Feeling Good Podcast | TEAM-CBT - The New Mood Therapy David Burns, MD
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- Health & Fitness
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This podcast features David D. Burns MD, author of "Feeling Good, The New Mood Therapy," describing powerful new techniques to overcome depression and anxiety and develop greater joy and self-esteem. For therapists and the general public alike!
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The Amy Story, Part 1 of 2
Featured Photo is Dr. Amy Huberman The Amy Story Part 1: True Confessions of a “Fraud” and a “Failure” Part 2: The Joys of Doing the Laundry
Amy and her exuberant son, Sasha, and husband, Poppy
Today’s podcast, and next week’s podcast, include a single, two-hour session with Amy Huberman, MD. Amy is a psychiatrist in private practice in Baltimore, MD. She also serves on the volunteer faculty at the Johns Hopkins University School of Medicine.
Amy specializes in brief, intensive psychotherapy to help people overcome struggles with anxiety, OCD, and trauma, but today comes to us to get some help with her own anxiety. Often doing our own work can be a vitally important part of our training and growth as mental health professionals.
Amy has been upset because she is stuck with two of her patients, and she’s telling herself that she’s a “fraud” and a “failure.” Although her life is undoubtedly very different from yours, the root cause of her problem might be very similar to the source of your unhappiness, especially if you sometimes get down in the dumps and tell yourself that you’re just not good enough.
My co-therapist for this session is Jill Levitt, Ph.D. co-founder and Director of Clinical Training at the Feeling Good Institute in Mt. View California. Jill also serves on the Adjunct Faculty at the Stanford Medical School and is co-leader of my weekly TEAM Therapy training group at Stanford, Tuesdays from 5-7:00 pm pst. If you are interested in joining David and Jill's Tuesday group, please contact Ed Walton, edwalton100@gmail.com.
That group is now virtual and therapists from the Bay Area and around the world are welcome to attend. It is free of charge. Rhonda Barovsky also runs a free weekly training group with Richard Lam, on Wednesdays, from 9-11:00 am pst, which is also free of charge. If you are interested in joining the Wednesday group, please contact Ana Teresa Silva, ateresasilva6@gmail.com. Because the groups are virtual, they are open to therapists from around the world.
Amy has been a member of our Tuesday training group, and is a highly skilled, certified TEAM therapist. Like nearly all the mental health professionals who come for training every Tuesday, Amy has incredibly high standards and is sometimes harshly self-critical when she feels she is not living up to them.
At the same time, those high standards can be strongly motivating, and this can create strong feelings of ambivalence when it’s time to change.
Sound familiar? If you’re struggling with perfectionism, you might want to check out these two podcasts!
Part 1. The True Confessions of a “Fraud” and a “Failure” Amy opened by saying she was anxious and telling herself:
I’m about to reveal my weaknesses and my inner self—This is something I’ve never done before in such a public setting. . . I also have to confess that I’m struggling with social anxiety right now. I’m afraid that my patients might see this and think, “I don’t want to work with her! I want to work with a competent psychiatrist.”
I Included that because I am hoping you will appreciate Amy’s incredible courage and gift of sharing her true inner self today!
Amy described the problem that’s been bothering her for several weeks. Although she specializes in the short-term treatment of anxiety, she has been struggling with two patients with OCD symptoms who have been stuck and not making significant progress for a long time.
This has triggered feelings of shame and intense anxiety which have invaded Amy’s every moment when she’s NOT seeing patients, and has even prevented her from getting restful sleep at night. She keeps ruminating and beating up on herself.
You can see Amy's Daily Mood Log Amy here.. As you can see, she was feeling intensely sad, panicky and ashamed, and rated these three feelings as 80% on a scale from 0 (not at all) to 100 (the most severe). She was also feeling worthless and defective which s -
The Acceptance and Resistance Survey, Part 2 of 2
Why Do We Resist Accepting Ourselves Other People, and the World? The Five Most Common Reasons! Rhonda and David are joined in today’s podcast by Dr. Matt May, a super popular and loved guest on our show, to discuss the resistance findings in David's recent survey on acceptance and resistance. The following is a summary of some of the statistical findings, but the actual podcast dialogue was wide ranging and tremendously engaging, and won't require a lot of statistical smarts!
We also discussed the vitally important difference between healthy and unhealthy acceptance.
Healthy acceptance is accompanied by feelings of joy, lightness, and liberation. Unhealth acceptance is accompanied by feelings of unhappiness and despair. Unhealthy acceptance is characterized by Should Statements and self-punishment for your failures and shortcomings. Healthy acceptance is an expression of self-love. The group brought the five most common reasons to life with engaging stories.
Why should you accept yourself? We are not saying that you "should," and it's really a decision. However, the statistical models the I (David) developed indicated that healthy acceptance can trigger a 49% reduction in negative feelings and a 39% boost in positive feelings, which is tremendous.
Matt told an inspiring story about two strategy for training the dolphins at SeaWorld. One strategy involved trying to shape the behavior of the dolphins with little shocks, in much the same way that some people train horses. Sadly, the dolphins went to the bottom of the pool and appeared depressed, not moving much. It was a complete failure.
Then they tried a radically different strategy--they gave a new group of dolphins fish to reward them for doing the things the trainers wanted them to do. This strategy was tremendously successful.
So, the question is whether you want to shape your own life with frequent shoulds and self-criticisms, which can have the effect of electric shocks every time you fail or screw up or fall short of your goals, or whether you want to shape your life with love and rewards. Some of us have discovered that acceptance is way more fun and vastly more effective!
Quick Bottom Line The typical survey respondent endorsed 1/3 of the 12 Resistance Scale items, and seemed to believed that Acceptance would be foolish and lead to a life of misery and mediocrity. The actual causal impact of the Non-Acceptance and Resistance scales on positive and negative feelings was massive and appeared to be in the exact opposite direction.
Findings The respondents in the Resistance survey endorsed an average of 33.8%. (+/- 0.1%) of the items, ranging from 0 to all 12. The most commonly endorsed was, “Acceptance is easy for rich and famous, but hard if you’re struggling just to pay the bills.” 47% (+/- 2%) endorsed this item.
The least endorsed was, “If I beat up on myself, people will love me more,” although 25% (+/- 1%) of the people endorsed this item, so it was fairly popular. The high scores on the resistance scale items is also pretty consistent with my experiences over the years—the people in the study, and the people I’ve worked with, have expressed MANY reasons to beat up on themselves.
You can see the list of the 12 Resistance Scale items below. I have bolded the five most often endorsed. As you can see, many people surveyed believed that acceptance is fine for people who are rich and famous, but terribly painful and foolish for people who struggle with real problems. Many respondents were convinced that acceptance leads to pain, robs you of motivation and does not make sense in a the world that’s falling apart.
If I accept my flaws and shortcomings, I'll end up with a second-rate life. If I accept my flaws and shortcomings, I’ll lose all my motivation to learn If I beat up on myself and work my ass off, people will love and admire me. It would be tremendously painful to accept my flaws and shortcomings. That would be like giving up -
The Acceptance and Resistance Survey, Part 1 of 2
Accept this Sh__? Hell No! Rhonda and David are joined in today’s podcast by two dear friends, Dr. Matt May, a popular regular on our show, and Matt Pierce, a co-founder of the soon-to-be-released Feeling Great App
Brief bio sketch of Matt Pierce goes here, should you wish to include it in the show notes. Matt,. A pic would also be great, but not required. People get tired of the same pics each week, so a fresh face to illustrate this episode would be cool!
You’ve probably heard about acceptance. It’s a popular buzzword in the mental health space these days. In fact, some experts claim that it’s THE key to happiness and enlightenment.
It’s NOT, but it can be incredibly helpful.
I wanted to learn more about Acceptance and put some numbers on it’s effectiveness, or lack of effectiveness, so I recently sent an invitation to the 45,000 people on my mailing lists to complete a new survey on acceptance and resistance. More than 1,000 quickly responded, which was great. I hoped the data could provide some answers questions like these:
What is acceptance? How interested are we in accepting themselves, other people, and the world? Many people, and perhaps most of us, strenuously resist acceptance. Why? What are the things that we have the most trouble accepting about ourselves and others? Is all the hype about acceptance justified? Does it actually have meaningful effects on how we feel? Can money buy happiness? And if so, how much, exactly, does it cost? Why are single people more depressed and unhappy than people with partners? And if so, is it because of the lack of a loving partner? Or was there some other reason? Thanks for listening, David, Rhonda and Matt -
Ask David: Do you have a "self" or "personality?" And more.
Do we have a "Self"? Or "Personality"? What's the best way to combat Should Statements? Is TEAM effective without a therapist? What's the Difference between
Positive Reframing and Positive Thoughts? Note: The answers below were written by David prior to the podcast, just to give some structure to the discussion. Keep in mind that the actual live discussion by Rhonda, Matt and David will often go in different directions with different information and opinions. So, please listen to the podcast for the more complete answers!
Questions for today’s Ask David Podcast:
Stefan asks if we have a “self” or a “personality.” Slash wants to know how to combat a “Should Statement.” Magellan asks about the effectiveness of TEAM without the guidance of a therapist. Werner asks about the differences between Positive Reframing and the Positive Thoughts you record on the Daily Mood Log.
1. Stefan asks if we have a “self” or a “personality.” What is the so-called “Great Death” of the “self,” referred to in Buddhism? Hi David,
I really love your work, both the books and the podcast you’ve created. Lots of great tools there. I think your down-to-earth approach is effective and great in de-mythologizing mental health care.
Still, one thing has been bugging me about your approach: the fact that you quite casually seem to discount the existence of the self. As a theologian I understand this position. In discounting the self as a construct, you’ll open the way to less resistance and more acceptance. I studied both Christianity and some Buddhism, and in that tradition the self is essentially something to let go of as an illusion. I think you called this the death of the ego, and it’s common in many mystical currents both within and without the major religious traditions.
However, by embracing this tradition in a therapeutic setting, I think there’s a great risk to gloss over long-held implicit beliefs or patterns in the construction of a personality that might hold people back from reaching their full potential. More specifically, I’m talking about schemas or Lifetraps (in the terminology of Jeffrey E. Young and Janet S. Klosko). I know Aaron Beck supports their work to address these “chronic self-defeating personality patterns” that are usually considered the be part of the self. What’s your take on their work?
Kind regards, Stefan
David’s reply
Hi Stefan,
Personality, like "self" is not a "thing," but just the observations that different people have different behavioral patterns. So, some are more outgoing, for example, while others are more introverted and shy and insecure.
The only meaning of "self" is the context in which the word appears. So, "behave yourself" simply means that you are misbehaving and need to stop!
Can you come to the Sunday hike is a question. It does not need the add on, "and do you plan to bring you 'self.'"
The only meaning of any word is the context, and many uses in the English language, or any language. Nouns do not always refer to "things." Words are just sounds that come out of our mouths.
I don't go into this much because few people "get it."
Thanks so much, Stefan.
Warmly, david
PS The above is my take on Wittgenstein's Philosophical investigations, published after he died in 1950. .
Second PS I had a random and fairly weak thought, but here it is. When doing my daily “slogging” a while back, I was going through a pleasant and familiar path and noticing how beautiful everything was, and had the thought, “This land is so valuable and expensive, and I’m SO GLAD I don’t have to own it. It would involve a nightmare of paper work, taxes and all kinds of worries. But I can just enjoy it without any of those burdens of ownership.
Then I thought of the “self,” and what a heavy burden it is to “have one,” and worry about whether or not it is “good enough,” or “inferior,” and so forth. Selves tend to be a bit overweight, a -
Ask David: ADHD; Humor; Rejection Practice
Can You Treat ADHD with TEAM? Does Humor Play a Role in Therapy? What's the Difference between Rejection Practice and Shame-Attacking Exercises? Featuring Dr. Matthew May Note: Not all of the information covered here is in the podcast, and much of what we discuss in the podcast is not covered here.
Questions for the next two Ask David Podcasts:
Rich asks how you treat ADHD in TEAM. Hwa-Chi Qiu Alvarez asks about the use of humor in therapy. Rima asks about the differences between Rejection Practice and Shame-Attacking Exercises.
Rich asks: How do you treat ADHD? From Richard: How about a podcast concerning ADHD? I feel that applying TEAM would work. No? I mean “disorders” arise from distortions…so what does a distraction “disorder” arise from?
Thanks for all you do David,
Rich
David’s reply: Hi Rich,
I don’t treat “disorders,” I treat individuals at specific moments when they’re struggling and wanting help! Hope that helps.
As an aside, if you or a friend, colleague, or patient have ADHD and you can describe a specific moment when that person was struggling, I would love to hear about it! Then you’ll see how TEAM works it’s magic by focusing on individuals, and not “problems” or “disorders,” etc.
TEAM is a “fractal psychotherapy.” I will explain!
Warmly, david
Matt’s Take: Thanks for the question, Rich! I love what David is saying, about treating the individual, not the diagnosis.
There are a lot of things that can interfere with focus and attention, such as. medical problems, sleep difficulties, toxin exposure, substance misuse, and relationship problems. In addition, depression and anxiety can interfere with concentration and contribute to ADHD symptoms.
Below, I’ve listed many of the distracting thoughts that my clients have had. Along with a list of some good things about being Distracted.
Hope you enjoy!
Matt’s A – Z List of Distracting Thoughts: I don’t feel like doing this This is boring and no fun I never get to do what I want It’s not fair I’ll do it later There’s plenty of time Best not to rush things I might be missing out on something interesting or important I’ll check my phone one more time, real quick, and then get right back to work This time will be different. Seriously. I mean it. Actually, I’m feeling too tired to concentrate I’ll just take a quick, 5-minute nap I’ll get to work when I feel more rested and motivated I’ve had a hard day and deserve a little break and some fun Tomorrow’s going to be really hard, so I need to rest up I just *can’t* concentrate, at all There’s something seriously wrong with me I lack willpower / I have no ambition I shouldn’t have to do this There’s no point doing this I’ll never be able to do this I need to be doing important, interesting things It would be really exciting and fun to … x, y, z, instead I need to tidy up a bit before starting this big project I don’t know where to get started / don’t want to mess up I’ll be too distracted if I don’t take care of this one thing, first
Matt’s A – Z List of GOOD Reasons to be Distracted I can be spontaneous, have fun and be present, in-the-moment I won’t miss out on something interesting and important I won’t waste my life doing boring stuff that leads nowhere I’ll focus on what makes me happy I won’t let other people control me or make my decisions for me I like to feel powerful and in-charge; I call the shots This is my time, nobody controls me It’s calming to know that I’m in-control I want to treat myself with respect I want to be free, not shackled It’s important to take breaks I want to maintain a good work-life balance It’s fun and exciting to be a bit of a ‘rebel’ I’m my own unique person, doing things my way I just want to ‘go with the flow’, it’s easier I want to be safe, protected me from failure. I can’t really fail if I don’t give it my all I can get instant relief from -
Transgender Issues, Featuring Dr. Robin Mathy
Transgender Issues Featuring Dr. Robin Mathy Emily Dickinson, from Amherst, Massachusetts, was one of the greatest American 19th century poets, and after hearing one of our Amherst professors explain her life and work, I fell in love with her incredible poetry. When she attended Mt. Holyoke College as a freshman, she was obligated to sign up as a “Christian,” a “Non-Christian with hope,” or a “Non-Christian without hope.”
She was the only student who had ever signed up as a “Non-Christian without hope,” and she was given one semester to change her registration category. When she refused, she was asked to leave, and spent the rest of her life living in Amherst, baking cookies for children and writing her fabulous poems, which were sometimes included in her cookie packages.
Her poetry was all about loss, which was much the story of her life. However, she was not self-pitying, which is part of what makes her poetry so sad and magical.
Emily Dickinson always dreamed of visiting the west, but never got the chance to travel much beyond the outskirts of Amherst.
She once wrote,
To make a prairie,
It takes one clover,
and a bee.
One clover and a bee.
And reverie.
The reverie alone will do, if bees are few.
Tears come to my eyes every time I think about that poem! When I was a student at Amherst, we used to visit her grave, and I once actually knocked on the door of the house where she once lived. I explained I was a huge fan and actually got the chance to look around. I actually found a poem scribbled on a scrap of paper on a window ledge.
Today we interview Dr. Robin Mathy, who describes herself as “A human who hopes.” Robin is a well-published expert on LGBTQ issues, with a specialization in transgender research and political activism based on science to debunk hateful myths about sexuality.
She is also a new member of our Tuesday training group at Stanford!
In addition to studying to become a TEAM therapist, Robin is a Doctor of Social Work student at Tulane University. She is a researcher and activist who has published four books and more than 50 peer-reviewed articles or book chapters. She is a beloved member of David and Jill’s Tuesday TEAM CBT group.
Rhonda kicked off today’s podcast by reading two very moving endorsements from people who heard part 1 of the live work with Jessica, “Living with Regrets,” which we had published just prior to our interview with Robin.
Then Rhonda kicked off our dialogue with Robin by asking if there are any special treatment considerations when you are working with trans individuals.
Robin said that there really aren’t—TEAM-CBT is already highly personalized and individualized, so we let the patient set the agenda. Robin emphasized the importance, of course, of being warm, affirming, and supportive.
In addition, do not assume that the patient is there because of gender identity issues, or automatically refer them to a support group on that topic, because the patient’s issue may be radically different, and that would amount to stereotyping your patient.
I asked Robin for a simplified introduction to LGBTQ, including what these terms actually mean. That’s because I have to admit I never had any good sexual diversity training during my medical school or psychiatry residency, and I suspect that some of our podcast fans, perhaps many, would also appreciate a little enlightenment based on science.
Robin pointed out that transgender has to do with identity issues: what is your sense of self? Do you see yourself more as a woman or a man? And sometimes, this will be quite different from the gender you were assigned at birth.
So, for example, you may be assigned as a boy at birth, but your sense of who you are may be a girl, when you are young, and a woman as you develop during puberty. In this case, you would be a trans-gender woman. To be respectful, you should refer to a transgender woman as she or her. And, of course, if you were assigne
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Awesome podcast
Love the podcast. It always feels so personal and as a listener I almost feel like part of the conversation. Great work keep it up!!
Helping me to feel better 🙂
Life is stressful right now. Feel like I have all these disorders. At least 3 or 4. The advice and techniques shared here are good!!