Today, we are pleased to present one of our favorite podcast topics—live work with a real human being who is suffering. We will be working with Madeleine, a woman who read a disturbing article while at the hairdresser and freaked out, sensing that one of her daughters might be in mortal danger.

This live and unedited session was first presented as part of a free webinar on September 11, 2025. There was no preparation or role-playing—everything was absolutely real and spontaneous, exactly as it evolved in real time. We present Part 1 as our final Feeling Good Podcast for our 2025 season. This is our most powerful and popular type of podcast, and we hope you enjoy it. We also give a big thanks to our courageous "patient," Madeleine.

My co-therapist will be Dr. Jill Levitt, a clinical psychologist and Director of Training at the Feeling Good Institute in Mountain View, California. Jill and I greatly enjoy working together as co-therapists when we teach and we typically see our "patient" for an extended, two-hour session.

We find that this is the most effective format for teaching, and that way, we can frequently complete a course of therapy in a single session. However, you do not need more than one therapist to do effective TEAM CBT, and you can do it in conventional 50 minute sessions as well. But often, you can do vastly more in a double session.

We will not be engaged in an ongoing therapeutic relationship with Madeleine. When we work with therapists, they are doing personal work as a part of their training. We feel that this experience is vital for every therapist who hopes to do world-class TEAM CBT with their own patients / clients.

More than 2,000 individuals registered for this workshop. Although the workshop was open to everyone, only 13% of the participants identified as general public, while 87% identified as mental health professionals.

In Part 1, which we present today, we focused on T = Testing and E = Empathy phases of the TEAM session.

In Part 2, which you will hear next week, we will focus on A = Paradoxical Agenda Setting and M = Methods. We will also show you the changes in her scores on the Daily Mood Log (DML) and Brief Mood Survey (BMS) from the start to the end of the session, as well as Madeleine's scores on the Evaluation of Therapy Session (EOTS) at the end, including what she liked the most and least about the session. That way, we can see clearly how much improvement there was (or wasn't) during the session, and how Jill and I did in terms of empathy, helpfulness, and other scales that evaluate the patient's view of the session.

In Part 3, which you will hear in two weeks, we did more Externalization of Voices along with Cognitive Exposure, since we had some loose ends we wanted to tie up before completing our work with Madeleine. This follow-up session occurred many weeks after the initial session at the workshop, and will also serve as a follow-up to see how Madeleine did in the days following the live work.

Our "patient," Madeleine, is a courageous woman who experienced sheer panic after being triggered at the hair salon while reading an article about a young woman who was abducted. Since Madeleine's oldest daughter's is away at college, taking a year abroad, Madeleine realized she could not protect her from predators and freaked out, thinking about all the horrible things that could happen to her.

In addition, Madeleine had many self-critical thoughts about ways she thought she had failed her daughter when her daughter was growing up, and worried about her daughter's judgement:

She hasn't always made the best decisions about guys she's gone out with, and she's shared everything with me. She says, 'Don't worry mom. I've learned from this.'"

At the start of the session, we reviewed Madeleine's scores on the Brief Mood Survey (BMS). This indicated only minimal depression (5/20), with no suicidal urges or anger, but her anxiety was still extremely elevated (18/20).

In addition, her Positive Feelings score was only 20 out of 40, with 0 meaning no positive feelings at all, and 40 being the highest possible feelings. However, her Relationship Satisfaction score with her husband was 25 out of 30, which indicates strong satisfaction, with just a little room for improvement.

We will ask Madeleine to complete the BMS again, along with the EOTS, so we can see precisely what changed, and by how much, during the session. Our goal, of course, with TEAM CBT, is nearly always to cause a near-complete, or complete, elimination of symptoms during a single, extended therapy session.

In addition, we want every patient to have a crystal clear understanding of how and why they got upset, along with how to use the tools that were the most helpful to them in the session. That way, they'll be armed to deal with future relapses, which are inevitable for all human beings.

And here's the big point. Our goal in sharing this session with you is so you can feel inspired, and see that rapid recovery really IS possible. And if you're a therapist, we hope that you will feel motivated to learn TEAM CBT so you can significantly improve your outcomes with your own patients.

You can see the Daily Mood Log Madeleine prepared just prior to the session if you

The upsetting situation was reading the article about the young abducted woman in the hair salon. On the Emotions table she indicated that she was feeling sad, down, and unhappy (85%), anxious, frightened and panicky (100%), inadequate (100%), frustrated (90%), and angry and upset (100%). These extremely high ratings tells us that Madeleine's negative feelings were about as intense as a human being can experience.

Although your life is undoubtedly very different from Madeleine's, perhaps you, too, have felt panic and helplessness when you thought the life of a loved one might be in danger.

Madeleine generated several additional negative Thoughts during the empathy phase of the session, including,

1. I'm totally responsible for how she's turned out. 95%
2. I was not present enough for her. 95%
3. She may not trust that I'm there for her. 60%
4. She's anxious and insecure and a people-pleasure, and she's also perfectionistic, and it's all my fault. 75%
5. I should have been more sensitive when she was growing up. I expected too much. 100%

Again, if you're a parent, you may have had similar negative thoughts about your own parenting. I know that I have!

During the Empathy phase, Madeleine described her horrors when reading the article at the hairdresser's, with thoughts of Natalie Hollaway's brutal murder as well as other women who were abducted and murdered.

Madeleine explained that she and her husband both married late, and felt somewhat insecure as parents:

"It wasn't easy having children late in life. . . . When our first baby was born, the milk was not coming down. My daughter would look deep into my eyes, and I had the thought, 'I'm letting my daughter down.'"

She said she had a rough time when she was growing up and her parents got divorced:

"My heart was broken, and I had to learn to be strong. I had to learn not to let so much emotion through. I had to learn how to keep guys at arm's length. I had to protect myself from getting hurt."

She said that wanted her daughters to grow up being strong and independent, but as she reflects back, she thinks she may have failed them and not provided enough warmth and support.

Our goal during E = Empathy is not to help or even try change anything, but simply to go with our patients to the gates of hell, so they can vent, cry, and express their deepest and most private feelings. At the end of the Empathy portion of the session, we asked Madeleine to grade us on the three key elements of empathy, using letter grades:

1. How accurately did we understand how you were thinking?
2. How accurately did we understand how you were feeling inside?
3. To what extent did we convey the spirit of trust, warmth, and acceptance?

She gave us 3 A's, indicating it was time to move on to A = Paradoxical Agenda Setting, which you will hear next week. We will want to find out what Madeleine might want help with. We will also try to melt away her resistance to change using the Miracle Cure Question, the Magic Button, Positive Reframing, and the Magic Dial.

Why would we anticipate resistance? After all, Madeleine is asking for help.

But remember, the desire for change cannot always be take for granted in anyone. Nearly all of us have mixed feelings about change. After all, a loving and concerned mother might NOT want to stop worrying about a beloved daughter who seems to be in grave danger! But if you deal with this resistance in a compassionate way, you may open the door to the possibility of rapid healing when you come to the M = Methods portion of the session.

We can check it out at the exciting conclusion of the work with Madeleine next week!

The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question.

Here are the questions for today's podcast.

1. Rhonda asks: What's the difference between Past Projection and Memory Rescripting?
2. Slash asks: How do I overcome my resistance to losing weight?
3. Constantina asks: Do negative thoughts come from demons?

And here are the answers!

1. Rhonda asks: What's the difference between Past Projection and Memory Rescripting?

I would love to learn more about Memory Rescripting, since I really don't see much difference between that and Past Projection, but maybe I am just dense. So if we could talk about that on the next Ask David, that would be great.

Thanks, Rhonda

David's reply

I use the term, Time Travel, and you can project yourself into the future or the past, hence Future or Past Projection. If you want a patient to travel into the past, there are a great many things you can do that might be helpful. You can do "Forgiveness Training," developed by Jaimie Galindo. Essentially, the patient talks to someone, like a parent, who abused them in some way, telling the parent how hurt they felt, and how they needed the parent's love. Or you can do Cognitive Flooding, simply "watching" some traumatic event to experience the anxiety until it wears out and loses its power to upset you. And there are many more techniques you can use to explore past experiences with a patient.

Memory Rescripting is like Cognitive Flooding—you have the patient close their eyes and vividly re-experience something traumatic, like the babysitter abusing them. Then, at the height of the feelings of anxiety, anger, and helplessness, you can tell the patient that they can be like a movie director, and change the scene so there is a different outcome. For example, the patient may want to enter the scene as a powerful adult and punish the perpetrator.

This is not some standard procedure, as every patient will be completely different. Often, they will want to do something violent to the perpetrator, so this procedure can be anxiety provoking for the therapist!

I have only used it on a couple occasions, but had good results with it both times. I am not a strong believer that patients "must" go into the past to "work through" a prior traumatic experience, so I don't have that much need for it. But it is a good technique to have in your toolbox.

1. Slash asks: How do I overcome my resistance to losing weight?

Dear Dr. Burns,

I recently listened to your podcast episode on Habits and Addictions, and it really resonated with me. I've been going to the gym regularly, but I'm struggling with my eating habits — I tend to eat too much, and my weight hasn't been decreasing.

What I've realized is that I may be experiencing what you describe as outcome resistance. A part of me feels that if I lose weight and become thin and attractive, I might still not take action in areas like dating — so then I ask myself, "Why should I even bother with weight reduction?"

I'm finding it difficult to overcome this resistance, even though I want to be healthier. Could you please share some guidance or strategies to work through this kind of resistance?

Thank you for all the wonderful work you do. Your podcasts have been truly insightful and helpful.

Warm regards,

Slash

David's reply

Thanks, and we will discuss this important question on the podcast. However, in the meantime, if you can search for Triple Paradox you may find your answer.

Also, you can download two free unpublished changers on habits and addictions from any page on feeling good.com, and use the Decision -Making, Tool.

That, too, will give you the answer!

Warmly, david

1. Constantina asks: Do negative thoughts come from demons?

David and Rhonda,

Hello. I am doing some research into "spiritual" causes of depression. I realize that you are both scientists (and BRILLIANT ones), but if you have any sources I could review, I would appreciate suggestions.

It might also make for an interesting Halloween season podcast. Do "demons" cause automatic negative thoughts. And if not demons, what actually causes them?

Please don't dismiss this as "crazy". I am a very religious person and at times I have sincerely asked the question...are depression and anxiety ...at least in part, spiritual maladies.

I have found tremendous help in Feeling Good, but also in prayer and religious practices. I want to research what has been done in terms of crossover studies/experiments (if any).

Marianne

David's reply

Thank you. The spiritual underpinnings are not so much something to be researched, but can add a deeper dimension of meaning and understanding to the healing.

Current thinking is that Self-Defeating Beliefs, not demons, trigger the negative thoughts. I have written about all of this extensively, so I won't try to say it all again here.

But we can exchange some ideas on the podcast.

Thanks! d

Thanks for listening today!

Matt, Rhonda, and David

The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question.

Here are the questions for today's podcast.

1. George asks: Would my approach help someone who is suicidal?
2. No Name asks: Do I need to worry about my daughter's anxiety?
3. Jeffrey asks: Can you disarm yourself?

1. George asks: Would my approach help someone who is suicidal?

Dear David,

Please tell me if this is too close to medical or other protected advice, but I had a question about something I tell people who are sometimes struggling with suicidal ideation.

Throughout my life, I have had the thought "I don't want to be alive anymore" more times than I can count. But what I have come to realize over time is that this is just something my brain says when I'm upset; it doesn't really mean anything other than that. It's just a reaction to being very upset and that reframing helps me feel better about it, knowing that it's not a conviction but rather just how my brain expresses negative distress.

Multiple people have found this helpful, but I wonder if telling certain people this would be dismissive/triggering/etc. In a dangerous way?

Do you think I should stop sharing this experience?

George

David's reply:

Hi George,

Thanks for asking. I will make this an Ask David question, if okay with you, using your first name or some other name if you prefer.

Short answer: to me, this is like giving advice, to my way of thinking, and I have spent the last 40 – 50 years indicating that this is NOT an approach that's ever worked for me.

Can say more on the podcast.

Thanks!

Warmly, david

1. No Name asks: Do I need to worry about my daughter's anxiety?

Dear Dr. Burns,

I am not very skilled at expressing how much you, Rhonda, the others and your work mean to me. So, I will just ask a question.

My daughter, who has a lot of anxiety issues told me that when she has a problem, she will purposely stew over it when trying to fall asleep so that she will wake up with an answer to the problem the next morning. I cringed. Is there any way that this is a safe or helpful paradoxical technique?

No name

David's reply

Thanks, I'll copy Rhonda. We are both grateful for your loving comments!

Rhonda, we can make this an ask David if you like for a podcast.

But short answer, at least, in my opinion, is that this is a cool way to use your brain. It is a skill. For example, I often get confused by a difficult statistics problem when analyzing data, and go to sleep confused. Nearly all the time, my brain wakes me up in the middle of the night with a brilliant answer. So, if she perceived is in a positive way, and isn't disturbed, you could try nourishing it, as opposed to worrying about it!

We'll see what Rhonda thinks.

Rhonda, I'll add this great brief question to our list for Tuesday. I am reluctant to postpone the Ask David as when we've done this in the past, we've ended up never answer at least 20 to 30 questions which are now too old to put on a podcast. Those who asked may no longer even be alive it's been so long!

Warmly, david

Rhonda's reply

Thank you for this lovely feedback. It really means a lot to us. Your daughter is going through something so many of us experience. I am excited we can respond to your question on an Ask David podcast.

Warmly, Rhonda

1. Jeffrey asks: Can you disarm yourself?

Subject: Question about using disarming technique on oneself, and also it being used against you.

Endless gratitude to all of you for the pipeline of clarity and hope.

I was wondering if one can use disarming on oneself. Much of the focus in feeling good seems focused on looking for and challenging our distortions, which seems the opposite of disarming.

Maybe the reversal of agendas emphasized in feeling great is essentially putting the disarming back into the process in regards to ourselves.

I would like to hear your thoughts on this.

On a side note, if one is in a legal contention or divorce, I could see how disarming could be effective and pacifying, yet what if those admissions could be used against you.

David's reply

I would like to include this in an Ask David podcast, with our first name or a fake name. Please advise if okay.

Short answer: the ideas and tools to treat individual mood problems, like depression, are the complete opposite of the ideas and tools to treat relationship problems. This is like matter and anti-matter. However, the Disarming Technique and the Acceptance Paradox connect these two opposed and radically different worlds. So, in a sense, you are right. The Acceptance Paradox is a lot like disarming yourself!

Best, david

Jeffry's reply to david

Thank you for the succinct response, and I look forward to hearing it fleshed out in the podcast.

I would be honored for you to mention my name: Jeffrey - from the outskirts of Jerusalem in Israel

And thank you to the whole team for keeping the best things in life for free (although I do hope everyone receives the funds they need).

Yet I feel converse maxim - "there's no free lunch" remains standing, app://resources/notifications.html

And that is, because, as you state over and over - anybody serious in improvement must pay the price; whether in completing the daily logs, or Burns assessment quizzes, or facing your fears, challenging your assumptions or fine-tuning one's communication skills, one interaction at a time.

The danger of apps, and screens in general, are the inherent passivity and superficiality they engender, so I am looking forward to seeing how this app overcomes that.

Lastly, you had sought feedback as to audience preferences for podcasts:

I think by now I and most regular listeners are clear in the general approaches of Team CBT, and how it differs from other schools and their adherents, so now I benefit most from the role playing to crystallize and internalize its application.

I would also be willing to forego multiple scenarios in each session in order to spend more time reiterating and clarifying individual scenarios - assuming that David, Rhonda, Matt, etc, have the willingness to keep going.

Keep on keeping us learning and laughing.

Jeffrey

David's reply

Thanks for the kindly and thoughtful note. We'll certainly try, but as you say, there's no free lunch and no guarantees! We are sometimes just hanging on!

I like your recommendation for podcasts: more role playing I think to bring techniques and ideas to life.

Warmly, david

Thanks, for listening!

David and Rhonda

The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question.

Here are the questions for today's podcast.

1. Zhang asks: I have intrusive daydreams and obsess about getting things perfect? What's causing this? And what can I do?
2. Yevhen asks: How can I use "I Feel" Statements without oversharing?

But first, we start today's podcast with a comment from Susan, one of our podcast fans. She extends our discussion of whether friendship is more of a human "need" or a human "want." She describes her work with Dr. Daniel Herman, a Level 4 certified TEAM CBT therapist.

Hi Rhonda, Matt, and David,

First, I wanted to say I am so glad sweet Rhonda is feeling better. This is wonderful news!

I have been a fan of Dr. Burns books for 10+ years and of the podcast for 3 years.

I just finished listening to podcast #469 on friendship and felt compelled to share my story as it relates to Team CBT. Three years ago, my 23 year-old son entered a 90 day inpatient rehabilitation center for a marijuana addiction followed by 1 1/2 years in a sober living facility. Six months into his recovery, I reached out to Dr. Daniel Hermann, a Team CBT level 4 therapist.

At that time, my son's progress had been steady yet I was still suffering greatly. One of many thoughts that contributed to my suffering was that my friends couldn't understand what I was going through. Although I have been fortunate to have had many wonderful friendships for 30+ years,

Although I was open with my friends about my struggles, I generally didn't feel they understood what I was going through and I felt isolated. Fortunately, Dr. Herman did not try to convince me that I "needed" these friendships or to be understood to "get through" this difficult time. Instead, he helped me to look at the situation realistically, without distortions.

My positive reframe regarding my friends was "I wish I could have felt closer to my friends during this difficult time. However, there are many ways in which I have supported myself and I have found other outside sources of comfort also."

I made a very detailed list of the myriad of ways I had supported myself which brought me great comfort and empowerment. I was able to accept that I wasn't feeling as close to my friends as I would have liked, without blaming them or myself. I also let go of my belief that my friends "should" have been able to empathize better with what I was going through. I learned that although I truly value these friendships, if I expect them to mean everything to me in every situation, I will be setting myself up for a lot of suffering.

I am so happy that sweet Rhonda had those strong friendships to help her during such a dark time. She is very fortunate! Since Rhonda had a change of heart during the podcast, the following comments are based on her beliefs at the beginning of the podcast: that the support of her friends is a need and that she could not have "gotten through" her treatments without it.

Did Rhonda mean that she would have not sought cancer treatment, the treatments would have been ineffective, or that she would have ended her life without the support of her friends? Would she have told a client of hers in a similar situation that she needed to focus all her time and effort on developing meaningful friendships rather than treating her cancer because friendship was the true need?

Obviously, I don't believe she would have and am glad that she had a change of heart regarding this belief.

Thank you all for your wonderful podcasts!

Susan

The point I was trying to make is that Dr. Hermann himself did not appear to believe in these self-defeating beliefs, contrary to public opinion. This was essential to me coming to the same conclusions. (To be clear, he NEVER told me what to believe lol. I was paying him but I did all the work! Frustrating at times but coming to my own conclusions was the only way to internalize these messages.)

1. Zhang asks: I have intrusive daydreams and obsess about getting things perfect? What's causing this? And what can I do?

Dear Dr. Burns,

Thank you so much for your kind and prompt reply. I truly appreciate you taking the time to direct me to the additional resources on your website—I have found them and am already finding them very helpful.

Please accept my sincere apologies for the delay in responding. The beginning of the new semester has kept me quite occupied, and I have only now found a moment to write to you properly.

I am writing to you again because I have been struggling with some persistent challenges and was hoping I might ask for your guidance. Lately, I often find myself distracted by vivid, intrusive daydreams—I create elaborate imaginary stories or visualize worst-case scenarios, such as natural disasters. In addition, I have developed what feels like an obsessive need to keep my books in perfect condition. Even minor wear causes me significant anxiety, and I find it difficult to stop thinking about it if I cannot repair the damage.

These thoughts and behaviors are beginning to affect my daily life, and I was wondering if you might have any advice or suggested resources that could help me better understand and manage them.

Thank you once again for your generosity and support. Your work has already made a profound difference in my life.

Warm regards,

Zhang

David's response

Thanks, Zhang.

There are many methods and ideas in When Panic Attacks, my book on anxiety. In particular, the Hidden Emotion Technique might interest you. If you are in the US, there is a class on it in the Feeling Great app, which is free until the end of September, so move fast.

Also, I would like to include this as an Ask David, if that's okay. Can use your first name, or a fake name.

Best, david

1. Yevhen asks: How can I use "I Feel" Statements without oversharing?

Hello Dr. Burns, Rhonda, and Matt,

I would like to express my heartfelt gratitude for the remarkable work you're doing in the field of TEAM-CBT. Your books and your voice of reason have been an immense help to me in some of the most difficult times. Dr Burns, I always feel amazed hearing your wisdom and patience each time you explain the concepts. Even those concepts that were explained before.

Additionally, thank you Dr Burns, Rhonda and Matt, for the exceptional Feeling Good podcast you host. Each new episode is a highlight of my week and nearly always offers profound insight and encouragement. On a lighter note, I sometimes play your podcast at night when I have trouble sleeping. It really helps me drift off within 20-30 minutes 😀

Rhonda, I admire your perseverance in the face of your illness. I wish you a smooth and speedy recovery.

Matt, I really appreciate all the cool insights you're sharing and contributing to this podcast.

I'd love to ask you a couple of questions:

1) When I meet new people, I tend to guide the conversation by asking relevant, open-ended questions. Something similar to the "TV host persona" you described in Feeling Great. The challenge is that I rarely share much about myself. This often leads my friends or partners to say that they hardly know me or that I keep personal matters private/do not share anything with them. How can I work on sharing more about myself without oversharing?

2) I usually appear calm and some people even describe me as having a "poker face." This sometimes leaves my partner/friends unsure how to read my reactions or feelings. Is there a way to become more comfortable showing emotions without forcing it?

3) I'm not naturally confrontational, so in difficult situations or disagreements I usually choose flight over fight. This sometimes leaves me feeling like I missed something or haven't explained my position/point of view. Is there anything I can do to develop a healthier balance in these moments?

I would be really grateful if you could answer any of these questions. Thank you again for your inspiring work!

Best regards

Yevhen M.

David's reply

Thanks, will add this to the next Ask David list. In the meantime, we did a podcast on "I Feel" statements that you could find on my website, with many practical ideas.

You said you want to practice something new and asked: :"How can I work on sharing more about myself without oversharing?" That sounds like you want to practice pitching, in baseball, and want to make sure you throw all perfect pitches. This is not possible! You WILL over or under share at times, it's a rule of the universe. Are you willing to learn by trial and error? And what are you the most afraid of?

On question #3, I never answer abstract, hypothetical questions, as you will know if you have followed my work. If you want help with this, write down one thing the other person said, (or might say), and what, exactly, you said next (or might say next.) This will provide a world of specific information that will contain the answer you're looking for. But on a general level, as the Buddha said so many years ago, "don't waste your time in worthless generalizations. Give me something specific and real, please!"

Best, david

Thanks for listening today!

Rhonda, Matt, and David

On today's podcast, we proudly feature an old friend, Dr. Angela Krumm, on the topic of relapse prevention for habits and addictions. This is certainly a top of incredible importance, since all treatments for all habits and addictions seem to have extremely high relapse rates. Anything we could do to reduce that would be a major contribution.

Angela was on our Feeling Good Podcast #270 on Nov 29, 2021 describing some TEAM CBT methods she'd developed to deal with her own weight gain. In podcast #270 she taught listeners how to set process goals, instead of outcome focused goals. She then taught about the Triple Paradox, Habit Addiction Log, Devil's Advocate technique, and the Problem-Solution log.

In that first episode she explained that this was a difficult time in her life: her father had died, and she'd also experienced a traumatic fall which caused a concussion. So she fell off being careful about her diet, and one day was shocked that she could not recognize herself—due to weight gain--in a photo, and was on the fast track to Type II Diabetes.

As a result, she utilized many of the TEAM CBT techniques and slowly, but surely, lost weight and kept it off for multiple years. She explains that she was

"solid for a long time, but have to confess, with shame, that I eventually relapsed because I got over-confident. I'd been tracking what I ate, which was an important key for me, and stopped keeping up with it consistently, thinking I didn't really need to anymore."

We reviewed the kinds of tempting thoughts she'd had (and still has, of course, at times), when she feels tempted by her favorites: things like delicious brownies, red wine, and other sweet treats. She has tempting thoughts such as:

1. I deserve to take a break from tracking what I eat.
2. I deserve a treat—I've had a hard day.
3. It's silly to be so rigid. I deserve to eat whatever I want. Spontaneity is one of my core values!

During the podcast, we illustrated the Devil's Advocate Technique (DAT), which is powerful and a lot of fun, but sometimes trickier than it looks. When Angela gave a "good" but not "huge" response to one of these tempting thoughts, I automatically suggested a role-reversal.

Rhonda immediately and rightly reminded us that we never do role-reversals when people are stuck during the Devil's Advocate. Instead, we paradox the person and sit with open hands.

Rhonda modeled this beautifully and it worked like a charm. Angela had a sudden about face and blew the tempting thought out of the water immediately.

We made three teaching points on DAT.

1. Don't give in to the urge to "help." This will have the opposite effect of keeping the patient stuck.
2. Realize that if you're a therapist, and your patient cannot convincingly defeat all the temping thoughts in the office, the likelihood that they can defeat them when they're at home is 0%. So, the DAT is both a powerful technique to boost motivation with tools you can use when tempted, but it is also a powerful test of motivation.
3. Remember to Sit with Open Hands if your patients cannot convincingly defeat their tempting thoughts.

Angela shared that she now realizes that the main reason for her relapse was that she had skipped relapse prevention. This is the danger of being your own therapist, sometimes you make the mistake of cutting corners or getting overly confident. She asked to return to the podcast today to talk about that important mistake and help others prevent that mistake in the future. She wants us to emphasize the important of Relapse Prevention for all habits and addictions.

When Angela mentioned that she'd relapsed in her eating to a therapist who was just learning TEAM-CBT, the therapist seemed shocked and asked, "Oh, does this mean that the techniques we're learning don't actually work?"

This is such a great (but naïve and common) question, because we always emphasize that all patients—in fact all human beings—will relapse after recovery from depression, anxiety, a relationship conflict, or a habit / addiction.

That's why it's so important to tell patients about relapse before discharge from therapy, and do a brief but intensive relapse prevention intervention.

We reviewed several of the Relapse Prevention techniques, including the Problem Solution List and the Relapse Prevention Daily Mood Log, using and recording the Externalization of Voices.

When you do this step with a patient, ask them to imagine the future moment in time when they have relapsed. It's important to capture the thoughts that will lead them to give up and quit using the techniques. Often, these are hopeless thoughts about the usefulness of the techniques or their ability to remain in recovery.

If these thoughts are left unchecked, they will spiral the person into a deeper and more lengthy relapse. If they can predict the thoughts ahead of time and generate powerful rebuttals to use in that moment, then their first moment of relapse can be turned around quickly! We listed several of Angela's predicted negative thoughts during her relapse:

1. I should not have let this happen. 100%
2. I'm not strong enough. 60%
3. It's just too hard to start tracking and logging what I eat again. 65%
4. It will be too painful to have to track and see what I've eaten. 60%
5. This isn't fair. It should be so hard to be healthy! 70%
6. Screw it. I should just accept this and give up! 40%
7. Podcast listeners will judge me because I have gained weight again. 10%

We practiced challenging those thoughts with the Externalization of Voices, and Rhonda summarize several of the strategies that can be the most helpful:

1. Self-Defense
2. The Acceptance Paradox.
3. The Counter-Attack Technique
4. A combination of two or three

Angela summarized three important take home messages from today's podcast.

1. Always prepare a Relapse Daily Mood Log ahead of time, anticipating what you will be telling yourself when you relapse
2. Challenge those thoughts with EOV and record that role-play so you can listen to it in the future when tempted.
3. After you have lost sufficient weight, make a plan to continue your healthier eating after the acute phase. Do NOT make the common mistake of thinking, "Oh, I've achieved my goal of losing 30 pounds (or whatever), so now I'm done, and can go back to my normal eating habits and patterns again."

Thank you for listening today!

Angela, Rhonda, and David

Most of us think we're great communicators… but the truth is, we often aren't. At the free webinar on Wednesday, December 3 from 11 to 1 PT, you'll learn some tremendous new skills that will blow your mind. They'll also transform your relationships with the people you care about!

Sign up now at FeelingGoodWebinar.com.

It's for EVERYBODY! Shrinks and the general public alike are warmly welcomed.

Therapists can purchase two CE credits if you attend the live event.

See you there!

COMING UP IN JANUARY: Fast Track to LEVEL 3 TEAM CBT Certification

Howdy! If you're a therapist looking to strengthen your TEAM CBT skills and earn continuing education credit, here's an exceptional opportunity coming up in January 2026.

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Special Offer for Podcast Listeners: Use discount code FRIEND50 for a course price of $595.*

Enroll Now at FastTrackCBT.com.

This hybrid course combines: • Live weekly practice groups • Self-paced video training featuring Dr. David Burns & Dr. Jill Levitt • Deliberate Practice exercises such as Externalization of Voices and the Double Standard Technique • FREE Therapist Toolkit ($199 value) • Certification exam fees included

*Early-Career Clinicians: If you're an Associate or Postdoc in the USA or Canada, use code EarlyCareer2026 and get the course for just $195 plus exam fee.

Enroll Now at FastTrackCBT.com.

If you want to level up your therapy skills for the rest of your career, this may be the ideal time.

Today, you will hear part 2 of the Webinar that Dr. Jill Levitt and I did on September 11th on TEAM CBT and powerful exposure techniques for anxiety disorders. Jill's fantastic teaching includes the importance of recognizing the "Safety Behaviors" that sabotage effective exposure therapy. You will hear the dramatic story of a woman who recovered from more than 20 years of OCD / germ phobia in less than one minute while attending David's free weekly psychotherapy seminar at Stanford. You will also learn about "Memory Rescripting," and how it suddenly changed the life of a veteran who'd lost the capacity to feel human feelings following a traumatic experience in Vietnam 25 years earlier.

Thanks for listening. Please let us know if you want future webinars presenting as podcasts. We will also publish them in their entirety on our YouTube Feeling Great channel, so the additional publication on a podcast may be overkill. Let us know!

Warmly, Rhonda, Jill, and David

Today, you will hear part 1 of the Webinar that Dr. Jill Levitt and I did on September 11th of the fine points of exposure techniques for anxiety disorders. More than 2,000 individuals (mainly therapists, but many general public as well) registered for this event.

It was super well received, thanks in large part to Jill's super awesome teaching skills! I feel so lucky every time we teach together. In part 1 today, you will hear about an overview of TEAM CBT, as well as the four treatment models we use with every person who is struggling with anxiety:

1. The Motivational Model
2. The Cognitive Model
3. The Exposure Model
4. The Hidden Emotion Model

You will also see a dramatic example of the use of a powerful cognitive technique (the Experimental Technique) with Terri, a woman who'd struggled for ten years with extreme panic attacks and depression. You will see the exact moment of recovery, when her uncontrollable sobbing suddenly turned into uncontrollable laughter, joy, and relief.

This may be the most dramatic psychotherapy example ever recorded. Although this podcast of the webinar is in audio only, you can also SEE this dramatic segment on YouTube at

Next week you will hear part 2 of that webinar, with Jill's fantastic teaching on the fine points of exposure, including the importance of recognizing the "Safety Behaviors" that sabotage effective treatment. You will hear the dramatic story of a woman who recovered from more than 20 years of OCD / germ phobia in less than one minute while attending David's free weekly psychotherapy seminar at Stanford. You will also learn about "Memory Rescripting," and how it suddenly changed the life of a veteran who'd lost the capacity to feel human feelings following a traumatic experience in Vietnam 25 years earlier.

Thanks for listening. Please let us know if you want future webinars presenting as podcasts. We will also publish them in their entirety on our YouTube Feeling Great channel, so the additional publication on a podcast may be overkill. Let us know!

Warmly, Rhonda, Jill, and David

The answers to today's questions are brief and were written prior to the show. Listen to the podcast for a more in-depth discussion of each question.

1. Jenn asks: Are you getting old and cranky now?
2. Jenn also asks: How did you get involved with / develop the spiritual and enlightenment aspect of TEAM?

Dear Dr. Burns,

Let me start by saying thank you for all of your hard work and diligence in creating a method which is so user friendly. Completing the book, When Panic Attacks, changed my life and helped me reach enlightenment.

My Ask David question is inspired by the last few podcasts, the live session with Rhonda and the live session with Madelaine which David just did with Jill.

David has clearly worked so hard to create TEAM and has dedicated so much time to perfect it. I was lucky enough to have been introduced to the podcast when it first started. Some of my favorite episodes to listen to are the live therapy sessions. I've gained insight and felt heard through many of these such as when David told Lee how lonely enlightenment can be because I agree with that!

Recently I have noticed that David's demeanor has changed and was hoping to ask about it. I can imagine David might feel lonely in his expertise sometimes. I might be on the wrong track here too but I wonder if David might be feeling frustrated with the lack of understanding from people around him.

He has been dedicating his life to this and still people do not understand certain aspects of his research and teaching. On recent podcasts, David had mentioned that he gets more irritated with teaching now too and it has seemed like he is irritated with Rhonda at points.

He has mentioned that he feels disappointed if he doesn't see change in 2 hour sessions.

Recently I watched a live session with Madelaine and some of the techniques (for example, calling her negative self sociopath during counter attack) did not seem to land or resonate with her and that wasn't addressed with David's usual love and tenderness and warmth with empathy. It seemed rushed and not necessarily focused on the patient outcome but the timeline.

I did not find it to be David's usual work of patience and warmth. I could be completely off the rails but I am wondering if this is resonating with David and if he could share more about what it's been like for him recently.

I also am wondering if it is difficult to navigate being seen as "a great leader" in a field. Do people see you as "David" simply a dedicated expert in your field or do people treat you like a "God" that has all the answers? I can imagine people would want help from you 24/7 and if you could speak to that.

I am hoping David can look at some of those thoughts and comments he's made on the podcasts and become the client for us listeners! I would love for David to show us how to experience TEAM from the client's perspective for all to hear.

I have used TEAM-CBT for 10 years and recently started the Fast Track Program which I am very excited for! Thank you again for this truly amazing process!

Jenn

David's reply

Thanks, Jenn,

You are right, I DO feel quite a bit of irritation with our field and can identify a bit with Martin Luther, who nailed his treatise / ideas on someone's door hundreds of years ago, and also Jesus who angrily threw the money changers out of the temple a couple thousand years ago. I know that sounds narcissistic, but that's how I feel sometimes.

My frustration has several dimensions:

1. The field, to my way of thinking, is incredibly screwed up and anti-scientific, divided into irrational cults called "schools" of therapy.
2. Nobody seems to notice this "elephant" in our room! Hey, are you all sleeping? Did you learn critical thinking in college?
3. When challenged by research that seriously questions the validity and effectiveness of current psychotherapies for depression and anxiety, for example, no one seems to care or notice. It seems like wrong theories die hard.
4. People do not like being criticized and got angry when I criticize the field of psychotherapy. So, there is a kind of a "let's be politically correct" and be super "nice" to everyone, so as not to stir them up or hurt their feelings.
5. There is a potential for massive change and improvements in psychotherapy and psychiatric treatment, but it would require a revolution and the acceptance of totally new approaches which would threaten many therapists' thinking and survival at a very basic level.

Are you or others interested in my thinking? Let me know. If so, more later, maybe on a podcast or two with Jill and Matt, and of course, Rhonda.

And here are the answers to some of your other questions. You say, "He has mentioned that he feels disappointed if he doesn't see change in 2 hour sessions."

We're not on the same page here. I nearly always see dramatic change in 2 hour sessions, and I'm dramatic that I have created a therapeutic approach that makes this possible. When I was a young man, a psychiatric resident, I use to dream about that, and wondered if it was even possible, since I almost never saw meaningful change, much less recovery and joy, in any of my patients using the methods I was talk (supportive listening and antidepressants.)

You also wrote:

I also am wondering if it is difficult to navigate being seen as "a great leader" in a field. Do people see you as "David" simply a dedicated expert in your field or do people treat you like a "God" that has all the answers?

Cool question. I think many people see me as a dedicated expert, but I think a few, particular from some of the Asian countries, to like to see people as "gurus" or something on that level. Sometimes I may even encourage that, as I am a strong believer that therapy, at its deepest level, does become spiritual.

So, questions about spirituality and enlightenment do interest me greatly, and many of the techniques I've created are designed to facilitate rapid improvement, in minutes, vs. years of meditation. The Externalization of Voices would be an example, and it was actually the first CBT technique I created, around or even prior to 1975.

You say,

Recently I watched a live session with Madelaine and some of the techniques (for example, calling her negative self sociopath during counter attack) did not seem to land or resonate with her and that wasn't addressed with David's usual love and tenderness and warmth with empathy. It seemed rushed and not necessarily focused on the patient outcome but the timeline.

You are partially correct and perhaps somewhat "off." Where you are right is that I miscalculated the time for the webinar, and thought we had to stop at 12:30. I later figured out we had until 1 PM, and we could have spent more time on EOV.

Where you're perhaps wrong is that sometimes a confrontation can "jar" a patient into enlightenment. Few therapists use confrontation, but I have always used it, ever since my days in psychodrama as a medical student. Madeleine commented in her follow up evaluation on the things most helpful to her during the session, and that was one of them.

Research has consistently proven that the observers of therapy cannot accurately assess the quality of the therapeutic alliance, as reported by the patient, or the effectiveness of what's happening during a session. I sometimes wish therapist observers had a bit more humility about the accuracy of their observations, based on research that's been replicated over and over!

But there I am, whining again so I will stop!

At any rate, Jenn, thanks for the wonderfully informative critical thinking, and great questions!

Warmly, david

Jenn's response to David

Hi Dr. Burns,

Thank you so much for your fast response. I am really honored that you took the time to reply to me!

Thank you for your honesty too and I can imagine it's super frustrating! I do not think that sounds narcissistic, I think you are right. I find it extremely frustrating too and I am just a user and learner of TEAM. I think I "see it" sometimes since I've done some personal work. I'm still human with many flaws as I am sure you caught on to a few in my email.

I completely agree with all of your points. I genuinely do not understand how TEAM-CBT is not the go-to. It is finally a scientific method that is proven to be effective. It truly leaves me speechless and I could ramble about TEAM for hours to be honest!

I am a registered nurse and I have a difficult time seeing my patients being "thrown" anti-depressants etc. The biological theory was the go-to in mental health and about 10 years ago as I was finishing my nursing degree I read When Panic Attacks. It was mind blowing to me. At the time I was working on a Stroke Rehab unit and the psychologist would recommend our depressed and anxious patients be put on medication. When I asked if she had heard about your work she scoffed at it and it made me so mad! I wanted to scream at her to read your work but she was resistant to even listening and perhaps that will not surprise you based on your points (and also how I incorrectly tried to sell it to her!). I would see so many of my patients put on antidepressants and left alone afterwards as if that would solve everything. Even recently during my labour and delivery training we had a psychologist speak to us about post partum mood "disorders" and she specifically mentioned her patients "yes-butting" her and made a joke about how resistant they are to change and I just had this thought HELLOOOOO has agenda setting not been around for years????? Do people not search out solutions and try to be better? I could Google "my patient is yes-butting me" and your work would come up and it is not easy but it is spelled-out and so accessible to learn. Anyway, I could rant forever. I'm on the same page with you, Dr. Burns!

Thank you for the follow-up email as well. You are right on this one for sure- my therapist observer totally was inaccurate! And I was thinking "I wonder what her EOV is here and if that was effective". I had asked that question in the chat after the webinar but it was at the end and we did not get to it So next time I will ask that as a question in my email instead. I had not seen confrontation used like that and it did seem off-putting and that just shows how well-versed you are in its use and how I am a learner. Thank you for the feedback. This is making me laugh because I am in the Fast-Track course and I really strive on feedback, and I like getting errors over with. In my nursing career I always had "med error" as the thing I never wanted to do and it felt so good when I finally made one (and it also helps the patient was fine haha). So, I had this thought about learning TEAM and how I know that the therapists are never accurate and how I never want to be the therapist that assumes their thinking. So, I am very happy to have done it already and I have not even started the course really.

I want to comment and ask about the spiritual aspect of TEAM. Did you find the spirituality came after personal work or did you see the spiritual aspect before or just as you were developing the whole process?

Externalization of voices and a daily mood log is what got me to enlightenment, but it is hard to put into words. I had blips of the euphoria enlightenment over the years but about 5 years ago I had this "big one" and it was not euphoric. It was nothing (but everything) and it was like I became an observer and absolutely none of my thoughts had emotional attachments. It was instant relief of human suffering for sure. Sorry if this is bizarre and I am not sure if this resonates or if I sound like a crazy person.

In your podcast with Lee you mentioned that enlightenment is lonely and so I thought maybe you have been here. When it first happened it was an overwhelm of being just matter and being everything and nothing all at once. I could see humanity from an outside perspective almost. I was raised catholic and everything that I learned made sense but in a very different way than I was taught - it was like I understood what Buddha and you and the bible talks about but the deeper meaning if that makes sense. And I sat in the observer role for a couple of days and it was fine because I had no emotional attachment.

Actually, as a test I looked at my husband when he got home from work the day it happened and I recognized him of course but I just felt the baseline contentment or a peace overall. The nothingness and the everythingness all at once. When I looked at him I had no emotions or gut reactions or anything and when I thought "that is my husband" I had no emotional ties but I could recognize that my human self loves him but even that love was all created from nothing and everything. This sounds so bizarre!

Day 3 or 4 I went to a house party and again I was just an observer and recognized that my human ego is very tied to wanting others to like me, when I attempted humor it would be to serve my ego, before I'd try to make people laugh for me rather for them and a lot of our actions are tied to our egos. After this party, maybe the next day or something I also saw that as I was observing that although I had no emotional ties that also means…I had no emotional ties! It came to me that to live a human life I cannot be in this enlightenment stage. It was lonely even though that did not bother me at the time and seeing humans from this outside perspective is incredibly hard to describe and was overwhelming.

So in my enlightenment it was almost like I had to decide to step back into trying to be human so I could carry on with life and try and find these emotional ties and what to do with this awareness of my flaws and what even my personality is. It has rocked me a bit! I have decided to just follow things that I find fun or challenging or have become an interest and the flaws quickly followed!

Have you heard of anyone having a bit of fear in reaching enlightenment again? Although the initial hit was so awesome and a huge relief of suffering, I experienced truly what it is like to not have flaws and not have any emotional ties to thoughts. I do have some interesting anxious thoughts about going "back there" and this was the perfect example of "everything in moderation". I must love my flaws haha.

Thanks for your time, Dr. Burns! I thought I had heard you mention during a podcast that you feel disappointed if you don't see change in a 2 hour session maybe while you were empathizing with another therapist so I apologize that I was wrong there. I am most likely remembering it incorrectly or I presented the context incorrectly -it's a common flaw of mine haha usually I need to write things down.

Looking forward to hearing back,

Jenn

David's response to Jenn

Thanks, Jenn. Awesome email. In the context of my empathizing with another therapist, I could well have said something like that for sure!

You are dipping into enlightenment. Way to go. Very exciting, and now YOU will be the expert.

When I lived in Philadelphia, I was lucky to audit a class by James Arbukcle at Temple University on structural equation modeling. It was unbelievably exciting for me, and even though I was in private practice, I went once a week for the three hour seminar and did 20 hours of homework every week. I could not believe my good fortune, as he made everything super simple and clear. It was a wow experience every week.

For quite a while, I would ask him question when I got stuck or puzzled analyzing my data with his AMOS program, and he seemed to know everything. Which was also cool.

Then, one day, he started answer my questions by saying, "Actually, I don't know the answer to that." Like, the first time this happened I asked him the cause of Heywood cases. That where you get a seemingly impossible result, like a correlation greater than one.

But then, an odd thing happened. I found that if I worked at it, I could figure these things out for myself. And often, the answers would come to me in a dream, in the middle of the night.

So, like James, I probably can't answer all your questions anymore, although hopefully I can still answer a few of them!

By the way, James Arbuckle was one of the most amazing teachers I've ever had, and I will forever be grateful for his generosity in letting me audit his class--I was not even a student at Temple--two years in a row for free. And what I learned forever changed my career and my life, especially my way of thinking about research and statistical analyses.

Warmly, david

Thanks for listening today!

Rhonda, Matt, and David