertive individuals make when trying to be more assertive? Do they sometimes overdo it?
Warmly, david
2. Brian asks: Is there anything to the theory that "suppressing emotions" is harmful or is that just Freudian mumbo jumbo? Thanks!!
David’s reply.
Thanks, Brian. Great question!
You can listen to the podcasts on the Hidden Emotion Technique, or read about it in my book, When Panic Attacks.
Will make this an Ask David question if that’s okay!
3. Matt asks about the “Miracle Cure” question in the Assessment of Resistance portion of a TEAM therapy session.
Hi David,
I've noticed that when I ask the 'miracle cure' question or 'magic wand' question, I'll sometimes get a response that isn't all that useful and I might waste time trying to figure out what the person is really asking for.
An example might be, 'I want to be able to support and understand my husband, who is addicted to video games and spends a lot of our money on games'.
I've found it helpful, in such situations, to ask, 'let's imagine you could achieve that goal, you were perfectly understanding and supportive, at all times, of your husband, who is addicted to video games and spends a lot of your money on games...what would change, in your life, if all your dreams came true?'
I think this might help in a lot of cases where the agenda is a bit fuzzy and unclear.
Wishing you the best!
Matt
David’s response
Matt and I exchanged several emails we’ll discuss on the podcast. Essentially, I don’t think this woman is asking for understanding why her husband is addicted to video games and spends money on them. Instead, she is secretly blaming him and is probably angry with him for not spending time with her! She wants to change him.
Matt agreed with this and has proposed a new tool therapists can use when setting the agenda.
I, David, also raised the problem of “hearing the music” behind the patient’s words. This is incredibly important—but hard for therapists to learn—when using the Disarming Technique. They have a tendency to agree with the patient’s words in a literal way without “hearing” what the patient is really trying to say.
If you use any form of therapy literally, with really grasping the patient’s feelings, your treatment will not be effective or helpful. There is a human art to therapy, and following rigid formulas simply won’t come across as compassionate or genuine most of the time.
That’s why I am dubious about testing different therapies with outcome studies with human therapists. You are actually testing the impact of a miscellaneous group of therapists with potentially widely divergent skill sets. This is one of the many reasons why psychotherapy outcome studies for depression all come out about the same—somewhat better than placebos, but not much better.
And there’s been no one winner when using human therapists.
Dr. Paul Crits-Christoph from the University of Pennsylvania Department of Psychology once published a study showing that the differences between therapists within each arm of an outcome study were grater than the differences between the two schools of therapy!
That’s why I’ve been so excited about analyzing data from our beta tests with the Feeling Great App. Each “patient” gets the exact same shrink! This makes the “dose” of the TEAM done by the computer the same for each patient, much like an outcome study of a medication.
TEAM is a actually series of metaphors! If you don’t “get” the metaphors, and try to apply TEAM in an overly literal way, you’ll have a lot of trouble learning TEAM!
David
Matt’s Musings:
David is incredibly gifted when it comes to ‘hearing the music’ behind what folks are saying, verbally. I suspect this is partially an innate gift, like someone who’s a prodigy at math, only for emotional states and understanding people.
After years of practice, I’m not quite as good as David. However, I think there were specific forms of experience that helped me improve my skill ‘hearing the music’.
In addition to using measurement and processing feedback with my patients, one thing that helped me a lot was using a lot of ‘uncovering techniques’. These include the ‘What If’ technique, to expose hidden fears, the ‘Individual Downward Arrow’, to expose hidden insecurities, the ‘Interpersonal Downward Arrow’, to expose hidden assumptions about how we ‘should’ act in our relationships.
Seeing several thousand of these has helped me with ‘pattern recognition’, which I think is related to ‘hearing the music’. I’m proposing that beginning therapists might also benefit from an ‘Uncovering Technique’ for agenda-setting, following the ‘Miracle Cure Question’, which keeps asking, ok, let’s say you got that, what would you hope for, if you got absolutely everything you wanted? Ok, and let’s say you also got that, what would you hope for, in your wildest dreams?
This might expose hidden agendas which can be super important if we want to be able to anticipate resistance and identify the ‘cost of recovery’.
Thanks for listening today!
Rhonda, Matt, and David
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