Rank #1: 118: Self-Defeating Beliefs (Part 1) — The Beliefs That Defeat You
- Is it possible to change an SDB?
- Does the mere knowledge of an SDB change it?
- How long does it take to change an SDB?
- How do you change SDBs?
- Aaron Beck said the SDBs never really go away. They just get activated and deactivated and activated again. Does this mean that depression is an incurable disease that will keep coming back over and over again?
- What’s the point in battling against a core belief if it cannot be changed?
Fabrice and I appreciate your questions--they often give us ideas for shows! In today’s Podcast you'll learn the answers to several questions about Self-Defeating Beliefs.
What’s the difference between Self-Defeating Beliefs (SDBs) vs. Cognitive Distortions?
The thoughts that contain cognitive distortions, such as All-or-Nothing Thinking, Overgeneralization, Discounting the Positive, and Self-Blame are distortions of reality, they are the cons that trigger depression and anxiety. When you're upset, these thoughts will flood your mind. These thoughts can be show to be false, and when you crush a distorted negative thought, you'll immediately feel better.
Self-Defeating Beliefs are stipulations, values that you've set up for your self. For example, you may base your self-esteem on your accomplishments due to your belief that people who accomplish more are more worthwhile as human beings. SDBs like this cannot actually be shown to be false--they are simply your personal, subjective values, and they are thought to be with you all the time, and not just when you're depressed, anxious, or angry.
The question with an SDB is this: What are the advantages and disadvantages of having this value system? How will it help me--what are the benefits--and how might it hurt me? What's the downside?
Why are Self-Defeating Beliefs thought to be important?
When you challenge and defeat a distorted thought, you feel better in the here-and-now. When you challenge and change an SDB, you change your value system at a deep level. This is thought to make you less vulnerable to painful mood swings and relationship conflicts in the future.
What are the different kinds of SDBs?
- David’s list of 23 Common SDBs is attached. This list is not comprehensive, as there are many more, but the ones on the list are very common. There are several categories of SDBs.
- Individual SDBs are often “Self-Esteem Equations”
- Perceived Perfectionism
- Achievement Addiction
- Approval Addiction
- Love Addiction
- Interpersonal SDBs are expectations of what will happen in certain kinds of relationships, or relationships in general
- What’s your understanding of the other person’s role in your relationship? What adjectives describe him or her?
- What’s your understanding of your person’s role in the relationship? What adjectives describe you?
- How would that kind of relationship feel?
- What rules connect the two roles?
- Other kinds of SDBs
- Anger / conflict cluster
- Anxiety cluster
- Conflict Phobia
- Anger Phobia
- Spotlight Fallacy
- Brushfire Fallacy
- Anger / conflict cluster
How can you identify your own, or a patient’s, Self-Defeating Beliefs?
- Look at the list of 23 individual SDBs (easiest). You might want to do that right now. Review the list, and you'll probably find many of your own beliefs!
- Individual Downward Arrow
- Interpersonal Downward Arrow
Rank #2: 152: Treating At-Risk Teens with TEAM-CBT. Can you REALLY Make a Difference?
In today's podcast, Rhonda and I interview the incredibly brilliant, funny, and creative Amy Spector. Amy is a licensed marriage and family therapist and credentialed school counselor with over a decade of experience working with adolescents and their families. She is passionate about providing school-based mental health services and advocates for legislation to mandate universal mental health care for youth.
Amy works with "at risk" teenagers at Vicente High School in Martinez, California. This is a continuation high school, as well as teens at Briones School, an independent study school. Her students are credit deficient and at risk of not graduating from high school. Nearly all have experienced significant trauma and most are severely depressed, anxious and angry when first referred to Amy, and some have suicidal thoughts or urges as well.
Although you might think that this would be an exceptionally challenging, oppositional, and frustrating group to work with, Amy has had tremendous success treating these teenagers with TEAM-CBT. She measures symptom severity at the start and end of every session, just as we do with adults, and often reports a phenomenal reduction of 60% in depression and anxiety in a single, 30-minute therapy session. Although this may be hard, or even impossible, to believe, it is real, and you'll see why when you listen to this amazing interview. Amy's secret involves a combination of superb E = Empathy skills to form a meaningful relationship, along with A = Paradoxical Agenda Setting to reduce resistance, followed by truly creative applications of M = Methods. And, of course, she does T = Testing with every student at every session, and plots her effectiveness over time.
Amy describes her work with a severely anxious young man with artistic skills, who drew an "Anxiety Hero" figure who saves the world by worrying constantly about every little thing, plus a "Chilled Out" figure who never worries and ends up getting hit by a bus. In other words, Amy skillfully emphasized the many BENEFITS of the young's man's constant anxiety, as well as the downside of getting cured. This paradoxically boosted his motivation, and he improved rapidly.
This is prototypical TEAM, which is difficult for many therapists to learn, because therapists are so used to, and addicted to, "helping." Amy has developed expertise in aligning with the resistance of her students. paradoxically, she ends up on the same page, and this allows some awesome TEAMwork to emerge.
Amy, Rhonda and David talk about the idea of teaching TEAM through creative innovations, with many examples of games Amy has created. For example, she created a game with another one of our fabulous TEAM-CBT therapists, Brandon Vance, MD, which can be played with teens and adults, called "Tune In / Tune Up." This game provides a really fun way to learn the 5-Secrets of Effective Communication. If you're interested, you can check it out at www.gamefulmind.com.
Amy and her students have also created a podcast that you might want check out.
Although I (David) have been primarily an adult shrink, I have really enjoyed working with teenagers as well. A few years back, I tested hundreds of juveniles who had been arrested in California, many for violent crimes, including murder, at the request of the probation department, using my Brief Mood Survey to find out how depressed, anxious, suicidal, and angry the kids were.
Toward the end of the podcast, I describe what happened when I was invited to visit two groups of incarcerated gang members at the Juvenile Hall in San Mateo, California to find out how they felt about the tests I administered, and to get their take on the causes of so much teen violence.
I think you'll find this episode to be fun, funny, and inspiring! Amy is a strong advocate for including mental health training in high schools, and her experience illustrates the enormous potential for rapid and profound mental health growth and learning in teens.
If you would like to contact Amy, she can be reached at firstname.lastname@example.org.
Rank #3: 093: 50 Methods in 50 Minutes (Part 1)
For a long time, Fabrice has wanted to do a show on my list of "Fifty Ways to Untwist Your Thinking" called "Fifty Ways in Fifty Minutes." So we finally did it, and it was fun!
If I'm helping you overcome depression or anxiety, I'll ask you to fill out a Daily Mood Log, so you can list your negative thoughts and feelings at some specific moment when you were upset. You may be thinking, "I'm a failure," or "I should not have made that mistake," or "I'm unlovable."
Your negative thoughts will nearly always be distorted, but you'll still believe them, and that's why you're feeling depressed and anxious. And the moment you discover that your negative thoughts aren't true, you'll immediately feel better. But that's not going to be easy, because you've probably been giving yourself the same negative messages for years, or even decades. And friends and family members, and even your therapist, may have been trying, unsuccessfully, to talk you out of them.
That's why I've developed more than fifty methods to help you crush the negative thoughts at the heart of your suffering. So today, you'll take a look at the landscape!
Rank #4: 053: Ask David — “I don’t feel like doing it!” Quick Cure for Procrastinators
A listener named Benjamin asks about procrastination. He wrote:
“The live therapy with Marilyn was very interesting - like other listeners, I was impressed by her character and strength.
“Towards the end of this most recent podcast, you were musing on what topics to cover in future podcasts. I would love to hear about how you treat people suffering from chronic laziness ("Do Nothingism"). In particular, there seems to be a strong potential of a Catch-22 with Process Resistance: The patient cannot find the motivation to do anything, yet they have to carry out the process (do the homework) to improve.
“Even worse, in "Feeling Good", you categorize "Do Nothingism" into around 10 different categories, and suggest a different approach for each one. What should a lazy person do, who identifies with multiple categories, but is already starting to feel overwhelmed at the prospect of doing one of those activities, let alone five of them?
“I would love to hear David's thoughts on this!”
David and Fabrice begin by thanking Benjamin, and David emphasizes how helpful and inspiring it is to receive specific questions like this, which makes it easy to create a (hopefully) informative and interesting podcast.
David says that his thinking about the treatment of procrastination has changed greatly since he wrote Feeling Good. One big change is that he no longer tries to “help” individuals who procrastinate, since this will cause them to continue to procrastinate, and the failure will now be the failure of the therapist, who’s “helping” wasn’t good enough.
Instead, David outlines a multi-step approach, based on someone who has ten years of unfiled papers that have piled up in his office, so that by now 15 feet of desk space is completely covered by piles of papers roughly one foot high. Fabrice plays the role of the resistant patient, and David plays the role of the therapist.
The steps include:
Paradoxical Agenda Setting: David asks, “The procrastination seems to be working for you. Why would you want to change? Let’s make a list of all the benefits of procrastination, and all the reasons NOT to change.” David emphasizes that the patient has to convince the therapist that this is something he really does want to change. It’s NOT the therapist’s role to help or to convince the patient to change!
Miracle Cure Question: What kind of help would you like in today’s session? Most patients say they need help with motivation. David declines to offer this, explaining that it isn’t on the therapeutic menu today—only the “Blue Plate Special!” The patient must agree to begin working on the filing in spite of having no motivation.
David also explains the underlying concept behind this strategy: most procrastinators are waiting for motivation, but that never works. You’ll be waiting forever, because you’re NEVER going to feel like doing all that filing! You aren’t entitled to motivation!
Productive individuals know that action comes first, and motivation comes second.
Specificity: What time would you like my help in overcoming your procrastination? The patient’s requests for help yesterday or tomorrow are declined by the therapist, so they settle on 6 PM today.
Little Steps for Big Feats: Let’s list the first five things you would need to do tonight at 6 PM, making sure that every step can be completed in 15 to 30 seconds. They list these steps:
- Walk into my office
- Choose one pile to start working on
- Pick up the top piece of paper on the pile
- Put it into a blank manila file folder
- Label the file folder
Let’s Be Specific: David asks if Fabrice needs help with Step 1? Step 2? Etc. Fabrice finally admits he can do these five steps.
Five Minute Rule: David asks if Fabrice will agree to do these five steps between 6 PM and 6:05 PM, and if he will agree to work on his filing for ONLY those five minutes. At the end of the five minutes he has completed 100% of the assignment. The rationale is that if Fabrice tries to do it all, he’ll get so overwhelmed that he won’t do anything. But if he agrees to ONLY five minutes, that will be do-able. And if he surprises himself, and gets motivated to do more, he can, be he only gets credit for the first five minutes.
Problem – Solution List: David asks Fabrice to put a line down the middle of a piece of paper, from top to bottom, and list all the problems that will get in the way at 6 PM, and then to list convincing solutions to each problem in the right-hand column. Fabrice lists two problems: 1. I won’t feel like it. And 2. Traffic might be heavy, so I might not get home by 6 PM.
“I Stubbornly Refused” Technique: David asks Fabrice to agree to an unusual phone call at 6:05 PM!
TIC – TOC Technique: David plays the role of Fabrice’s “Task-Interfering Cognitions” (TICS) that will tempt him to procrastinate, and asks Fabrice to play the role of the “Task-Oriented Cognitions” (TOCS) he can use to combat the TOCs. The TICS include the familiar ones such as:
- Five minutes won’t help, the job is overwhelming.
- Even if I get started, I’ll just relapse, so there will never be a permanent solution.
- It’s not such a big problem, I don’t need to do my filing now.
- I can watch Game of Thrones on TV instead. That will be more fun.
- It will be too anxiety provoking to get started.
- It’s too late to get started anyway.
- Tomorrow will be a better day.
David confesses the problem is one that he actually had, and describes how he solved it, using this exact approach!
Rank #5: 001: Introduction to the TEAM Model
In this podcast, Drs. Fabrice Nye and David Burns discuss an exciting breakthrough in psychotherapy.
Leave your questions and comments below. Also, let us know if you’d like to see certain topics addressed in future podcasts.
Rank #6: 134: Smashing Shyness (Part 1) — Beating Social Anxiety
David and Rhonda begin with two emails (among many) from listeners asking for more help on the problem of social anxiety.
Email from “Margaret:”
How do you distinguish a personality disorder - say, for example, Avoidant Personality Disorder, from "just" (and I don't mean that in a derogatory way) being depressed and anxious?
I ask because I have a strong suspicion that I may be suffering from Avoidant Personality Disorder, and I think if you knew my history you would probably agree that there are strong signs (I have been having problems from my early childhood until now, and I am 30 years old now).
Also, a further question – is it possible to have severe anxiety without feeling like the confrontation with the thing you’re afraid of means you’re going to die? I have isolated myself completely, and I have no social life in any sense of the word – my only real contact with the outside world is through my job, because it is a necessity for living. But it’s not because I think I’m going to die if I hang around people – I just very strongly dislike it and ‘shut down’ or ‘freeze’ due to all the thoughts in my head about being negatively judged and watched, so I prefer to avoid contact with people, and in situations where I’m forced to endure it, I’ll usually find ways to ‘avoid’ or escape the situation.
There are many ways I do this – since I was very young I’ve had the habit of purposely looking annoyed, so that people would not approach me, even though I secretly wish they would (oh, the paradox..), and at work I will often be listening to music with earphones – both because the music calms my anxiety, and because it makes me appear less ‘available’ to other people.
In situations where I cannot escape crowds – say, in the canteen during my lunch break - I’ll sit by myself, as far away from everyone else as I can, and leave as soon as I have taken the last bite of my food. In college I would often hide in the bathroom by myself during breaks, or I would avoid interpersonal contact in some other way. And so on and so forth. These are just a few examples – I could give you a million others.
I am aware of my own behavioral patterns but still feel powerless to change them. It’s like being an observer, observing yourself committing the same mistakes over and over, but with an anxiety so strong that rationality alone is not enough to change the behavior. After 30 years of this, it’s getting old. I have never felt any other way, so I cannot fathom what it means to lead a normal life.
I have never had a friend in any usual sense of the term, and I literally never spend time with anyone in my spare time except for my parents. As a consequence, I have never learned or understood how to make friends, and I have never been in an intimate relationship, or taken part in any of the social activities that are normal to other people (parties, school dances, etc.) The simplest things are rocket science to me. So, I’m interested to know when a person crosses over from “simply” being depressed or anxious into having a personality disorder.
If you use any of this for a future episode I am fine with that - you can even quote me directly. But I only ask that you please don't use my real name as to not jeopardize my job and so on. Thank you. 🙂
David explains that there is no such thing as “Avoidant Personality Disorder.” It is just an imaginary concept created by the American Psychiatric Association, and is applied to individuals with shyness that is so severe that it causes significant problems in their lives.
And yes, you can definitely deal with mild, moderate, or even extremely severe problems with the TEAM-CBT as well as exercises in my books, such as The Feeling Good Handbook, When Panic Attacks, and Intimate Connections.
They also read an email from “Abdul,” a podcast fan who’s been struggling with shyness.
I’m from Pakistan. Please make podcasts on shyness and public speaking and other anxiety issues.
I have anxiety shyness. My father has also anxiety. I know he is not happy. I also sometime feel exactly like him.
And one of my cousins is very much depressed. He is a cleaner in a garments shop. He always use to pack clothes all the time even if they are kept properly.
Dr burns please guide us. It would be very very helpful.
Sorry if I wrote anything unprofessional.
Several days later, David received an additional email from “Abdul:”
My social anxiety has returned back. In my office I feel very lonely.
Here my negative thoughts:
- I should say something impressive.
- I'm good looking so I should not be anxious.
- I should talk to girls.
- I should say hi to people.
- I should mix with people.
Today and next week, David and Rhonda will describe how to treat / overcome shyness using TEAM-CBT. David explains that this is probably his favorite problem to treat, since he himself has struggled with every conceivable form of social anxiety, so he really knows how to defeat this problem.
But to start out, David and Rhonda want to see how shy YOU are, so they administered David's Shyness Test verbally to listeners. if you'd like to take the paper and pencil version, click here. You'll also find the scoring.
How did you do on the Shyness Test?
We'll publish them next week, too. You'll find Jason's Daily Mood Log, the Recovery Circle, the Downward Arrow Technique, and more. These visuals will help your learning!
We always start with a Daily Mood Log, focusing on how you were thinking and feeling at a specific moment when you felt shy. We don’t just throw techniques at patients based on a problem (shyness) or diagnosis (Social Anxiety Disorder). We're all different, so the treatment is highly individualized.
Rhonda and David describe a shy young man named Jason who wanted to flirt with an attractive woman checking groceries when he was inline at his local supermarket on a Saturday. However, he was flooded with Negative Thoughts and feelings, and by the time he got to the front of the line, he was so terrified that he avoided all eye contact with the checker, and didn't even say a word to her, when she checked his groceries. He left the store feeling like a total loser.
David and Rhonda talk about reducing the Outcome and Process Resistance before trying to “help” Jason, or any one who's anxious. Outcome Resistance means that Jason may have some pretty strong resistance to recovery, in spite of how much he's suffered, even if all he had to do was to press a Magic Button and be instantly cured.
Process Resistance, in contrast, means that if Jason does want to recover, he’ll have to use some Interpersonal Exposure Techniques that will be frightening to him. Is he willing to do that if David agrees to treat his shyness?
David and Rhonda illustrate how to do Positive Reframing , listing all the really positive things about Jason's negative thoughts and feelings. They encourage listeners to turn off the podcast briefly, and see if they can list some positives before listening to the list that David and Rhonda generated. I'd encourage you to do that, too, while listening. Try it yourself before you see the "answers."
They discuss how they might issue a Gentle Ultimatum, along with Dangling the Carrot and “Sitting with Open Hands,” to reduce Jason’s Process Resistance.
Once Jason's resistance has been reduced, they will go on to the M = Methods of the session, and focus on how to help Jason challenge the Negative Thoughts that Jason had while standing in line waiting to check his groceries.
Next week, they'll describe the methods they selected and describe what happened when David used them during his session with Jason.
Rank #7: 065: The Five Secrets (Part 1) — Overview
Is there someone in your life who just
- won't listen?
- won't open up?
- always has to be right?
- always has to get his or her way?
- doesn't seem to understand how you feel?
- doesn't seem to care?
- is relentlessly critical?
- whines and complains endlessly, but always ignores your attempts to help?
Would you like greater intimacy and respect, and more rewarding relationships with the people you care about?
If so, this podcast series on the Five Secrets of Effective Communication will be right up your alley. Although the Five Secrets have been introduced in previous podcasts, David and Fabrice will bring them to life with clear explanations and vignettes, and will give you homework assignments so you can practice them, one at a time, between podcasts. In the first two Five Secrets podcasts, David and Fabrice will be joined by Helen Yeni-Komshian, MD. Helen was David's student during her psychiatric residency training at Stanford roughly 15 years ago, and she now teaches David's at weekly psychotherapy training group at Stanford, and is on the adjunct faculty there.
David, Helen, and Fabrice begin with a brief definition of each of the Five Secrets of Effective Communication. They emphasize the importance of intense desire if you really want to learn and master these techniques. They compare the Five Secrets to the notes on a musical instrument. Lots of dedication and practice will be necessary if you hope to use them skillfully and effectively in your relationships with the people you care about. The goal is to help you develop greater satisfaction in your interactions with others and to resolve conflicts and arguments with others.
Helen emphasizes that these techniques must be applied in a genuine fashion if they are to be effective. If they are used simply as techniques to manipulate another person, they will not be effective.
David mentions that the Five Secrets exist on two levels. One the one hand, they are sophisticated and powerful psychological techniques that can change your life and your relationships with others. But on the other hand, they are profound spiritual techniques that require the death of the ego. And they also require us to relearn our usual knee-jerk habits of arguing, blaming, and defending ourselves when we're at odds with another person.
These podcasts will be for mental health professionals and for the general public. We will give vignettes illustrating challenging therapeutic logjams that were resolved with the skillful use of the Five Secrets, as well as examples how you can use the Five Secretes with loved ones, friends, colleagues, customers, and even aggressive or irritating strangers.
The Five Secrets require lots of hard work and practice, in much the same way that learning to play a musical instrument will require lots of practice. In addition, when you practice you may initially find them difficult to use, and you may experience some failures. David, Helen, and Fabrice emphasize the spirit of "joyful failure" or "learning through failure," and urge you to check your ego at the door, since the rewards of the learning can be immense.
Rank #8: 022: Scared Stiff — What Is Anxiety? (Part 1)
David and Fabrice answer these questions:
- What is anxiety?
- How does it differ from depression?
- Do anxiety and depression always go hand in hand?
- How does anxiety differ from healthy fear?
- What are the most common forms of anxiety?
- How common is anxiety?
Anxiety, like depression, has been called the world’s oldest con. That’s because you are always fooling yourself, and buying into negative thoughts that aren’t true, when you’re feeling anxious and insecure. Dr. Burns highlights the most common cognitive distortions that trigger anxiety, and discusses the powerful role of shame in anxiety.
In the next several podcasts, Dr. Burns will describe powerful, fast-acting, drug-free treatment methods that can help you defeat every type of anxiety, Including
- Chronic worrying
- Social anxiety
- Public speaking anxiety
- OCD (Obsessive-Compulsive Disorder)
- PTSD (Post-Traumatic Stress Disorder)
- Panic attacks
- BDD (Body Dysmorphic Disorder)
So stay tuned!
Rank #9: 103: Ask David — Dealing with Intrusive Memories, Is Depression Inherited?
Today we answer six questions submitted by listeners like you:
- Harald: How can I find the Show Notes for the Feeling Good Podcasts?
- Kristin: How do you help patients who obsess about past traumatic events, with intrusive thoughts about a cruel ex-lover or bullying by classmates? These thoughts can feed into the idea that their life is miserable and they can’t move forward because they feel blocked by these harmful memories.
- Valentina: How are cognitive distortions, self-defeating beliefs, and feelings of depression transmitted? What you describe in your books seems to describe my mother’s behaviors when I was growing up? Could it be that depression is transmitted by the family?
- Alicia: How would you treat someone with cyclothymic disorder who cycles between euphoria and suicidal depression? He’s happy now, so how do I get him to fill out the Daily Mood Log?
- Kathy: I’m a big fan, and I have a question about “bibliotherapy.” What’s the best way to use your books and other materials to help yourself?
- Matthew: Do you ever use drugs in the treatment of depression? Are medications sometimes necessary or helpful?
Rank #10: 082: Neil Sattin Interview — Cognitive Distortions and Relationships
This interview was first published on Neil Sattin's highly regarded Relationship Alive Podcast. Although some of the material may be familiar, there's much that's new, and you will enjoy the chemistry between Neil and David as they discuss each of the ten cognitive distortions and raise many challenging questions, such as:
- Is it really true that only our thoughts--and NOT external events--can change the way we feel?
- If someone has the belief, "I'm unlovable," isn't that type of thought immutable? How could you possibly change or modify a thought that may be rooted in traumatic experiences and so deeply embedded in a patient's psyche?
- Should we try to change other people's cognitive distortions, or just our own?
- How can we challenge each of the ten cognitive distortions?
And much more!
David's first interview with Neil received more than 25,000 downloads in the first month, and this riveting interview promises to be every bit as popular. If you want to download a transcript of this exciting interview, you can do so at www.neilsattin.com.
Rank #11: 109: David's Top 10 Techniques
A podcast listener asked about what techniques David is the most proud of. We briefly discuss each one on today’s podcast. So here they are!
- The list of Ten Cognitive Distortions
- The Disarming Technique and Law of Opposites
- The Externalization of Voices plus Acceptance Paradox
- The two classic Uncovering Techniques: the Individual and Interpersonal Downward Arrow
- The Feared Fantasy and Acceptance Paradox
- The Experimental Technique for extremely rapid treatment of patients with Panic Attacks
- My published research with colleagues in the mid-1970s did not support the popular notion that depression results from a chemical imbalance in the brain
- Brief Mood Survey
- Positive Reframing
- The use of extended, two-hour therapy sessions
Rank #12: 150: I'm anxious but don't have any negative thoughts. What can I do?
Rubens, a faithful and enthusiastic Feeling Good Podcast fan, sent me an email with a terrific question that has both practical and theoretical implications. He wrote:
Dear Mr. David,
I've read "Feeling Good" and I'm reading "When Panic Attacks" now. Both have and are helping me immensely.
However, the one thing I have never understood is that my anxieties and worries often don't come as a thought. For instance, I have an academic presentation tomorrow, and I'm suffering from much anxiety because of that. But the symptoms did not appear because I thought in my mind the sentence "you are going to fail!". In my case, it is usually silent. I just remember that I have a presentation tomorrow, then I immediately feel worried. My chest hurts before any thought. How do I counter-argument my thoughts, if I have none?
Thank you for replying, Mr. David!
In today's podcast, Rhonda and I address this question and explain what to do when you can't pinpoint your negative thoughts. There are two really good methods.
We will also demonstrate how to deal with some of the negative thoughts that typically trigger public speaking anxiety. The cure involves changing the way you think, and changing the way you communicate with the people in your audience. If you've ever struggled with public speaking anxiety, this podcast may be helpful for you!
Thank you again, Rubens, for your excellent question!
David D. Burns, MD / Rhonda Barovsky, PsyD
Rank #13: 039: Uncovering Techniques (Part 1) — The Individual Downward Arrow
What are the root causes of depression? Anxiety? Relationship problems? In this, and the next two podcasts, you will discover the answer!
Cognitive Therapists believe that negative thoughts, or cognitions, can exist on two different levels. When you’re upset, you’ll have Automatic Negative Thoughts (ANTs) in the here and now, and they’ll usually be something like this:
- Depression: You may be telling yourself that you’re a loser, or a failure, or that you’ll be miserable forever.
- Anxiety: You’re probably telling yourself that you’re in danger, and that something terrible is about to happen. “When I get up to give my talk at my church group, my mind will probably go blank and I’ll make a total fool of myself!”
- Relationship conflicts: You may be telling yourself that someone you’re ticked off at is a self-centered jerk who only cares about himself or herself and shouldn’t be that way!
Individual Downward Arrow
But why do we get these ANTs in the first place? Cognitive therapists believe that Self-Defeating Beliefs, and other deeper structures in the brain, make us vulnerable to painful mood swings and conflicted relationships with the people we care about. To help you pinpoint your own Self-Defeating Beliefs, David has created two uncovering techniques called the Individual Downward Arrow and the Interpersonal Downward Arrow, and Albert Ellis, the noted New York psychologist, created a third called the “What-If” Technique. In today’s podcast, Drs. Burns and Nye illustrate the Individual Downward Arrow technique, using as an example a psychologist named Harold who was understandably devastated when his patient unexpectedly committed suicide.
You can follow along on this PowerPoint presentation starting with Harold’s Daily Mood Log with David and Fabrice while they illustrate the Individual Downward Arrow technique.
Once they come to the “bottom of the barrel,” they will ask you to pause the recording, and see if you can pinpoint five or six or more of Harold’s Self-Defeating Beliefs, using the list of 23 Common Self-Defeating Beliefs.
David emphasizes that we create our own emotional and interpersonal reality at every moment of every day, but we aren’t aware of this, so we often feel like victims of forces beyond our control. We are really talking about emotional and interpersonal enlightenment, and the uncovering techniques will make this ancient Buddhist concept more understandable for you.
If you’d like more tips on precisely how to do the Individual Downward Arrow Technique, you can read David’s recent Feeling Good Blog on this topic!
In our next Feeling Good Podcast, David and Fabrice will illustrate the Interpersonal Downward Arrow Technique, which will allow you to complete a course of psychoanalysis in just 5 to 7 minutes, rather than the 5 to 7 years free associating on the couch. It is truly psychoanalysis at warp speed, and is pretty amazing! And when you change the beliefs that trigger interpersonal conflicts, you can change them and enjoy greater satisfaction in your relationships with the people you care about. But sometimes, that requires a little bit of courage!
And in the third Feeling Good Podcast on the uncovering techniques, David and Fabrice will illustrate Dr. Albert Ellis' famous "What-If Technique." If you struggle with any type of anxiety, including fears and phobias, this technique can help you uncover the feared fantasy at the root of your fears, so you can challenge the monster and attain freedom from the fears that hold you back!
Rank #14: 007: M = Methods (Part 1) — You FEEL the Way You THINK
The three basic principles of CBT:
- Negative feelings, like depression, anxiety, and anger, do not result from what happens to us, but rather from our thoughts about what’s happening. In fact, our thoughts, or “cognitions,” create all of our emotions, positive and negative.
- When you’re depressed or anxious, the negative thoughts that trigger your distress, like "I’m no good," or "Things will never change," are distorted or illogical. In fact, depression is the world’s oldest con.
- When you change the way you THINK, you can change the way you feel.
Rank #15: 079: Live Session (Daisy) — The Secret of a "Meaningful" Life
Sound familiar? Sometimes, the messages we get from society, and the impossible standards that we accept, can lead to enormous, intense suffering.
Several months ago I received a compelling email from a young woman named Daisy who asked about the message we get from society that lead to suffering. Fabrice and I were so inspired that we devoted an entire Feeling Good Podcast to it (Podcast 038: Negative Messages from Society) The theme of the podcast, as well as the three subsequent podcasts, was how to pinpoint and modify the Self-Defeating Beliefs (SDBs) that lead to depression, anxiety, and relationship problems.
Today, Fabrice and I are thrilled and honored to present an entire TEAM-CBT therapy session with Daisy, along with her husband Zane.
Rank #16: 113: Ask David — How Can I Overcome My Perfectionism?
1. Steven asks about the best route to take if you want to learn and practice TEAM-CBT? Is the degree important? What's the best degree? Should you go to school to become a psychologist, clinical social worker, addiction counselor, psychiatrist, professional counselor, pastoral counselor, marriage and family therapist, life coach, or what? There are so many degrees and potential paths that my head is spinning!
2. Sandy asks how to overcome long-standing, entrenched perfectionistic tendencies.
3. Rin asks about the Burns Depression checklist and the criteria for depression in the DSM. He is (understandably) confused about the so-called "somatic" symptoms of depression, like insomnia or changes in appetite.
For example, some “experts” would argue that the following are all symptoms of clinical depression:
- insomnia or the opposite—sleeping too much;
- increased appetite or the opposite--decreased appetite;
- loss of interest in sex, or the opposite, sex addiction;
- loss of interest in work, or the opposite, being a workaholic.
How can opposite symptoms be symptoms of depression? Does this make sense? Are these really the symptoms of depression, or simply non-specific symptoms? What are the five key symptoms of real depression?
4. Kevin is a therapist with a simple question: How do I get over my desire to help?
5. Amanda asks how to use the Disarming Technique with a patient who thinks he or she isn’t making any progress in the therapy.
Rank #17: 066: The Five Secrets (Part 2) — Disarming Technique
David, Helen and Fabrice focus on the Disarming Technique, which is the first of the Five Secrets of Effective Communication. The definition of the Disarming Technique is finding truth in what the other person is saying, even if it seems blatantly wrong, or illogical, or exaggerated. And it's based on the Law of Opposites.
Rank #18: 074: Five Simple Ways to Boost Your Happiness (Part 1) — The Pleasure Predicting Sheet
David begins with a brief discussion of the philosophy of happiness, including the ancient Buddhist idea that everything in the universe is transitory and constantly changing, including our positive and negative moods, so the idea that you will be hopelessly depressed forever, or endless happy, are both illusions. Happiness, or pleasure, are transitory, and can only be achieved at specific moments. However, you can significantly increase the number and duration of the happy periods in your life.
David briefly discusses research evidence that simply doing potentially satisfying and rewarding activities, whether or not you're "in the mood," can reduce depression and enhance feelings of happiness and joy in daily living. This simple treatment method, called "Behavior Therapy," was pioneered by Dr. Peter Lewinsohn, from the Oregon Research Institute, and has been shown to have significant anti-depressant effects.
One way of doing this is with David's famous "Pleasure-Predicting Sheet." It's pretty simple to use. As you can see from the link, it is a sheet with four vertical columns. In the first column, you schedule activities with the potential for pleasure, learning, personal growth, or helping others. You can include activities that are not overly time consuming or burdensome. In the second column, record who you plan to do each activity with. If you do the activity alone, put "self" in the second column, since you're never truly alone. You're always with your "self."
In the third column, predict how satisfying or rewarding the activity will be, on a scale from 0% (not at all satisfying) to 100% (tremendously satisfying.) Make sure you complete this column before you do the activity! And make sure you do it on paper, and not just in your head!
Once you've completed each activity, indicate how satisfying and rewarding it turned out to be on the same scale, from 0% to 100%. That's all there is to it!
Then you can compare the last two columns (the predicted and actual satisfaction). Sometimes, depressed individuals think that things they used to enjoy will be boring or unrewarding, so they give up on things, fail to answer the phone, and mope around at home in a state of hopelessness and self-pity. Of course, that's a self-fulfilling prophecy and a vicious cycle, because when you stop doing things, you will probably become more depressed, and then you'll be even more likely to give up doing things for pleasure. In contrast, when you do things, you may discover that many activities are more rewarding than you anticipated.
You can also compare the satisfaction you experience when doing things by yourself versus the activities you do with others. Many depressed people with the Love Addiction believe they cannot be happy when they're alone, thinking they must be loved to feel truly happy and fulfilled. David describes a woman who tested this belief, and made an unexpected discovery, after her husband rejected her for another woman. You can see her Pleasure Predicting Sheet if you click here.
Finally, David gives an example of how a depressed, perfectionistic medical professor made another unexpected discovery with a modified version of the Pleasure-Predicting Sheet.
The Pleasure-Predicting Sheet is one of only 50 to 100 methods that David has learned or created for defeating depression and anxiety. He doesn't see it as a complete treatment for depression, but it usually has some nice mood-elevating effects. Fabrice and I encourage you to try it this week, so you can let us know how it works for you!
Next week, we'll have another cool tool you can use to boost your happiness by overcoming procrastination!
Rank #19: 064: Ask David — Quick Cure for Excessive Worrying!
How would you treat excessive worrying? a listener asks.
David describes a new patient who had struggled with 53 years of failed therapy for excessive, relentless worrying, and describes how she was "totally and irreversibly cured" in just two therapy sessions, which was the "good news." The Hidden Emotion Technique was the key to her remarkably rapid recovery. David explains that the "even better news" was that her relentless worrying would come back over and over in the future, and that this was actually a really good thing!
David also emphasizes the importance of using all the four models, along with a Daily Mood Log, when treating any form of anxiety: the Motivational Model, the Cognitive Model, the Exposure Model, and the Hidden Emotion Model. To learn more about how these four powerful treatment models work, you can listen to Podcasts 022 through #028.
The DSM5 is the Diagnostic and Statistical Manual of Mental Disorders, published by the American Psychiatric Association. It is used to assign diagnoses to patients. David critiques the DSM5 diagnostic criteria for "Generalized Anxiety Disorder" (GAD) and emphasizes that while worrying exists, and can easily be treated in most cases, the "mental disorder" called Generalized Anxiety Disorder does not exist, and is simply a fantasy made up by the psychiatrists who have created the DSM.
Soon, David and Fabrice will launch a series of five podcasts on the Five Secrets of Effective Communication, focusing on one technique each week. Say tuned, because these podcasts could change your life and show you the road to more loving and satisfying relationships with friends, patients, colleagues, and family members--and "enemies" as well!
Rank #20: 023: Scared Stiff — What Causes Anxiety? What’s the Cure? (Part 2)
There are 4 powerful treatment models for anxiety, including
- The Cognitive Model
- The Exposure Model
- The Motivational Model
- The Hidden Emotion Model
Each approach has a completely different theory about the causes of anxiety and utilizes completely different treatment techniques. For example, cognitive therapists believe that distorted thoughts trigger all anxiety, and that the most effective treatment involves challenging these distortions. In contrast, exposure therapists argue that avoidance is the cause of all anxiety, and that exposure is the only effective treatment. Those who adhere to the Motivational Model emphasize the role of resistance. In other words, anxious individuals are reluctant to let go of the anxiety because they secretly believe that the anxiety will protect them from danger. And those who adhere to the Hidden Emotion Model claim that “niceness” is the true cause of all anxiety in the United States at this time, and that hidden problems and feelings may need to be brought to conscious awareness before the patient can recover.
Dr. Burns argues that, in fact, all four theories are correct, and that if you skillfully integrate all four approaches, you will often see a rapid and total elimination of anxiety in the great majority of your patients.
Dr. Burns describes how he created the Hidden Emotion Model when he was treating a woman with mysterious and intractable case of Panic Disorder. Every time her boss walked past her desk, she became nauseous and panicky, and had the overwhelming urge to vomit on him. Then she would have to rush to the ladies’ room to rest until the nausea and panic diminished, and she sometimes had to go home because the symptoms were so severe. This was all the more puzzling because she insisted she had the best boss in the world and that there were no problems at work. She explained that her boss constantly praised her and gave her promotions and generous raises, and that she had no complaints whatsoever.
Cognitive and exposure techniques were only partially effective, until an unexpected discovery suddenly emerged during a therapy session that led to a surprising outcome. What do you think the hidden emotion was? Tune in and you’ll find out!
In the next several podcasts, Drs. Burns and Nye will bring these four models to life, using real life examples, including some of Drs. Burns’ personal struggles with anxiety early in his career.